Chemotherapy: Killer Effects of Chemotherapy You Must Know (Must Read)

What is Chemotherapy?

Chemotherapy is the use of medication (chemicals - medicine or drug) to treat disease(s).

Apparently, chemotherapy refers to the destruction of cancer cells. It may also include the use of antibiotics or other medications to treat any illness or infection.

The thought of having chemotherapy frightens many people. But understanding what chemotherapy is, how it works, and what to expect can often help calm your fears. It can also give you a better sense of control over your cancer treatment.

How is Chemotherapy Used to Treat Cancer?

Chemotherapy is the use of any drug to treat any disease. But to most people, the word chemotherapy means drugs used for cancer treatment. It’s often shortened to “chemo.”

Surgery and radiation therapy remove, kill, or damage cancer cells in a certain area, but chemo can work throughout the whole body. This means chemotherapy can kill cancer cells that have spread (metastasized) to parts of the body far away from the original (primary) tumor.

Chemotherapy (chemo) is used to treat cancer in three major ways. But the reason for the treatment used or prescribed for you is based on the stage which the disease has reached. The three goals for chemotherapy are briefly described below:

1.  Cure

If possible, chemo could be used to cure cancer. That is, the cancer is destroyed – it goes away and doesn’t come back. or used to destroy cancer cells that may remain after surgery or radiation therapy. 

Most doctors don’t use the word “cure” except as a possibility or intention. So, when giving treatment that has a chance of curing a person’s cancer, the doctor may describe it as treatment with curative intent.

There are no guarantees, and though cure may be the goal, it doesn’t always work out that way. It often takes many years to know if a person’s cancer is really cured.

2. Control

If cure is not possible, the goal may be to control the disease. Chemotherapy is used to shrink tumors and/or stop the cancer from growing and spreading. This can help the person with cancer feel better and live longer.

In many cases, the cancer doesn’t completely go away, but is controlled and managed as a chronic disease, much like heart disease or diabetes. In other cases, the cancer may even seem to have gone away for a while, but it’s expected to come back. Then chemo can be given again.

3. Ease (Also Palliation or Palliative care)

Chemotherapy can also be used to ease the symptoms caused by the cancer. This is called palliative chemotherapy or palliation.

When the cancer is at an advanced stage, - when it’s not under control and has spread from where it started to other parts of the body - the goal may be to improve the quality of life of the person or help the person feel better. For instance, chemo may be used to help shrink a tumor that’s causing pain or pressure.

Sometimes, chemotherapy may be used as the only cancer treatment. But more often, chemotherapy is used alongside with surgery, radiation therapy, or biological therapy.

The Side Effects Of Chemotherapy

 

Cancer cells tend to grow fast, and chemo drugs help kill fast-growing cells. But because these drugs travel throughout the body, they can affect the normal, healthy cells that are fast-growing, too. Damage to these healthy cells causes side effects. Although, side effects are not always as bad as they may seem, many people worry about this part of cancer treatment.

The normal cells most likely to be damaged by chemo are :

- Blood-forming cells in the bone marrow

- Hair follicles

- Cells in the mouth, digestive tract, and reproductive system.

Some chemo drugs can damage cells in the heart, kidneys, bladder, lungs, and nervous system. Sometimes, you can take medicines with the chemo to help protect your body’s normal cells. There are also treatments to help relieve side effects.

Doctors try to give chemo at levels high enough to treat cancer, while keeping side effects at a minimum. They also try to avoid using multiple drugs that have similar side effects.

What you should know about side effects

Even though chemotherapy has it's side effects, you should however know that:

• Every person doesn’t get every side effect, and some people get few, if any.
• The severity of side effects (how bad they are) varies greatly from person to person. Be sure to talk to your cancer care team about which side effects are most common with your chemo, how long they might last, how bad they might be, and when you should call the doctor’s office about them.
• Some chemo drugs cause long-term side effects, like heart or nerve damage or fertility problems. Still, many people have no long-term problems from chemo. Ask your doctor if the chemo drugs you’re getting have long-term effects.

