Cancer treatment

Chemotherapy means using drugs or medications to treat any disease. But most often, it refers to drugs used for cancer treatment. Chemotherapy can consist of one drug or a group of drugs that work together.

Sometimes chemotherapy is used with different treatments, like surgery and radiation. 

Cancer cells grow in an uncontrolled way. They can break away from their original site and spread to other parts of the body. Chemotherapy disrupts the ability of cancer cells to grow and multiply.

Chemotherapy drugs can also affect normal tissue. Most normal cells recover quickly once treatment is over.

Choosing chemotherapy drugs depends on a number of factors, including:

• Type and location of the cancer 
• Stage of development of the cancer
• How the cancer affects normal body function 
• General health of the patient

You may be treated with one drug or several. A combination of drugs may be used because cancer cells that are not affected by one drug may be destroyed by others. Also, drugs sometimes work better together than they do alone.

Most chemotherapy drugs are given in one of two ways:

• Directly into the blood through an IV; most chemotherapy drugs are delivered this way
• In a pill that should be taken as directed

Chemotherapy may be given daily, weekly, monthly or at other intervals. It depends on the kind of cancer you have, the drugs being used and how you respond to them. Your doctor should be able to give you an idea of how long you’ll need chemotherapy.

Chemotherapy is often adjusted to fit individual responses and treatment needs. Sometimes treatment is given in an on-and-off cycle that includes rest periods. This gives your body a chance to build healthy new cells and regain strength.

For first-time patients, we recommend eating if you’re hungry on the days you have chemotherapy. If your treatment takes more than a few hours, you may want to pack snacks or a lunch.

Hard candy like peppermints can help calm an upset stomach and get rid of any bad tastes in your mouth. After your first treatment, you’ll have a better idea of how chemotherapy will affect you.

If you take any prescription medications, talk with your doctor. He or she will let you know if they might interfere with the chemotherapy drugs. 

Cancer cells divide and reproduce quickly. Chemotherapy works to stop this growth. Since some normal cells also grow quickly, they might be affected by the chemotherapy. Whether or not you have side effects depends on the drug(s) you’re taking and your response.

Possible side effects of chemotherapy include:

• Hair loss and feeling tired
• Sores in the mouth, and dry skin and hair
• Upset stomach 
• Vomiting
• Infection

Greater chances of getting an infection

Most anti-cancer drugs affect the bone marrow, the spongy tissue in the center of most bones. It produces white blood cells, red blood cells and platelets. The white blood cells help fight germs that cause infections.

When your white blood cell count is low, you have a greater chance of getting an infection. Because of this, your doctor will watch your blood cell count closely while you’re getting treatment. Signs of an infection include:

• A fever of more 100.4° F/38° C
• Chills
• Sweating (especially at night)
• Loose bowels
• A burning feeling when urinating
• A severe cough or sore throat

Anti-cancer drugs can affect any of the blood cells that bone marrow produces. These include red blood cells, platelets and white blood cells. Each type of blood cell plays an important role in your body’s normal functions:

• Red blood cells carry oxygen to all parts of the body. When your red blood cell count is low, your body tissues don’t get enough oxygen. This can make you feel tired, dizzy, chilly or short of breath.
• Platelets help make your blood clot, which stops bleeding when you hurt yourself. If you don’t have enough platelets, you can bleed or bruise more easily than usual. If this happens, or if you have any unusual bleeding (from the gums or nose), tell your doctor.
• White blood cells protect you against illness and disease. When the white blood cell count is low, your chances of getting an illness or infection are high. This can be a serious health threat. 

Nadir is a word that means the lowest point of anything. When you have a chemotherapy treatment, the nadir is when your blood cell counts are at their lowest levels — usually 10 days to two weeks after your last treatment. After this, they begin to recover.

Your doctor will have you follow up at the office and check your blood levels during the nadir. 

Radiation therapy uses high-energy particles or waves, such as X-rays, to destroy or damage cancer cells. It can be used alone or in combination with surgery, chemotherapy or other treatments.

Sometimes doctors use radiation before surgery to shrink a tumor. This allows the tumor to be removed more easily. Radiation can also be done after surgery to stop the growth of any cancer cells that remain.

Radiation therapy is usually done every day for several weeks at a time. We work with radiation specialists throughout the Seattle area. This helps make sure you get treatment at a facility near you. 

Radiation therapy uses special equipment to deliver high doses of radiation to cancerous tumors. This kills or damages the tumors so they can’t grow, multiply or spread.

Unlike chemotherapy, which exposes the entire body to cancer-fighting chemicals, radiation therapy affects only the tumor and the surrounding area.

Most patients get radiation from a machine. It aims high-energy rays at the part of your body with the cancer. Radiation is usually done at a hospital or treatment center. You will probably be scheduled for treatment five days a week for four to six weeks. 

Surgery has been used to treat cancer for many years. It’s often done to achieve one or more of these goals:

• Preventive surgery can lower the chances of getting cancer. Doctors remove tissue that is not yet cancerous but is likely to become cancerous.
• Diagnostic surgery is done to get a tissue sample. The tissue is examined to see if it is cancerous and to find out what type of cancer it is.
• Staging surgery is used to find out the size of a tumor and if the cancer has spread. 
• Curative surgery is done when there is hope of taking out all of the cancerous tissue.
• Palliative surgery is used to treat complications of advanced cancer. It can also help relieve pain or restore physical function. 
• Plastic and reconstructive surgery is used to restore appearance or the function of an organ or body part after the main surgery.

A biopsy is a procedure to remove a tissue sample and test it for cancer. Some biopsies may require surgery. But sometimes tumor samples can be removed using a thin needle or an endoscope (a flexible lighted tube).

Some insurance companies require you to get a second opinion before surgery. But you may not need to have tests done again. Often you can bring or send the results of your original tests to the second doctor.

Check with your insurance company before going ahead with surgery. Making an informed decision about your health is almost always better than making a decision quickly.