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PicoMed Chemotherapy Elimination!
Chemotherapy: How It Works and How You'll Feel
What is chemotherapy?
Also called “chemo,” it’s a way to treat cancer that uses drugs to kill cancer cells.
How does chemotherapy work?
It targets cells that grow and divide quickly, as cancercells do. Unlike radiation or surgery, which target specific areas, chemo can work
throughout your body. But it can also affect some fast-growing healthy cells, like those of the skin, hair, intestines, and bone marrow.
That’s what causes some of the side effects from the treatment.
What does chemotherapy do?
It depends on the kind of cancer you have and how far along it is.
Cure: In some cases, the treatment can destroy cancer cells to the point that your doctor can no longer detect them in your body. After
that, the best outcome is that they never grow back again, but that doesn’t always happen.
Control: In some cases, it may only be able to keep cancer from spreading to other parts of your body or slow the growth of cancer tumors.
Ease symptoms: In some cases, chemotherapy can’t cure or control the spread of cancer and is simply used to shrink tumors that cause pain
or pressure. These tumors often continue to grow back.
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How is chemotherapy used?
Sometimes, it treats cancer by itself, but more often it’s used in combination with:
Surgery: A doctor removes cancerous tumors or tissue, or organs contaminated with cancerous cells.
Radiation therapy: A doctor uses invisible radioactive particles to kill cancer cells. It may be delivered by a special machine that
bombards parts of your body from the outside, or by putting radioactive material on, near, and even inside your body.
Biological therapy: Living material in the form of bacteria, vaccines, or antibodies are carefully introduced to kill cancer cells.
Chemotherapy may be used to:
Shrink a tumor before radiation therapy or surgery -- called neoadjuvant chemotherapy
Destroy any remaining cancer cells after surgery or radiation therapy -- called adjuvant chemotherapy
Make other therapies (biological or radiation) more effective
Destroy cancer cells that return or spread to other parts of your body
How long does chemotherapy last?
That depends on:
The type of cancer you have
How far along it is
The goal of treatment: cure, control growth, or ease pain
The type of chemotherapy
The way your body responds to the treatment
You may have chemotherapy in “cycles,” which means a period of treatment and then a period of rest. For example, a 4-week cycle may be
1 week of treatment and then 3 weeks of rest. The rest allows your body to make new healthy cells. Once a cycle has been planned out,
it’s better not to skip a treatment, but your doctor may suggest it if side effects are serious. Then your medical team will likely
plan a new cycle to help you get back on track.
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How Well Are You Living With AS?
Take this WebMD assessment to get tips to manage your disease and live with less pain and fatigue.
How is chemotherapy given?
Injection: The drugs are delivered with a shot directly into muscle in your hip, thigh, or arm, or in the fatty part of your arm,
leg, or stomach, just beneath the skin.
Intra-arterial (IA): The drugs go directly into the artery that is feeding the cancer, through a needle, or soft, thin tube (catheter).
Intraperitoneal (IP): The drugs are delivered to the peritoneal cavity, which contains organs such as your liver, intestines, stomach,
and ovaries. It is done during surgery or through a tube with a special port that is put in by your doctor.
Intrathecal (IT) chemotherapy: Medicine is injected into the cerebrospinal fluid (CSF), which is found in the area surrounding the
spinal cord and the brain.
Intravenous (IV): The chemotherapy goes directly into a vein.
Topical: You rub the drugs in a cream form onto your skin.
Oral: You swallow a pill or liquid that has the drugs.
How does intravenous (IV) delivery work in chemotherapy?
Needle: Drugs may be sent through a thin needle in a vein on your hand or lower arm. Your nurse inserts the needle and removes it when
treatment is done. Tell your doctor right away if you feel pain or burning during treatment.
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Catheter: It’s a soft, thin tube. Your doctor puts one end into a large vein, often in your chest area. The other end stays outside
your body and is used to deliver chemotherapy or other drugs, or to draw blood. It usually stays in place until all your treatment
cycles are finished. Watch for signs of infection around your catheter.
