Chemotherapy

Chemotherapy

Summary

·         Chemotherapy means treatment with anti-cancer drugs

·         Using chemotherapy as part of cancer control can help some patients

·         The side effects and risks should be understood before starting

How does this work?

Most chemotherapy drugs are cancer cell poisons.  The aim is to kill as many cancer cells as possible.  The higher the proportion of the cancer cells that are killed, the more the cancer is set back. 

Unfortunately, most of these drugs have quite strong side effects and these need to be weighed up when thinking about chemotherapy.

Before you start chemotherapy you should be informed by your doctor what is the chance that the chemotherapy will help you.  Usually this is not 100%. 

In most people, some of the cancer cells will be resistant to the chemotherapy drugs and will survive the treatment.  There are various ways the cells can evade the effects of the drugs and be resistant.

What are the benefits?

By killing cancer cells, the tumours are reduced in size.  This can lead to less symptoms from the cancer, at least for a while, and possibly longer survival.

What is the evidence?

All chemotherapy drugs are carefully tested in clinical trials before they are licenced and approved for use as standard therapies for people with cancer.  It is obviously beyond what we can do in PlanBe to go through each drug and what it can do for each cancer, this is something your doctor will do if they think chemotherapy could help you.

Who would this be good for?

Chemotherapy is an “all-over” type of treatment for cancer.  The chemotherapy drugs are absorbed into the blood stream which takes the drugs to all parts of the body.  Chemotherapy is therefore usually considered for people where the cancer has spread from the primary site to other sites in the body.

Your oncologist will give you advice on whether there are chemotherapy drugs that have a known effect for your cancer.

In order to have chemotherapy, you need to be well enough and strong enough to cope with the side effects.  This is another factor your oncologist will take into account.  If you want to have a chemotherapy, the more you can improve your general health before you start, the better.  Ideally, you need to continue to maintain your health during your treatment too.  Choosing other elements from the other domains in PlanBe (Body, Diet, Spirit / Mind, Complementary Therapies, and Resilience) are all important in making sure you are as fit as possible if you are going to have chemotherapy and will also help you recover once your chemotherapy is finished.

Who should be careful?

Not everybody chooses to have chemotherapy after a diagnosis of advanced stage cancer. 

In some cases, none of the drugs have shown any benefit in which case treatment is only going to give side effects without helping.  For other patients, the balance between the pros and cons may not be enough for them to embark on this treatment. 

Committing to have chemotherapy can take up quite a lot of time, with many hospital appointments – this may not be top of the priority list for every patient. 

If you think you may not want to have chemotherapy, don’t hesitate to discuss this with your doctor and or nurse, they will want to help you make the decision that is best for you.

Myth busting

Preparation and Self-Assessment

If you decide you are going to have chemotherapy then it is likely you will have a little time to get yourself ready. 

Your doctor will probably give you quite a lot of information about the treatment, how it is given, how frequently, for how long, what side-effects you can expect, and what additional medication you will be given to help with side effects.  It may seem a lot to have to absorb but don’t worry, you needn’t remember it all at once, and you will be given a leaflet explaining everything so you can read it later and discuss it with those closest to you.  Try to get the basics clear in your mind and if you have questions, write them down and bring them the next time you go to see your doctor.

If you have time, try to improve your general fitness as much as you can before you start treatment.  You can use the suggestions in PlanBe to help you.  Try to take some regular physical activity (see Body domain); review your diet and see if it can be improved (see Diet domain); think about what you can do to help reduce stress and anxiety (see Spirit / Mind domain); are there some complementary therapies you could choose to help you with side effects or to help keep calm (see Complementary Therapies domain); review the elements in the Resilience domain too.  Let your doctor know what you choose for your self-care alongside your chemotherapy.

Local Resources

If you haven’t already done so, this would be a good time to see your GP.  You may think that having chemotherapy is simply about the treatment you have at the hospital but your GP is an essential part of the package: they are responsible for the community side of your health care and there may be many things they can do to help support you through your chemotherapy.  This can include: providing repeat prescriptions, checking if you should have the flu vaccine, providing sick notes if you need them etc. etc.

Gadgets and Apps

Method / Planning what to do

Setting personal goals

Evaluating your progress

Further Reading