What is Chemotherapy? Treatment and Side Effects

Chemotherapy is a special form of drug treatment that aims to stop or destroy the growth and proliferation of cancer cells that grow uncontrollably in the human body and damage healthy tissues.

Chemotherapy is a special form of drug treatment that aims to stop or destroy the growth and proliferation of cancer cells that grow uncontrollably in the human body and damage healthy tissues.

This article was written by Prof. Dr. Şeref Kömürcü, Prof. Dr. Serdar Turhal and Assoc. Dr. It was created by Yeşim Yıldırım to provide general information about chemotherapy and to answer frequently asked questions.

For what conditions is chemotherapy used?

• Given alone as primary treatment of cancer
• Elimination of remaining cancer cells after surgical treatment
• Reducing the patient’s tumor and preparing it for surgery and radiotherapy
• Reducing cancer symptoms in advanced stage cancer patients and improving the patient’s quality of life (palliative treatment).

How does chemotherapy work?

1. It can completely destroy cancer cells.
2. It may slow the growth of cancer and prevent it from spreading.
3. It can eliminate the feeling of pain and pressure caused by the tumor in advanced stage cancer patients.

What is the duration and frequency of chemotherapy?

In chemotherapy, the doses, application methods and application times of drugs vary depending on the type of disease. In addition, treatment duration and frequency may vary depending on the patient’s age, general health status, extent of disease and non-disease health problems. For this reason, different treatment schemes can be applied even in patients with the same diagnosis. In chemotherapy protocols, a treatment period is usually followed by a rest period. Taking these factors into consideration, treatments can be applied daily, weekly, every 14 days, every 21 or 28 days.

How is chemotherapy done? How is it applied?

Preparing the patient for chemotherapy:

1. The majority of chemotherapy drugs are given intravenously. If establishing a vascular access will be a problem for the patient every time, a catheter can be inserted into the patient or a port can be placed in one of the neck veins.
2. Before chemotherapy, the patient’s liver function tests, kidney function tests and complete blood count are performed. Tests are also performed to evaluate the patient’s heart functions.
3. Before starting chemotherapy, it would be appropriate to see a dentist and have any dental infection treated. Because chemotherapy drugs can weaken the body’s fight against infections.
4. Possible side effects of chemotherapy are explained to the patient. Those who want to have children in the future can freeze their eggs or sperm. They can prepare against hair loss.
5. It is discussed in advance whether the patient will continue to work after receiving chemotherapy and whether he will need help at home.

How is chemotherapy administered?

1. Infusion form: Medicines are placed in a serum and administered intravenously by connecting to a pump.
2. Oral: It can be used orally in capsule or tablet form.
3. It can be applied as a needle under the skin.
4. Chemotherapy drugs can be applied directly to the area where the tumor is located. For example, into the abdominal cavity, into the pleural membrane space surrounding the lungs, between the vertebrae, or into the urinary bladder.
5. Chemotherapy drugs can be applied directly to the vessels feeding the tumor.

Where is chemotherapy treatment given?

Chemotherapy should be applied in hospitals and chemotherapy units. It is not suitable to be applied at home.

How do doctors determine chemotherapy drugs?

The first rule when choosing a chemotherapy drug is the type of cancer. Some chemotherapy drugs are effective in many types of cancer. Some cancer drugs are specific to a single type of cancer. The second rule is the chemotherapy drugs the patient has previously taken. Accordingly, the physician determines the drug treatment. The last one is; The general condition of the patient, evaluation of the suitability of organ functions, and whether he/she has a disease such as diabetes, heart disease and liver disease. Medical oncologists determine chemotherapy drugs.

Are any other medications used during chemotherapy?

During chemotherapy, there will be supportive treatment drugs that will be recommended to reduce the side effects of the drugs. Apart from these, most of the drugs used for reasons such as high blood pressure, heart disease, diabetes or infectious diseases do not have a negative effect on chemotherapy, and the patient can continue them. However, some drugs may interact with chemotherapy drugs, the positive effects of the drugs may decrease or their side effects may increase. For this reason, all medications used must be reported to the oncologist who will plan chemotherapy.

What are the side effects of chemotherapy?

The most common side effects are:

• Nausea
• Vomiting
• Diarrhea
• Hair loss
• Loss of appetite
• Tiredness
• Fire
• mouth sores
• Pain
• Constipation
• Bruising on the skin
• August

More rare side effects are as follows:

• Damage to lung tissue
• heart problems
• Infertility
• kidney problems
• Nerve damage (peripheral neuropathy)
• Risk of developing a second cancer

What should be taken into consideration after chemotherapy treatment?

