Chemotherapy, broadly speaking, is any regimen of therapy that makes use of chemicals to try to fight a disease. More specifically, it usually refers to a specific set of practices in which chemicals are used to help fight cancer. Since the widespread adoption of chemotherapy to fight cancer, the more general use of the term is rarely used outside of medical circles.
In the 1940s, a chemical used during wartime, nitrogen mustard, was found to be somewhat effective in treating lymphoma. Ultimately, the effects turned out to be very temporary, but it nonetheless demonstrated to the medical establishment that chemicals could be used to suppress, and perhaps even to eliminate, cancer. Throughout the late 1940s and early 1950s, further research was conducted on a wide array of cancers, utilizing different chemical strategies.
By the late 1950s, a treatment first used in the 1940s on children with leukemia was found to be effective in completely destroying a type of tumor called choriocarcinoma. This was the first great victory for chemotherapy in curing cancerous elements, and it helped push along the building enthusiasm for chemical cures for cancer. The 1950s also heralded what was perhaps the peak of the West’s idealization of chemicals of all stripes, and this general enthusiasm for modernity was a driving force behind funding and widespread support for chemotherapy.
In the mid-1960s, after a number of subsequent breakthroughs in various individual areas of cancer research, a new technique was developed that would prove to be one of the most important ever for the field of cancer research. This was combinational chemotherapy, by which a number of different chemicals were administered to attack different trouble regions and to bolster one another in the event that the cancer cells mutated to resist a single chemical. By the late 1960s, this technique had proven effective in curing a significant portion of lymphoma patients to whom it was administered.
Chemotherapy works by impairing the reproduction of the fastest-splitting cells, a property common in cancerous cells. Unfortunately, a number of other cells also have a high rate of mitosis, and are therefore targeted by many chemotherapy treatments as well. Hair cells are perhaps the most visible of these, as many subjects of chemotherapy lose their hair as their drug regimens attack the cells responsible for hair growth along with cancerous cells.
Chemotherapy has a number of negative side effects, including severe nausea, bowel problems, a wide range of toxic effects, hemorrhaging, and a sometimes fatal suppression of the immune system. Chemotherapy, although relatively successful, is certainly not a silver bullet for fighting cancer, and many people consider the risks and potential damage not worth the chance of cure. For all its ills, however, chemotherapy offers the best hope for many victims of cancer, and as a field it is constantly innovating and progressing.
It is difficult to predict exactly what side effects you will experience while having chemotherapy. Different people react to treatment in different ways.
A small number of people have very few or even no side effects.
The common side effects of chemotherapy are listed below, although it is unlikely that you will experience them all.
Your care team is there to help you cope with the physical and psychological side effects.
While the side effects of chemotherapy can be distressing, most do not pose a serious threat to your health.
However, occasionally some side effects can be very serious. For example, if you have a rapid fall in white blood cells, you may be vulnerable to a serious infection.
People having chemotherapy for cancer that developed inside their blood cells or bone marrow are most at risk of serious infections. This is because this type of cancer will already have caused a reduction in white blood cell numbers.
Symptoms of serious infection include:
a high temperature of 38C (100.4F) or above
shivering
breathing difficulties
chest pain
flu-like symptoms, such as muscle aches and pain
bleeding gums or nose
bleeding from other parts of the body that does not stop after applying pressure for 10 minutes
mouth ulcers that stop you eating or drinking
vomiting that continues despite taking anti-sickness medication
four or more bowel movements a day, or diarrhoea
If you have any of these symptoms, contact your care team immediately. Your care team should give you a card with 24-hour emergency phone numbers.
Fatigue or tiredness is a common side effect of chemotherapy. Almost everyone who has chemotherapy will experience fatigue. You may feel generally tired or you may tire very easily after doing normal, everyday tasks.
While having chemotherapy, it is important to get plenty of rest. Do not carry out tasks or activities that you do not feel up to.
Light exercise, such as walking, can help boost your energy levels, but be careful not to push your body too hard.
If you are working, you may need to ask your employer to let you work part time until your chemotherapy has finished.
Read more about coping with the effects of tiredness and fatigue.
Contact your care team if you are suddenly significantly more tired than usual and you also feel out of breath. Extreme fatigue and shortness of breath can be a sign of anaemia. This is a condition caused by having a low number of red blood cells.
Nausea (feeling sick) and vomiting (being sick) are common side effects of chemotherapy. They affect around half of all people being treated.
If you have nausea and vomiting, you will be given medication to help control your symptoms. This type of medication is known as an anti-emetic.
Anti-emetics can be given in a number of different ways, including:
as a tablet or capsule, which can either be swallowed or placed under your tongue to dissolve
as an injection or drip
as a suppository, which is a capsule that you put into your rectum (back passage) so that it can dissolve
through a patch that you place on your skin
Continue to take your anti-emetics even if you do not feel sick because they will help prevent your symptoms from returning.
There are several different types of anti-emetics. If the one you are taking doesn't work or if it causes too many troublesome side effects, contact your care team. There may be an alternative anti-emetic that works better for you.
Hair loss is a common side effect of some chemotherapy. It usually begins one to three weeks after the first chemotherapy dose. The hair that grows on the side of your head, near your ears, becomes more brittle and thin. Most people have significant hair loss after one to two months.
The scalp is most commonly affected, although hair loss can occur on other parts of the body. These include the arms, legs and face.
Chemotherapy lowers the amount of white blood cells in your body. The main function of white blood cells is to fight infection. If the number of white blood cells is reduced, your immune system will be weakened and you will be more vulnerable to infection.
You may be given a course of antibiotics to reduce your risk of developing an infection. You will also need to take extra precautions to protect yourself against infection. For example, you should:
Have good personal hygiene – take daily baths or showers and make sure that clothes, towels and bed linen are washed regularly.
Avoid contact with people who have an infection, such as chickenpox or flu.
Wash your hands regularly with soap and hot water, particularly after going to the toilet and before preparing food and eating meals.
Take extra care not to cut or graze your skin – if you do, clean the area thoroughly with warm water, dry it and cover it with a sterile dressing.
The regular blood count tests that you will have during chemotherapy mean that your care team should be able to tell you when you are most vulnerable to infection.
You may be advised to take extra precautions, such as avoiding crowded places and using public transport at busy times.
Your doctor will develop a treatment plan scientifically designed for you, based on your type of cancer, its stage of advancement, and your overall health. It will consist of specific chemotherapy agents, at specific doses and intervals. These are called your scheduled cycles. Generally, treatments are given daily, weekly, or monthly. Your doctor will help you determine the most effective treatment schedule for you.
The goal is to make your chemotherapy as effective, timely, and problem-free as possible. But while your chemotherapy treatment works to fight your cancer, it also can cause side effects such as a lowered white blood cell count. A low white blood cell count means your immune system isn't as strong as it could be, which can increase your risk of infection. It also can require your doctor to change your dose or schedule of your chemotherapy.
A chemotherapy-induced low white blood cell count, caused by healthy cells lost during chemotherapy, is an expected side effect of many chemotherapy drugs. A low white blood cell count typically occurs after the administration of certain types of strong chemotherapy and may continue for several days. To help reduce the risk of developing side effects like low white blood cell count that may interfere with your treatment schedule, learn more about managing chemotherapy side effects.
Under certain circumstances, your doctor may decide your body is too weak to receive chemotherapy. A low white blood cell count can temporarily disrupt your cancer treatment or result in having your chemotherapy dose decreased.
Many doctors agree that it's important to stick to a schedule of treatment. Find out about chemotherapy cycles and schedules.