Pham Dinh Vien

Chemotherapy drugs are pretty numerous and they fall into various categories following such criteria as the way they work, the relationship they establish with other drugs and the chemical structure they have. Most drugs are based on chemicals obtained from plants and this very origin or source leaves room to further classification. And, last but not least, one drug may be found in various categories as they may have several effects on the body of the patient. Doctors have a very precise duty of getting fully informed about chemotherapy drugs and know how to combine them or in what order to prescribe them to cancer patients.

A first category of chemotherapy drugs is the one relying on alkylating agents. These drugs are pretty damaging to the bone marrow because they damage the DNA to prevent the cancerous cells from reproduction. This type of chemotherapy drugs is used in a wide variety of cancers and it is recommended only in small dosage to reduce the risk of leukemia that may appear 5 or 10 years after following the recommended chemotherapy treatment. The platinum based drugs are sometimes included in the same category because they act in a very similar manner against the disease.

Another category of chemotherapy drugs is the one consisting of antimetabolites. They are used in treating leukemia, breast tumors, ovary and intestinal cancers and they also interfere not only with the DNA but also with the RNA.

The anthracyclines are another type of chemotherapy drugs being part of the antibiotic group. They work against enzymes that help in DNA replication and they are encountered in a wide variety of cancer treatments.

Next is the category of inhibitors. The topoisomerase inhibitors help in separating and copying strands of DNA being helpful for the treatment of leukemia besides many other types of cancer. The mitotic inhibitors are more natural-based derived from plants and they help in preventing enzymes from producing proteins required in cell reproduction. However, there is one huge risk that patients take when following such a treatment: these chemotherapy drugs may cause peripheral nerve damage to mention just one the health threats one may fear.

Last but not least, the corticosteroids are chemotherapy drugs based on hormones meant to treat lymphoma, leukemia and myeloma together with other diseases. Besides reducing the speed of cell growth, they also have a good impact on the way the body reacts to chemotherapy by preventing nausea, vomiting or other types of allergic reactions. These types of drugs may be used as chemotherapy ones or not, depending on the purpose they are supposed to serve.

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Chemotherapy hair loss is one of the numerous effects of this cancer treatment. What is the reason why hair loss occurs during chemotherapy? Well, the drugs used in this type of cancer treatment are very strong, therefore very efficient in attacking the rapidly developing cancer cells. These medicines also attack other cells in the body that have a rapid growth; among these, the cells in the hair roots, as well. The effects of chemotherapy on hair are not limited only to the scalp as the procedure affects the hair on the body, too. Unfortunately, eyelashes, eyebrows, armpit and pubic hair and other body hair may also fall out.

There is a wide variety of drugs that are used in chemotherapy. Among these, obviously some are more likely to cause chemotherapy hair loss than others. The difference in chemotherapy drug doses is another aspect to consider when hair loss is under discussion, as hair loss ranges from thinning to complete baldness. Thus, discussing the medication that will be prescribed with the doctor and nurse is very important as they are the specialists able to inform the patient on what to expect from chemotherapy.

Hair usually starts falling out after 10–14 days from the beginning of the treatment. It may fall out quite fast, either in clumps or gradually. Hair loss usually continues throughout the treatment and even one month after it. Half of the hair can fall out before this is noticed by people around. Luckily, in most cases, chemotherapy hair loss is a temporary effect. Hair can be expected to grow again within six months to one year from the end of the procedure. Although the regrowth of the hair occurs in most of the cases, the new hair could be of a different texture and shade temporarily.

It usually takes about four to six weeks for the hair to recover from chemotherapy, and generally, the hair grows at a rate of about a quarter inch each month. When the hair starts growing back again, it might be a little different from the hair that was lost because of therapy. As mentioned before, chemotherapy hair loss leads to new texture or color temporarily. The changes will stop and the hair will become what it used to be before the treatment the moment the cells that control the hair pigment begin working again. Unfortunately, chemotherapy hair loss cannot be prevented as there is no treatment which will guarantee that the hair will not fall out.

