Chemotherapy

Chemo can be used...

• as the only treatment needed to fight off cancer
• after surgery or other treatment to kill off any remaining cancer cells
• before surgery or other treatment to reduce the size of the cancer so that those treatments are more successful
• to reduce signs and symptoms that may be causing the patient pain. If chemo is used to reduce symptoms of cancer, it is usually it palliative care in patients with very advanced cancer.

Chemotherapy can also be administed in 6 different ways.

1. The most common form of chemo is intravenous (through the vein). In intravenous chemo the drugs will be in plastic bags connected to a tube that runs into a vein in the body. Patients that have a lot of chemo sessions coming up may get a port (port-a-cath) in which they undergo minor surgery to insert a device underneathe the skin that connects to a large vein in the body for the chemo to travel through. This is recommended as a safer option in many cases as there can be less damage done to the vein.
2. Oral chemotherapy is when the drug will be taken in a pill or liquid form. This is usually a less invasive form of chemotherapy treatment.
3. Chemotherapy cream is a cream or gel that can be applied onto the skin to kill certain types of skin cancer.
4. Chemotherapy injections can also be used to transfer chemotherapy into the body. These injections are done into the muscle, under the skin, or directly into the cancer lesion.
5. If the cancer tumor is in an arm or leg, isolated limb perfusion chemo may be considered to treat the tumor in cases such as metastatic melanoma and some sarcomas. Blood supply will be cut off from that limb to the rest of the body while heated chemo is pumped through the limb via tubes that are inserted into small incisions.
6. There is also hepatic arterial infusion chemotherapy which is only used for liver cancer. In this case, a tube is connected to the artery which supplies blood to the liver and chemotherapy is pumped through.

Why do people struggle with it?

Chemotherapy can be very hard on the body and can come with both short term and long term side effects depending on the type of chemo drug and the amount of the drug that is used to treat your cancer. Short-term side effects of chemo might include nausea, vomiting, diarrhea, constipation, temporary hair loss, loss of appetite, exhaustion and fatigue, fever, mouth sores and changes in taste, general body pain, easy bruising and easy bleeding. A lot of the short term side effects can be managed by your oncology team, so ask what they can do to help.

Long term side effects may not appear for months or even years after treatment but they could include damage to the lung tissue, heart problems, increased chance of being diagnosed with a second cancer, nerve damage in hands or feet (neuropathy), infertility and kidney problems.