How chemotherapy works-How does chemotherapy works

Chemotherapy drugs are generally divided into two groups: the cytostatic, preventing the replication of malignant cells but not destroyed already, and cytotoxic, which instead induce cell death. Generally, chemotherapy does not use a single drug, but associate more than one substance in order to attack the malignant cells on multiple fronts simultaneously, with several advantages, chief of which is to prevent the tumor becomes resistant to the effect of treatment.
The choice of drugs will depend upon diagnosis, affected by the body (of any substance is distributed differently in different tissues) and the general condition of the patient. Chemotherapy is often combined with surgery and radiotherapy, and today the new biotechnology drugs.

How do chemotherapy drugs?
Chemotherapy drugs are able to block the replication of cells. Since the therapeutic substances are transported through the bloodstream, can reach any area of the body. The chemotherapy drugs are also absorbed by healthy cells that are partially able to repair the damage that the drugs induce, while this does not occur in cancer cells. Nevertheless, rapid replication in some cell types (such as blood cells, the lining of the mouth and digestive system pilliferi or bulbs) can be damaged by the care and this explains the frequent presence of side effects (gastrointestinal disorders, immunosuppression, loss of hair, etc.).
Chemotherapy is usually given in hospital sessions, intravenously. However, there are also based on chemotherapy drugs administered orally. Typically the sessions are grouped into cycles (more sitting close), at the end of each doctor to carry out a revaluation of the case and the tumor response to drugs.
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Why do chemotherapy?
The reasons are essentially four, depending on the characteristics of the disease and the prognosis of the same:
1. In some forms of cancer, chemotherapy destroys all malignant cells and can be cured permanently.
2. The chemo can be administered after surgery or radiotherapy to destroy any residual malignant cells and minimize the risk of relapse (adjuvant chemotherapy).
3. The chemo can be given to reduce the size and aggressiveness of a tumor before other treatments such as surgery (neoadjuvant chemotherapy).
4. Medications can help reduce symptoms and improve quality of life even when there is no hope of recovery: This is called palliative chemotherapy, which is still very useful to help patients in the later stages of the disease.
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How is chemotherapy applied?
Most chemotherapy is administered directly into the bloodstream. To do this you can use a simple infusion, a needle inserted in the arm or hand. It is a convenient but not always the best, because the substances used are highly irritating to the vein walls and, over time, the vein can be closed or catch fire. To avoid this, especially if there will be more cycles of chemotherapy, the doctor may decide to implant a permanent catheter, usually in the subclavian vein above the clavicle. A cannula is placed in a simple outpatient surgery and is left in place until the end of treatment. The only precaution in this case, is to prevent the cannula is infected: this should be handled only by experienced and well cleaned as directed by your doctor.
An alternative to classic chemotherapy is the pump infusion: the patient carries a small device that contains the amount of drug required for several days. The device is connected to a central catheter and put into circulation very small amounts of chemotherapy in a continuous cycle. When you use this system, the advantages are many, primarily because it reduces hospital visits, and secondly because the side effects are reduced, due to less accumulation of drug in the body.
In addition to oral administration, in some rare cases selected and you can inject the drug directly into the cavity affected by the disease, for example inside the skull or abdominal cavity.

