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 it is 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 may 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 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 given in cycles. Chemotherapy may be given daily, weekly, every few weeks, or monthly, depending on your specific situation.

Chemotherapy is usually given in an outpatient setting, such as a hospital, clinic, or physician’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, such as music to listen to. It is also recommended to bring something to help pass the time, such as a deck of cards or a book.

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

There are over 50 chemotherapy drugs that are commonly used. The following table gives examples of some 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 various side effects. Side effects may occur just after treatment (days or weeks) or they may occur later (months or 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/her reaction to treatment. Side effects may be severe, mild, or absent. Be sure to discuss with your cancer care team any/all possible side effects of treatment before the treatment begins.

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 for cancers of the ovary, head and neck, and lung	decrease in blood cell counts hair loss (reversible) confusion nausea, vomiting, and/or diarrhea (usually a short-term side effect occurring the first 24 to 72 hours following treatment)
cisplatin (Platinol, Platinol-AQ) usually given intravenously (IV) used for cancers of the bladder, ovary, 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 ringing in ears and hearing loss fluctuations in blood electrolytes kidney damage
cyclophosphamide (Cytoxan) not common can be given intravenously (IV) or orally used for lymphoma, breast cancer, and ovarian carcinoma	decrease in blood cell counts nausea, vomiting, abdominal pain decreased appetite hair loss (reversible) bladder damage fertility impairment lung or heart damage (with high doses) secondary malignancies (rare)
docetaxel (Taxotere) given intravenously (IV) used for breast cancer, lung, and prostate	decrease in blood cell counts nausea, vomiting, abdominal pain diarrhea decreased appetite hair thinning rash numbness and tingling in hands and feet
doxorubicin (Adriamycin) given intravenously (IV) used for breast cancer, lymphoma, and multiple myeloma	decrease in blood cell counts mouth ulcers hair loss (reversible) nausea and vomiting heart damage
erlotinib (Tarceva, OSI-774) given orally used for non small cell lung cancer	rash and other skin changes diarrhea
etoposide (VePesid, VP-16) can be given intravenously (IV) or orally used for cancers of the lung, testicles, leukemia, and lymphoma	decrease in blood cell counts hair loss (reversible) nausea and vomiting allergic reaction(rare) mouth ulcers low blood pressure (during administration) (rare) decreased appetite diarrhea and abdominal pain bronchospasm (rare) flu-like symptoms (rare)
fluorouracil (5-FU) given intravenously (IV) used for cancers of the colon, breast, stomach, and head and neck	decrease in blood cell counts diarrhea mouth ulcers photosensitivity dry skin, darkening of skin and nail beds
gemcitabine (Gemzar) given intravenously (IV) used for cancers of the pancreas, breast, ovary, and lung	decrease in blood cell counts nausea and vomiting fever and flu-like symptoms rash
imatinib mesylate (Gleevec, STI 571) given orally used for chronic myelogenous leukemia (CML) and gastrointestinal stromal tumor (GIST)	nausea and vomiting fluid retention (swelling around ankles, eyes) muscle cramps diarrhea gastrointestinal bleeding rash
irinotecan (Camptosar, CPT-11) given intravenously (IV) used for cancers of the colon and rectum	decrease in blood cell counts diarrhea fatigue
methotrexate (Folex, Mexate, Amethopterin) may be given intravenously (IV), intrathecally (into the spinal column), or orally used for cancers of the breast, lung, blood, bone, and lymph system	decrease in blood cell counts nausea and vomiting mouth ulcers skin rashes and photosensitivity dizziness, headache, or drowsiness kidney damage (with a high-dose therapy) liver damage (rare) hair loss (reversible)
paclitaxel (Taxol, Abraxane) given intravenously (IV) used with cancers of the breast, ovary, and lung	decrease in blood cell counts allergic reaction nausea and vomiting loss of appetite change in taste thin or brittle hair joint pain (short term) numbness or tingling in the fingers or toes
sorafenib (Nexavar) given orally used for advanced kidney cancer	high blood pressure (during first few weeks of treatment) rash, other skin changes diarrhea fatigue hair loss nausea and vomiting
sunitinib (Sutent) given orally used for gastrointestinal stromal tumor (GIST) and kidney cancer	diarrhea nausea and vomiting mouth ulcers upset stomach skin changes, including skin discoloration and rash fatigue high blood pressure bleeding swelling taste disturbance
topotecan (Hycamtin) given intravenously (IV) used for cancers of the ovary and lung	decrease in blood cell counts diarrhea hair loss (reversible) nausea and vomiting
vincristine (Oncovin) usually given intravenously (IV) used for leukemia and lymphoma	numbness or tingling in the fingers or toes weakness loss of reflexes jaw pain hair loss (reversible) constipation or abdominal cramping
vinblastine (Velban) given intravenously (IV) used for lymphoma and cancers of the testis and head and neck	decrease in blood cell counts hair loss (reversible) constipation or abdominal cramping jaw pain numbness or tingling in the fingers or toes