Port: It’s a small disc that a surgeon places under your skin. It’s linked to a tube (catheter) that connects to a large vein,
usually in your chest. A nurse may insert a needle into your port to give you chemotherapy drugs or draw blood. The needle can
be left in place for treatments that last more than a day. Tell your doctor if you notice any signs of infection around your port.
Pump: Often attached to catheters or ports, it controls the amount of chemotherapy drugs, and how fast they get into your body.
You may carry this pump with you, or a surgeon may place it under your skin.
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How will I feel during chemotherapy?
There’s no way to know for sure. It depends on your overall health, the type of cancer you have, how far along it is,
and the amount and type of chemotherapy drugs. Your genes may also play a part.
It’s common to feel ill or very tired after chemotherapy. You can prepare for this by getting someone to drive you back
and forth from treatment. You should also plan to rest on the day of and the day after treatment. During this time, it
may help to get some help with meals and child care, if necessary. Your doctor may be able to help you manage some of
the more severe side effects of chemotherapy.
Can I work during chemotherapy?
It depends on the work that you do and on how you feel. On days you don’t feel well, you may want to see if you can work
fewer hours or work from home. In some cases, employers are required by law to adjust your schedule when you have cancer
treatment. A social worker may be able to help you learn about what the law allows.
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How much does chemotherapy cost?
It depends on the type of chemotherapy, how much you get, and how often you get it. It also depends on where you live, and
whether you get treatment at home, in an office clinic, or during a hospital stay. Make sure to read your health insurance
policy to find out exactly what it will and won’t pay for, and whether you can go to a doctor that you choose for your chemotherapy treatment.
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Tuesday, August 20, 2019 - 04:05 pm
Cancer Research & News
Learning the difference between chemotherapy, immunotherapy and targeted therapy
Until the 1960s, surgery and radiation were the mainstays of cancer treatment; drugs were not seen as a “cure” for cancer. With the exception of hormone therapy for men with prostate cancer in the late 1930s, drug therapies, at best, offered brief, incomplete remission. Then, the National Cancer Act of 1937 provided support for cancer research, setting up the National Cancer Institute (NCI), and doctors and researchers began to pay more attention to using chemical agents and drugs against cancer. The first breakthroughs came in the 1960s and early 1970s, when chemotherapies successfully treated adults with advanced Hodgkin lymphoma and children with leukemia. Today, more than 500 drugs are approved in the U.S. to treat cancer. Most of these fall into three main categories — chemotherapy, immunotherapy and targeted therapy — and work against cancer in different ways.
Chemotherapy Attacks Cancer Cells
Chemotherapy drugs kill cancer cells by stopping them from growing and multiplying. If the cells can’t grow and multiply, they usually die. Some chemotherapy drugs work during a specific stage of the cell cycle. One of the reasons chemotherapy is given in treatment cycles is to deliver drugs when they will be the most effective. Treatment periods are often alternated with rest periods to allow your body time to get stronger before the next round or “cycle” of chemotherapy.
Chemotherapy drugs attack cells that grow and replicate quickly, like most cancer cells. The bad news is that some normal cells (such as blood cells and cells in the hair follicles and lining of the digestive tract) also replicate quickly and are attacked. The effect on these normal cells cause many of the side effects commonly associated with chemotherapy — hair loss, nausea, vomiting, diarrhea, and low blood-cell counts that lead to increased infection risk, fatigue and bleeding. The good news is that the healthy cells usually repair themselves after chemotherapy has ended.
Examples of Chemotherapy
Alkylating agents: busulfan, procarbazine, carmustine, carboplatin, and cisplatin
Plant Alkaloids: vincristine, paclitaxel, docetaxel, etoposide, and irinotecan
Antitumor antibodies: doxorubicin, idarubicin, mitomycin, and bleomycin
Antimetabolites: methotrexate (MTX), gemcitabine, cytarabine, 5-fluorouracil (5-FU), and capecitabine
Topoisomerase inhibitors: irinotecan, topotecan, and amsacrine
Miscellaneous: hydroxyurea, mitotane, estramustine, bexarotene, and tretinoin (ATRA)
Side effects will depend on your health before treatment, your type of cancer, and the type and dose of the drugs. Chemotherapy can cause nausea, diarrhea, fatigue, increased risk for bleeding and infection, hair thinning or loss, mouth sores, constipation, taste changes, loss of appetite, and nerve and skin problems.