What is high dose chemotherapy?
It is a form of therapy that uses very high doses of chemotherapy. In general, this strategy is useful for some forms of cancer such as blood, also leads to a destruction of the bone marrow (the central production of blood cells and immune system) that is followed by a bone marrow transplant or cells Blood stem. The strategy of high-dose chemotherapy combined with transplantation can cure many cases of leukemia, lymphoma and myeloma.
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Possible side effects of chemotherapy on bone marrow has?
The bone marrow is compromised by chemotherapy and is also reduced the number of blood stem cells. This results in a decrease of the three cellular components of blood or red blood cells (anemia occurs then), white blood cells (thus causing reduction of the immune system) and platelets (and thus a reduced ability to clot blood).
White blood cells usually an important reduction of between 7 and 14 days after chemotherapy: this is therefore the most critical moment in which to pay attention to possible infections. Also it is good to seek medical attention immediately if the temperature exceeds 38 ° C: it may be that now decides to administer antibiotics to prevent superinfection more severe.
When the immune defenses are low, you have to wash often, especially your hands, avoid crowded places and contact with children, sometimes carriers of potentially serious infections to immunocompromised individuals.
Among the important practical advice, to not take public transportation (or choose the less crowded hours and wear a mask), avoid swimming pools, should be evaluated regularly to ensure that their pets are healthy. It is also important to avoid the risk of pulmonary fungal infections (mycosis), the most dangerous of which is the fungus that is found in wet leaves, in soil, the deposits of building materials and, in general plant decomposition. It is also useful, after talking with your doctor, go to the vaccination.
Anemia occurs with rather extreme fatigue and shortness of breath. If the levels of hemoglobin in the blood falls below a certain limit, your doctor will prescribe some medications (such as epoetin) can promote the replication of red blood cells. Sometimes it may also be necessary transfusions.
Particular attention is given to the risk of bleeding: one should avoid physical activity and sport at risk of trauma, as you must immediately contact the emergency room if they begin to bleed from the nose, mouth or anus.
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What effect does the chemo on hair and hair?
Not all chemotherapies cause the complete loss of hair and hair, but this is still common an occurrence. It is worth specifying that this is just a temporary fall and the hair grow back thick and beautiful as before when you stop caring.
The most common advice is to cut your hair short once you start treatment, because the weight of the canopy accelerates the fall. To keep them for as long as possible is also necessary to avoid aggressive or shampoos and styling techniques with brushes or rollers. If possible, it would be better not to even use a hair dryer.
In some forms of chemotherapy, you can use the so-called cooling helmet: it is a helmet full of ice (or ice gel) to wear during the session that, by reducing blood flow to the follicles, it also limits the amount of drug comes to hair. Does not always work, but sometimes it can be sufficiently strong to prevent the patient from having to rely on wigs or hats. It's good to talk with your doctor or nurse of the department of medical oncology, which will give the right advice.
Many patients prefer not to wait for the natural fall of the hair and proceed with a drastic cut, then make a wig out and a scarf or a hat at home. The skin of the head should be treated like you do with your hair, especially if you use the wig for many hours a day in summer. The scalp is nourished with a moisturizer and washed with mild shampoo (such as that of children).
Not all chemotherapy drugs have the same effect on other body hair (beard, mustache, eyebrows, pubic hair): it may be that these are subject to fall. Even in this case the re-growth is complete within 3-6 months after completion of treatment.
The new hair may be slightly finer (or more raised) than before the treatment and sometimes even the color is slightly different, but generally it's subtle changes.
If hair loss has a very strong psychological impact, do not hesitate to ask for help from a psychologist or a group of self-help among patients.

What effect does the chemo on the digestive system?
Several chemotherapeutic agents cause nausea and vomiting, although this is not an absolute rule. In addition, the sensitivity to side effects is very individual. The reasons for this side effect are twofold: firstly, a direct toxic effect on the nerves that control digestion and gastrointestinal motility, the other a loss of mucosal lining of the digestive system.
The physician will join a chemotherapy treatment with anti-nausea drugs, which must be followed according to his requirements. Some food-related measures can give a hand to avoid this annoying effect: there are printed guides in all departments of medical oncology.
In general, avoid eating and cooking during times of nausea, splitting meals several times a day taking small portions of food and avoid drinking large quantities of liquid all at once.
In addition to nausea, chemotherapy may cause diarrhea or, conversely, constipation, and change the taste of food so even annoying. For all these disorders there are remedies that should be discussed with your physician.
The sensation of dry mouth and pain can be alleviated with special gel can be purchased in pharmacies, which also helps the healing of ulcers and wounds. Even sucking on small ice cubes can help. It is good to brush your teeth regularly using soft brushes.