While side effects can be unpleasant, they must be weighed against the need to kill the cancer cells.

Be sure to talk to your cancer care team about which side effects are most common with your chemo, how long they might last, how bad they might be, and when you should call the doctor’s office about them.

How long do side effects last?

Many side effects go away fairly quickly after treatment ends, but some may take months or even years to completely go away. The time it takes to get over some side effects and get your energy back varies from person to person. It depends on many factors, including your overall health condition and the drugs you were given.

Sometimes the side effects can last a lifetime, such as when chemo causes long-term damage to the heart, lungs, kidneys, or reproductive organs. Certain types of chemo sometimes cause delayed effects, such as a second cancer that may show up many years later.

People often become discouraged about how long their treatment lasts or the side effects they have. If you feel this way, talk to your cancer care team. You may be able to change your medicine or treatment schedule. They also may be able to suggest ways to reduce any pain and discomfort you have.

What are the common side effects?

Most people worry about whether they’ll have side effects from chemotherapy or not, and, if so, what they’ll be like. Well, here are some of the most common side effects caused by chemotherapy:

1. Nausea and vomiting

Over half of all patients receiving chemotherapy will experience nausea and vomiting.

Doctors will usually prescribe anti-emetics for this. These need to be taken even when symptoms have gone as they will prevent them from coming back. If the anti-emetics do not work the patient should contact his/her doctor who may switch to another method.

2. Alopecia (hair loss)

Some chemotherapy medications cause hair loss while others don't. If hair does start to fall out this will usually happen a few weeks after treatment starts. On some occasions the hair will just become thinner and more brittle (without falling out). Hair loss can occur in any part of the body.

Although hair loss has no physical health consequences, it may cause distress and embarrassment for some people. The psychological impact tends to be greater among women than men. If you experience hair loss and find it is causing distress and embarrassment, there are several steps you can take:

• Tell your doctor, who may refer you to a counselor who can provide effective help and support.
• Many people find that if they purchase a wig their quality of life improves significantly. So, you also can try using a wig.
• If there is a cancer support group in your area, go to their meetings. Meeting people who share similar experiences to yourself may help give you a boost, as well as providing you with some useful tips, and possibly an opportunity to make new friends.
• Cold cap - this looks a bit like a bicycle helmet and keeps the scalp cool while the chemotherapy dose is being administered. If the scalp can be kept cool less chemotherapy medication reaches the scalp, thus preventing the occurrence or reducing the severity of hair loss. Some people however, cannot wear a cold cap - leukemia (blood cancer) patients need the medication to reach their scalp.

NB: The hair loss is NOT permanent - it will grow back soon after treatment is finished.

3. Fatigue

Most patients receiving chemotherapy will experience some degree of fatigue. This may be a general feeling which exists most of the day, or may only appear after certain (strenuous) activities. Doctors say patients need to make sure they get plenty of rest and not to perform tasks which are requires extra strength and/or energy.

While light exercise has been shown to help, it is important to remember to keep the activities 'light'.

If the tiredness becomes severe it is important to tell the doctor, as this could be caused by a significant drop in red blood cells.

4. Hearing Impairment (deafness)

Some chemotherapy drugs, other medications or radiation used to treat children’s cancer can damage hearing. Hearing loss can interfere with daily living.

Radiation to the ear or brain can cause inflammation or ear wax buildup in the outer ear, problems with fluid buildup in the middle ear, or stiffness of the eardrum or middle ear bones. Any of these problems can result in conductive hearing loss. Radiation can also damage the sensory hair cells in the inner ear, causing sensorineural hearing loss. Damage from radiation may affect one or both ears, depending on the area of radiation treatment.

Platinum chemotherapy and aminoglycoside antibiotics damage sensory hair cells in the inner ear, causing sensorineural hearing loss. Most often, the effect is similar in both ears and is permanent.

