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Chemotherapy

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Chemotherapy patient.jpg

Chemotherapy is a process where chemicals are administered to a patient to destroy cancerous cells and tumors. Because it kills off any sort of cell, there are many long and short term side effects that coincide with the treatment. With over 200 types of cancer, chemotherapy is the most common treatment used for patients that have been diagnosed. There are over 50 different types of drugs that can be used in treatment. Although this process is used for millions of people, each individual receives their own unique treatment plan.[1]

Treatment

Some of the drugs a single woman must take during chemotherapy treatment.

During chemotherapy treatment, chemical agents are used to prevent cancer cells from continued growth. It works to kill cancer cells that have traveled far away from the cancer’s origin. It is considered a form of systemic treatment. Over half of the patients diagnosed with cancer receive chemotherapy treatment. In the millions of those infected it has become an effective process helping for a better recovery. [2]

The treatment process can be administered through several different ways. One such way would be through an IV because intravenous administration allows the medicine to go directly into the vein. This process provides quick distribution of the chemotherapy throughout the entire body. Another form is orally through the swallowing of certain pills. Injections are taken from needles injected into the muscle or cancerous area. For skin cancer, another option is the application of topical creams on the skin. [3]

The regimen includes treatment plans, schedules, and drugs that will fight the cancer or help support a patient that has become cancer-free. It is vital that these patients stay on schedule with their doses to achieve the best, most successful results. Treatments are administered at hospitals or outpatient clinics, but there are many occasions where patients are allowed to take them in the comfort of their own home by way of pills or the use of small needles. Because the cancer fighting medicines can’t determine differences in cells, it not only kills the cancerous cells, but also healthy cells. For example chemotherapy aims to destroy fast-growing cancer cells, but also destroys hair and blood cells too. Fast and slow growing cancer cells call for different types of drugs. These drugs are determined by the patient’s doctor upon examination to target the specific cell at the specific time of growth. [4]

Effects

The treatment process is a long and grueling one on not only the patient, but also those that surround the patient. It is not always right down the street at your local hospital; sometimes they are inconvenient and far away. This leads to long time away from loved ones such as family and friends. [5]

Doctors provide a treatment plan based upon the type of cancer, stage of advancement, and overall health of a patient. They will specific doses and intervals called scheduled cycles. These cycles can range from daily, weekly, or monthly. Side effects may also cause a disruption in the treatment process. For example a lowered white blood cell count will lower the immune system’s effectiveness which will put the patient at great risk to infection. If the patient doesn’t stall their treatment schedule to strengthen their immune system it could hurt them even more. In other words the disruption of the schedule could hurt the overall effectiveness of the chemotherapy. [6]

Running through the blood stream, the drugs are able to react to the cancer cells more quickly. Not only will the drugs affect the cancer cells, but it will also block the effects of body hormones. They will destroy the cancer cells and/or change the way the body reacts to a tumor. Even the healthy parts of the body will not go untouched by the drug; the digestive system, hair follicles, bone marrow (its ability to make blood cells), and mouth lining will be affected in some way. It is because of this that the treatments come in sessions in between rest periods. During the treatment sessions the drugs will attack the cancer cells. Immediately following the administration of the drugs is a period of rest where the patient is able to recover for a time to allow normal cells and tissues to continue growth. [7]

Determining Drug Treatment

An IV containing chemo medicine and saline.

For the past several years doctors have tested and recorded ways to provide the best treatment options for cancer patients. Document responses and clinical trials have been compared and contrasted to find the most productive treatment with the least side effects. Through these tests doctors have created different protocols specific to different types of cancers. These protocols include specific types of drugs, doses of drugs, and the schedule of drug consumption. They are based upon specific cancers, the different stages of the cancer, and specifics personal to the individual patient. Over time treatments have changed because of new research that has led to more effective cures. Most cancers already have a standard protocol that doctors refer to, but they can be adjusted to meet the needs of each individual. These treatment plans, though having many advantages, also have their disadvantages and several options that patients must take into consideration. The treatment is distributed based upon the best research and responses, but certain individuals may not acquire the desired results. Since the 1940’s, when chemotherapy was developed, researchers and doctors have continued to pursue cures for cancer. [8]