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Cancer is a disease that gains more and more of the ground we used to own in health matters especially now, in the 21st century. As a result, it is highly important that not only chemotherapy patients understand the risks and side effects of treatments but also those who are healthy and may or may not come in contact with cancer patients.

The most widely used treatment of cancer is chemotherapy either followed or preceded by surgery. Chemotherapy patients usually face a great deal of problems they have to go through. To begin with, there are the physical aspects that will break down their morale. The side effects that they will experience may eat away at their self-esteem, since they may include alopecia, constant nausea and dizziness, pains and infections of all sorts depending on the part of the body that is affected or on the type of medication that has been prescribed to follow. Some chemotherapy patients feel that they are somewhat physically impaired since they can no longer perform certain activities that have previously defined their life or that have brought smiles on their faces.

Another level of impact on chemotherapy patients is the psychological one. They need to receive the moral needed support from their family and friends and the trouble is that many choose not to share this burden with their loved ones. Because of this, they will most likely lack in support and will have to carry this burden by themselves. Not being able to talk about it as they would, not being able to share will make them feel marginalized, separated from the people in their lives and will break their morale.

On the other hand, those chemotherapy patients that initially build rapport with family and friends and choose to communicate about it and share the burden, may end up feeling guilty for spoiling family life and for being set on the top priority list, a list that is usually not considered a pleasure bringing one. They themselves may end up feeling that they have turned into a burden to their family putting strain on relationships and may choose to seclude themselves as a result of this feeling.

All these considered, it is highly obvious that family and friends of chemotherapy patients should get informed about what their beloved ones are going through and about how help can be provided in such situations. The moral strength of chemotherapy patients can be kept above surface level or increased only by psychologists and people who honestly display affection and interest in helping.

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Cancer patients may have no other choice but to resort to chemotherapy in order to treat their illness. In oncology, adjuvant chemotherapy will have quite a special role for the patient because it is related to other cancer treatments. Adjuvant chemotherapy is an additional treatment given to the patient after surgery to help prevent any cancerous cells that may have not been completely removed during surgery from developing or increasing in number. The patient may relapse even if surgery has been performed because unfortunately, medicine is not sufficiently developed to be able to foresee whether cancer cells will reoccur or not.

Radiotherapy or regular chemical-based treatments are included in the adjuvant chemotherapy category and they are recommended by the doctors based on some statistical evidence which is employed in order to figure out whether there is low or high risk in relapse for the patient. Statistics show that about a third of the patients who have received adjuvant chemotherapy treatment have already been completely cured with the help of the surgery alone. For those who are not included in the above mentioned third, the long term purpose of the adjuvant chemotherapy is to lengthen the life of the cancer patients.

The types of cancer in which adjuvant chemotherapy is used are quite various and here we may include colon cancer, lung, pancreatic, breast and prostate cancer as well as some forms of gynecological cancers.

Beside the adjuvant chemotherapy, there is also another type of treatment that resembles the former in name; that is, neo-adjuvant chemotherapy. The latter is given to patients before the primary treatment and it may take the form of chemical drug-based treatment. For example, neo-adjuvant chemotherapy may be prescribed to a patient suffering from breast cancer who will have to undergo surgery for breast removal. The aim of such a type of therapy is to minimize the size of the tumor so that the surgery may be performed more efficiently and with less risk.

All in all, adjuvant chemotherapy has been identified as more effective when it is prescribed after the tumor removal rather than before it because the remaining cancer cells are fewer in number and, as a result, the drug is more powerful on them. The drugs specific to this type of treatment are most efficient when they are administered directly into the blood of the patient, that is, intravenously; another way of increasing drug efficiency is to insert it directly into the part of the body that is affected by cancer.

