Chemotherapy for cancer

Chemotherapy for cancer is a method of treatment that involves administering various medications to the patient.

In addition, after using chemotherapy, the patient will face a number of side effects - hair loss, bleeding, nausea and others. Side effects appear due to the effect of drugs on healthy cells of the body. Another feature of chemotherapy for cancer is that for complete treatment it is necessary to undergo several courses, since a single injection of medications will not give the proper effect.

Advantages of chemotherapy:

• Complete or partial destruction of cancer cells.
• Control of cancer disease - chemotherapy slows the growth of cancer cells, which allows you to control the process of their spread, and in time to destroy the foci of metastasis.
• Chemotherapy alleviates the painful symptoms of the disease. In the process of treatment, the cancerous tumor decreases in size and volume, so it ceases to squeeze adjacent organs and tissues, does not cause painful sensations.
• Chemotherapy can be used as the only way to treat cancer or combine with radiation therapy or surgery.

[1], [2], [3], [4]

Does chemotherapy help with cancer?

Whether chemotherapy helps with cancer is an urgent issue for patients who have been diagnosed with cancer. The effectiveness of chemotherapy depends on the stage of cancer and its location, the age of the patient and the individual characteristics of his body. Chemotherapy can be used as the only method of treatment or combined with surgical treatment and other therapies, which significantly increases the chances of recovery.

Preparations for chemotherapy are selected individually for each patient. The choice of the drug and the effectiveness of treatment depend on such factors as: the type of cancer, previous treatment, the presence of medical disorders and chronic diseases. The treatment scheme depends on the purpose of the course of treatment. So, chemotherapy can be used to control cancer cells, to ease the symptoms of the disease or completely destroy them.

In order for chemotherapy to help cure the disease, drugs are prescribed courses with interruptions. So, for example, after a week of therapy, the patient is assigned a month of break, and then a few more courses are repeated. Breaks are necessary for the body to create new healthy cells and tissues.

To make sure that the chemotherapy is helping, the oncologist attending the doctor periodically conducts examinations and takes tests. The patient can determine the effectiveness of treatment and how he feels. Some patients mistakenly believe that if after the course of treatment severe side symptoms have begun, then the treatment is effective. But this is not always the case, because each patient has an individual reaction to the drugs. And the effectiveness of treatment can be determined only after several courses of chemotherapy.

Indications for chemotherapy

Indications for chemotherapy depend on the type of cancer and its stage. Treatment is carried out by cycles that alternate with recovery periods. The course of chemotherapy can last from three months to six months. There are a number of factors that affect the indications for chemotherapy, let's consider them:

• Features of a cancerous tumor, its size, stage of development, growth rate, degree of differentiation, expression, the degree of metastasis and involvement of regional lymph nodes, hormonal status.
• Individual features of the patient's body, such as age, localization of malignant cancer, chronic diseases, regional lymph nodes and general health.
• Possible complications and positive effects of chemotherapy. The doctor assesses the risks, complications and the likelihood of treatment effectiveness.

It is from the above described factors that the indications for chemotherapy depend. But do not forget that the evidence for this type of treatment in each case is different. Thus, the chemotherapy procedure will never be prescribed for patients with non-invasive cancer or when the probability of tumor metastasis is very small or absent. In these cases, the patient is given hormone therapy. Chemotherapy is indicated in all cases of lymph node involvement. The size of the tumor does not matter.

The main indications for the course of chemotherapy:

• Cancer diseases, whose remission occurs only after a course of chemotherapy (leukemia, hemoblastosis, rhabdomyosarcoma, chorion carcinoma and others).
• Prevention of metastasis and addition to other therapeutic methods of cancer treatment.
• Transfer of a tumor into an operable state for more effective treatment, that is, complete removal of cancers.

Chemotherapy courses

Chemotherapy courses are made individually for each patient and depend on the structure of the tumor, the stage of development, the site of localization and previous treatment. Typically, the course of chemotherapy consists of several drugs, which are introduced in cycles with interruptions of 3-5 weeks. Breaks are necessary for the body and the immune system to recreate the destroyed healthy cells and can recover a little after the drug therapy is provided.

