Chemotherapy means using chemicals to treat disease.
In cancer, chemotherapy means medications that kill cancer cells or prevent their growth. Most (but not all) patients with lymphoma will have chemotherapy at some point during their treatment. Chemotherapy works to prevent lymphoma cells from multiplying and to remove or reduce the number of cancerous cells in the body. It is often part of a larger treatment plan, used in combination with other therapies such as radiation or biologic therapy.
How does chemotherapy work?
Chemotherapy are medicines that target and kill rapidly dividing cells in the body, such as cancer cells. There are also normal cells in the body which are rapidly dividing as well, and chemotherapy may damage these healthy cells. This is why chemotherapy can have side effects including hair loss, diarrhoea, nausea and vomiting.
Not all people experience side effects from chemotherapy and if side effects do occur they can often be mild and treated effectively.
many different ways of attacking rapidly dividing cells and hence many
different types of chemotherapy. Each chemotherapy medicine attacks the cell in
a specific way but because these are all different ways of achieving the same
result—destruction of the cancer cells—chemotherapy medicines are often given
in combination in order to attack the lymphoma cells from all possible angles
to increase the odds of achieving remission.
combinations are often referred to by the initials of the medicine names in the
combination. An example of a combination
used in lymphoma is CHOP which is a combination of four medicines, namely,
three chemotherapy medications and one steroid medication: Cyclophosphamide,
Doxorubicin (also called Hydroxydaunorubicin), Vincristine (also called
Oncovin) and Prednisone (steroid medication). Steroid medicines are included in many of the lymphoma treatments as
they are effective therapies for lymphoma and can quickly get symptoms under
is given in cycles, where the treatment is given for a period of time (e.g. for
one day) followed by a rest period where no treatment is given. The rest period
allows the healthy cells and the body to recover. Together, each period of
treatment and rest is called a chemotherapy cycle. A full course of
chemotherapy often takes several months (4-6 cycles). Each dose of chemotherapy kills only a
percentage of cancer cells. Chemotherapy is, therefore, often given in multiple
treatment cycles in order to destroy as many cancer cells as possible
How is Chemotherapy Given
chemotherapy treatments are given in a day oncology centre, so patients can go
home the same day but sometimes people can be admitted as an inpatient for
their treatment which means they have to stay in the hospital ward overnight or
for several days at a time. Chemotherapy may be given in different forms:
pills, injections or given through a vein (intravenously through a needle).
patient is receiving multiple cycles of intravenous chemotherapy, the doctor
may recommend having a central venous catheter inserted. This is a device,
usually a flexible tube that is more permanent catheter and is usually inserted
into a large vein in your arm, chest or neck. Once the catheter is inserted the
patient will not require a new needle with each treatment and the chemotherapy
and blood tests can be done using this device.
Can the dose be reduced if I have a lot of side effects?
It is very important to try to maintain the highest tolerable dose during chemotherapy treatment. Studies have shown that reducing the dose or delaying chemotherapy treatments until side effects subside may decrease the likelihood of cure and the chances for long-term survival in some types of lymphomas. It is important for someone receiving chemotherapy to understand that changing the dose or treatment cycle to reduce short-term side effects may actually be harmful in the long run.
However, quality of life is valuable as well, and you need to decide whether the side effects are tolerable or not. It is important to make this decision in an informed way and understand the potential consequences of your choice.
What are the side effects of chemotherapy?
Many people are frightened by the side effects of chemotherapy. However, it is important to understand that:
- Not all people who receive chemotherapy experience side effects
- Side effects are not always severe, they can be mild
- Different chemotherapy drugs have different side effects
- Doctors are familiar with chemotherapy side effects and can treat them so they are less severe and, sometimes, even prevent them from happening altogether
Many of the side effects caused by chemotherapy are due to the effect the medications have on the healthy, non-cancerous cells of the body. The following table outlines the most common cell types affected as a result of chemotherapy, as well as the resulting side effects.
Chemotherapy Treatment Overview
||Associated Side Effects
Cells of the digestive system including the mouth, oesophagus, stomach and intestines/bowel
Changes in taste
Loss of appetite
Cells of the skin and hair
Cells of the skin and hair
Cells of the bone marrow: red blood cells, white blood cells and platelets
Decreased blood cell production (myelosuppression) including:
Anaemia (decrease in red blood cells)
Neutropenia (decrease in white blood cells)
Thrombocytopenia (decrease in platelets)
Useful Questions to Ask Before Receiving Chemotherapy
- What chemotherapy will I be receiving?
- What is the expected outcome of my chemotherapy?
- What is the schedule (treatment cycle) and how long will I be receiving chemotherapy treatment?
- What side effects will I experience? How serious are they? Can they be managed with treatment?
- What should I do to try to stay healthy and strong during my treatment?
- Can I come for my chemotherapy treatments alone or do I need assistance?
- How is the treatment monitored to determine whether or not it's working?
- What symptoms should prompt me to call the doctor's office?
From The DVD - "Your Journey of Lymphoma Treatments"
Related video: Chapter 5 - Treating Your Lymphoma