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What is oral chemotherapy? The term refers to the way of administering chemotherapy, namely taking chemo drugs by mouth. Chemotherapy is medicine used in treating cancer and the ways to apply it are multiple. Nowadays, due to progress in cancer treatments and research, patients benefit from many different types of chemotherapy that can be taken in as tablet, liquid or capsule. Thus any drug that can be taken by mouth to treat cancer belongs to oral chemotherapy. The effects of pills will be the same, with the mention that they are more likely to trigger adverse reactions because of the impact on the digestive tract.

Some chemotherapy drugs can never be taken orally as they cannot be absorbed in the stomach or they can cause harm if swollen. As a matter of fact, most of the chemotherapy drugs are introduced into the patient’s veins by means of injecting it through an intravenous line. In the case of oral chemotherapy, the treatment is more facile as the patient can do it at home, without being forced to go to hospital every time it is applied.

A good way to administer oral chemotherapy is by giving it in cycles. Thus, the possibility to damage healthy cells is reduced and drugs are allowed to destroy more cancerous cells. Obviously, the doctor is the one who will decide how frequently (daily, weekly, monthly, etc) medication will be taken. Anyway, Anyway, the anti-cancer treatment scheme proposed by the specialist ought to be discussed with the patient so that she/he may know what lies ahead in terms of challenges, difficulties and success rate. Only when one is informed and convinced of the efficiency of the treatment, can one decide to begin it.

Although oral chemotherapy drugs are not as strong as the others and although they do not affect the patients’ stomach, there are side effects of the treatment here too. Tiredness for a few days after beginning the treatment, nausea and vomiting, possible change in the amount of blood cells – anemia, lower capability of the blood to clot, diarrhea or constipation, flu-like symptoms, hair loss, increased risk of infection, kidney or bladder problems, mouth, gum and throat sores, pains, and nerve and muscle problems, are some of the long list of side effects of oral chemotherapy, just the same as those of any other form of chemotherapy treatments. For any of these side effects it is advisable that patients address their doctors for advice and help.

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Chemotherapy refers to the treatment of a disease by means of chemicals meant to kill cells, typically cells of micro-organisms or cancer. This treatment works by attacking and killing cells which divide very quickly as cancer cells do. Unfortunately, chemotherapy damages cells that have a rapid division process which is normal for the body functions; this is the case with the cells in the digestive tract, hair follicles and bone marrow. Hence, the chemotherapy effects usually damage these areas. The most common side effects that occur during and after chemotherapy include myelosuppresion – decrease in the production of blood cells, mucositis – inflammation of the lining of the digestive tract, and alopecia – hair loss.

Chemotherapy effects or side effects can be divided into two major groups as short and long term. Side effects of chemotherapy represent unwanted symptoms which occur as a direct result of taking a drug. It is not difficult to confuse drug side effects with symptoms of cancer. Symptoms are specific to the disease in fact, while the side effects represent natural adverse reactions to a powerful external intervention in the body. Anyway, various chemotherapy drugs have different short term and long term side effects; not all chemotherapy drugs lead to every side effect.

Generally speaking, chemotherapy harms those cells that divide at a quicker pace as we have already mentioned. The mouth, intestines, skin, hair, bone marrow (the spongy material that fills your bones and produces new blood cells) are mainly affected by chemotherapy. Since hair is growing all the time, the skin is constantly renewing itself and the lining of the mouth and digestive system have the same dynamics, the cells of all these body tissues must constantly divide to produce a steady supply of new cells. And, unfortunately, when cells are dividing, chemotherapy drugs attack them.

It is known that most drugs used in chemotherapy have side effects, yet, not all the patients get the same chemotherapy effects. The intensity of the experience, and their evolution during the treatment depend on many various factors. These elements include the period during which the drug has been taken, the dose or amount of drug, how the drug is administered, the patient’s general health state, as well as the combination of the chemotherapy drug with other medicines. Some chemotherapy effects are serious medical conditions which must be dealt with; others, although upsetting, are not necessarily damaging to the patient’s health. It is also important to discuss the effects of chemotherapy with the doctor and the contact person at the treating center where the patient is given the treatment.

