What is cytotoxic chemotherapy?
Cytotoxic means the poisoning of cells.
Chemotherapy is the chemical or drug treatment of cancerous cells. It can be used on its own or in combination with other cancer treatments such as surgery, radiotherapy and immunotherapy.
A single agent or multiple (combination) chemotherapy drugs can be used to treat the specified cancer.
The definitions below are commonly used to define chemotherapy use in relation to treatment:
How does it works?
Chemotherapy kills cancer cells which stops them multiplying and spreading elsewhere in the body. There are many chemotherapy drugs used to treat many types of cancer. After each dose of chemotherapy some of the cancer cells will have been destroyed, but some healthy cells will also have been destroyed. To allow the body time to replenish the healthy cells, chemotherapy is not given as a single treatment but usually over a number of cycles to destroy as many of the cancer cells as possible while maintaining the body’s healthy cells.
How is chemotherapy given?
Different types of cancerous cells are sensitive to different chemotherapy drugs. The treatment decisions aremade based on the cancer type, stage of cancer and the individual patient’s body’s ability to tolerate and sustain treatment. The doses calculated for each individual are usually calculated using their height and weight, this can change during their treatment cycle.
Chemotherapy can be given in one of the following ways:
- Intravenous- The drugs are administered directly into the vein either using asmall needle (butterfly); through a plastic needle (cannula) or through a central line (PICC, Hickman, Portacath). Different drug treatments affect the body at different rates, some infusion may take only 5 or 10 minutes, some may need to be administered over several hours and there are those that might require several days and the individual may need to be admitted and regularly monitored.
- Tablet- This can be a single tablet given at regular intervals or one or more tablets taken a number of times a day for a specific period of time.
- Injection- It can be administered into the muscle (intramuscular), into the tissue between the skinand muscle (subcutaneous) or under the skin (intradermal).
- Lumbar Puncture (intrathecal)- This involves inserting a needle into the spine to enable the drugs to reach the cerebrospinal fluid surrounding the brain.
- Ointment- Applied directly to your skin.
- Intra-arterial- Chemotherapy administered into the artery supplying blood to the tumour.
- Intravesical- Chemotherapy given into the bladder using a urinary catheter.
- Intra-peritoneal- Chemotherapy directly administered into the abdominal cavity.
- Intra-pleural- Chemotherapy given into the pleural cavity (the space between the lung and the lining of the lung) .
What are the side effects of chemotherapy?
Side effects experienced from chemotherapy vary from treatment to treatment. This effects can also vary between two people receiving the same drug. Most side effects are temporary and gradually disappear after treatment is completed.
Common side effects:
- An increased risk of infection
- An increased risk of bleeding
- Loss of taste
- Familiar tastes change
- Nausea and vomiting
- Hair loss (alopecia)
- Fatigue and tiredness
- Infertility, congenital abnormalities
- Tingling and numbness on fingers and toes
- Dry skin, photosensitivity (increased risk of sunburn)
Chemotherapy and Clinical Trials
Clinical trials remove bias in their results by allocating treatments randomly when comparing different drugs or techniques. It is a first step in the testing of new drugs or treatments for humans with an aim to find a more effective treatment for cancer.
The drugs used today will have been through the clinical trials (research) stage to prove their effectiveness before licensing.