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Need more information don't be afraid of being informed 

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Need more information don't be afraid of being informed 

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571-483-1780 Cancer.org
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Overview

Chemotherapy is a drug treatment that uses powerful chemicals to kill fast-growing cells in your body.

Chemotherapy is most often used to treat cancer, since cancer cells grow and multiply much more quickly than most cells in the body.

Many different chemotherapy drugs are available. Chemotherapy drugs can be used alone or in combination to treat a wide variety of cancers.

Though chemotherapy is an effective way to treat many types of cancer, chemotherapy treatment also carries a risk of side effects. Some chemotherapy side effects are mild and treatable, while others can cause serious complications.

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Why it's done

Chemotherapy is used to kill cancer cells in people with cancer.

There are a variety of settings in which chemotherapy may be used in people with cancer:

To cure the cancer without other treatments. Chemotherapy can be used as the primary or sole treatment for cancer.

After other treatments, to kill hidden cancer cells. Chemotherapy can be used after other treatments, such as surgery, to kill any cancer cells that might remain in the body. Doctors call this adjuvant therapy.

To prepare you for other treatments. Chemotherapy can be used to shrink a tumor so that other treatments, such as radiation and surgery, are possible. Doctors call this neoadjuvant therapy.

To ease signs and symptoms. Chemotherapy may help relieve signs and symptoms of cancer by killing some of the cancer cells. Doctors call this palliative chemotherapy.

Chemotherapy for conditions other than cancer

Some chemotherapy drugs have proved useful in treating other conditions, such as:

Bone marrow diseases. Diseases that affect the bone marrow and blood cells may be treated with a bone marrow transplant, also known as a stem cell transplant. Chemotherapy is often used to prepare for a bone marrow transplant.

Immune system disorders. Lower doses of chemotherapy drugs can help control an overactive immune system in certain diseases, such as lupus and rheumatoid arthritis.

Risks

Side effects of chemotherapy drugs can be significant. Each drug has different side effects, and not every drug causes every side effect. Ask your doctor about the side effects of the particular drugs you'll receive.

Side effects that occur during chemotherapy treatment

Common side effects of chemotherapy drugs include:

Many of these side effects can be prevented or treated. Most side effects subside after treatment ends.

Long-lasting and late-developing side effects

Chemotherapy drugs can also cause side effects that don't become evident until months or years after treatment. Late side effects vary depending on the chemotherapy drug but can include:

Damage to lung tissue

Heart problems

Infertility

Kidney problems

Nerve damage (peripheral neuropathy)

Risk of a second cancer

Ask your doctor if you have a risk of any late side effects. Ask what signs and symptoms you should be aware of that may signal a problem.

How you prepare

How you prepare for chemotherapy depends on which drugs you'll receive and how they'll be administered. Your doctor will give you specific instructions to prepare for your chemotherapy treatments. You may need to:

Have a device surgically inserted before intravenous chemotherapy. If you'll be receiving your chemotherapy intravenously - into a vein - your doctor may recommend a device, such as a catheter, port or pump. The catheter or other device is surgically implanted into a large vein, usually in your chest. Chemotherapy drugs can be given through the device.

Undergo tests and procedures to make sure your body is ready to receive chemotherapy. Blood tests to check kidney and liver functions and heart tests to check for heart health can determine whether your body is ready to begin chemotherapy. If there's a problem, your doctor may delay your treatment or select a different chemotherapy drug and dosage that's safer for you.

See your dentist. Your doctor may recommend that a dentist check your teeth for signs of infection. Treating existing infections may reduce the risk of complications during chemotherapy treatment, since some chemotherapy may reduce your body's ability to fight infections.

Plan ahead for side effects. Ask your doctor what side effects to expect during and after chemotherapy and make appropriate arrangements. For instance, if your chemotherapy treatment will cause infertility, you may wish to consider your options for preserving your sperm or eggs for future use. If your chemotherapy will cause hair loss, consider planning for a head covering.

Make arrangements for help at home and at work. Most chemotherapy treatments are given in an outpatient clinic, which means most people are able to continue working and doing their usual activities during chemotherapy. Your doctor can tell you in general how much the chemotherapy will affect your usual activities, but it's difficult to predict exactly how you'll feel.

Ask your doctor if you'll need time off work or help around your home after treatment. Ask your doctor for the details of your chemotherapy treatments so that you can make arrangements for work, children, pets or other commitments.