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Melanoma is a type of cancer that affects the skin and is recognized by the dark spots that appear on the dermis. In order to treat melanoma, diagnostic tests must first be completed and then the cancer team will be able to recommend one or maybe more treatment options. Melanoma chemotherapy is one of the possibilities here. Anyway, patients should consider these treatment variants carefully, without rushing into one of them. First of all, patients ought to understand everything about the treatments. It is obvious that the choice of the procedure depends on the thickness of the primary tumor and the stage of the disease mainly.

Among the treatments for melanoma there are options like surgery and chemotherapy. There are different choices in as far as surgery is concerned, depending on where and how advanced the melanoma is. Thus doctors might consider re-excision, amputation or lymph node dissection. If melanoma has spread from the skin to distant organs, then surgery will not be a curable option to use. Therefore, melanoma chemotherapy might be the solution. Systemic chemotherapy that is normally involved in the procedure uses injectable anticancer drugs.

These are usually injected into a vein or taken orally. Melanoma chemotherapy drugs travel through the bloodstream to all parts of the body. They attack cancer cells which have already spread beyond the skin to lymph nodes or other organs. The drugs kill cancer cells but, unfortunately they also destroy some normal cells as well. Among these normal cells that can be killed are blood-producing cells of the bone marrow, cells that line the gastrointestinal tract and cells of hair follicles. As a result, patients will go through temporary side effects like nausea and vomiting, mouth sores, loss of appetite and loss of hair.

Melanoma chemotherapy drugs include temozolomide, cisplatin, vinblastine, DTIC, BCNU and tamoxifen. DTIC can be used alone or with other chemotherapy drugs like BCNU and cisplatin. The above three combined with tamoxifen, which is a hormonal therapy drug commonly used in treating breast cancer, bear the name Dartmouth Regimen. Then there is another combination of DTIC, cisplatin and vinblastine to use against melanoma. Temozolomide is a newer medicine, whose mode of function is similar to that of DTIC, except that it is used in the form of a pill.

Since melanoma chemotherapy drugs kill normal blood cells as well, patients might experience low blood cell counts and this can lead to bleeding or bruising after even minor cuts or injuries; excessive tiredness (frequently because of low red blood cell counts but also because of chemotherapy itself) and an increased chance of infection (because of white blood cell shortage).

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Do you realize how painful it is to watch someone dear to you ravished by the fight with cancer? And it all has to do with the perception we have of cancer and with the very intense chemotherapy medication administered to patients diagnosed with this malignant disease. All sorts of treatments and therapeutic approaches are available, but in general lines, it is all reduced to types of chemotherapy.

Lots of solutions are possible starting from the treatment diversity, but each and every one has its challenges. Based on a certain protocol that also involves decision making as to when, how long, how often and under what circumstances the treatment should be applied, the doctor will also choose from the potential types of chemotherapy that which is mostly indicated for a particular case.

The list with the types of chemotherapy drugs is pretty long and it might turn out a bit confusing for those that have never come into contact with chemo until now. It includes alkylating agents chemotherapy, alkaloid-based treatment, anti-tumor antibiotics, antimetabolites, topoisomerase inhibitors, antineoplastics and so on. Each of the categories mentioned above may include tens of types of medication out of which the doctor should select the appropriate ones.

Out of the many types of chemotherapy treatments the doctors will choose one based on a protocol and will take into account when doing so the response rate of a certain patient to the suggested drug. These response rates are established based on research that has been done so far analyzing the treatments that have been applied and their results. For example, the response rate of a combination of drugs selected out of several types of chemotherapy may be of 70% which means that, out of 100, 70 patients with that type of tumor and the same stage of cancer have responded positively to that treatment.

The rest of 30 may not respond at all to the treatment or may have the minimally expected results which are not satisfactory from a medical point of view. In that case the doctor has to act fast and direct the patient to another of the many types of chemotherapy that might have a better effect.