What effect does chemotherapy on skin and nails?
The skin, like all tissues in rapid turnover, tends to embrittle during therapy. It is therefore advisable to keep much food, using creams with sun protection factor of at least 15, even in winter. Also the nails may become brittle or discolour. In this case, you should fix them with a glaze hardener to prevent break.

You can combine chemotherapy with a happy sex life?
The period in which you are undergoing chemotherapy is one of the most tiring for a patient with cancer: one more reason for not disposing of physical and emotional contact that give joy and support.
Since the chemo damages the mucosa, it is possible to prove that sexual intercourse painful for women.
In this case, a visit to the gynecologist and the use of lubricants should be enough to solve the problem.
The more complex the psychological aspect: to have sex should have a good relationship with your body and not be too tired. During therapy is also possible that other concerns are and then that sex is temporarily set aside: do not feel guilty about it, since it is momentary changes, but discuss them with your partner and, if necessary, with a psychologist may be helpful.
If you are still of childbearing age is essential to use a contraceptive, because chemotherapy drugs can induce, in some cases, malformations in the fetus. Most chemotherapy drugs do not pass through the vaginal secretions and semen, but for safety reasons, some doctors may recommend the use of a condom to avoid going to the partner even infinitesimal doses of pharmacologically active substances.

You always hear talk about smart drugs or biologics. They are different from chemotherapy?
What are called smart drugs or biologics (biotech is the correct term) are substances produced in the laboratory to target a specific molecular target within the cancer cell. Typically, this is still experimental therapy, although some are already commonly used successfully to treat many different types of cancer. Most biotech drugs are made of monoclonal antibodies, special proteins similar to those that the human body produces on its own, capable of interfering with a key mechanism of cell proliferation.
The biotech drugs, despite being targeted against a specific target, are not entirely free of side effects, although they are generally better tolerated than traditional chemotherapy. But these are no alternative but a complement. There are still smart enough to send therapies in the attic of the "old" chemotherapy.

It is true that there is more classic research on chemotherapy?
No, it is not true. Several research groups in Italy and around the world are studying new combinations and new protocols that take advantage of drug substance "old" (meaning they are still based on the principle of the elimination of cells with rapid replication), but using them in the light of new knowledge gained the progress of molecular oncology. As we better understand the mechanisms that induce malignant transformation of a cell, you can choose more carefully the drugs to be included in a protocol of chemotherapy.

Chemotherapy is, literally, any treatment can be done with chemicals. In this sense it is not a term used only in cancer care, but includes any use of chemical drugs.
In fact, in common usage means chemotherapy for the treatment of cancer with substances that block the replication of malignant cells. Since there are over 200 different types of cancer and more than 60 categories of chemotherapeutic molecules, the following information should be considered general and should be evaluated with your doctor regarding their condition.

Treatment of cancer in different stages may have different objectives. Main goal of treatment may be that the patient should be completely healthy, it can be to prolong life and may be pure symptom relief, such as pain relief, relief of nausea and psychological support.


World Health Organization defines palliative care as the active treatment and care for patients with incurable disease and short life expectancy. Relief from pain and other distressing symptoms are central, together with measures aimed at the psychological, social problems, and spiritual / existential needs. The aim of all treatment and care is that patients and their families should have the best possible quality of life.

Talking openly with
It is important that health professionals, patients and their families talk openly with the goal of treatment. Patients and their families must be assured that the information they receive about the future prospects and the expected effect of treatment is truthful and realistic. Doctor and nurse must have ample time for such discussions with patients and their families. Many health authorities have now established palliative team, which means that doctors and nurses work with other disciplines such as physiotherapist, social worker and chaplain. Many hospitals have their own palliative devices. In addition to palliative units in hospitals and nursing homes, there are also separate Hospice for seriously ill and dying. There are not many of them in the country. Some nursing homes have created their own beds-Hospice.

Most time at home
Most patients who need palliasjon, wants as much time as possible at home. It requires that they receive close follow-up. To achieve security, it is important to know who is responsible and who they can contact. Individual plan, which is now legislate, is a good help. In such a plan will be goals, needs and responsibilities for treatment and follow-up to be written down.

