Chemotherapy

What is chemotherapy?

Chemotherapy is the use of anticancer drugs to treat cancerous cells. Chemotherapy has been used for many years and is one of the most common treatments for cancer. In most cases, chemotherapy works by interfering with the cancer cell's ability to grow or reproduce. Different groups of drugs work in different ways to fight cancer cells. Chemotherapy may be used alone for some types of cancer or in combination with other treatments, such as radiation or surgery. Often, a combination of chemotherapy drugs is used to fight a specific cancer. Certain chemotherapy drugs may be given in a specific order, depending on the type of cancer they are being used to treat.

While chemotherapy can be quite effective in treating certain cancers, chemotherapy drugs reach all parts of the body, not just the cancer cells. Because of this, there can be many side effects during treatment. Being able to anticipate these side effects can help you and your caregivers prepare and, in some cases, prevent these symptoms from occurring.

How is chemotherapy administered?

Chemotherapy can be given:

As a pill to swallow
As an injection (shot) into the muscle or fat tissue
Intravenously (directly to the bloodstream; also called IV)
Topically (applied to the skin)
Directly into a body cavity

To reduce the damage to healthy cells and to give them a chance to recover, chemotherapy is usually given in cycles. Chemotherapy may be given daily, weekly, every few weeks, or monthly, depending on your situation.

Chemotherapy is usually given in an outpatient setting, such as a hospital, clinic, or doctor’s office. Patients receiving chemotherapy will be watched for reactions during treatments. Since each chemotherapy treatment session may last for a while, patients are encouraged to take along something that is comforting and helps to pass the time, such as music to listen to or a book to read.

What are some of the chemotherapy drugs and their potential side effects?

There are a number of chemotherapy drugs that are commonly used. The following table gives examples of a few of the more commonly used chemotherapy drugs and their various names. It lists some of the cancer types but not necessarily all of the cancers for which they are used, and describes more common side effects. Side effects may occur just after treatment (days or weeks) or they may occur later (months or even years) after the chemotherapy has been given. The side effects listed below do not comprise an all-inclusive list. Other side effects are possible.

As each person's individual medical profile and diagnosis is different, so is his or her reaction to treatment. Side effects may be severe, mild, or absent. Be sure to discuss with your cancer care team possible side effects of treatment before treatment begins. Ask for written information on each drug that you're getting so you know what to watch for and what to report to your doctor.

Chemotherapy drug	Possible side effects (Not all side effects are listed. Some of those listed may be short-term side effects; others are long-term side effects.)
Carboplatin (Paraplatin): Usually given intravenously (IV) Used mainly for cancers of the ovary and lung	Allergic reactions in some people while the drug is being given can include feeling lightheaded or dizzy, fever, chills, hives, itching, headache, coughing, shortness of breath, or swelling of the face, tongue, or throat Decrease in blood cell counts Hair loss (reversible) Numbness and tingling in the hands or feet Nausea, vomiting, and/or diarrhea (usually a short-term side effect occurring the first 24 to 72 hours following treatment)
Cisplatin (Platinol): Usually given intravenously (IV) Used mainly for cancers of the bladder, ovary, lung, and testicles	Decrease in blood cell counts Allergic reaction, including a rash and/or labored breathing (rare) Nausea and vomiting that usually occurs for 24 hours or longer Numbness and tingling in the hands or feet Ringing in ears and hearing loss Fluctuations in blood electrolytes Kidney damage
Cyclophosphamide (Cytoxan): Can be given intravenously (IV) or orally (as a pill) Used mainly for lymphoma, leukemia, multiple myeloma, breast cancer, and ovarian carcinoma	Decrease in blood cell counts Nausea, vomiting, and diarrhea Decreased appetite Mouth sores Hair loss (reversible) Bladder damage Fertility impairment Lung, kidney, or heart damage (with high doses)
Docetaxel (Taxotere): Given intravenously (IV) Used mainly for breast, lung, stomach, head and neck, and prostate cancers	Decrease in blood cell counts Nausea, vomiting, and weakness Diarrhea Decreased appetite Hair thinning Rash Numbness and tingling in hands and feet
Doxorubicin (Adriamycin, Rubex): Given intravenously (IV) Used mainly for breast, endometrium, lung and ovarian cancers, lymphoma, leukemia, and multiple myeloma	Decrease in blood cell counts Mouth ulcers and loss of appetite Nails and skin creases in hands may darken Hair loss (reversible) Nausea and vomiting Heart damage
Etoposide (VePesid, VP-16): Can be given intravenously (IV) or orally (as a capsule) Used mainly for cancers of the lung and testicles	Decrease in blood cell counts Hair loss (reversible) Nausea and vomiting Allergic reaction (rare) Mouth ulcers Decreased appetite Diarrhea
Fluorouracil (5-FU): Given intravenously (IV) or as a cream to treat skin cancers Used mainly for cancers of the colon, rectum, and head and neck	Decrease in blood cell counts Diarrhea Appetite loss Mouth ulcers Nausea and vomiting Photosensitivity (skin gets sun burned easily) Dry skin, darkening of skin and nail beds
Gemcitabine (Gemzar): Given intravenously (IV) Used mainly for cancers of the pancreas, breast, ovary, and lung	Decrease in blood cell counts Nausea and vomiting Appetite loss Tiredness Swelling, such as in the arms or legs Fever and flu-like symptoms Rash
Methotrexate (Folex, Mexate, MTX): May be given intravenously (IV), intrathecally (injected into the spinal column),as a shot into a muscle (IM), or orally (as a pill) Used mainly for cancers of the breast, lung, head and neck, blood, bone, and lymph system	Diarrhea Nausea and vomiting Mouth ulcers Appetite loss Skin rashes and photosensitivity (increased risk of sun burn) Kidney damage (with a high-dose therapy)
Paclitaxel (Taxol): Given intravenously (IV) Used mainly with cancers of the breast, ovary, and lung	Decrease in blood cell counts Allergic reaction Nausea and vomiting Diarrhea Change in taste Thin or brittle hair Joint pain (short-term) Numbness or tingling in the fingers or toes
Vinblastine (Velban, Velbe, Velsar): Given intravenously (IV) Used mainly for lymphoma and cancers of the testis, breast, and head and neck	Decrease in blood cell counts Mouth sores Tiredness Hair loss (reversible) Constipation or abdominal cramping
Vincristine (Oncovin, Vincasar PFS, Vincrex, vincristine sulfate, VCR): Given intravenously (IV) Used mainly for leukemias, lymphomas, and childhood cancers	Constipation Tiredness Hair loss or thinning Numbness or tingling in the fingers or toes

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