Chemotherapy

Chemotherapy

Chemotherapy uses special medications or a combination of medications to kill cancer cells. Chemotherapy sometimes is the primary treatment for certain types of cancer, or it can be combined with other forms of treatment such as surgery or radiation therapy. Many factors will determine the length and the frequency of the treatments. Prior to the start, your medical oncologist (a cancer doctor who specializes in chemotherapy) will explain your treatment plan and answer any questions you may have.

Because chemotherapy affects the bone marrow, the body’s cell-producing mechanism, we will keep a close watch on blood counts throughout your treatment. Your oncologist and oncology nurse will evaluate your progress regularly.

Chemotherapy

Sometimes, other non-chemotherapy drugs may be used in your treatment. Your doctor will evaluate you to see which medications are best.

Chemotherapy is most often administered through a vein (intravenously); however, there are times when chemotherapy is given orally or through injection. Oncology nurses, under direct medical supervision, administer the chemotherapy drugs and provide instructions to help patients through the treatments. A specific, customized treatment plan is developed by the physician for each patient.

Frequently Asked Questions About Chemotherapy

Chemotherapy can be administered:
  • Intravenously (IV),
  • By mouth in the form of a pill,
  • With a shot (injection), or
  • By intrathecal and intraventricular injection (meaning into the spinal fluid surrounding the spinal cord or brain).
Chemotherapy is typically given in cycles, which is a treatment followed by a period of rest. A cycle can last one or more days, but is usually one, two, three, or four weeks long. A course of chemotherapy is comprised of multiple cycles. Each course is different, but generally consists of four to six cycles. It may take a relatively short period of time to receive some chemotherapy drugs, while others take hours. It all depends on the treatment regimen that your doctor recommends.

If your chemotherapy is given through an IV, your doctor may suggest an implanted venous access device (VAD) such as a Port-a-Cath. VADs are surgically placed in a large vein near the heart and can stay in place for long periods of time. By using a VAD, you will not have to have smaller catheters repeatedly placed in your arm veins.
Generally, treatments are given daily, weekly, or monthly. How often you receive chemotherapy depends on the type of cancer and which drug or combination of drugs you receive. Your doctor will help you determine the most effective treatment schedule for you. Chemotherapy is usually given in cycles with rest periods between each administration.
Family and friends are welcome to come with you during your treatment. For the privacy of patients, we ask that you only bring one family member to sit with you during this time. Due to the safety and concern of all our patients, we request that you do not bring any family or friends who might be ill.
You will receive chemotherapy that is best suited to achieve your goals of therapy. When selecting a treatment or treatments, your doctor will consider:
  • Your diagnosis
  • How far along your cancer is in its development
  • The expected behavior of the cancer
  • Where the cancer originated
  • Other medical problems you may have
  • Any potential side effects from the treatment.
The most common side effects of chemotherapy are low blood counts, nausea, vomiting, hair loss, and fatigue. Some side effects may be temporary and merely annoying. Others, such as infection or a low white blood count, can be life-threatening. For example, one of the most serious potential side effects of chemotherapy is a low white blood cell count – a condition called neutropenia (new-truh-pee-nee-ah) – which can put you at risk for severe infections or treatment interruptions.

Fortunately, the research and innovations over the past 20 years have brought a great deal of progress in the development of treatments to help prevent and control the side effects of cancer therapy.
Many people who receive chemotherapy experience fatigue. Fatigue has many causes but frequently occurs because of anemia caused by the chemotherapy. Your daily activities should be planned according to how you feel, and you should take rest periods throughout the day as often as you feel necessary. Anemia can be effectively treated.
Without receiving special anti-nausea medications, most patients will experience some nausea after treatment with chemotherapy. Nausea and vomiting may last 24-48 hours. The severity of nausea and vomiting mainly depends on which chemotherapy drugs were used. A number of very effective medications called anti-emetics or anti-nausea drugs are now available to help lessen or prevent nausea and vomiting. These medications may be given to you intravenously during your chemotherapy, or you may be given a prescription medication to take at home.
Your doctor determines what kinds of tests are needed. If you are receiving chemotherapy, you may have blood work done that may include a complete blood count (CBC), chemistry profile, and any necessary cancer markers.
Chemotherapy destroys rapidly dividing cells, a characteristic of cancer cells. However, red blood cells, white blood cells, and platelets also divide rapidly and are frequently damaged by chemotherapy. Your red blood cell count, white blood cell count, and platelet count may all go down. Your doctor monitors these counts to determine the toxicity of treatment and to predict your risk for complications, as well as to plan future therapy.
Hair loss occurs with some, but not all, chemotherapy drugs. The amount of hair loss varies from a slight thinning to complete baldness and affects the scalp, eyelashes and eyebrows, legs, armpits, and pubic area.

Hair loss will typically begin two or three weeks after your first treatment. The amount of hair that you lose will depend on the type of chemotherapy drug you are taking. Hair typically begins to grow back approximately 4 weeks after treatment is finished. The hair may grow back differently than it was before treatment. For example color or texture (curly or straight) may be different.
Remember that hair loss associated with chemotherapy is temporary and the hair WILL grow back. In the meantime, here are a few tips to help you cope with the loss:
  • You may wish to cut your hair before it starts falling out. The experience of losing the hair is sometimes worse than dealing with it once it’s gone. If you expect to lose all or a lot of your hair, cutting it first may be easier to cope with.
  • Plan ahead; shop for a wig before your hair is gone, especially if you wish to match your natural color. Or, take this opportunity to try something different.
  • Try hats or head scarves; these are good alternatives or a compliment to a wig.
  • Remember to cover your head or use sunscreen on your scalp. Skin that has been covered with hair may be particularly sensitive to UV rays of the sun.
  • Treat your new hair gently once it grows back. Avoid chemicals, bleach, peroxide, or colors.
There are different types of hair pieces. You should consult with a specialist and choose the one that best fits your life style.
Most hair pieces should be washed in a gentle fabric detergent. They should be swished gently in soapy water, rinsed thoroughly, and hung to drip dry. This would apply to synthetic wigs. Human hair wigs should be shampooed and set as normal hair, either at home or at your beauty salon.
Be sure and ask your oncologist for a prescription to get a wig. Usually, the cost is partially or fully covered by most insurance companies.
The Cancer Center has a Boutique, which is located on site and is a convenient place to purchase bras, camisoles, prostheses and other items. Women who have had mastectomies or lumpectomies may be fitted for breast prostheses at the Boutique by our professionally trained and certified fitters. Many items are covered under Medicare, Medicaid and private insurance plans, and we will file for you. Boutique hours are by appointment - call 334-528-4370 or 334-741-7410.