Medicine has come a long way, and that much research when it comes to relieving pain and other physical symptoms for cancer patients. It developed a tool that maps the individual's physical and mental problems, ESA (Edmonton Symptom Assessment System) provides a good overview of the symptoms that each patient has, and while it is a good starting point for communication. Good palliative care is to experience the confidence that healthcare professionals know how to provide adequate and proper medical treatment.

Life-prolonging treatment
The life-prolonging treatment and the relief of physical symptoms, you must always have the expected effect of treatment, ie possible life extension and possible symptomatic relief, assessed against the possible deterioration of quality of life that may occur as a result of treatment side effects.

The palliative phase
In the palliative phase of life, it is important to plan how you want things to be open and honest with their relatives and talk about what needs you have, so you can spend your time on what the individual is most important.

It can be difficult to find out about walk by the offer of alternative treatment. We have collected some general advice and some questions may be important for you to reflect on.


When cancer patients are using alternative therapies in addition to the treatment they receive at the hospital, it is also called complementary treatment. Always discuss alternative treatments with your doctor.

What expectations do you have for treatment?
By thinking through how the alternative treatment can help you, you will be better able to make a conscious choice. When you require both the manager and the treatment, you are also self-help to decide what you want to achieve.

You should think through:

-The goal of treatment, such as relieving symptoms, reducing side effects of medical treatment, provide new energy, strengthen the immune system or increase the opportunities for recovery.
- How much time, effort and money you are willing and able to invest.
- How long you want to try the alternative treatment before you decide whether you will benefit from it.

What is important to talk to manager about?
Ask for a thorough and informal conversation with one or more specialists before you start. Then you can get information and answers to many of the questions. You have the right to make demands on the manager and his / her expertise. Do not be afraid to take this up. The most important thing is that you feel confident if you start with the treatment. Even if you have a conversation with the manager, you do not anything.

This should be clarified in the meeting:
- Which manager has experience with treating cancer patients.
- What training manager has and if he / she is a member of an organization.
- Who is he / she works with (eg, doctor or other specialists).
- What treatment requires of you.
- What you can accomplish with treatment.
- When it is reasonable to assess the impact and decide whether to terminate or continue.
- Price, the treatment, possible side effects and duration.

What is important to clarify with your doctor?
Some alternative treatments can have negative impacts on the medical treatment. There are, among others, documented that natural medicine, St. John's wort affects the effect of chemotherapy treatment. Therefore, be open and honest with your doctor to follow up cancer treatment.

- Tell your doctor what treatment you want to try.
- Ask your doctor know of this treatment, and whether it can have a negative effect on your medical treatment.
- If your doctor is skeptical about your plans, talk with him / her about the reason for this.

Who can you use as your supporters?
Many in the same situation as you experience being showered by "good advice". It can be experienced both overwhelming and binding. You should not start with a treatment because others think it could be a good idea. You will even have faith in it and feel like trying.

- Think through who you want to get involved. Find people whom you can discuss with.
- Take someone with you in meetings with the manager.
- None other than those directly involved, your doctor and your loved ones, need to know about your choice.

How can you determine if the treatment had any effect?
It only knows it as literally feel it in the body. But often it can be difficult to know whether the treatment or other factors affecting the shape of your. Especially if you combine alternative and medical treatment. By being aware of what you may do as well, such as changing diet, or other daily routines, it becomes easier for you to determine the effect.

- Be aware of how you feel before treatment begins. Please write down what you hope the treatment will contribute.

- By keep a diary where you note the day's form, any changes, improvements or worsening, you get a conscious awareness of your own development.

- Try to restrict yourself to one or very few alternative treatments at a time. Then it is easier to find what you're feeling better, and what, if any, gives you side effects.

- Side effects you should talk to both doctors and treats about.

- Join agree with manager about how long you will be treated before you consider the impact.

- Matches the treatment and the results with your expectations? Talk to your manager about this.