• During the course of chemotherapy, the patient's diet does not change in practice, the doctor introduces adjustments, taking into account the drugs used. So, if the patient is prescribed platinum drugs, then you need to consume a lot of liquid, but from alcoholic beverages completely discard. It is also forbidden to visit the sauna during the course of chemotherapy.
• During therapy, the patient should avoid exposure to direct sunlight. It is forbidden to carry out physiotherapeutic and thermal procedures.
• Chemotherapy courses increase the risk of colds. But patients are allowed to take herbal decoctions, antipyretics, sulfonamide drugs and antibiotics.
• During the course of chemotherapy, the doctor regularly takes blood tests from the patient, performs ultrasound examination of the liver and kidneys. Women may experience changes in the menstrual cycle (irregular or no-monthly periods). Patients may suffer from insomnia and other side effects of chemotherapy.

The number of courses to be passed to the patient is determined by the attending physician, based on anamnesis. The optimal number is from 4-6 courses of chemotherapy. After several courses, the doctor makes a preliminary prognosis of the effectiveness of treatment and, if necessary, corrects it.

[5], [6],

Chemotherapy regimens

Chemotherapy regimens are a method of treatment that is tailored individually for each patient. Of course, the chosen scheme of medicines does not guarantee complete recovery, but it helps to get rid of painful symptoms and slow down the development of cancer cells. Chemotherapy can be performed both before surgery and after surgery. If the patient suffers from diabetes, obesity or other chronic diseases, then the scheme is selected with extreme caution, taking into account the history.

An effective chemotherapy regimen should have the following properties:

• The level of side effects should be minimal or such that the patient can transfer them.
• Preparations should be carefully chosen so that their interaction does not cause side effects, but rather intensifies the therapeutic effect.
• A matched chemotherapy regimen must destroy all varieties of cancer cells. In this case, cancer cells should not adapt to chemotherapy drugs.

The chemotherapy regimen can be presented as a combination of drugs, while the effectiveness of such a scheme will be from 30 to 65%. Chemotherapy can be performed with a single drug, the effectiveness of such treatment will be from 25 to 60%. Let's look at the most common chemotherapy regimens.

Scheme of chemotherapy	Used drugs	Cancer
ABVD	Adriamycin, Bleomycin, Vinblastin, Dacarbazin	Granulomatosis
BEACOPP	Cyclophosphamid, Etoposid (phosphat), Adriamycin, Procarbazin, Vincristin, Bleomycin, Prednisolon	Severe granulomatosis
CMF	Cyclophosphamid, Methotrexat, 5-Fluoruracil	Mammary cancer
CHOP	Cyclophosphamid, Hydroxydaunorubicin, Vincristin, Prednisolon	Malignant lymphoma
COPP	Cyclophosphamid, Vincristin, Procarbazin, Prednisolon	T-cell and B-cell lymph
CVI	Cyclophosphamid, Vincristin, Prednisolon	Lymphomas, soft tissue sarcomas, skeletal sarcomas
ECF	Epirubicin, Cisplatin, 5-Fluoruracil	Tumors of the breast or stomach, granulomatosis, lymphomas
FLP	5-Fluoruracil, Folinsäure, Cisplatin	Breast cancer, colon cancer
5FUFS	5-Fluoruracil, Folinsäure	Breast cancer, colon cancer
MCF	Mitomycin, Cisplatin, 5-Fluoruracil	Bony sarcomas, tumors of the stomach, intestines, esophagus, pancreas, liver, breast, uterus, bladder, and anal cancer
MTX	Methotrexat	Lymphoblastic leukemia, urothelial tumors, breast cancer, non-granulomatous lymphomas, bone sarcomas
PCV	Procarbazin, Lomustin, Vincristin	Skeletal sarcomas
TEC	Docetaxel, Epirubicin, Cyclophosphamid	Breast cancer of the stomach, non-granulomatous lymphomas, sarcomas
PEB	Cisplatin, Etoposid, Bleomycin	Tumors of the testicles, ovaries, lungs, cervix, bladder.

[7], [8], [9], [10]

Chemotherapy for Breast Cancer

Chemotherapy for breast cancer is a method of complex treatment. The task of this method is to slow the development of malignant cells in the mammary gland. As a rule, cytotoxic drugs are used for treatment. Chemotherapy can be used as an independent treatment method or applied after or before a surgical procedure. Chemotherapy helps prevent relapse of the disease and stop metastasis.

[11], [12], [13], [14], [15], [16],

Chemotherapy for lung cancer

Chemotherapy for lung cancer is aimed at the complete destruction of cancer cells. Treatment with antitumor drugs can be used both as a monotherapy and as part of a therapeutic anticancer complex. Chemotherapy presupposes several courses of administration of cytostatics by a drop route. Preparations for chemotherapy are selected individually for each patient. In addition to chemotherapy, patients are prescribed therapy to reduce the side effects of the drugs used.

