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Oncology treatment

Chemotherapy

What is it prescribed for? What types are there? Treatment benefits and side effects.
Chemotherapy is a method of treating malignant tumors using chemicals—cytostatics. They affect fast-growing cells, including cancer cells, which leads to their death.

Treatment with chemotherapy can be carried out either alone or in combination with other methods, such as surgery, radiotherapy, immunotherapy, targeted therapy.

Depending on the type of tumor and the stage of the disease, chemotherapy can be prescribed before, after, or as the primary treatment.

It is worth noting that the mechanisms of action of drugs may be different, but the principle is the same - they damage cancer cells and lead to their death.

Since this technique has a number of side effects, the selection of medication and calculation of its dosage are carried out by an experienced oncologist. He determines all contraindications and safety of manipulations, and also builds a treatment regimen.

What is chemotherapy used for?

Treatment with chemotherapy drugs is carried out to destroy malignant cells and stop the growth of tumors of various types and stages. As we have already noted, it can be used as the main method of treatment or in combination with other methods such as surgery, cytokine therapy or radiotherapy.

Therapy can be used for the following types of cancer:

Drug treatment may be required before surgery to reduce the size of the tumor and reduce the risk of cancer cells migrating to other parts of the body. In addition, drugs are prescribed after surgery to  eliminate remaining pathogenic cells and  prevent relapse.

In addition, chemotherapy courses can be used as the only treatment method in cases where other options are not possible or do not provide the desired effect.

Like any technique, exposure to chemotherapy carries risks and side effects, such as nausea, vomiting, hair loss, fatigue and bowel dysfunction. However, many of them are manageable and temporary.

In particular, with the combined use of chemotherapy with cytokinogenetic therapy, the toxicity of chemotherapy drugs is reduced by 50-60%. This method also eliminates forced long breaks between chemotherapy courses, when patients need to restore their health to continue treatment.

It is important to discuss the pros and cons of treatment with your doctor to make an informed decision about which method is best for a particular patient.

How the method works

Let's take a closer look at how chemotherapy courses affect cancer cells. The mechanism is based on the fact that drugs that enter the body work with rapidly multiplying cells, which is typical for cancerous tumors.

Cancer cells multiply and divide faster than normal cells in the body, so they are more vulnerable to the effects of chemotherapy drugs. In addition, drugs can affect different stages of the cell cycle.

Some substances can destroy the DNA of cells and prevent them from dividing, others can disrupt the formation of proteins necessary for cell growth and reproduction. This allows you to slow down or stop the growth of the tumor.

Chemotherapy can be carried out with one drug or a combination of several active substances. In some cases, the combination may be more effective, since each drug affects the tumor in its own way, increasing the chances of completely destroying cancer cells.

However, chemotherapy does not always act selectively, affecting normal cells in the body, which also multiply rapidly. These are cells of the hair follicles, digestive system and bone marrow.

This results in unwanted side effects such as hair loss, nausea, vomiting, diarrhea, fatigue and the risk of secondary infections. However, there are methods that trigger antitumor immunity and   in   combination with   chemotherapy, allow you to achieve better results (for example: immunotherapy, cytokine genetic therapy, etc.). Therefore, the choice and development of a treatment regimen should be based on the individual characteristics of each case and discussed with a doctor.

Types of therapy

Depending on the timing in relation to surgical treatment, chemotherapy courses can be divided into several types:
  • 1
    Adjuvant
    This is a treatment that is given after the tumor has been removed. Its purpose is  to destroy possible remnants of cancer cells that may remain in  the body after surgery
  • 2
    Neoadjuvant
    This is a treatment given before surgery to  reduce the size of the tumor and  improve the results of the operation
Также выделяют:
  • 1
    Palliative care
    This is a treatment that is given to relieve symptoms and improve the patient's quality of life. It is used in cases where the cancer is already in an advanced stage and cannot be completely cured
  • 2
    Hyperthermic intraperitoneal therapy
    This is a treatment that combines chemotherapy and hyperthermia (heating the tumor to a high temperature). This method may be more effective for some types of cancer
Depending on the number of drugs administered simultaneously, there are:
  • 1
    Polychemotherapy
    this is a treatment that uses several drugs simultaneously to achieve maximum effect
  • 2
    Monochemotherapy
    This is a treatment that involves the use of only one drug

In addition, chemotherapy differs in the  combination of techniques:

By dosage:

  • High dose therapy
    This is a treatment that uses very high doses of chemotherapy drugs. It can be used in  cases where other methods are ineffective; it is used rarely, mainly for leukemia; for solid tumors, the method has not justified itself
  • Calculated dosage
    at which individual concentrations of substances are prescribed for  treatment of a particular form of cancer
  • Low dose
    the minimum concentration of the active substance that is used to influence the tumor process between courses of the main antitumor treatment or after the end of the main treatment

