StemCell Therapy

New medicines and treatments can often help patients better tolerate the sometimes harsh side effects of chemo

Chemotherapy, or chemical treatment, is often recommended as a treatment for a variety of cancers as it uses powerful chemicals to kill fast-growing cells, such as cancer cells, in ones body. Particularly for cancer that has spread to different parts of the body beyond the original tumor, chemotherapy can be effective as it can work throughout the whole body. According to the American Cancer Society, the three main goals for using chemotherapy in cancer treatment are to cure cancer, to control the disease if a cure isnt possible and palliation, to ease symptoms.

Dr. Lindsey Prochaska, DO, a medical oncologist with NHRMC Physician Group - Cape Fear Cancer Specialists, and Katie Evans, an oncology clinical pharmacist at NHRMC, have shared some information about this common cancer-fighting treatment, often called chemo. Prochaska treats patients at Cape Fear Cancer Specialists office in Leland and at New Hanover Regional Medical Centers Zimmer Cancer Center, and Evans collaborates with the oncology teams and patients at the Zimmer Cancer Center.

1) Chemotherapy can be used alone or along with other treatments

Sometimes chemotherapy is the only treatment a patient may need to treat a cancer, other times it may be used along with other forms of treatment.

"Chemotherapy can be used after surgery, before surgery, or even in the metastatic non-curable setting for control of cancer, said Prochaska. In the setting in which surgery removes a cancer, chemotherapy is often used before or after the surgery to rid the bloodstream of cells to reduce recurrence.

Some cancers respond to chemotherapy better than others, and Prochaska said chemotherapy may not be recommended in some circumstances.

More aggressive cancers sometimes respond better to chemotherapy than slow growing ones, she said. Very few cancers have no role for chemotherapy, but if a cancer is caught at a very early stage chemo may not be recommended.

As for if chemotherapy can sometimes provide a complete cure, Prochaska said, Absolutely. When given before or after surgery cure is commonly the goal, she said.

2) Chemotherapy drugs can be taken orally or received through ones veins

Chemotherapy is most often administered intravenously (IV), although, there are some oral chemotherapy treatment options, Evans said. Chemotherapy is administered by chemotherapy certified nurses in the infusion center, whereas, the oral options patients can self-administer following safety precautions for hazardous medications.

3) Chemotherapy can also treat other conditions

Chemotherapy is mostly only used for cancer, but there are some targeted therapies and conventional chemotherapies that treat autoimmune diseases, like lupus and rheumatoid arthritis, Prochaska said.

4) Chemotherapy can reduce chances of a cancer returning

The side effects of chemo can be harsh, but many times when recommended, its to increase the chances of cure, Prochaska said. Chemo can reduce the chances of recurrence 25-50% -- sometimes higher.

5) Side effects are common with chemotherapy

It is true that most systemic chemotherapy can affect both healthy and cancer cells in causing cell death, Evans said. Chemotherapy targets fast growing cells inside of the body which can be both cancer cells and healthy cells. Herein lies the potential for side effects. With newer, more targeted therapy and immunotherapy coming into use, we have seen the potential for side effects to lessen as compared to traditional, systemic chemotherapy.

Evans said these targeted therapies still have side effects that are manageable by an oncologist.

As clinical oncology pharmacists we counsel patients on the side effects they may experience, timeline, and management of the particular side effects with the chemotherapy regimen, she said.

Evans said some common side effects of chemotherapy include lowering blood counts, nausea, vomiting, gastrointestinal disturbances, peripheral neuropathy, hair loss, appetite and taste changes.

Side effects from chemotherapy are common, but can be managed with supportive care medications, Evans said. Once chemotherapy is completed, many side effects will resolve, though we know that some side effects like hair loss and neuropathy will take months to resolve.

Evans said side effects with chemotherapy treatment also differ in the time of onset. The effects on blood cell counts are relatively soon after chemotherapy has begun, hair loss is usually between 2-3 weeks after chemotherapy, and neuropathy may take several weeks before noticing.

Contrary to what some may think, Evans said not all types of chemotherapy cause hair loss.

Prochaska said medications have made a difference regarding some side effects.

Chemotherapy premedications and postmeds have come a long way, Prochaska said. Many people tolerate chemotherapy much better than expected now that we have medications that can help control nausea and vomiting.

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Health watch: 5 things to know about chemotherapy - StarNewsOnline.com

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