[17], [18], [19],

Chemotherapy for gastric cancer

Chemotherapy for stomach cancer has several directions. So drugs can be used after radical surgery, for postoperative intraperitoneal therapy, before surgery or as a treatment for disseminated stomach cancer. Chemotherapy is carried out in a hospital, under the supervision of an oncologist. The drugs are administered intravenously and are used in tablets. The consequences of chemotherapy are destructive for the whole body, so the rehabilitation period after such treatment can last several years.

[20], [21], [22],

Chemotherapy for ovarian cancer

Chemotherapy for ovarian cancer is used to stop metastasis and prevent recurrence of the disease. Chemotherapy can be used before and after radical surgery, to slow the growth of the tumor, alleviate the painful symptoms and reduce the volume of surgical treatment. Chemotherapy drugs are administered intravenously, taken orally or injected into the abdominal cavity. There are many different drugs and treatment regimens, each of which has certain efficacy and side effects. The oncologist selects the optimal treatment option for a high chance of complete recovery of the patient.

[23], [24], [25], [26], [27],

Chemotherapy for colorectal cancer

Chemotherapy for rectal cancer takes place in a hospital, under the supervision of an oncologist-chemotherapist. The doctor selects the treatment regimen, determines how many courses of chemotherapy it is necessary to conduct and monitor the patient's condition during the treatment. Drugs can be administered intravenously, but more often by mouth, that is, through the mouth. If chemotherapy is used in the early stages of the disease, it allows completely to stop the cancer process and prevent its recurrence in the future.

[28], [29]

Chemotherapy for stage 4 cancer

Chemotherapy at stage 4 cancer is a method of treatment of irreversible uncontrolled spreading and proliferation of tumor cells throughout the body. Correctly formulated scheme of chemotherapy allows you to extend the life of the patient and significantly improve it. Survival of patients after chemotherapy with stage 4 cancer ranges from 30-70%, and life expectancy from six months to five years. Everything depends on the type of tumor, the presence of concomitant diseases and the degree of destruction of vital organs.

A key indicator of the effectiveness of chemotherapy in stage 4 cancer is a five-year survival rate. Under this concept, the survival of the patient from the moment of diagnosis is implied - stage 4 cancer. Let's consider the effectiveness of chemotherapy in the 4 stages of oncology, with various localizations of cancer.

• Lungs' cancer

When chemotherapy is carried out at the 4 stages of lung cancer, the five-year survival rate among patients is 10%. In addition to chemotherapy, radiotherapy can be used to alleviate the symptoms of the disease and reduce the size of the tumor. This allows you to significantly reduce the size of the tumor and destroy metastases in vital organs.

• Liver cancer

Chemotherapy for liver cancer stage 4 is effective for 6% of patients. At this stage, chemotherapy allows you to destroy part of the metastases. But classical chemotherapy is not effective in fighting the source of the disease.

• Stomach cancer

This disease during the course of chemotherapy at the last stage, has a high favorable prognosis, 15-20%. For treatment, palliative chemotherapy is used, which helps to stabilize the course of cancer.

• Pancreas cancer

At 4 stages of cancer, chemotherapy is not effective. Five-year survival rates of patients range from 2-5%. Chemotherapy is used to relieve the patient's condition, reduce the size of the tumor, which squeezes adjacent organs and tissues, as well as to destroy metastases.

• Bowel cancer

In bowel cancer in 4 stages, chemotherapy is used only after palliative surgical treatment. Survival of patients is about 5%.

• Mammary cancer

Chemotherapy is used to destroy metastases, relieve symptoms of cancer or after surgical manipulation.

• Prostate Cancer

With this disease, chemotherapy has a positive result. Thus, the survival rate of patients in the 4th stage of cancer after the course of chemotherapy is about 30%. Particularly dangerous are metastases that disrupt the functioning of the liver, kidneys and lungs.

• Uterine cancer

The effectiveness of chemotherapy is 8-9%. The risk of cancer in 4 stages is that the process affects the organs of the small pelvis.

The therapeutic effect of chemotherapy in stage 4 cancer depends on a number of factors. So, the effectiveness of treatment affects the development of metastasis in the brain, violations of vital organs, blood clotting disorders, severe pain syndrome, arterial thrombosis and other pathologies.

