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.