Chemotherapy is a treatment that involves much toxicity. The effects of the toxins on any person can be harmful, even healthy people would be wise to be cautious. There are many risks and benefits when entering into chemotherapy and both must be weighed to determine treatment options. Patients who are old and whose health is slowly declining or may already have medical needs have a different response to the necessary drugs. Their bodies have become so fragile that their systems may not be able to withstand the excruciating battle that they will have to endure. It is normal for a cancer patient to take a combination of drugs during treatment, but for cases involving the elderly it is normal for them to take a single drug at a time so as not to strain their bodies. [9]

Response rates of drugs to different types and stages of cancer are key factors in determining which protocol to follow. Doctors will give the protocol with the highest response rates with the longest durations. Durations of a drug’s effect on a person is how long the response will last. The durations are figured out by averaging the recordings of several different responses. When a patient’s tumor responds to a drug by either shrinking or disappearing it is considered a good response rate and will be recorded as so. There are both partial and complete response rates depending on the effectiveness of the drug to the tumor. For instance, there could be 60% of people with the same cancer, at the same stage, that could respond to a set of drugs or a single drug and show shrinkage or disappearance of their cancerous tumor, but the other 40% of the people will have shown little or no response at all. This would mean that while 60% of the people showed good results there is still a 40% chance that the treatment won't help enough or at all. Only continued research can determine the response rates of drugs on people and use them successfully. [10]

This link will provide you with a list of various types of drugs used in chemotherapy. Each drug is linked up to specific details pertaining to itself including: side effects, marketing name, drug type, what its meant to do, how its administered, precautions, and other helpful facts. See: Chemotherapy Drug List

Side Effects

GMA's Robin Roberts shaves her head when her hair begins to fall out during chemotherapy treatment.

While there are many benefits that can be obtained from taking chemotherapy treatment, there is also great potential to have side effects. Some will be uncomfortable to deal with, but these are also mostly temporary. [11] For these, when a patient stops using the chemotherapy treatment drugs, the side effects will also discontinue. Some of these can be controlled by taking other drugs such as anti-emetic medicines. Drugs such as adriamycin, taxol, cisplatin, and 5FU are a few of the most common medicines used to help abate the side effect symptoms. [12] Unfortunately there are also effects that are very harmful to the patient that could essentially delay treatment and/or become life-threatening. The most common side effects consist of low white blood cell count, low red blood cell count, low platelet count, nausea, vomiting, hair loss, and fatigue. For example, because chemotherapy is meant to destroy cells, healthy or cancerous, it causes a very serious condition called neutropenia which is the low count of infection-fighting white blood cells. The loss of these white blood cells is detrimental towards a healthy immune system making a patient easily susceptible to infection or sickness. These infections may lead to hospitalization and/or be life-threatening. [13]

Short term side effect include: dryness of mouth and change of taste sense, diarrhea, sickness, swelling with pain, loss of appetite, constipation, bleeding, mouth sores (stomatitis), susceptible to infection, infertility, numbness in the feet and hands, hearing changes, and discolored and dry skin.

Long term side effects that are much more serious are: organ damage to the heart, lungs, kidneys, nerve damage, and hemorrhagic cystitis (blood in urine). [14]

Remission

Remission is the phase when there is temporary or permanent decrease or subsidence of a disease. There are two different remission phases in chemotherapy: complete remission and partial remission. Complete remission is when the cancer has completely disappeared with the treatment. It can be determined upon examination when the tumor cells are no longer visible through chest x-rays or blood tests. Partial remission is when there is a decrease in the number of cancer cells. The type will be confirmed by laboratory tests and examinations that will check the therapy responses. Even though the patient may be in remission, they may not be completely cured. The cancer can not be cured without a remission phase. To ensure that the cancer has been completely destroyed, patients must wait several years to see if it returns. If it doesn’t return one can conclude that the cancer has been cured. Unfortunately, just because a patient may be in remission, it does not guarantee that the cancer will not return at a later time. There are instances where the cancer may return after a long period of time. [15]

References