Prepare for your first treatment. Ask your doctor or chemotherapy nurses how to prepare for chemotherapy. It may be helpful to arrive for your first chemotherapy treatment well rested. You might wish to eat a light meal beforehand in case your chemotherapy medications cause nausea.

Have a friend or family member drive you to your first treatment. Most people can drive themselves to and from chemotherapy sessions. But the first time you may find that the medications make you sleepy or cause other side effects that make driving difficult.

What you can expect

Determining which chemotherapy drugs you'll receive

Your doctor chooses which chemotherapy drugs you'll receive based on several factors, including:

Type of cancer

Stage of cancer

Overall health

Previous cancer treatments

Your goals and preferences

Discuss your treatment options with your doctor. Together you can decide what's right for you.

How chemotherapy drugs are given

Chemotherapy drugs can be given in different ways, including:

Chemotherapy infusions. Chemotherapy is most often given as an infusion into a vein (intravenously). The drugs can be given by inserting a tube with a needle into a vein in your arm or into a device in a vein in your chest.

Chemotherapy pills. Some chemotherapy drugs can be taken in pill or capsule form.

Chemotherapy shots. Chemotherapy drugs can be injected with a needle, just as you would receive a shot.

Chemotherapy creams. Creams or gels containing chemotherapy drugs can be applied to the skin to treat certain types of skin cancer.

Chemotherapy drugs used to treat one area of the body. Chemotherapy drugs can be given directly to one area of the body. For instance, chemotherapy drugs can be given directly in the abdomen (intraperitoneal chemotherapy), chest cavity (intrapleural chemotherapy) or central nervous system (intrathecal chemotherapy). Chemotherapy can also be given through the urethra into the bladder (intravesical chemotherapy).

Chemotherapy given directly to the cancer. Chemotherapy can be given directly to the cancer or, after surgery, where the cancer once was. As an example, thin disk-shaped wafers containing chemotherapy drugs can be placed near a tumor during surgery. The wafers break down over time, releasing chemotherapy drugs. Chemotherapy drugs may also be injected into a vein or artery that directly feeds a tumor.

How often you receive chemotherapy treatments

Your doctor determines how often you'll receive chemotherapy treatments based on what drugs you'll receive, the characteristics of your cancer and how well your body recovers after each treatment. Chemotherapy treatment schedules vary. Chemotherapy treatment can be continuous, or it may alternate between periods of treatment and periods of rest to let you recover.

Where you receive chemotherapy treatments

Where you'll receive your chemotherapy treatments depends on your situation. Chemotherapy treatments can be given:

In an outpatient chemotherapy unit

In a doctor's office

In the hospital

At home, such as when taking chemotherapy pills

Results

You'll meet with your cancer doctor (oncologist) regularly during chemotherapy treatment. Your oncologist will ask about any side effects you're experiencing, since many can be controlled.

Depending on your situation, you may also undergo scans and other tests to monitor your cancer during chemotherapy treatment. These tests can give your doctor an idea of how your cancer is responding to treatment, and your treatment may be adjusted accordingly.

Clinical trials

Explore Mayo Clinic studies testing new treatments, interventions and tests as a means to prevent, detect, treat or manage this disease.

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Chemotherapy is a drug treatment that uses powerful chemicals to kill fast-growing cells in your body. Chemotherapy is most often used to treat cancer, since cancer cells grow and multiply much more quickly than most cells in the body. Many different chemotherapy drugs are available.

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3.3.1. Perinatal effects

At birth and in the 1st few weeks of life, a number of children born to mothers treated with chemotherapy present with transient myelosuppression, which involve leukopenia (white blood cell count <5000/mm ³) and/or neutropenia (absolute neutrophil count <1500/mm ³) with anemia and/or thrombocytopenia (platelet count <15,000/mm ³). Moreover, in children born to mothers treated with rituximab, a monoclonal antibody against the protein CD20 used to treat B-cell non-Hodgkin lymphoma, selective B-cell depletion was observed.

