CHEMOTHERAPY
The best cancer therapy is the combination
of surgery, radiation and medicine with the aim of ensuring the
patient's recovery, preventing the return of the disease and increasing
the patient's life expectancy and quality of life.
Cancer therapies by surgery and
by surgery followed by radiation are already well-known, but people
do not really understand cancer therapy by chemotherapy. Therefore,
the chemotherapy team at Bangkok Pattaya Hospital would like to
present some information about this form of treatment.
1. WHAT IS CHEMOTHERAPY?
Chemotherapy is a treatment by medication
which destroys and stops the growth and spread of cancer cells,
but might also affect normal cells. The medication might be
a single medicine or a combination of several, depending on
the type and advancement of the disease.
2. HOW MANY METHODS OF ADMINISTERING
CHEMOTHERAPY?
2.1. By mouth
2.2 By injection – there are several methods:
a)
muscular injection
b)
intravenous injection, either directly or dilute chemotherapy
with a normal saline drip in to the vein
c)
injection in to artery that holds cancer mass
d)
epidural injection for some cancers
e)
direct injection to the cancer mass
3. DOES CHEMOTHERAPY DESTROY
OR AFFECT NORMAL CELLS?
It will affect only the normal cells that are divided. These
include bone marrow cells, parts of the digestive system, blood
and the root and pores of the hair. The doctor will take great
care to prescribe medication that will not destroy normal cells
unnecessarily, but normal cells will recover in time.
4. WHAT PREVENTION MEASURES ARE TAKEN TO PREVENT POISONING
OR OTHER SIDE EFFECTS?
There are many methods, all well-tried and established.
4.1 The doctor will select suitable medication for each individual
patient
4.2 Anti-nausea medication is successful in 80 – 90% of cases
4.3 At present there are developments towards stimulants to retain
the condition and normal
function of bone marrow cells, white blood cells,
ovalocyte and platelets.
• There are also developments
in creating a medication that would prevent normal cells from
being poisoned or otherwise affected by the chemotherapy.
• There are now much better
treatments to relieve or decrease the various side-effects.
5. HOW MANY CHEMOTHERAPY SESSIONS WILL I NEED?
In general, you will require at least 2 – 3
sessions. The number of treatments and the medication for each
individual will be different. The doctor will set out a therapy
plan according to the type of cancer you have and how long you
have had it. It is important that you keep every appointment with
the doctor so that your response to the treatment can be recorded,
your medication adjusted, if necessary, and checks made to ensure
that your general health is strong enough to take the medication.
It would be better to postpone the start of
treatment than to miss an appointment or session. YOU MUST NOT
STOP THE THERAPY BY YOURSELF. 6. WHAT ARE THE SIDE EFFECTS OF CHEMOTHERAPY AND HOW
CAN THEY BE REDUCED?
Chemotherapy medication causes various side
effects which may affect the oesophagus and mouth, bone marrow,
hair, skin, blood system, urinary system, nervous system, muscles
and the emotions of the patient. No two people react the same
and side effects will be different according to the toxicity and
dosage of the medication.
Always remember that the side effects
are only temporary and will slowly disappear after the end of
the chemotherapy treatment. 6.1 Nausea and Vomiting
Chemotherapy medication can affect the oesophagus
and nerves that control vomiting. Whilst this more or less depends
on the type and quality of the medication, as well as the patient's
condition, the doctor will normally prescribe anti-nausea medication
to all patients. If symptoms persist, tell the doctor so that
he can prescribe a different anti-nausea medication, if required.
Sometimes it helps to eat small meals at frequent
intervals, to chew slowly and to avoid fried, oily, very sweet
and strong-smelling food.
After stopping chemotherapy, the nausea
should disappear. 6.2
Urinary System
Some chemotherapy medication affects the kidneys
and urinary system, resulting in pain, frequency in urinating,
blood in urine or fever. If you get any of these symptoms you
must inform the doctor. It is advisable to drink at least 8-10
glasses of clean water per day, especially on treatment days.
You can of course drink fruit juice, weak tea, ice cream, soup,
soda, ice lollies or jelly. Alcohol should be avoided .
6.3
Diarrhoea or Constipation
Inform the doctor immediately if you have diarrhoea
as a side effect of the medication. Eat frequent small meals,
avoid drinking fresh milk and eating high fibre foods like fruit
and vegetables.
drink a lot of water . Exercise may also
help.
6.4 Mouth Infection
The lips and mouth membrane could become dry or pale. There could
be bleeding, redness or pain. Take extra care with mouth hygiene
and rinse the mouth with warm salted water. Try not to use cheap
mouthwashes as they are alcohol-based. Use a soft toothbrush and
gentle toothpaste. If the mouth is sore or painful eat soft, tasteless
food and wipe the mouth with cream or wax to prevent dryness.