Symptoms of hearing loss include:

• Ringing or tinkling sounds in the ear
• Difficulty hearing in the presence of background noises
• Not paying attention to sounds (such as voices, environmental noises)
• Some people may have no symptoms at all

5. Neutropenia (low white blood cells) - Susceptibility to infections

When receiving chemotherapy, the immune system will be weakened because the white blood cell count will go down. White blood cells form part of our immune system - they fight infection. Consequently, patients become more susceptible to infections.

The following precautions will help reduce the risk of infections:

• Personal hygiene - the cleaner you are, the fewer bacteria there will be around which can infect you. Regularly wash your hands (mostly after visiting the toilet/restroom) with warm water and soap, have a bath/shower at least once a day, change your clothes and bathroom towels daily. Change your bed linen regularly.
• Preparing food - make sure your food is free of food borne pathogens (organisms, such as bacteria that can make you ill). If you handle raw meat make sure you wash your hands before touching plates and cutlery or work surfaces. Thoroughly cook animal sourced proteins before eating them. Wash your dishes thoroughly and always use a clean plate and cutlery - always keep the kitchen clean.
• Infected people - stay away from people who are ill. This may include those who just have a temperature.
• Skin wounds - bacteria find it hard to get in through your skin, unless there is a cut. If you graze or cut your skin, clean the area well with warm water, dry it, and cover it with a sterile dressing.

Patients receiving chemotherapy who develop an infection need immediate treatment. This may mean being hospitalized.

6. Thrombocytopenia (low blood platelet count) - blood clotting problems

Chemotherapy may lower the patient's blood platelet count. A platelet is a type of blood cell that helps the blood to clot (coagulate). Coagulation is essential, otherwise bleeding does not stop. Lower blood platelet counts linked to chemotherapy is a risk, but less so that lower red or white blood cell counts. If you are affected you will bruise more easily, you will be more likely to have nosebleeds and bleeding gums, and if you cut yourself it may be harder to stop the bleeding.

Patient's whose blood platelet counts fall too low will need a blood transfusion.

Below are few steps you may wish to take to reduce your risk of bleeding:

• Shave with an electric razor (or don't shave)
• Avoid hard toothbrushes
• Be very careful when you use kitchen utensils and gardening equipment
• Wear gloves when you are gardening

7. Anaemia (low red blood-cell count)

As well as reducing your white blood cell count, chemotherapy will also lower your red blood cell count. Tissues and organs inside your body get their oxygen from the red blood cells. If your red blood cell count goes down too many parts of your body will not get enough oxygen and you will develop anaemia.

People with anemia feel very tired. A patient on chemotherapy who has anaemia will feel extra tired - much more tired than straightforward fatigue caused by the treatment. Also, shortness of breath is another symptom of anaemia, as are palpitations (when the heart beat is irregular).

Anemia linked to chemotherapy requires immediate treatment. A blood transfusion will bring the red blood cell count back up immediately. Erythropoietin (EPO) is a drug that makes the body produce more red blood cells.

The following foods are rich in iron, which helps red blood cells carry more oxygen. Dark green leafy vegetables, beans, meat, nuts, prunes, raisins, and apricots.

8. Mucositis (inflammation of the mucous membrane)

Chemotherapy attacks rapidly dividing cells, such as blood cells, bone marrow cells, and cells of the mucous membranes that line the digestive system - this includes the mouth, oesophagus, stomach, intestines, and the rectum to the anus. Chemotherapy may damage and even destroy some of these mucous membrane cells.

Symptoms do appear about 7 to 10 days after treatment starts. The inside of the mouth may feel like sunburn; some people say it feels as if the area had been scalded. Ulcers often appear on the lining of the mouth, the tongue, and sometimes around the lips. The severity of symptoms is closely linked to the strength of the chemotherapy dose.

Some may find it painful when they eat, drink, or even talk. If the ulcers bleed there is a risk of infection.