All in all, the choice and application of types of chemotherapy are tricky. Doctors need to constantly monitor and administer tests to their patients in order to make the right decisions at the right time for them. This line of work requires a great deal of responsibility and carries lots of emotional burdens because someone’s life may depend only on the doctor’s decision.

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Most cancer patients that have started undergoing chemotherapy would most likely be able to speak about their chemotherapy protocol and would know what that is. For those of you unfamiliar with the concept, it is a list of procedures and characteristics that describe the aim, the means, the potential risks and complications and the expected positive results of the medication that is included in the chemotherapy treatment offered by the doctor. This protocol is to be used as a sort of guide or reference throughout the prescribed treatment.

To get down to more details, the chemotherapy protocol should present the prescription circumstances, meaning that it should specify the pathology type that the treatment has been prescribed for (the location of cancer, the cancer stage, and so on). It should also include indications and contraindications, it should pinpoint all the situations in which this specific chemotherapy protocol should be allowed or forbidden and it ought to make references to specialized literature for whatever sort of clarifications may be needed throughout the treatment.

Another important aspect of the chemotherapy protocol is to include information and clear description of the drugs that the patient will take. Drug information will have to refer here to the dosage which is usually established depending on the patient’s body weight, surface, the appropriate concentration to be found in the blood, and so on. Other details should make reference to the day and the hour(s) when the dosage should be administered and the period of the administration. Moreover, the chemotherapy protocol should specify how the drug is to be administered, that is, the route of administration, as doctors call it (oral, intravenous, abdominal, etc). In some cases adjuvant treatment may be required and that should also be mentioned in the protocol together with all the precautions and measures that ought to be taken during and after the treatment.

Last but not least, the chemotherapy protocol should talk about the cycles of the treatment. That means it should specify the intervals that separate the various cures and whether the dose intensity varies or not, and if so, under what circumstances. It should also stipulate the recommended number of cycles, the toxicity that the drugs may lead to, the level of recovery reached before beginning a new cycle, the conditions that may require partial or complete cessation of treatment, the modifications and the ways for the patient to adapt to dose increase or decrease.

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Breast chemotherapy refers to the treatment applied to patients who suffer from breast cancer. Its purpose is to kill or to reduce in size the tumor consisting of cells that multiply very quickly compared to the normal rate of multiplication of normal cells. Breast chemotherapy can be of very many kinds depending on the combination of drugs that the doctor has selected for you. That is why it is highly important that patients and their family ask for clarifications from their doctors in case they haven’t understood how it all works and that they also know what side effects may be expected as a result of the medication.

Breast chemotherapy is administered either orally or intravenously and it is usually given in cycles. The drug reaches in the blood and then travels throughout the entire body to locate and attack the sick cells meant to be destroyed. Even though breast chemotherapy is directed at breast cancer, the drugs that are recommended as treatment may act on whatever other unhealthy cells that may have already developed somewhere else than the breast. From this perspective doctors call breast chemotherapy a systemic form of treatment precisely because it may act all throughout the patient’s organism.

Breast chemotherapy may be recommended after lumpectomy or mastectomy and in this case it is known as adjuvant treatment. The patients undergo this type of treatment only when doctors are certain from analyses that cancer has not yet spread to any other parts of the body but the breast.

Another case when breast chemotherapy becomes necessary is when cancer has spread from the lymph nodes or breast to other parts of the body. This particular spread is known as metastatic breast cancer and women rarely have this form at the time of the diagnosis.

Whichever of the breast chemotherapy treatments you are to receive it is important to know how you can figure out if it has any effect. This does not mean however that it is mandatory for you to experience side effects or otherwise your treatment is inefficient. This would be the wrong approach to it all. Adjuvant breast chemotherapy may have no side effects but it has always proved to be very helpful as it impedes unhealthy cells from spreading or redeveloping in your body.

All in all, breast chemotherapy is no easy treatment. That is why our world today fights strongly against breast cancer trying to teach women how to avoid it and how to manage or identify it in its early stages when it can be treated.

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