6.5 Anorexia and Weakness
Chemotherapy can result in eating problems if it is difficult
to chew, food tastes “different”, or food is not absorbed properly
by the body. Taking the correct portion of food is important but
sometimes the patient is unable to eat properly. It is better
to eat as much as possible on the days when you feel well but
on difficult days keep trying to eat small portions. Exercise
might help or try sipping beer or wine before eating (By doctor's
agreement)
6.5 Hair loss
Hair loss is most probable, depending on the
medication. The head, eyebrows and underarms could all be affected.
New hair will grow after the end of chemotherapy. During treatment
you should use a gentle shampoo and a soft hairbrush. Shampoo
with cool water and avoid using a hairdryer. It may help to have
your hair cut short and to wear a hat or turban when out-of-doors.
A wig might be a consideration.
6.6 Neurology System and Muscles
Some chemotherapy medication causes numbness in the fingers,
weakened muscles or deafening noises in the ear. You must inform
the doctor if you get any of these symptoms so that the medication
can be adjusted or changed.
6.7 Reproduction System
For women, the medication could cause irregular or cessation
of periods. For men, it may cause temporary infertility. These
symptoms should disappear 18-24 months after the cessation of
the treatment. There is no need to stop sexual intercourse, provided
the spouse has no infection, but sex should be avoided for 2 weeks
after any vaginal bleeding. It is advisable to discuss contraception
with the doctor who is treating you as the medication could be
harmful to an unborn baby.
6.8 Immune System
Chemotherapy medication may cause less or low white blood cells,
ovalocyte and blood platelets.
Fewer white blood cells increase the risk of
infection, as the immune system becomes less effective. Take extra
effort with your personal hygiene and avoid contact with anyone
suffering from infectious illnesses such as measles, colds and
flu and chicken pox. Stay away from crowded places. Any symptoms,
such as fever, cough or pain on passing water, should be reported
to the doctor.
Less ovalocyte results in paleness, weakness and tiredness. You
will need to take plenty of rest. The doctor may recommend a blood
transfusion.
Fewer blood platelets result in easy bleeding that is difficult
to stop. There may be a rash. Take care when using knives or other
sharp objects. Do not take any medicine by yourself, especially
aspirin. Use a soft toothbrush and avoid tooth picking. Do not
strain if you are constipated. The doctor will give platelet replacement
if your level is too low.
6.9
Effect on Emotions.
You have to be strong and very patient during chemotherapy treatment.
If you become depressed or anxious you should talk to a good friend
or someone close to you. Your doctor or nurse may be able to help
you overcome your concerns. 7. PREPARING FOR TREATMENT
7.1 Nourish your body by eating valuable foods
such as meat, milk, fruit and vegetables. Eat soft tasty food
that is easily digestible. Drink a lot of water – not less than
2-3 litres a day.
7.2 Take plenty of rest and keep the mind calm.
7.3 Go to the dentist for treatment before you start chemotherapy
so that any decayed teeth or gumboils can be treated. During chemotherapy
the dentist needs to check the platelet level before he can carry
out any dentistry.
7.4 Have blood tests to check that the body is ready to take
the treatment
7.5 Inform the doctor of any medication, such as antibiotics,
you are already taking, as some medicines affect the ones used
for cancer therapy
7.6 About 2-3 hours before a chemotherapy session you should
only eat soft food to reduce the likelihood of nausea and vomiting.
7.7 If you are having intravenous treatment, lay down in the
most comfortable position. Do not move or lift up the arm that
is receiving the injection, as the medication could spill out.
Do not open, close or adjust the rate of drip yourself. If the
liquid seems too fast or the input area swells, inform the doctor
immediately.
7.8 Do inform the doctor of any side effects. He will make an
appointment for blood tests 2 weeks after the treatment session
to check on the white blood cells, the ovalocyte and the blood
platelets. Liver and kidney function will be checked as well as
the mineral levels in the body. The blood test will help the doctor
determine the effectiveness of the medication and whether the
patient can tolerate the treatment.
7.9 Take the medication regularly, in accordance with the doctor's
instructions.
7.10 Keep all your appointments
for treatment
7.11 Should there be any abnormal
symptoms, such as fever, cold, bleeding, diarrhoea or excessive
vomiting, go to the hospital immediately. You do not need to
wait for the next appointment date. The use of chemotherapy medication is most advantageous
to the cancer patient if used correctly in line with the principle
of cancer therapy by medicine. If the patient does not understand
or co-operate for the treatment, then failure may occur and
the chance of recovery may be lost.
Therefore, the patient, relative or superintendent, needs
to have a proper understanding of cancer therapy by medicine,
the type of medication being administered and the possible side
effects. This will enable them to discuss matters with the doctor
at any time.
We hope that this information will be useful in helping
Cancer Therapy by Medicine meet with its objective: “Recover
from cancer, have long life and good quality of life” |