Caphosol is often prescribed for mucositis.

As better drugs are appearing, mucositis is becoming less common. Symptoms clear up a few weeks after treatment is completed.

9. Loss of Appetite

Loss of appetite is a common side effect of chemotherapy. It is possible that the chemotherapy, or the cancer itself, affects the body's metabolism. If the loss of appetite is just due to the chemotherapy it will come back when the treatment is finished - although this may sometimes take a few weeks.

The severity of appetite and consequent weight loss depends on the type of cancer and chemotherapy treatment.

Although this is sometimes easier said than done, it is important to keep trying to eat well and take in plenty of fluids. Also, drinking liquids through a straw may result in a better fluid intake.

Patients who become seriously affected by lack of food and liquid intake may need to be hospitalized and fed through a nasogastric tube. The tube goes into the patient's nose and down to his/her stomach.

10. Flaky Nails and Dry Skin

Chemotherapy can sometimes cause dry and sore skin. Nails may also become flaky and brittle.

The skin may become more sensitive to sunlight. It is important to protect yourself from too much sunlight exposure. This includes staying out of the sun during peak times of the day, using sun blocks, and wearing clothes that provide maximum protection.

11. Cognitive problems

About one fifth of patients undergoing chemotherapy report some kind of cognitive problems, including attention, thinking and memory. This can sometimes have an impact on daily tasks. Patients who do experience these symptoms should talk to their doctor, and social worker.

Symptoms may include:

• Shorter attention span; concentration, focus and attention problems
• Memory problems; especially the short-term memory
• Comprehension and understanding problems
• Judgment and reasoning problems
• Multitasking problems (performing/thinking about several things at the same time)
• Mood swings.

Experts are unsure how much is due to the chemotherapy, and how much is due to fatigue, stress and anxiety that come with having cancer.

12. Libido (sex drive) and Fertility

For a significant proportion of patients, chemotherapy may result in a lower sex drive (less interest in sex). This is temporary and usually returns after treatment is completed.

Depending on the type of medication administered, chemotherapy may also damage men's sperm. Some women may become infertile. In most cases - though not all - fertility returns after treatment is over.

Men who wish to father children and women who plan to become pregnant one day should discuss possible options with their doctors before starting treatment. It is possible to freeze sperm and embryos.

13. Bowel Movement Problems (Diarrhea or Constipation)

Sometimes when damaged cells in the intestinal tract are rapidly expelled from the body there is a risk of diarrhea. Constipation is also a possible risk for chemotherapy patients. You should talk to your doctor if you experience any unpleasant change in your bowel movements. Symptoms occur a few days after chemotherapy begins.

14. Depression

The risk of developing depression is already higher for patients with cancer. It is normal to feel distressed, anxious, sad and stressed - especially if you are concerned about what the future holds and whether treatment is going to be effective.

It is important that you talk to a member of the medical team if you feel it is all getting to be overwhelming, or if you no longer get pleasure out of the things that you used to like. Joining a support group and talking to people who are going through the same as you and understand how you feel has helped many people with cancer.

While you’re getting chemotherapy, you’ll probably notice every physical change and imbalance. Do not take any physical symptoms you have with levity hands. Always update your cancer care team about changes in order to prevent further damages or threat to your health.

Some side effects are short-lived and minor, but others may be a sign of serious problems. You should not be the judge. Make sure you know how to reach someone on your team any time, including after hours, weekends, and holidays.

Contact your cancer care team right away if you have any of the following symptoms during chemo treatment:

• Bleeding or unexplained bruising
• A rash or allergic reaction, such as swelling of the mouth or throat, severe itching, trouble swallowing
• Intense chills
• Pain or soreness at the chemo injection site
• Unusual pain, including intense headaches
• Shortness of breath or trouble breathing (If you’re having trouble breathing call 911 first.)
• Long-lasting diarrhea or vomitting
• Bloody stool or blood in your urine