Cytotoxic Chemotherapy

What is chemotherapy?

Chemotherapy, or chemo, is most commonly associated with the use of cytotoxic or “cell killing” chemical agents to destroy rapidly dividing cancer cells. Unlike localized forms of cancer treatment, such as radiation or surgery, chemotherapy eliminates cancer cells throughout the entire body which is why it is often referred to as systemic therapy.

Chemo can be delivered with one drug as a single agent or in combination with other drugs. As well, chemotherapy may be used in conjunction with other treatment modalities such as radiation therapy or surgery.

Why is chemotherapy used?

The exact goals of chemotherapy will depend on the type and stage of the cancer and overall health of the patient. Chemo can be used for the following reasons.

  • To reduce the size of a tumor before surgery (neoadjuvant chemo)
  • To prevent the cancer from coming back after surgery (adjuvant chemo)
  • To make the cancer cells more susceptible to the damage caused by radiation therapy (radio-sensitizing chemo)
  • To treat disease that has metastasized or spread to distant sites
  • To maintain a patient who has stable disease or is in remission
  • To re-treat cancer if it returns
  • To manage symptoms and improve quality of life
  • To extend life

How should a patient prepare for chemotherapy?

Prior to the first chemotherapy appointment and every three to four weeks thereafter, the patient will meet with the treating physician. If possible, a patient should bring someone to the physician visits to help listen to the facts and keep the information in context. Taking notes may also help the patient to remember and understand all of the information and prepare for treatments.

Prior to starting chemo, a list of all current medications should be provided to the physician to ensure there will be no interactions with the prescribed chemotherapy. Once treatment begins, the patient should inform the physician of any new medications, vitamins or herbal supplements.

For each chemotherapy appointment, the patient should plan to spend approximately 2-4 hours at the center. He/she should wear warm, comfortable clothes, and try to get a lot of rest prior to the appointment. If the patient is having trouble sleeping, the treatment team should be notified, and an anti-anxiety medication or a mild sedative may be prescribed.

Upon arrival, if a patient does not have a port or a catheter in place, a nurse will start an IV in order to infuse the chemotherapy. Our nurses are the most skilled nurses in the industry, so patients experience minimal discomfort. The chemotherapy will be delivered over the next few hours. Many patients find that they are able to nap through their treatments at the center. Following treatment, the patient will want to continue to get a lot of rest. If any redness, pain, burning, swelling or discomfort at the injection site is observed following the appointment, it should be reported immediately.