What are the advantages of treatment

The main advantages of this treatment method include:
  • Efficiency
    Chemotherapy can destroy cancer cells and prevent them from further spreading in the body
  • Wide range of applications
    used for treatment of various types of cancer, and also for various stages of the disease
  • Adaptability
    dosages of drugs can be changed  depending on the patient's response to treatment
  • Possibility of combining several drugs
    may increase the effectiveness of treatment
  • Palliative effect
    Chemotherapy can help relieve cancer symptoms and improve a patient's quality of life
  • Possibility of use in combination with other treatment methods such as surgery, radiation therapy or cytokinegenetic therapy
  • Modern drugs have a milder side effect profile, which can reduce the negative impact on the patient’s body
  • Can be used as adjuvant therapy to destroy remaining cancer cells after surgery
  • More affordable compared to other cancer treatments such as immunotherapy and radiation therapy
  • Some types of cancer can be completely cured with chemotherapy

Methods of drug administration

Depending on the goals of treatment, drugs can be administered in different ways:
  • 1
    Intravenous administration
    chemotherapy drugs can be injected into the patient's vein using a catheter or needle
  • 2
    Oral administration
    medications are taken by the patient in the form of tablets or capsules
  • 3
    Injection into the muscle
    chemotherapy drugs can be injected into the patient's muscle using a needle
  • 4
    Intracavitary administration
    the medicine is injected directly into a body cavity, for example, into the abdominal or pleural cavity
  • 5
    Intra-arterial administration
    chemotherapy drugs can be injected directly into the  artery that feeds the tumor
  • 6
    Intratumoral administration
    drugs are injected directly into the tumor using a needle
Implantable port systems are often used. This is a special catheter installed directly into a vessel or cavity, which is connected to a small reservoir. This is a fairly convenient and  functional option, used for many decades.

Thanks to the port system, the therapy cycle is tolerated more easily and safely by the patient. Treatment can be carried out in  a hospital setting or  at home, depending on the instructions of the oncologist. The port system is invisible and does not interfere with everyday activities, suitable for long-term use.

What are the stages of chemotherapy?

Treatment of various types of cancer, including breast, ovarian, and prostate cancer, is always carried out according to an individual scheme. Dosage and  number of procedures depends on:

patient's health status
presence of chronic diseases
stages of the tumor process

Drugs are selected and prescribed taking into account the maximum possible therapeutic effect, but at the same time the doctor tries to reduce the development of side effects. This allows the patient to recover faster after treatment with minimal risk to health.

Cancer therapy may include several stages, each of which has its own goal and objectives.
  1. Induction therapy is the first stage of treatment, which is aimed at reducing tumor size and destroying malignant cells.
  2. Consolidation chemotherapy is the next stage of treatment, which is aimed at  destroying remaining cancer cells and  preventing relapse.
  3. Maintenance therapy is the third stage, which is aimed at maintaining the effects of previous treatment and preventing relapse.
  4. Palliative therapy is the last stage, aimed at stopping or reducing the severity of the manifestations of the malignant process. The goal of this stage is to improve the patient's quality of life and reduce cancer symptoms such as pain, fatigue and depression.

What are the side effects

Side effects may vary depending on the type of medication, dose, duration of treatment and individual patient characteristics. Some of the most common side effects include:
  • nausea and vomiting, which can be caused by the effect of chemotherapy drugs on the vomiting centers located in the brain. Doctors can provide patients with medications that help reduce or prevent these symptoms
  • hair loss—chemotherapy can lead to hair loss on the head and other parts of the body
  • fatigue—many patients feel tired during treatment, which can make it difficult to complete daily tasks
  • changes in  blood test  - chemotherapy can affect the number of blood cells in the body, which can lead to low neutrophils, anemia, and low platelet counts
  • changes in  skin and  nails —after a course of chemotherapy, changes in the skin and  nails may appear, such as dryness, irritation, or discoloration
Side effects are usually temporary and disappear after treatment is completed. At each stage of therapy, constant medical supervision and, if necessary, correction of observed toxicity are important.

Duration of treatment

The duration of chemotherapy may vary depending on the type of cancer, stage of the disease, response to treatment, and other factors. Some chemotherapy courses may last several weeks or months, while others may last years.

The doctor can create an individual treatment regimen, including a specific combination of chemotherapy drugs, and determine the dosage of cytostatics. It is important to follow your doctor's instructions and report any side effects promptly to get the most out of your treatment.

Author of the article:

Aleksanyan Aleksan Zavenovich

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