Also known as a systemic treatment, chemotherapy is one of the strongest weapons available to fight cancer. The cytotoxic (cell-killing) chemicals used interfere with cell division. Because each drug interferes with division at different points, a combination of several different chemicals may be used at any given time and can be taken orally, by injection, intravenously (IV), or using a combination of these methods. One of the drawbacks to this is that the chemicals are not selective and interfere with the division of all cells, both healthy (i.e. hair cells, bone marrow cells) and cancerous. It is for this reason that chemotherapy is given in cycles with time in between so that cell production and division is not stopped totally. Since cancer cells do not divide at the same time, the chemotherapy cycles are staggered so that each batch of cells that begins to divide will be attacked as well. Treatments are generally given in 21-day or 28-day cycles. The main purpose behind chemotherapy is to destroy enough cancer cells so that your body's immune system can destroy what is left.
As previously mentioned, there are several different drugs used for chemotherapy, but the most commonly used are:
Cyclophamide (Cytoxan) (C)
5 fluorouracil (F)
You can find more information about the drugs currently in use and the current clinical trials by visiting the National Cancer Center web site.
Before beginning any course of chemotherapy you'll want to speak with a qualified medical oncologist or cancer specialist. While there are general guidelines for cancer treatment, the field is always changing, so be sure to select someone who is up to date on the latest research. Please be sure to get a second opinion on any treatment outlined for you. You might also want to look into any protocols or clinical trials that you can qualify for. Make sure you ask questions about what drugs you will be getting and how you will be getting them. Ask questions about how often you'll have treatments and for how long you might expect a treatment to last, as this varies by patient, doctor, course of treatment, and the location of your treatments. If you are going to have intravenous treatments, you might want to consider a central access device (or port), which is placed under the skin and into a major blood vessel. This can spare your skin repeated needle sticks and is very good to have in case of emergencies or problems with your veins. Your doctors should let you know about any side effects you might encounter as well as how to deal with them. For your convenience, we have also included a basic list of many of the possible side effects and "treatments" for these.
Once you have decided on a course of treatment and have signed a consent form, you'll be scheduled for your treatment. Treatments can take place in your doctor's office, at a clinic, or in the hospital. Think about bringing a book, walkman, or other activity with you. Most treatments centers will also allow you to have a friend with you. At your first visit you may have a sample of your blood taken to check your blood count before treatment begins. You'll also have your height and weight measured before each treatment, as the initial dose is calculated on body surface area. If your blood is taken at your first visit, you can expect to wait anywhere from fifteen to forty-five minutes before your actual treatment begins. Your treatment will be administered by either your medical oncologist or by a specially trained nurse. If you have not chosen to (or were not able to) use a central access device, an IV will be started to administer the chemotherapy. If you do have a central access device (port), it will be hooked up to the IV bag of drugs. Expect your treatment to last from ten minutes to three or four hours.