What is chemotherapy will be the question many cancer patients ask themselves. Chemotherapy is one of the most commonly used cancer treatments. The term encompasses a wide range of drugs with different mechanisms of action, administration methods and side effects. These drugs are commonly referred to as anti-neoplastic or chemotherapy drugs.
Tumour cells are cells from our own body that start growing and dividing out of control due to a change in growth-control and cell-multiplication mechanisms.
As a result, these tumour cells can invade organs and travel to other tissues far from their origin, meaning they cause metastasis. Chemotherapy aims to stop this growth and division of cancerous cells and destroy them. As a result of their mechanism of action, they can also “damage” healthy cells, mainly those that grow quickly like blood and hair cells, causing side effects.
How many different types of chemotherapy are there?
There are several types of chemotherapy, depending on their mechanism of action and active ingredient. Furthermore, depending on the stage of the disease, we can talk about three types of chemotherapy treatment:
- Neoadjuvant chemotherapy: this is the treatment administered before surgery that aims to reduce tumour size and cure the patient.
- Adjuvant chemotherapy: this is the treatment administered after surgery, to cure the patient.
- Palliative chemotherapy: this is the treatment administered when the disease is already quite advanced, in metastasis, and it aims to slow the disease to improve symptoms and prolong the patient’s life.
How chemotherapy is given?
Chemotherapy is administered in periods called cycles. Each cycle of chemotherapy is comprised of a certain number of days of administering the treatment and rest days. Each cycle can last between 15 and 28 days. The type of cycle depends on the chemotherapy drugs used.
There are intravenous and oral chemotherapy drugs. Intravenous chemotherapy is normally administered through reservoirs or PICC (peripherally inserted central venous catheter), which puts the drugs directly into a large vein to avoid damage to veins in the arms.
Intravenous chemotherapy is usually an outpatient process and, except for exceptional cases, it is not necessary to stay in hospital. Firstly, your oncologist, after reviewing your lab work and situation at your first appointment, will confirm which type of treatment you will be given. After that the hospital pharmacy will prepare the medication that will then be administered in a special part of the hospital, called the day hospital.
How long does chemotherapy last?
The length of the chemotherapy treatment depends on the following factors:
- Goal of the treatment. If it is neo or adjuvant chemotherapy, there is usually a set number of cycles and it tends to last 5-6 months in total. For more advanced cases (with metastasis), there isn’t usually a set number of cycles and the treatment length depends on whether the disease responds and how well the patient tolerates it.
- The side effects: if they appear and, above all, if they are very severe, treatment may be cut short.
- The response: if the disease responds or remains unchanged, treatment will continue; if not, the treatment will be stopped and the oncologist will look into changing course.