Chemotherapy is a cancer treatment, a type of anti-cancer medication treatment. It works by killing cancer cells by using medicines and its effects differ depending on the type of cancer. It is a systemic treatment which means it works throughout the body. At times doctors use the word cytotoxic to describe the way chemotherapy works. Cytotoxic means toxic to cells.
Paul Ehrlich, a German chemist, coined the term chemotherapy. He investigated the use of drugs to treat infectious diseases.
Chemotherapy aims to restrict cell proliferation and multiplication of tumours, therefore avoiding invasion and metastasis of cancer cells. Tumour growth can be inhibited at multiple levels, both inside the cell and in its environment. Chemotherapy therapy results in side effects due to damage to normal cells as well.
Chemotherapy treatment can be administered in neoadjuvant, adjuvant, combined, and metastatic conditions. Neoadjuvant therapy is a treatment given before the primary treatment, and adjuvant therapy is the cancer treatment delivered along with the initial therapy; it can suppress or eradicate the growth of occult cancer cells. This therapy is now the standard therapy for lung, breast, colorectal, and ovarian cancers.
In the treatment of certain cancers, a combination of chemotherapy and radiation therapy is employed to shrink the tumour before surgery or with the goal of achieving a cancer cure. This approach is commonly used in cancers affecting the head and neck, lungs, and anal areas.
Multitargeted or combination therapy is better than single-agent therapy in most cancer treatments. To reduce resistance and toxicities, combination chemotherapy drugs can be selected based on their distinct modes of action and nonoverlapping toxicities.
Chemotherapy medicines can be given orally (PO), intravenous (IV), subcutaneous (SC), intramuscular (IM), and intrathecal (IT). Usually, chemotherapy drugs are delivered IV because of their 100% absorption rate.
Majority of the chemotherapy drugs are metabolized and excreted by either liver or kidney. Few chemotherapy drugs are harmful to the liver or kidneys causing buildup of toxic levels and resulting in organ dysfunction. It is crucial to make chemo dose adjustments for patients with organ failure.
Chemotherapeutic drugs are associated with side effects. The chemotherapy side effects are a reflection of their mechanism of action. Common side effects include nausea, vomiting, GI side effects, myelosuppression, mucositis, alopecia, sterility, infertility, infusion reactions, and increased infection risk due to immunosuppression.
Cancer chemotherapy can cause acute or prolonged side effects and may require monitoring. Multidisciplinary monitoring would be necessary because specific patient populations are at higher risk of complications.
Since most chemotherapy agents are administered at infusion centres, nursing and allied health professionals are crucial in caring for patients receiving these drugs. They are typically the first point of contact for patients. All health professionals need to understand the specific type of drug being used and its associated side effects for each patient. Close monitoring and early recognition of cancer treatment side effects is essential to prevent severe disease consequences.
Patients receiving chemotherapy often need a lot of emotional support because they can feel anxious and sad about the side effects of the treatment and whether it will be successful or not. It’s important for different types of medical professionals to work together to support their mental health at different times during their treatment.
Patients receiving chemotherapy need a lot of support from a team of healthcare providers. Nurses and other healthcare providers play a prominent role in taking care of these patients. They help with things like making sure patients stay healthy, avoiding infections, keeping an eye on their nutrition and hydration, and making sure they stay safe. Nurses also keep a close watch on the patient’s lab results and let the doctor know if they notice anything unusual. Taking prompt action can have a significant impact on helping patients feel better.