- You yourself must decide whether to continue treatment or not.

Chemotherapy (chemotherapeutic agents)
Research on the contrary gases in the interwar period led to the development of chemotherapy. Chemotherapy, also known chemotherapeutic agents or chemotherapy, the drugs used to fight and kill cancer cells. Most cell toxins attack the cell's genetic material (DNA), by damaging it or preventing formation. Chemotherapy specifically attack cells that are dividing rapidly, such as cancer cells do.


Chemotherapy treatment may have different purposes

* Healing
* Make the tumor smaller before surgery
* Killing cancer cells present elsewhere in the body after surgery or radiation therapy
* Keep illness at bay and prevent or reduce symptoms such as tumor (s) causing

How chemotherapy is given?

* Directly into a vein (intravenously), often mixed in a larger flow rate. This is the most common way
* As tablets or capsules
* In the body cavity.

How does chemotherapy?
Chemotherapeutic agents transported by the blood to cells and tissues. When the drug reaches the cancer tumor, be it in the individual cancer cell and inhibit or stop cell division. Thus destruction of cancer cells, and they lose the ability to reproduce. Often, combining several types of chemotherapeutic agents in a single cure. This makes treatment more effective because the different drugs attack tumor cells in different ways.

Side effects of Chemotherapy
Most patients - but not all - are side effects of chemotherapy. There is a lot different, how each responds to chemotherapy. Some have more side effects than others. One can not know in advance how the individual will react.

All cell toxins used in the treatment of cancer, also affects our normal cells. When the results are still good, this is due to the normal cells have a greater ability to repair DNA damage and that normal tissues recover more quickly between each dose. Dose chemotherapy given is calculated from a balance between what we know, healthy cells can tolerate and the amount needed to achieve the desired effect on cancer cells.

The different types of chemotherapy for various side effects such as nausea, hair loss, etc. Any side effects are also determine what precautions are taken. There are many good medications against side effects. Patients get more information about the current cellegiftkur and the most common side effects of doctor and nurse.

The most common side effects of Chemotherapy

* Tiredness / fatigue
* Impaired general condition
* Impaired immune system, anemia and bleeding
* Foot and mouth ailments, and taste changes
* Nausea and vomiting
* Reduced appetite
* Diarrhea and constipation
* Hair loss (alopecia)
* Reduced reproductive capacity

Chemotherapy effect is the same whether you get side effects or not.


Some side effects do not disappear when the chemotherapy treatment is over. Fixed effects depends on both the drug and the dose.

In rare cases arise a new cancer - particularly leukemia - as a result of treatment.

For more information read Krefetforeningens fact sheets about chemotherapy

Home Precautions for Chemotherapy
There may be waste products from cell poison in the body for up to five days after treatment. The concentration and excretion of waste products is greatest the first day after treatment.

Decomposition products can be found in: urine, feces, large amounts of sweat, vomit and blood.

* Vomiting, urine and feces wiped up with paper, which flushed down the toilet. Then wash hands with soap and water.
* Brush creek or the like with vomiting, thrown in the rubbish bin in a sealed plastic bag.
* Wash clothes and bedding in the washing machine - not at hand.

Precautions for relatives of patients receiving chemotherapy
Many people feel uncertain about how closely they may have with a person receiving chemotherapy. Fortunately, you can pretty much live and interact with each other as you usual.

The amount of waste substances in the body is so small that it poses no risk to family and friends. One can, therefore, generally live and interact with each other as we usually - both in hospital and at home.

Pregnant and lactating women
Mon recommend that pregnant and lactating women are not in contact with urine, feces, vomit, etc. from people who receive chemotherapy. This is true for five days after treatment ended.

Small children and Chemotherapy
Many worry especially of young children's contact with people who get chemotherapy. No studies show that one should take extra precautions in relation to young children.

Surgery is an important treatment to cure cancer. Over half of cancer patients are operated. Surgical treatment means that cancer tumor removed by surgery. If the cancer tumor is limited and has not spread, it can sometimes be removed in its entirety. When not restricted, provided the patients a combination therapy.