1. Nutrition during and after chemotherapy:

While chemotherapy kills cancer cells, it also damages healthy cells. During and after chemotherapy, patients often experience some nutritional problems. The most common nutritional problems are:

1. Loss of appetite
2. Impaired sense of taste in the mouth, inability to perceive the smell of food
3. Constipation
4. Diarrhea
5. dry mouth
6. Lactose intolerance (developed intolerance to milk and dairy products)
7. Nausea, vomiting
8. weight loss
9. Swelling in the throat, difficulty swallowing
10. abnormal weight gain

Nutritional recommendations for patients receiving chemotherapy:

• Keep healthy foods and drinks in your fridge.
• If you have nausea after chemotherapy, you can eat crackers. Ginger ale, ginger tea, lemon, lemon tea and mint can soothe your stomach.
• If you experience loss of appetite, consume small meals 5-6 times a day instead of 3.
• If you don’t want to cook because of food smells, find a helper.
• Try to consume liquid foods in sips throughout the day. However, drinking too much liquid before a meal may suppress your appetite, so be careful.
• Be careful to get enough protein.
• Eat nuts.
• Consume plenty of fresh vegetables and fruits.
• Focus on olive oil.
• Try to turn meal times into enjoyable times. Prepare beautiful, appetizing tables and be together with your loved ones. Remove negative thoughts from your brain while eating.
• Try to prepare meals in different styles to account for changes in taste.
• If the taste of the water has changed, you can drink mineral water or add lemon to your water.
• If you develop constipation after chemotherapy, eat plenty of fiber. Move.
• If you have a tendency to gain weight, reduce fat in foods.
• If you have diarrhea due to medications, focus on bananas and potatoes and drink plenty of water.
• If you have mouth sores after chemotherapy, avoid spicy foods. Rinse your mouth with salt water after meals.
• Avoid excessive caffeine consumption.
• Do not use vitamins and herbal supplements without consulting your doctor.
• You can consume red meat, fish and turkey in balance.
• It would be appropriate to avoid sugary foods as much as possible.

How to relieve pain after chemotherapy in cancer patients?

Sometimes after chemotherapy, patients experience pain in muscles and joints. Chemotherapy may have side effects on the musculoskeletal system. After the treatment, side effects such as muscle weakness and numbness in the arms and legs may also occur. In this case, you can use painkillers recommended by your doctor and take a warm shower. If your balance is disturbed due to pain while walking, you can temporarily use a cane.

When does chemotherapy-related hair loss begin?

Hair loss usually begins 2-3 weeks after chemotherapy. Hair grows back 1-2 months after chemotherapy is completed. The amount of hair loss may vary depending on the drug and the patient. With some medications, there is no hair loss at all, while with some medications, complete hair loss may occur. You can use materials such as caps, scarves or wigs for hair loss.

What should patients receiving chemotherapy generally pay attention to?

• Every patient receiving chemotherapy should know how to measure temperature at home. Fever indicates infection and requires a visit to the doctor.
• Chemotherapy patients should not have close contact with people around them and should stay away from people with infections.
• If they smoke, they should quit; They should avoid environments with cigarette smoke, dust and airlessness.
• The fruits and vegetables they will consume should be washed thoroughly. Drinking water should be clean and healthy. Milk should be boiled well and food should be cooked well.
• Care should be taken to consume plenty of fluids.
• If possible, they should not eat at outside restaurants.
• If there is a cut on the skin while cutting the nails during chemotherapy, bleeding may last for a long time. It is recommended not to use a razor when shaving and not to cut nails too short.
• If a tooth is to be extracted during chemotherapy, the physician must be informed.

How correct is it to use methods such as “alternative medicine”, “natural methods” or “herbal solutions” in cancer treatments? Are there any methods you recommend in addition to treatment?

The cancer treatment process can cause stress, burnout, or affect your relationships with the people around you and your emotional life. There are various programs and methods that you can get support in controlling these problems. You can benefit from these methods by sharing any relaxation program you want to implement with your doctor and finding out if there is any problem for you. Examples of such practices include massage therapy, biofeedback, physical or breathing exercise, yoga. In addition, sharing with family, close circle and patient groups is also very important.

Various non-medical treatment methods will be suggested to you by many people around you. We recommend that you do not use all these recommended methods without learning the scientific basis from your doctor. Because the methods you use, assuming they are very innocent, may reduce the effectiveness of your actual treatment or disrupt your organ functions.

Is it possible to work during chemotherapy?

Some patients can work while they are receiving chemotherapy, but since factors such as the type of treatment applied, possible side effects, and the condition of the working environment will vary, patients should decide on this process by talking to their physicians.

Can I take a vacation during chemotherapy?

Vacation may sometimes be possible during chemotherapy, but this may vary depending on the side effect profile of chemotherapies, the frequency of administration, and the patient’s additional diseases.

Can I get pregnant during chemotherapy? Can chemotherapy be administered if a tumor is detected during pregnancy?

Generally, in patients receiving chemotherapy, ovarian functions are suppressed and menstruation may stop or be delayed. Despite this, patients have a risk of becoming pregnant. For this reason, we recommend birth control in patients receiving chemotherapy; Otherwise, the pregnancy must be terminated because the resulting fetus will be exposed to toxic agents.

Can a woman undergoing chemotherapy breastfeed?

Cancer can be diagnosed during pregnancy. In this case, the stage of the cancer, the type of tumor, and the person’s desire to continue the pregnancy or not are the main factors in deciding the process. In the first three months of pregnancy, chemotherapy is never administered because the organ formation of the fetus is not yet fully completed. After the 2nd trimester, some chemotherapy drugs may be given. As a general approach, if cancer develops in the first 3-4 months of pregnancy and urgent treatment is required, it is preferred to terminate it. In the last 1-2 months, depending on the condition of the disease, treatment can be started after the development of the fetus is accelerated and birth is postponed early. In other months, the decision must be made together with the family, depending on the prevalence of the disease and the urgency of the treatment. Breastfeeding is not recommended for patients receiving chemotherapy.