The main goal of chemotherapy in stage 4 cancer is to limit the spread of the tumor, to reduce the rate of its growth, to preserve the functioning of organs and systems, and to prevent the life-threatening complications.

[30], [31], [32]

Preparations for chemotherapy

Drugs for chemotherapy are antineoplastic drugs that destroy cancer cells and destroy them. In the treatment of cancer, two types of chemotherapy can be used. The first type is the treatment of cancer with one drug or monochemotherapy, and the second - treatment with several drugs or polychemotherapy. The second type of chemotherapy is more effective. Very often chemotherapy is combined with other methods of treatment - surgical treatment, radiotherapy.

There are many drugs for chemotherapy and all of them have a similar mechanism of action. So, the faster the cancer cells divide and grow, the more sensitive they are to antitumor drugs and the more effective the chemotherapy. All drugs for chemotherapy are divided into certain groups. Allocate anti-cancer drugs that act on all phases of the cell cycle, drugs effective for a particular phase of cancer and cytotoxic drugs with a different mechanism of action. Let's take a closer look at some groups of drugs used in chemotherapy.

Alkylating agents

The drugs act on cancer cells at the molecular level. The most popular anticancer drugs from this group are: Cyclophosphan, Embihin, Nitrosourea preparations.

[33], [34]

Antibiotics

Some antibiotics have antitumor activity and effectively destroy cancer cells at different phases of the cell cycle.

[35], [36], [37], [38],

Antimetabolites

Drugs block the metabolic processes in cancer cells, which leads to their destruction. The most effective drugs in this group are: Methotrexate, Citarabin, 5-fluorouracil

[39], [40], [41],

Anthracyclines

The composition of the drug includes active substances that interact with DNA and destroy cancer cells. This group of drugs includes: Rubomycin, Adryblastin.

[42], [43], [44], [45]

Winkalkaloids

Anticancer preparations on a plant basis. Destroy the division of cancer cells and destroy them. This group of drugs includes: Vinblastine, Vincristine, Vindesin.

Preparations of platinum

Preparations have in their composition toxic substances, elements of one of the most heavy metals. By the mechanism of action, platinum preparations are similar to alkylating agents.

Epipodophyllotoxins

Antineoplastic drugs, which are a synthetic analogue of the active substances of the extract of mandrake. The most popular of them: Etoposide, Tniposide.

Each group of drugs for chemotherapy has its advantages and disadvantages. Drugs for treatment are chosen by the oncologist, focusing on the localization of the cancer, the stage and type of cancer, as well as the age of the patient and the characteristics of his body.

[46], [47], [48], [49], [50], [51], [52]

Contraindications to chemotherapy

Contraindications to chemotherapy, as well as indications for the treatment, depend on the stage of cancer, the location of the tumor and the individual characteristics of the patient's body. So the main contraindications for the course of chemotherapy are:

• Intoxication of the body.
• Metastasis in the liver.
• High level of bilirubin.
• Metastasis in the brain.
• Cachexia.

The attending oncologist after conducting the examinations and examining the results of the analyzes draws conclusions about the effectiveness of the use of chemotherapy or prohibits the use of this method of treatment.

[53], [54], [55], [56], [57]

Side effects of chemotherapy

The side effects of chemotherapy are the main drawback of this type of treatment. Side-line symptomatology is due to the fact that chemotherapy acts on the entire body, affecting not only cancerous, but also healthy cells of the body. Chemotherapy affects the cells of the hematopoietic system and blood, gastrointestinal tract, nose, hair bulbs, nails, appendages, vagina, skin, mucous membrane of the mouth. But unlike cancer cells, these cells can be restored. That is why, the side symptomatology of chemotherapy is after the withdrawal of drugs. Some side effects of chemotherapy are fast, but others last for several years or manifest themselves in a few years.

There are the following side effects of chemotherapy:

• Osteoporosis is the rarefaction and weakening of bone tissue. A side symptom arises from combined chemotherapy, with the use of drugs: cyclophosphamide, methotrexate, fluorouracil.
• Nausea, vomiting, diarrhea - chemotherapy affects all cells of the body. This abnormal symptomatology is caused by abnormalities in the work of the gastrointestinal tract, but the symptoms go away after the chemotherapy is discontinued.
• Hair loss (alopecia) - after chemotherapy hair can fall out partially or completely. Hair loss can occur at the beginning of treatment, and after several courses of chemotherapy. Hair growth is restored after cessation of treatment.
• Side effects on the skin and nails - in some patients, rashes may appear all over the skin, dryness, itching, peeling. Nails become brittle, and the skin is sensitive to temperature changes and mechanical damage.
• Fatigue and anemia are the most frequent side effect of chemotherapy. Fatigue and anemia appear due to a drop in red blood cells.
• Infectious complications - chemotherapy significantly weakens the immune system, which makes it sensitive to various infections and viruses.
• Violation of blood clotting - most often due to chemotherapy treatment of blood cancer. The main cause of the disorder is a decrease in the number of platelets in the blood. The patient has bleeding and bruises on the body.
• Stomatitis - chemotherapy has a harmful effect on the mucosa of the oral cavity. Ulceration and stomatitis appear in the oral cavity. Ranks become open to any infection, fungi and viruses.
• Changes in taste and smell - the use of chemotherapy can change the habitual sense of smell and taste. Many patients note the appearance of metallic taste in the mouth. This is due to the fact that the taste receptors are located in the tongue, which transmit the taste sensations to the brain. But because of the action of chemotherapy, this process is broken.
• Influence on the reproductive system - chemotherapy causes irregularities in the menstrual cycle and adversely affects the performance of the ovaries. As a result - a woman is experiencing temporary or complete infertility. This side effect also applies to men who undergo chemotherapy.

In addition to the above side effects, sleep disorders, temporary loss or deterioration of memory, hormonal disorders, insomnia or increased drowsiness, frequent headaches and other consequences of chemotherapy are possible.

Complications of chemotherapy

Complications of chemotherapy occur very often, usually with aggressive chemotherapy and a weakened body of patients. The most severe complications of chemotherapy are manifested as tiflitis, that is, inflammation of the cecum, anorectal infections and pneumonia. Let's take a closer look at each of the options for complicating chemotherapy.

• Typhlitis

A very serious complication, which is manifested by minor pain in the abdomen. The peculiarity of this disease is that it rapidly progresses, causes inflammation of the caecum, gangrene or perforation. Among patients with cancer, the mortality rate is precisely this side effect. The main task of an oncologist is to diagnose the disease in time and prescribe a treatment.

• Anorectal infection

Infection in the anus is found in 8% of patients who undergo chemotherapy. Complication can occur due to the use of chemotherapy through the mouth. The disease is susceptible to patients with a weakened immune system, the mortality rate for this lesion is 20-40%.

• Pneumonia

Complications of the inflammatory nature, as a rule, appear in patients with a weakened immune system. Timely diagnosis and treatment can prevent the lethal outcome of this complication of chemotherapy.

[58], [59], [60], [61], [62]

Nutrition for chemotherapy

Nutrition with chemotherapy is aimed at restoring the body and maintaining its normal functions. So, a balanced diet should include such groups of products as: protein, cereals, fruit and vegetable and dairy groups.

Chemotherapy adversely affects the digestive and gastrointestinal tract. It is because of this that the patients have problems with nutrition. The main rule of recovery and maintenance of the body in cancerous diseases is a balanced diet. Regular meals can alleviate the side symptoms of chemotherapy and other treatments. Let's take a closer look at each of the product groups that should be included in the diet of a patient with cancer.

• Protein products - with chemotherapeutic treatment, it is recommended to use soy products, meat, liver, fish, eggs, legumes. All these foods are rich in protein, B vitamins and iron.
• Dairy products - lactic acid products favorably affect the gastrointestinal tract of patients and overall well-being. It is recommended to consume kefir, milk, cheese, butter, yogurt, yoghurt and other dairy products.
• Fruits and vegetables - during the chemotherapy period, patients should consume both boiled and raw vegetables and fruits. It is recommended to make salads, juices, fresh, eat dried fruits. Do not forget about the greens, which can be added to all dishes.
• Bakery products and cereals - patients with cancer should eat a variety of cereals, cereals and cereals.

Before each course of chemotherapy, the patient should have a snack. It is not recommended to take drugs on an empty or overloaded stomach. In the process of chemotherapy, it is necessary to exclude from the diet acute dishes, as well as fried and fatty. But after the course of chemotherapy nutrition should be abundant, in order to restore strength.

Chemotherapy for cancer is an effective treatment method that destroys cancer cells, reduces the volume of malignant formation and fights with distant lymph nodes. Chemotherapy is selected individually for each patient. The effectiveness of this type of treatment depends on the stage of cancer, the degree of damage to the body and other individual characteristics of the patient's body.