Combination therapy involves chemotherapy and / or radiation is given first, to reduce tumor size before surgery. In some cases, be given chemotherapy and / or radiation afterwards, to reduce the risk of the disease coming back.

Before surgery

The preparation must be done before the operation depends on the nature of the procedure. In some cases, you must clear the bowel before surgery. This will let you know and help of staff at the hospital.

In connection with the operation you will receive general anesthesia. You will be informed of how long you will be fixed and what precautions you should take. You get to talk to anesthesia doctor before the operation, and it is in that context is important that you give your doctor some information. For example:-if you use drugs, have you had anesthesia before and you have experienced complications associated with it.

The evening before the operation showers, and possibly cut (shaved) operation field.

After surgery

If you've been to a very brief intervention, such as. examination of the urinary tract, rectum or gynecological examination, you will be driven straight back to your room. In other cases, you'll be a while on the postoperative / intensive care unit to be monitored. You can wake up the connected equipment differ depending on which procedure you have been through.

It is important that you notify the staff if you experience having pain after surgery. After the procedure should not the body is exposed to additional stress because of pain, so it is important that you say before the pain gets too bad.

You might be surprised how quickly they will have you going again after the operation. The reason for this is that the risk of blood clots and pneumonia increases when you lie passive in bed for a long time.

It is important that you are active, by doing breathing exercises and try to eat after the personnel manual. It might be good to just relax after the operation, but a balanced training will be to ensure that you get faster after surgery.

It is not unusual with a psychological reaction after surgery. Such a "downturn" is usually 3-5 days after surgery. We can not explain why this often happens, but it might be nice to be prepared in case you experience such a reaction.

Radiation Therapy for Cancer Treatment
The radiation affects cells' ability to divide. Radiation affects only the tissue in the appropriate radiation field and the effect of radiation increases with the size of the dose is.

The goal of radiation treatment is to give a radiation dose sufficient to destroy tumor tissue while minimal healthy tissue is destroyed. Fresh tissues have a greater tolerance to radiation than the tumor tissue and thus better ability to repair the damage that radiation may cause. Radiation therapy uses other words, a weakness in cancer cells that make them selectively die.

There are inner and yttre radiation. The inner radiation brakyterapi, placed inside the radiation source or until the tumor using special equipment.

Radiation therapy is a well-documented and effective treatment that can be used alone or in combination with other therapies such as surgery, hormone and chemotherapy treatment.

Sometimes radiation therapy for cancer treatment, gives a time before an operation, in order to try to shrink the tumor, thus easier to remove surgically.

One can also give it in addition to other treatment to reduce the risk of relapse. When it is called adjuvant therapy.

As an individual treatment plan may be what you read does not fit your situation. Do not be afraid to ask your doctor or nurse if you have any questions.

Radiation therapy is done by some of the country's largest hospital. If you have a long travel distance should be on patient hotel in the treatment period. If you can not manage even one is admitted to the hospital.

While you are in the radiation, one should avoid:

* Remove the streaks on the skin, they mark the area to be irradiated.
* Wearing clothing made of wool or synthetic material directly on the area being irradiated. It can be irritating. Instead, use clothing made of cotton or silk.
* Bathing in the tub and go swimming - use instead of a shower and gently pat the skin dry.
* Use soap, deodorant and plaster on the irradiated area.
* Get the sun and tanning of the irradiated area.
* Consume more antioxidants than from healthy diet and a regular vitamin pill.
* Røyke.Hvis you have to smoke should be avoided 2 hours before and 2 hours after treatment.

When you receive treatment for his cancer, it is important to find their own way to deal with the situation and the tribulations it entails. It works for one person is not necessarily right for another. Some continue to work all the time during treatment. For them it is perhaps important to think about anything else and meet their fellow workers. Others have enough to get through treatment and will be home in peace.

It is wise to listen to your body's signals and not demand too much of themselves during treatment ..