Chemotherapy

Chemotherapy

Chemotherapy is the use of any drug to treat any disease. But to most people, the word chemotherapy means drugs used for cancer treatment. It’s often shortened to “chemo.”

Surgery and radiation therapy remove, kill, or damage cancer cells in a certain area, but chemo can work throughout the whole body. This means chemo can kill cancer cells that have spread (metastasized) to parts of the body far away from the original (primary) tumor.

Goals of chemotherapy treatment

If your doctor has recommended chemotherapy to treat your cancer, it’s important to understand the goals of treatment when making treatment decisions. There are three main goals for chemotherapy (chemo) in cancer treatment:

  1. Cure
  2. Control
  3. Palliation

Cure

If possible, chemo is used to cure cancer, meaning that the cancer is destroyed – it goes away and doesn’t come back.

Most doctors don’t use the word “cure” except as a possibility or intention. So, when giving treatment that has a chance of curing a person’s cancer, the doctor may describe it as treatment with curative intent.

There are no guarantees, and though cure may be the goal, it doesn’t always work out that way. It often takes many years to know if a person’s cancer is really cured.

Control

If cure is not possible, the goal may be to control the disease. Chemo is used to shrink tumors and/or stop the cancer from growing and spreading. This can help the person with cancer feel better and live longer.

In many cases, the cancer doesn’t completely go away, but is controlled and managed as a chronic disease, much like heart disease or diabetes. In other cases, the cancer may even seem to have gone away for a while, but it’s expected to come back. Then chemo can be given again.

Palliation

Chemo can also be used to ease symptoms caused by the cancer. This is called palliative chemotherapy or palliation.

When the cancer is at an advanced stage, meaning it’s not under control and has spread from where it started to other parts of the body, the goal may be to improve the quality of life or help the person feel better. For instance, chemo may be used to help shrink a tumor that’s causing pain or pressure.

It’s important to know that any treatment that’s used to reduce symptoms or improve comfort is called palliative care. For example, anti-nausea treatments or pain medicines are palliative, and can be used at all stages of treatment. It can be confusing when chemo is used as a palliative treatment, because it’s most often used to try to cure or control the cancer. But when it’s used with the goal of comfort, chemo becomes palliative care.

Planning chemotherapy treatments

You and your cancer doctor, called an oncologist, will decide what drug or combination of drugs you will get. Your doctor will choose the doses, how the drugs will be given, and how often and how long you’ll get treatment. All of these decisions will depend on the type of cancer, where it is, how big it is, and how it affects your normal body functions and overall health.

Cancer can be treated with a single chemo drug, but often several drugs are used in a certain order or in certain combinations (called combination chemotherapy). Different drugs that work in different ways can work together to kill more cancer cells. This can also help lower the chance that the cancer may become resistant to any one chemo drug.

Sometimes chemo is the only treatment you need. More often, chemo is used with surgery or radiation therapy or both. Here’s why:

  • Chemo may be used to shrink a tumor before surgery or radiation therapy. Chemo used in this way is called neoadjuvant
  • It may be used after surgery or radiation therapy to help kill any remaining cancer cells. Chemo used in this way is called adjuvant
  • It may be used with other treatments if your cancer comes back.

Determining which chemotherapy drugs to use

In some cases, the best choice of doses and schedules for each chemo drug is clear, and most doctors would recommend the same treatment. In other cases, less may be known about the single best way to treat people with certain types and stages of cancer. In these cases, different doctors might choose different drug combinations with different schedules.

Factors to consider when choosing which drugs to use include:

  • The type of cancer
  • The stage of the cancer (how far it has spread)
  • The patient’s age
  • The patient’s overall health
  • Other serious health problems (such as heart, liver, or kidney diseases)
  • Types of cancer treatments given in the past

Doctors take these factors into account, along with information published in medical journals and textbooks describing the outcomes of similar patients treated with chemo.

Determining chemotherapy doses

Most chemotherapy (chemo) drugs are strong medicines that have a fairly narrow range for dose safety and effectiveness. Taking too little of a drug will not treat the cancer well and taking too much may cause life-threatening side effects. For this reason, doctors must calculate chemo doses very precisely.

Depending on the drug(s) to be given, there are different ways to determine chemo doses. Most chemo drugs are measured in milligrams (mg).

The overall dose may be based on a person’s body weight in kilograms (1 kilogram is 2.2 pounds). For instance, if the standard dose of a drug is 10 milligrams per kilogram (10 mg/kg), a person weighing 110 pounds (50 kilograms) would get 500 mg (10 mg/kg x 50 kg).

Some chemo doses are determined based on body surface area (BSA), which are calculated using height and weight. BSA is expressed in meters squared (m2).

Because children’s bodies process drugs differently, dosages for children and adults differ, even after BSA is taken into account. Children may have different levels of sensitivity to the drugs, too. For the same reasons, dosages of some drugs may also be adjusted for people who:

  • Are elderly
  • Have poor nutritional status
  • Are obese
  • Have already taken or are currently taking other medicines
  • Have already had or are currently getting radiation therapy
  • Have low blood cell counts
  • Have liver or kidney diseases

Determining a chemotherapy schedule (cycle)

Chemotherapy is commonly given at regular intervals called cycles. A cycle may be a dose of one or more drugs followed by several days or weeks without treatment. This gives normal cells time to recover from drug side effects. Sometimes, doses may be given a certain number of days in a row, or every other day for several days, followed by a period of rest. Some drugs work best when given continuously over a set number of days.

