Chemotherapy

Chemotherapy is a type of drug treatment that kills cancer cells, controls their growth or relieves disease-related symptoms. It may involve a single drug or a combination of two or more drugs, depending on the type of cancer and how fast it is growing.

Chemotherapy can be used as a stand-alone treatment for specific cancers or stages of disease. It can also be given with other treatments, like targeted therapy and radiation therapy.

Patients also can get chemotherapy to shrink tumors before surgery (called neoadjuvant therapy). It may also be used after surgery to eliminate any remaining cancer cells (adjuvant therapy).

Types of chemotherapy

Chemotherapy is administered in several ways:

• Intravenous (IV) is the most common method. A needle is inserted into a vein and attached with tubing to a plastic bag holding the drug.

Some IV chemotherapy requires a catheter, a tube that connects directly to a large vein and is left in place throughout treatment. Patients may choose to have a catheter inserted to avoid frequent needle sticks. Patients with a catheter may have an IV connection device called a port implanted under the skin.

• Oral chemotherapy drugs are taken by mouth, either in pill or liquid form.
• Injections are administered into the muscle, under the skin, or directly into a tumor, depending on the type or location of the cancer.
• Intrathecal chemotherapy is delivered directly into the cerebrospinal fluid, a liquid that surrounds and protects the brain and spinal cord. It is typically delivered with an injection between two vertebrae. Intrathecal chemotherapy is used to treat patients with evidence of cancer in the cerebrospinal fluid. It is also used as a preventive treatment for patients with cancers that have a high risk of spreading to the central nervous system, such as leukemia and lymphoma.
• Isolated limb perfusion is a way to deliver chemotherapy directly to tumors in the arm or leg. The blood supply of the affected limb is isolated from the rest of the body. Heated chemotherapy drugs are then pumped into the treatment area through tubes inserted into tiny incisions. Isolated limb perfusion is used to treat advanced or metastatic melanoma and some sarcomas.
• Hepatic arterial infusion is a method of delivering chemotherapy directly to tumors in the liver. It is typically used to treat cancers that have metastasized, or spread, to this organ. A tiny pump is surgically inserted under the skin and connected to the hepatic artery, which supplies blood to the liver.
• Topical chemotherapy delivers the drug as a cream applied to the skin. It is used to treat skin cancer.

Side Effects of Chemotherapy

The side effects of chemotherapy depend on the specific drug or drugs that a patient receives. The duration and severity of chemotherapy side effects differ from patient to patient. Most are temporary and will disappear once treatment has ended.