Generally, transient myelosuppression is maximally evident in the 1st days of life and is resolved within 2 to 10 weeks. Its frequency varies from 43% and 33% in the studies by Aviles and Neri and Reynoso et al, respectively, to 4% observed by Cardonick and Iacobucci in a review of 321 published case reports. Data from an international cancer and pregnancy registry collected from 1995 to 2008 showed that among 157 neonates exposed to various chemotherapy drugs during pregnancy, only 2 infants suffered from transient myelosuppression or anemia at birth, and neither suffered from opportunistic infections. These differences may have several explanations, including the different therapeutic regimens. However, the most important reason may be the timing of therapy suspension with respect to the timing of childbirth; specifically, when treatment is maintained until the end of pregnancy, the risk of transient myelosuppression is significantly higher whereas the risk is greatly reduced the more extensive time period between the suspension of chemotherapy and childbirth. For this reason, it is recommended that delivery is avoided during the maternal nadir period, and chemotherapy should not be administered after the 35th week of gestation in order to allow the fetus to eliminate the cytotoxic drugs. Theoretically, transient myelosuppression might lead to severe infections, and systematic monitoring of at-risk neonates at birth is recommended. Additionally, supportive care including thrombocyte transfusions, erythrocyte transfusions, erythropoietin, and recombinant granulocyte colony-stimulating factor administration are given when needed. However, in general, transient myelosuppression is mild and does not cause clinical problems. The same is true for transient myelosuppression-related immune depression. If transient myelosuppression is resolved within 10 weeks, even when maternal treatment is continued until delivery, it is reasonable to expect that in children that are not exposed to chemotherapy in the last week of gestation, immune depression would also last for a limited period of time and should not induce an immune response to inactivated vaccines given according to the recommended pediatrician schedule. Consistent with this conclusion, data collected in children born to mothers who received rituximab to treat hematologic tumors show that the administration of rituximab is associated with a selective inhibitory effect on the development of newborn B-cells. However, the condition is reversible, and B-cell levels return to normal by 3 to 6 months of age. In the short-term follow-up, no significant infections were identified, and subsequent immunological controls revealed an adequate response to standard vaccinations. However, because no substantial data to this regard is currently available, further studies on the immune response of children receiving chemotherapy in utero are needed to exclude the possibility that vaccines (mainly the live attenuated ones) administered in the 1st days of life may be dangerous. For example, severe neonatal neutropenia and fatal dissemination of Bacillus Calmette-Guérin has been reported in children born to mothers treated with biologicals.

3.3.2. Long-term effects

Several studies have evaluated the long-term impact of cytotoxic drugs administered during pregnancy on children. Together with growth and general development, the main target of most of these studies was the neurological and psychological development because the central nervous system is extremely sensitive to these drugs. Mennes et al, found that children with acute lymphoblastic leukemia, treated exclusively with chemotherapy, processed information slower compared to control children, especially when more information has to be processed or when attention has to be focused precisely. However, contrary to what was feared, the 1st evaluation of the impact of in utero chemotherapy did not find any neurological problems, even in subjects whose mothers were treated during the 1st trimester of pregnancy. Subjects were evaluated during high-school or college and showed normal neurological and psychological development. Furthermore, the educational performance of these children corresponded with the economic and social status of their families, and no learning disabilities were observed. Similar results were obtained with other studies including those published by Hahn et al and Amant et al. Average neuropsychological development was demonstrated in the great majority of chemotherapy-exposed children. In addition, when neuropsychological issues were present, they could be ascribed to prematurity or maternal stress. Despite these reassuring findings, the conclusions were not considered definitive due to the small sample size of the enrolled children and the limited follow-up for a number of the cases. Recently studies have concluded that prenatal exposure to maternal cancer with or without treatment does not impair the cognitive development of children. Cardonick et al examined 57 children of mothers diagnosed with cancer while pregnant, 35 of whom had been exposed to chemotherapy in utero. The children underwent developmental testing and ranged in age from 18 months to 10.4 years. Based on age, the Bayley Scales of Infant Development-Third Edition, the Wechsler Preschool and Primary Scale of Intelligence-Revised, the Wechsler Intelligence Scale for Children, Third Edition, or the Wechsler Individual Achievement Test were administered. All parents or primary caregivers completed the Child Behavior Checklist, which is a parent questionnaire to assess behavioral and emotional issues. No significant differences were noted in cognitive ability, school performance, or behavioral competencies between the chemotherapy-exposed group and the unexposed children. Cognitive assessments were within the normal limits in 95% of the cases. In addition, 71% and 79% of children demonstrated at or above age equivalency in mathematics and reading scores, respectively, and 79% of children scored within the normal limits on measures of behavior. However, older children had significantly higher rates of internalizing behavioral problems. Amant et al performed a similar study where 96 children (median age, 22 months; range, 12-42 months) were prospectively assessed (by means of a neurologic examination and the Bayley Scales of Infant Development) at 18 months, 36 months, or both and compared with a control group. No significant between-group differences were observed in cognitive development on the basis of the Bayley score or in subgroup analyses. Prematurity was correlated with a worse cognitive outcome, but this effect was independent of cancer treatment.

