Chemotherapy - Cancer

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 they are 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 can 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 (shot) 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 usually given in cycles. Chemotherapy may be given daily, weekly, every few weeks, or monthly, depending on your situation.

Chemotherapy is usually given in an outpatient setting, such as a hospital, clinic, or doctor'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 a number of chemotherapy drugs that are commonly used. The following table gives examples of a few of the more commonly used 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 more common side effects. Side effects may occur just after treatment (days or weeks), or they may occur later (months or even 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 or her reaction to treatment. Side effects may be severe, mild, or absent. Be sure to discuss with your cancer care team possible side effects of treatment before treatment begins. Ask for written information on each drug that you're getting so you know what to watch for and what to report to your doctor.

Chemotherapy drug
Carboplatin (Paraplatin):     Usually given intravenously (IV)
                                            Used mainly for cancers of the ovary and lung

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.)
Allergic reactions in some people while the drug is being given can include feeling lightheaded or dizzy, fever, chills, hives, itching, headache, coughing, shortness of breath, or swelling of the face, tongue, or throat

Decrease in blood cell counts
Hair loss (reversible)
Numbness and tingling in the hands or feet

Nausea, vomiting, and/or diarrhea (usually a short-term side effect occurring the first 24 to 72 hours following treatment)

Chemotherapy drug
Cisplatin (Platinol):     Usually given intravenously (IV)
                                   Used mainly for cancers of the bladder, ovary, lung, and testicles

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.)
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
Numbness and tingling in the hands or feet
Ringing in ears and hearing loss
Fluctuations in blood electrolytes
Kidney damage

Chemotherapy drug
Cyclophosphamide (Cytoxan):      Can be given intravenously (IV) or orally (as a pill)
                                                      Used mainly for lymphoma, leukemia, multiple
                                                       myeloma, breast cancer, and ovarian carcinoma

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.)
Decrease in blood cell counts
Nausea, vomiting, and diarrhea
Decreased appetite
Mouth sores
Hair loss (reversible)
Bladder damage
Fertility impairment
Lung, kidney, or heart damage (with high doses)

Chemotherapy drug
Docetaxel (Taxotere):      Given intravenously (IV)
                                         Used mainly for breast, lung, stomach, head and neck, and
                                         prostate cancers

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.)
Decrease in blood cell counts
Nausea, vomiting, and weakness
Diarrhea
Decreased appetite
Hair thinning
Rash
Numbness and tingling in hands and feet

Chemotherapy drug
Doxorubicin (Adriamycin, Rubex):     Given intravenously (IV)
                                                           Used mainly for breast, endometrium, lung, and
                                                           ovarian cancers, lymphoma, leukemia, and
                                                           multiple myeloma

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.)
Decrease in blood cell counts
Mouth ulcers and loss of appetite
Nails and skin creases in hands may darken
Hair loss (reversible)
Nausea and vomiting
Heart damage

Chemotherapy drug
Etoposide (VePesid, VP-16):     Can be given intravenously (IV) or orally (as a capsule)
                                                   Used mainly for cancers of the lung and testicles

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.)
Decrease in blood cell counts
Hair loss (reversible)
Nausea and vomiting
Allergic reaction (rare)
Mouth ulcers
Decreased appetite
Diarrhea

Chemotherapy drug
Fluorouracil (5-FU):     Given intravenously (IV) or as a cream to treat skin cancers
                                     Used mainly for cancers of the colon, rectum, and head and
                                     neck.

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.)
Decrease in blood cell counts
Diarrhea
Appetite loss
Mouth ulcers
Nausea and vomiting
Photosensitivity (skin gets burned easily)
Dry skin, darkening of skin and nail beds

Chemotherapy drug
Gemcitabine (Gemzar):     Given intravenously (IV)
                                           Used mainly for cancers of the pancreas, breast, ovary, and
                                           lung

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.)
Decrease in blood cell counts
Nausea and vomiting
Appetite loss
Tiredness
Swelling, such as in the arms or legs
Fever and flu-like symptoms
Rash

Chemotherapy drug
Methotrexate (Folex, Mexate, MTX):      May be given intravenously (IV), intrathecally
                                                                (injected into the spinal column), as a shot into
                                                                a muscle (IM), or orally (as a pill)

                                                               Used mainly for cancers of the breast, lung,
                                                               head and neck, blood, bone, and lymph system

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.)
Nausea and vomiting
Mouth ulcers
Appetite loss
Skin rashes and photosensitivity (increased risk of sun burn)
Kidney damage (with a high-dose therapy)

Chemotherapy drug
Paclitaxel (Taxol):     Given intravenously (IV)
                                  Used mainly with cancers of the breast, ovary, and lung

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.)
Decrease in blood cell counts
Allergic reaction
Nausea and vomiting
Diarrhea
Change in taste
Thin or brittle hair
Joint pain (short term)
Numbness or tingling in the fingers or toes

Chemotherapy drug
Vinblastine (Velban, Velbe, Velsar):     Given intravenously (IV)
                                                              Used mainly for lymphoma and cancers of the
                                                              testis, breast, and head and neck

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.)
Decrease in blood cell counts
Mouth sores
Tiredness
Hair loss (reversible)
Constipation or abdominal cramping

Chemotherapy drug
Vincristine (Oncovin, Vincasar PFS, Vincrex, vincristine sulfate, VCR):
     Given intravenously (IV)
     Used mainly for leukemias, lymphomas, and childhood cancers

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.)
Constipation
Tiredness
Hair loss or thinning
Numbness or tingling in the fingers or toes

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