It is the use of drugs, with different mechanisms of action, to attack tumour cells.
 

• These drugs act on the whole body, with a greater effect on those cells that grow and reproduce more rapidly than normal cells.
• They can destroy tumour cells which have spread, or prevent them from spreading (metastasising), to parts of the body far from the original tumour (primary).

Your oncologist will find the treatment regimen which is best suited to you depending on:
 

• type of cancer
• stage of cancer
• state of health
• aim of treatment.

 
Generally treatment is given in cycles composed of a determined number of sessions. A cycle is a period of treatment followed by a period of rest.
 
A rest is required between cycles so that your body can recover after treatment.
 
Administration time or session length depends on the drug and the premedication time prescribed.

The day of the session

• Your oncologist will assess whether your state of health is appropriate for you to undergo treatment.
• Treatment will be given in the day hospital, by a specialist nurse.
• In the majority of cases patients can drive after treatment, however, it is recommended that you always do so accompanied.

 
Sometimes treatment may require pre- or post-medication which the nurse will give via the same route, with the aim of minimising side effects

Chemotherapy can be given as a single treatment or in combined therapy with other types of treatment such as radiotherapy or surgery, targeted therapy, or hormone therapy.
 
The intention of treatment may be:
 

• To eliminate possible remaining tumour cells following surgery (adjuvant).
• To reduce the tumour or prevent it from spreading (metastasising) before surgery (neoadjuvant).
• To control disease-related symptoms.
• To enhance another treatment given at the same time (concomitant), generally radiotherapy.

Your oncologist will assess the most appropriate administration route for you, it may be:
 
Intravenous:
 
medication is given directly into the vein. When treatment is long or has numerous sessions, permanent administrations systems may be recommended as these prevent having a needle inserted at every session and possible complications. We can use these systems to extract blood for analysis and to administer medication. There are two alternatives:

Oral:
The drug is dispensed in tablet form. Your oncologist will prescribe treatment and will monitor you to ensure that treatment is tolerated and effective.
 
Intrathecal:
Given via lumbar puncture, the aim is for the drug to remain in the space surrounding the spinal cord, together with the cerebrospinal fluid. It is more commonly used in haematological cancers.
 
Intraoperative:
Administered directly to the tumour, during surgery.

Side effects depend highly on the drug, dose, and regimen as well as how the chemotherapy is tolerated by the patient. Premedication helps us to control toxicity and reduce side effects.
 
Possible side effects:
 

• Digestive abnormalities: nausea, vomiting, diarrhoea, loss of appetite…

 

• Changes in sense of taste or smell.

 

• Mouth ulcers

 

• Fatigue

 

• Tendency to bruise.

• Changes in hair, skin and nails: some types of chemotherapy can cause hair loss, this hair loss can have an emotional impact. There are different solutions including hairpieces…

• Effects on fertility: Infertility in the oncological patient depends on:
  –  The type, stage and site of the tumour.
  –  The age and sex of the patient.
  –  Chemotherapy dose and drug.
  –  In young, fertile patients who wish to have children, egg or sperm preservation may be considered prior to treatment.

 

Would you like to know more about preserving fertility?

 

Advice for dealing with side effects

Before, during and after treatment, your oncologist will request different tests to check treatment response.
 
These may be:
 

• Clinical response: the patient has symptoms of the disease which are reduced or disappear after having treatment.
• radiological response: comparing various radiological investigations with previous ones.
• Biochemical response: monitoring of tumour markers such as PSA during treatment.
• Pathological response: on neoadjuvant treatment. When chemotherapy is administered prior to surgery, the tumour is checked to see how it has responded after surgical removal.