Chemotherapy

Chemotherapy in Cancer Treatment

There are different forms of cancer therapy. These include radiation therapy, chemotherapy, surgical removal, gene therapy, immunotherapy, and other specific drug treatments. Cancer is one of the most feared diseases of humanity, and rightly so because, in addition to severe discomfort and long therapies, cancer in some cases leads to death. However, with the help of new methods and targets, the treatment of tumors of various types and thus also the cure rates have improved significantly. Chemotherapy is one of them.

Chemotherapy has the advantage over radiotherapy and surgery in that it reaches all organs affected by tumor cells via the bloodstream. It and can kill the cancer cells that are located there. Not only one, but often several chemotherapeutic agents can be combined to achieve a synergistic effect. Chemotherapeutic agents, also known as cytostatics, inhibit the metabolism of the cell. Fast-growing and dividing cells are particularly affected, which is where the side effects such as hair loss come from, as it is not only cancer cells that divide rapidly. However, the advantage of our healthy cells is their good repair system, which allows them to regenerate if they are given the necessary time, and the dose of chemotherapeutic agents is adjusted accordingly. Since chemotherapy reaches all parts of the body, it is often used in combination with other therapeutic procedures.

When Is Chemotherapy Carried Out?

Chemotherapy can be used for many types of cancer: Early-stage or late-stage, solid tumor (palpable tumor mass, as in breast cancer), or blood cancer. It is an option when the tumor first appears or returns (recurs). Chemotherapy is often not the sole therapy; it is combined with radiotherapy or surgery.

In principle, however, not every tumor responds equally well to every type of therapy. Leukemias (blood cancers), for example, cannot be operated on. Chemotherapy and radiation therapy are used here. Kidney cancer responds poorly or not at all to radiation.

Therefore, specific therapy regimens have been developed for each type of cancer, which the treating physician should discuss in detail with the patient before starting therapy.

How Does Chemotherapy Work?

The treating physician administers chemotherapy according to a chemotherapy regimen. The duration, frequency, and type of chemotherapeutic agents can vary greatly depending on the disease. In some cases, monotherapy (with one drug) is sufficient, but often several cytostatic drugs are combined with supporting each other (polychemotherapy). The doctor decides how many times per week, on which days breaks are taken, and how many cycles of chemo are needed in total, according to the stage of the disease and other disease parameters.

These days, chemotherapy can often be administered in outpatient settings. However, an inpatient stay is necessary for some instances where strong or many chemotherapeutic agents are used. In this way, the patient is protected in the best possible way against infections (chemotherapy also attacks the immune system), and other organ functions that may be at risk (e.g., kidney function) can be closely monitored.

Usually, in addition to the chemotherapeutic drugs, other additives are given, which have few side effects, but can enhance the chemotherapeutic drugs in their effect. To make chemotherapy as tolerable as possible, the physician may administer additional medications, for example, to treat nausea, which is typical.

The medication is usually administered through venous access. Chemotherapy in tablets is rare and has the disadvantage that absorption into the blood depends on meals and body metabolism and is therefore difficult to control. In cases of frequent chemotherapy administration, damage to the vein used may occur due to its venous irritant property. Consequently, it may be appropriate to implant a port. This is a reservoir that is implanted just under the skin in the area of the collarbone. From there, a small tube goes directly into a large-volume vein near the heart. The port can be pierced with a needle, and the chemotherapy can be administered directly close to the heart.

The advantage is the rapid distribution in the body without severely damaging small veins by high chemotherapy concentrations.

Chemotherapy can also be administered into an artery. In this way, the drug reaches only the nearest organ to a large extent and no other parts in the body. In rare cases, chemotherapy can also be injected directly into the cerebrospinal fluid. This is necessary if there is a suspected brain infestation that standard chemotherapy cannot reach sufficient concentration through the so-called blood-brain barrier.

Side Effects and Risks of Chemotherapy

Chemotherapy offers good chances of cure for many types of cancer. Nevertheless, it involves highly damaging substances that also attack and damage our healthy body cells. The rapidly growing tissues are particularly affected by the acute side effects. These include the mucous membrane in the mouth and digestive tract, hair and nails, and blood formation in the bone marrow. Consequences are hair loss, intestinal discomfort, open sores in the mouth, and especially nausea.

These side effects also depend on the type, duration, and dosage of the particular chemotherapy. In most cases, the body manages to recover from the stresses and strains after a short time. However, each chemotherapeutic agent also has a specific pattern of organ damage. Some cause long-term damage to the heart, others to the lungs, and still others to the nerves.

This damage may not become apparent until years later, mainly affecting young cancer patients with long life expectancies.

Like radiation therapy, chemotherapy itself can be the cause of new cancer that appears years or decades later. In addition, because our reproductive organs can also be attacked by chemotherapy, infertility repeatedly occurs in men and premature menopause in women.

In a detailed discussion with your treating specialist, you can find out what options there are to keep the side effects as low as possible and what therapy alternatives there are for certain types of cancer.

Which Doctors are Specialists in Chemotherapy?

Every patient who needs a doctor wants the best medical care. Therefore, the patient is wondering where to find the best clinic. As this question cannot be answered objectively and a reliable doctor would never claim to be the best one, we can only rely on the doctor's experience.

We will help you find an expert for your condition. All listed doctors and clinics have been reviewed by us for their outstanding specialization in chemotherapy and are awaiting your inquiry or request for treatment.

Sources:

http://www.krebsinformationsdienst.de/behandlung/chemotherapie-durchfuehrung.php

Herold, Gerd: Innere Medizin. Köln, Eigenverlag 2012.

Arasteh, K. ; Baenkler, H.-W. ; Bieber, C. ; et al.: Innere Medizin. Stuttgart, Georg Thieme Verlag KG 2009.