Immunotherapy Mounts Your Defenses
Your immune system involves the many organs and tissues of the lymphatic system and several types of white blood cells. Normally, your immune system attacks foreign invaders — including abnormal cells — but cancer cells are sneaky and can “hide” from the immune system, avoiding detection.
Immunotherapy (also called biotherapy) uses drugs that go after the ability of cancer cells to hide from your immune system. Some immunotherapy drugs mark the cancer cells, allowing the immune system to find and destroy them. Other immunotherapies boost your immune system to work better against cancer.
Types of Immunotherapies
Checkpoint inhibitors don’t target the tumor directly but interfere with the ability of cancer cells to avoid an attack by the immune system by releasing the “brakes” that keep T-cells (a type of white blood cell) from killing the cancer cells. Examples include Keytruda® (pembrolizumab) and Opdivo® (nivolumab).
Adoptive cell therapy aims to boost the natural ability of your T-cells to fight cancer. We take T-cells from your tumor and test them. The T-cells most active against your cancer are grown in a laboratory and multiplied in large numbers, a process that takes two to eight weeks. During this time, you may have chemotherapy and/or radiation therapy to reduce the number of immune cells in your body. After these treatments, the multitudes of laboratory-grown T-cells are given back to you through an intravenous (IV) line to attack the cancer cells. Examples include Kymriah® (tisagenlecleucel) and Yescarta™ (axicabtagene ciloleucel).
Monoclonal antibodies are immune system proteins made in a laboratory and designed to attach to specific targets found on cancer cells. Some monoclonal antibodies mark cancer cells so the immune system can detect and attack them. (Other monoclonal antibodies work differently and are considered targeted therapy.) Examples include Erbitux® (cetuximab) and Herceptin® (trastuzumab).
Treatment vaccines work against cancer by boosting your immune system’s response to cancer cells. Treatment vaccines are different from the vaccines that help prevent disease. An example is Provenge® (sipuleucel-T).
Side effects may include skin reactions or problems, flu-like symptoms (aches, fever), diarrhea, fatigue, risk of infection, and inflammation.
Targeted Therapy Blocks Cancer Growth
This class of drugs works by interfering with certain molecules or “targets” that are key to the cancer cells’ ability to grow and spread. Where chemotherapy drugs aim to kill cancer cells directly, targeted therapies focus on blocking the cancer cells’ growth, with less harm to normal cells.
Most targeted therapies are either monoclonal antibodies, which attach to proteins on the outside of the cancer cell, or small molecules, which target specific proteins inside the cancer cells. Researchers continually look for new “targets” for these therapies, including:
abnormalities in the chromosomes of the cancer cells that are not present in normal cells
cancer cells that make proteins that instruct the cancer to progress
specific proteins that are present in cancer cells but not in normal cells, or are found in higher amounts in cancer cells than in normal cells.
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Types of Targeted Therapies
Hormone therapies slow or stop the growth of cancers that need those hormones to grow. Examples include Arimidex® (anastrozole) and Lupron® (leuprolide).
Angiogenesis inhibitors stop the tumor from growing the new blood vessels it needs for continued growth. Examples include Avastin® (bevacizumab) and Zaltrap® (ziv-aflibercept).
Signal transduction inhibitors block signals from one molecule to another inside a cell, such as the signal for the cell to grow and divide. Examples include Herceptin® (trastuzumab) and Gleevac® (imatinib).
Apoptosis inducers make cancer cells vulnerable to the normal cell process called apoptosis, which directs old cells to die. Examples include Velcade® (bortezomib) and Lynparza™ (olaparib).
Targeted therapies do have some limitations. The cancer can become resistant and the drugs no longer have the desired effect. To get around this — or delay it as long as possible — targeted therapies are often given in combinations. Side effects of targeted therapies include diarrhea, high blood pressure, skin rashes and problems with liver function, wound healing and blood clotting.
Drug therapies are part of the treatment plan for many patients to cure cancer, keep the cancer in check, relieve symptoms and improve the quality of life. If you have questions, please talk to your oncologist or your clinical pharmacist.