Each drug is given on a schedule that makes the most of its anti-cancer actions and minimizes side effects. If more than one drug is used, the treatment plan will say how often and exactly when each drug should be given. The number of cycles given may be decided before treatment starts, based on the type and stage of cancer. In some cases, the number is flexible, and will take into account how the treatment affects the cancer and the person’s overall health.

Changing chemotherapy doses and schedules

In most cases, the most effective doses and schedules of drugs to treat specific cancers have been found by testing them in clinical trials. It’s important, when possible, to get the full course of chemo, the full dose, and keep the cycles on schedule. This gives a person the best chance of getting the maximum benefit from treatment.

There may be times, though, when serious side effects require adjusting the chemo plan (dose and/or schedule) to allow you time to recover. Sometimes, you might be given supportive medicines to help your body recover more quickly. Again, the key is to give enough chemo to kill the cancer cells without causing other serious problems.

10 thoughts on “Chemotherapy”

    1. Prostate Cancer – Prostate cancer is cancer that occurs in the prostate — a small walnut-shaped gland in men that produces the seminal fluid that nourishes and transports sperm.

      Prostate cancer is one of the most common types of cancer in men. Usually prostate cancer grows slowly and is initially confined to the prostate gland, where it may not cause serious harm. However, while some types of prostate cancer grow slowly and may need minimal or even no treatment, other types are aggressive and can spread quickly.

      Prostate cancer that’s detected early when it’s still confined to the prostate gland has a better chance of successful treatment.

      Survival Rate : The 5-year survival rate for most men with local or regional prostate cancer is nearly 100%. For men diagnosed with prostate cancer that has spread to other parts of the body, the 5-year survival rate is 30%.

    1. The decision on when to start chemotherapy is difficult and highly individualized based on several factors:

      What other treatment options or clinical trials are available.
      How well chemotherapy is likely to be tolerated.
      What prior therapies you have received.
      If radiation is needed prior to chemotherapy to relieve pain quickly.
      Often chemotherapy is given before pain starts, with the goal of preventing the cancer from spreading further to other sites. Discuss the use of chemotherapy with your medical oncologist early and often, and keep an open mind despite your concerns about chemotherapy’s “bad rap.” Docetaxel can extend life, reduce pain, and improve quality of life, but it does not cure prostate cancer. For this reason, clinical trials of docetaxel combinations and other promising therapies are a high priority for researchers.

      Many men who are suffering from their cancer will experience symptomatic improvement after starting chemotherapy. For example, pain is often reduced in men starting docetaxel, and quality of life is generally better for men with cancer-related symptoms who receive chemotherapy as compared with no therapy.

      Taxane Chemotherapy:Currently, taxane chemotherapy, given with prednisone, is the standard of care for men with metastatic prostate cancer that has spread and is progressing despite hormone therapy. Taxane chemotherapy agents approved for the treatment of advanced prostate cancer include docetaxel (Taxotere®) and cabazitaxel (Jevtana®).

      Taxane chemotherapy is also effective in prolonging life in patients who have a high burden of cancer on scans when starting hormonal therapy for the first time for metastatic disease.

      Platinum Chemotherapy :Platinum-based chemotherapy agents including carboplatin (Paraplatin®), cisplatin (Platinol®), and oxaliplatin (Eloxatin®), are used for the treatment of various cancer types. Platinum chemotherapy is not FDA approved for the treatment of prostate cancer; however, it is sometimes used in very advanced prostate cancer patients who have exhausted all other treatment options or in patients who have rare subtypes of prostate cancer. Patients with advanced disease who are not responding to standard therapy can talk with their doctor about whether they may be candidates for platinum chemotherapy.

    1. The use of high-energy radiation from x-rays, gamma rays, neutrons, protons, and other sources to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external-beam radiation therapy), or it may come from radioactive material placed in the body near cancer cells (internal radiation therapy or brachytherapy). Systemic radiation therapy uses a radioactive substance, such as a radiolabeled monoclonal antibody, that travels in the blood to tissues throughout the body. Also called irradiation and radiotherapy.

      Radiation Therapy to Treat Cancer cells :
      Radiation therapy (also called radiotherapy) is a cancer treatment that uses high doses of radiation to kill cancer cells and shrink tumors. At low doses, radiation is used in x-rays to see inside your body, as with x-rays of your teeth or broken bones.

      Types of Radiation Therapy
      There are two main types of radiation therapy, external beam and internal.

      The type of radiation therapy that you may have depends on many factors, including:

      The type of cancer
      The size of the tumor
      The tumor’s location in the body
      How close the tumor is to normal tissues that are sensitive to radiation
      Your general health and medical history
      Whether you will have other types of cancer treatment
      Other factors, such as your age and other medical conditions

      Cost of Radiation therapay depends on ,

      1) Type of Cancer
      2) Location of Cancer
      3) Current Stage of Cancer
      4) Patient’s current health condition, etc.

