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Frequently Asked Questions About Chemotherapy
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What is chemotherapy?
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Chemotherapy involves the utilization of a variety of medications that can be given either
orally or intravenously. The purpose of the chemotherapy is to either treat existing
malignancy or hopefully prevent a malignancy from recurring. Chemotherapy is
administered with different schedules and methodologies, depending upon the malignancy
being treated and the types of drugs being given. Each of these different regimens can be
associated with it's own set of side effects and toxicities.
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Why do I need chemotherapy?
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It would be more accurate if surgeons would say they have removed "all visible or
detectable cancer". However, we know from experience that in some cases residual microscopic cancer may be present. The purpose of giving chemotherapy in many cases is to attempt to eradicate malignancy that we can't see.
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How does chemotherapy work?
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Different drugs work by different mechanisms, but underlying all the activity of the chemotherapy drugs is some propensity for the drug to interfere either with the growth or life cycle of the malignant cells. Chemotherapy drugs are selected which are more selective for cancer cells than for normal cells.
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If I receive chemotherapy, will I be free of cancer for the rest of my life?
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Unfortunately, there is no guarantee that chemotherapy will always prevent the regrowth of cancer. In fact, in some instances, we unfortunately see late cancers develop as a consequence of chemotherapy. However, for many cancers, once you have been cancer-free for five years, the likelihood of a relapse becomes significantly smaller.
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How is chemotherapy administered?
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Chemotherapy can be administered by a variety of routes. For most intense regimens, the medications are given intravenously. However, some chemotherapy drugs are very effective when given by intramuscular injection or orally in the form of pills or capsules. In rare, circumstances, the chemotherapy may be administered directly into a body cavity, such as the lung or abdominal cavities.
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Do I have to go to the hospital to receive chemotherapy?
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No, most chemotherapy regimens are given as an outpatient. There are selective programs that do require hospitalization because of the intensity of the treatment programs or because of co-existing risk factors, such as heart, renal, or lung disease that may make outpatient therapy too risky.
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Will chemotherapy make me sick?
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Reactions to chemotherapy are dependent upon two primary factors. One depends upon the individual sensitivity of the individual patient. The other factor is the type of drug being given. For the most part, the majority of chemotherapy infusions and treatments are accomplished with very little, if any, patient discomfort. Fortunately, there are very effective medications available to diminish the chances of developing nausea or vomiting, which have commonly been associated with chemotherapy.
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Will I lose my hair?
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Hair loss associated with chemotherapy is entirely dependent upon the individual medication. Your doctor and nurse will discuss with you the possibilities of hair loss.
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How long does chemotherapy treatment take?
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Chemotherapy treatments can last just a few minutes or as long as a week. However, most of the outpatient chemotherapy regimens are accomplished within a few hours.
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Can I continue to take my vitamins, herbs and medicines prescribed by other doctors?
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Your physician will review your medications and make sure there are no problems related to conflicting drugs. For the most part, you should continue with your regularly prescribed medicines, but this needs to be discussed with each patient on a case-by-case basis.
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Can I start or continue to exercise while receiving chemotherapy?
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Patients are encouraged to continue to engage in active physical exercise and pursue their normal lifestyle as much as their disease and symptoms will allow. If any restrictions on exercise, diet, or other activities are necessary, these will be discussed with you on an individual basis.
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How do I know if the chemotherapy treatments are working?
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Response to treatment is generally measured by improvement in either measurable tumor masses or by improvement in blood tumor markers. Obviously, each patient is going to differ in how their response to treatment will be measured, but for the most part this is accomplished by follow-up blood tests, x-rays, and scans.
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Can I be with people who are ill while I am receiving chemotherapy?
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In general, it is best to avoid anyone who has an obvious illness, especially any respiratory infections such as a cold or influenza. At times you may have a very low resistance to infection, and staying away from large crowds of people will be recommended.
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Should I be on a special diet?
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Generally speaking, there are no special dietary requirements while undergoing chemotherapy. However, if your white count becomes low, your physician may recommend that you avoid raw foods, such as salads, that could be contaminated with bacteria.
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Will chemotherapy interfere with my dental treatments?
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For the most part, all elective dental procedures are best postponed until the chemotherapy is completed. However, if dental work needs to be accomplished, this should be discussed with your doctor concerning the optimum timing of the dental procedures.
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My friends tell me that chemotherapy will make me very tired and that foods will taste terrible. Is this true?
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It is true that during the course of chemotherapy some patients will experience the onset of fatigue. This generally occurs after multiple treatments rather than after the first one, and is more of a cumulative effect. However, many patients will not experience any fatigue at all. Also, many of the malignancies that are being treated by themselves cause fatigue. It is common to have alteration of taste while undergoing chemotherapy and many patients feel their food takes on a "metallic" taste. This, again, is dependent upon the drugs being administered and individual patient idiosyncrasies. If this does occur, it is a reversible process and recovers once chemotherapy is suspended.
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Will I be able to have a baby during or after chemotherapy treatment?
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It is a general recommendation that women not become pregnant during the period of receiving active chemotherapy. This is also true for many hormonal manipulations done for breast cancer. Be sure to discuss this very important issue with your oncologist.
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Is it safe to have sex during treatment?
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Unless special circumstances are present, it is completely possible to have a healthy and normal sex life while receiving chemotherapy. However, there may be special circumstances where your oncologist may recommend that intimacy would be best postponed until the clinical situation has improved.
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Can I safely use alternative therapies while undergoing chemotherapy?
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Alternative therapies are generally untested and unproven, and their effect when mixed with chemotherapy is not really known or understood. While it is probable that alternative therapies will not interfere with treatment, that is not a known fact. Alternative therapies are not given in standardized fashion and the toxicities and problems associated with concurrent chemotherapy have not been defined. For the most part, the oncologist would prefer that you do not take alternative substances, but certainly many patients do, and if this is the situation in your case, be sure to notify your physician of the fact that you are taking alternative medications.
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