Chemotherapy

What are the treatment goals of chemotherapy?

Depending on each patient’s medical condition and severity of the disease, the goal of chemotherapy may vary. Chemotherapy is generally advised for one of these reasons:

• To cure cancer: Intended to kill or eliminate the cancer cells totally from the body.
• To control the growth or spread of cancer: Intended to prevent cancer from spreading, slow down its growth, or destroy any cancer cells that may have spread to areas other than the original site.
• To ease the symptoms of cancer with poor outcome or prognosis, also known as palliative Eg: tumor shrinking, reduce nausea and vomiting, achieve a better quality of life.

How does chemotherapy work?

There are hundreds of chemotherapies (medicines acting against cancer) and different ways by which they act. Some of the ways chemotherapy works include:

• Alkylating agents – Reduce reproduction of DNA damage (mutations). They find utility in different cancers of lung, breast, ovaries, blood as well as Hodgkin disease, multiple myeloma and sarcoma.
• Antimetabolites – Affect the growth of defective DNA and RNA. These agents are commonly used to treat leukemias and GI cancer.
• Anti-tumor antibiotics – Affect division of cancerous DNA by interfering with the enzymes of DNA copying.
• Mitotic inhibitors & topoisomerase inhibitors – Impair process of cell division.

Innovations in anticancer research have resulted in effective treatments such as –

Targeted therapies – Chemotherapeutic drugs are laced with substances that specifically carry themselves to the tumor or cancer site. These substances include proteins, receptors, or antigens specifically act on cancer cells thus allowing the chemotherapy to show localized effect. This way the normal cells in the nearby structures remain unaffected and the patient experiences fewer side effects.

Differentiating therapies – These medicines act by differentiating the cancerous cells into normal cells.

Immunotherapies – Certain cancer vaccines and cell therapies are directed to provoke the immune system to attack cancer cells and destroy them.

Hormone therapies – Hormone-like medicines help to reduce the growth of breast, prostate and endometrial cancer that respond to natural sex hormones in the body.

What are the factors to be considered before choosing chemotherapy?

It is important to understand the pros and cons of chemotherapy. The oncologist will discuss the benefits, risks and side effects of the chosen chemotherapy. Only after the patient provides the consent will the medical oncologist begin chemotherapy.

So, here are few points one can ask their doctor:

• The chemotherapeutic agents used
• Method of use – IV or oral
• Number of courses and cycles
• Treatment goals and how to find out if it works
• Possible side effects and risks
• Effect of chemo on work and physical activities
• Effect of chemo on fertility and ability to conceive
• Any other treatments – radiation or surgery

References