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Chemotherapy is the medical treatment which is given to cancer patients to destroy fast multiplying cells in the body. The drugs are called as chemotherapeutic agents/drugs.
Targeted therapy is a form of treatment in which drugs act by targeting specific receptors on cancer cells. This form of therapy is less toxic, but it has side effects too. Broadly chemotherapy may be classified based on if given before surgery or after surgery or along with radiation therapy.
1. Combined modality chemotherapy
Neo-adjuvant Chemotherapy – Chemotherapy which is given before surgery. It is given with an intent to reduce the size of the tumor to make it surgical resectable.
Adjuvant Chemotherapy – Chemotherapy which is given after surgery. It is given with an intent to kill the cancer cells present in the blood circulation in the body.
Concurrent Chemotherapy – Chemotherapy which is given when the patient receives radiation therapy. It is usually given once in a week, while the patient receives radiation therapy on a daily basis.
2. Curative Chemotherapy
Chemotherapy when given with a curative intent is called as curative chemotherapy. It is usually given in the early stages of cancer.
3. Palliative chemotherapy
It is a chemotherapy given to the patient, when the disease is in stage IV, with an intent to improve the symptoms & improve the quality of life. The other kinds of chemotherapy are induction, consolidation and maintenance chemotherapy (in leukemia).
Chemotherapy may be used in the following cases:
Chemotherapy is also administered in bone marrow diseases and immune system disorders.
Depending on the chemotherapy will be administered, you might have to make certain preparations. In most cases, there is no special requirement to get chemotherapy. You may need to:
You should eat and drink right during your chemotherapy sessions.
It is usually given in the form of Intravenous (blood administration), also given in the form of oral pills, intramuscular, spinal, peritoneal, directly into CSF.
A single chemotherapeutic agent may be used or a combination of many drugs may be used at the same time or at different times.
It can be given via intravenous line (through veins), or via Chemoport or PICC line (Peripherally Inserted Central Catheter). You may or may not be able to get admitted for chemotherapy. It is usually administered in day-care (where chemotherapy is administered for a few hours & then patient is discharged) under the supervision of paramedical staff. Chemotherapy may be administered over few seconds, or minutes or hours. It may be given over a period of few days also, depending on the treatment protocols, for which you may have to get admitted. Your doctor (medical oncologist) will decide which form of chemotherapy should be given to you based on age, cancer site, histological type, stage and other parameters.
Some International organizations, such as, NCCN (National Comprehensive Cancer Network), ASCO (American Society of Clinical Oncology), ESMO (European Society for Medical Oncology) publish guidelines & protocols specifying dosage, schedule, method of administration of chemotherapy, duration of administration of chemotherapy etc. based on evidence based medicine. You will receive chemotherapy according to the chemotherapy protocols.
You may receive chemotherapy daily, on alternate days, weekly, twice weekly, monthly or so on. It depends on the chemotherapy protocol (designed by the international organizations or personalized protocols).
Various types of chemotherapy agents have different side effects. The severity may vary from person to person. Few of the predictable side effects are:
Similarly, there are other side effects of chemotherapy, which may or may not be managed with the help of supportive treatment. Different types of chemotherapeutic agents have different types of side effects. Not everybody suffers from all side effects & severity of side effects may vary.