      Actual cost of Radiation therapy can be given only after Physical evaluation of the patient.

  1. How much does around of chemotherapy cost for ovarian cancer in Delhi?

    Who is the best doctor in Delhi for treatment?

    1. Ovarian cancer often goes undetected until it has spread within the pelvis and stomach. At this late stage, ovarian cancer is more difficult to treat and can be fatal.
      Ovarian cancer often has no symptoms in the early stages. Later stages are associated with symptoms, but they can be non-specific, such as loss of appetite and weight loss.
      Surgery and chemotherapy are generally used to treat ovarian cancer.

      Best 5 Oncologist in Delhi :

      1. Dr. Vikas Goswami
      MBBS, MD – General Medicine, DNB – Medical Oncology
      Senior Consultant – Medical Oncology – 18 Years of Experience

      With 18 years of experience in Medical Oncology, he has earned reputation nationally and internationally given to his individualized clinical and ethical approach. Dr. Vikas Goswami is a graduate from one of the prestigious Medical institutes of the country Maulana Azad Medical College, New Delhi. Afterwards, he pursued his training in Internal Medicine from the renowned and well-facilitated, Gandhi Medical College in Bhopal.

      He also holds the prestigious ECMO certification issued by the “European Society of Medical Oncologists” as well. In his long career of medical oncology, he has earned reputation and trust of his patients and colleagues. Dr. Vikas Goswami, with 8 years of experience, aims to help his patients to recover physically as well as emotionally and does not just focus on the removal of the tumor(cancer) from the body. Dr. Vikas Goswami is one of the best oncologist in India who along with his team of skilled and well-trained cancer specialists believes that educating patients about cancer and its treatments is the first step to prevent and cure cancer. He is an accomplished speaker and has imparted his deep knowledge in the field of oncology in the form of paper presentations in National & International conferences and workshops.

      Hospital : Max Healthcare Delhi

      2. Dr. Amit Agarwal
      MBBS, MD – Medicine, DM – Oncology
      Medical Oncologist, 27 Years Experience

      Dr. Amit Agarwal is an experienced Oncologist in Rajender Nagar, Delhi. He has had many happy patients in his 25 years of journey as a Oncologist. He has completed MBBS, MD – Medicine , DM – Oncology. He is currently practising at Dr. Amit Agarwal@ExpertChikitsa:disqus
      BLK Super Speciality Hospital in Rajender Nagar, Delhi

      Experience
      Working as a Director & HOD in Medical Oncology Department at BLK Super Speciality Hospital, New Delhi

      Previous Experience

      Sr. Consultant – International Oncology & Fortis Hospital
      Sr. Consultant – Batra Hospital and Medical Research centre
      LAS Oncology – Mount Vernon Hospital, Hertfordshire
      Clinical Fellow Oncology – Addenbrookes NHS Trust, Cambridge, UK
      Clinical attachment, Oncology – Churchill and Radcliff Hospital, Oxford
      Specialist Oncology – Royal Hospital, Sultanate of Oman

      Hospital : BLK Super Speciality Hospital in Rajender Nagar, Delhi

      3. Dr. Sunil Kumar Gupta has over 20 years of rich professional experience in his field and currently serves as Director & Head of the department of Medical Oncology in Fortis Hospital, Shalimar Bagh. Dr. Sunil Kumar Gupta’s primary areas of interest lies in treatment of breast & lung cancers, gastrointestinal malignancies, genito-urinary malignancies, lymphoma and multiple myeloma. He has authored and published several scientific papers i n India and abroad and is an executive member of several medical fraternities. He has been treating all stages of solid tumors and hematological malignancies, performing peripheral stem cell transplant, autologous and allogenic bone marrow transplant, high dose chemotherapy with growth factor support and regional chemotheraphy

      Award & Recognization
      Excellence award for outstanding contribution towards cancer research by Eli Lily and Company
      Best Poster award at first Asia Pacific meeting on Lung Cancer in Thaliland
      Best Medical Oncologist award by Medgate

      Hospital :

    1. Chemotherapy, or ‘chemo’, is the most common form of cancer treatment. Chemo uses drugs called cytotoxics to kill or slow the growth of cancer cells. The thing is, while chemotherapy drugs can stop cancer cells growing and multiplying, they also affect normal, healthy cells in the process.

      Chemotherapy is often used in combination with other therapies, such as surgery, radiation, or hormone therapy.

      This depends on:

      the stage and type of cancer you have
      your overall health
      previous cancer treatments you’ve had
      the location of the cancer cells
      your personal treatment preferences

      Chemotherapy is primarily used to:

      lower the total number of cancer cells in your body
      reduce the likelihood of cancer spreading
      shrink tumor size
      reduce current symptoms

      Cost of Chemotherapy depends on ,
      1) Type of Cancer
      2) Location of Cancer
      3) Current Stage of Cancer
      4) Patient’s current health condition, etc.

      Actual cost of Chemotherapy can be given only after Physical evaluation.

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