A 2nd largely studied problem is the potential toxicity of some drugs, especially anthracyclines and trastuzumab, on fetal heart development. Interest in the effects of these 2 drugs is based on the results from several studies. Anthracyclines are well-known for their cardiotoxic effects that depend on multiple mechanisms, including oxidative damage, changes in calcium metabolism, and activation of apoptotic pathways, leading to progressive deterioration in cardiac function. Moreover, anthracycline toxicity has been shown to be enhanced by the concomitant use of trastuzumab, a monoclonal antibody that inhibits proliferation of cells overexpressing human epidermal growth factor receptor tyrosine kinase, which is used in breast cancers where these cells are present. Several case reports have described the development of fetal heart toxicity after the administration of anthracycline to pregnant women and have shown these affects are mostly reversible. Finally, data from pediatric cancer survivors have shown that anthracycline exposure at a young age can result in progressive left ventricular dysfunction and clinical heart failure 10 to 20 years after stopping chemotherapy.

Transplacental passage of anthracyclines has been studied in vitro and in animals but available data seem to suggest that delivery to the fetus is relatively poor and umbilical artery sample concentrations were no higher than 65% of the levels detected in the mother. However, because the fetal myocardium significantly differs from the adult myocardium, it is theoretically possible that lower drug concentrations may induce toxic effects in the fetus. Fortunately, no evidence of cardiac disease was found in the studies in which the heart function of children exposed to chemotherapy in utero was evaluated. In the most recent study, cardiac function was evaluated in 50 children, aged 36 months, who had been exposed to chemotherapy in utero and 26 of the cases involved exposure to anthracyclines. A 12-lead electrocardiography and a detailed echocardiographic examination were performed. In addition, standard views and measurements were carried out according to the guidelines of the American Society of Cardiology. The results were compared with 47 healthy children matched for age and sex. No structural abnormalities were detected. All measures of cardiac-chamber dimension and cardiac wall thickness were within normal ranges, and there were no between-group differences in ejection fraction, fractional shortening, or values for global longitudinal strain and circumferential strain. In particular, there were no differences in the subjects exposed to anthracyclines compared to the subjects exposed to other chemotherapy drugs.

Finally, no differences in growth and general development have been found between exposed children and healthy controls.

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Chemotherapy against cancer during pregnancy: A systematic review on neonatal outcomes

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The concomitant incidence of cancer and pregnancy has increased in recent years because of the increase in maternal age at the time of the 1st pregnancy. The diagnosis of cancer in a pregnant woman causes ethical and therapeutic problems for both the ...

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After 14 weeks of gestation doctors advice the patient of the low risk that is present when administering the chemo treatment. But the the danger is still present but just in a low amount. Due to this. Termination of pregnancy is very low and not needed to continue with chemotherapy.

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This stage of the pregnancy is when the organs of the fetus are developing. This area on the pregnancy's timeline is the most vulnerable. In every pregnancy the mother has a 3-5 percent chance of losing the child or having birth defects. This chance is greatly raised during the first trimester with effects being, low white cell count, low blood count, anemia and leukemia. Termination of pregnancy is a requirement before continuing with chemo.

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A teratogen is an agent which can be a medicine, environmental condition, or any vices that can create life altering affects on a fetus in its earliest stages. The effects of these agents range from brain abnormalities to physical deformation which can cause the infant to prematurely die.

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Chemotherapy uses a drug named cyclophosphamide (Cytoxan) which can have drastic effects on fetal development. Due to its effects on the fetus in its development stages it is classified as a teratogen which in the simplest of forms is an agent which can malformation in an embryo. It is highly recommend to consult a doctor incase of pregnancy before going ahead with this treatment.

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These effects vary on person to person.
Effects include but not limited to:
-Fatigue
-diarrhea
-hair loss
-mouth sores
-skin and nail problems

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This life saving treatment is used to combat against the effects of cancer as it stops or reduces the growth of white blood cells. But comes with a range of side effects some greater than others