Note: The following video provides a quick overview of the three types of cancer conventional therapy: chemotherapy, radiation and surgery.
Chemotherapy works by stopping or slowing the growth of cancer cells, which grow and divide quickly. But it can also harm healthy cells that divide quickly, such as those that line your mouth and intestines or cause your hair to grow. Damage to healthy cells may cause side effects. Often, side effects get better or go away after chemotherapy is over. Chemotherapy works best if the cancer cells do not recover as well as the normal cells. Exploiting the difference in the sensitivity of cancer cells as opposed to normal cells is central to effective chemotherapy treatments.
What Does Chemotherapy Do?
Depending on your type of cancer and how advanced it is, chemotherapy can:
- Cure cancer - when chemotherapy destroys cancer cells to the point that your doctor can no longer detect them in your body and they will not grow back.
- Control cancer - when chemotherapy keeps cancer from spreading, slows its growth, or destroys cancer cells that have spread to other parts of your body.
- Ease cancer symptoms (also called palliation of symptoms) - when chemotherapy shrinks tumors that are causing pain or pressure - such as by lessening a cough, or pain by affecting the cancer cells causing such symptoms.
Sometimes, chemotherapy is used as the only cancer treatment. But more often, you will get chemotherapy along with surgery, radiation therapy, or biological therapy. Chemotherapy can:
- Make a tumor smaller before surgery or radiation therapy. This is called neo-adjuvant chemotherapy.
- Destroy either hidder or obvious deposits of cancer cells that may remain after surgery or radiation therapy. This is called adjuvant chemotherapy, and it attempts to improve upon the results of the other treatment previously given.
- Help radiation therapy and biological therapy work better.
- Destroy cancer cells that have come back (recurrent cancer) or spread to other parts of your body (metastatic cancer).
Chemotherapy and Your Daily Life
Chemotherapy affects people in different ways. How you feel depends on how healthy you are before treatment, your type of cancer, how advanced it is, the kind of chemotherapy you are getting, and the dose. Doctors and nurses cannot know for certain how you will feel during chemotherapy. They should inform you of the common side effects of the proposed treatment before you agree to take the treatment.
Some people do not feel well right after chemotherapy. The most common side effect is fatigue, feeling exhausted and worn out. You can prepare for fatigue by:
- Asking someone to drive you to and from chemotherapy
- Planning time to rest on the day of and day after chemotherapy
- Getting help with meals and child care the day of and at least 1 day after chemotherapy
- Make a list of your questions before each appointment. Some people keep a running list and write down new questions as they think of them. Make sure to have space on this list to write down the answers from your doctor or nurse.
- Bring a family member or trusted friend to your medical visits. This person can help you understand what the doctor or nurse says and can talk with you about it after the visit is over.
- Ask all your questions. There is no such thing as a stupid question. If you do not understand an answer, keep asking until you do. If the doctor uses terms that you do not understand, then say so and ask that it be explained in other terms that you can understand.
- Take notes. You can write them down or use a tape recorder. Inform your doctor if you are recording the visit. The doctor should not object but it is polite to inform them. Later, you can review your notes and the recording so that you can remember what was said.
- Ask for printed information about your type of cancer and chemotherapy drugs you are to receive and the schedule on which you will receive them. Also request a schedule of follow up lab tests and other studies which may be needed prior to your seeing the doctor again.
- Let your doctor or nurse know how much information you want to know, when you want to learn it, and when you have learned enough. Some people want to learn everything they can about cancer and its treatment. Others only want a little information. The choice is yours.
- Find out how to contact your doctor or nurse in an emergency or after normal office hours. This includes who to call and where to go.
Questions to Ask Your Health Care Professional
About My Cancer
- What kind of cancer do I have?
- What is the stage of my cancer?
- Why do I need chemotherapy?
- What is the goal of this chemotherapy?
- What are the benefits of chemotherapy?
- What are the risks of chemotherapy?
- Are there other ways to treat my type of cancer?
- What is the standard care for my type of cancer?
- Are there any clinical trials for my type of cancer?
- Do you recommend that I participate in a clinical trial?
About My Treatment
- How many cycles of chemotherapy will I get? How long is each treatment? How long between treatments?
- What types of chemotherapy will I get?
- How will these drugs be given?
- Where do I go for this treatment?
- How long does each treatment last?
- Should someone drive me to and from treatments?
About Side Effects
- What side effects can I expect right away?
- What side effects can I expect later?
- How serious are these side effects?
- How long will these side effects last?
- Will all the side effects go away when treatment is over?
- What can I do to manage or ease these side effects?
- What can my doctor or nurse do to manage or ease these side effects? When should I call my doctor or nurse about these side effects?
Your Feelings During Chemotherapy
At some point during chemotherapy, you may feel:
How can I cope with my feelings during chemotherapy?
- Relax. Find some quiet time and think of yourself in a favorite place. Breathe slowly or listen to soothing music. This may help you feel calmer and less stressed.
- Exercise. Many people find that light exercise helps them feel better. There are many ways for you to exercise, such as walking, riding a bike, and doing yoga. Talk with your doctor or nurse about ways you can exercise.
- Talk with others. Talk about your feelings with someone you trust. Choose someone who can focus on you, such as a close friend, family member, chaplain, nurse, or social worker. You may also find it helpful to talk with someone else who is getting chemotherapy.
- Join a support group. Cancer support groups provide support for people with cancer. These groups allow you to meet others with the same problems. You will have a chance to talk about your feelings and listen to other people talk about theirs. You can find out how others cope with cancer, chemotherapy, and side effects. Your doctor, nurse, or social worker may know about support groups near where you live. Some support groups also meet online (over the Internet), which can be helpful if you cannot travel.
It is normal to have a wide range of feelings while going through chemotherapy. After all, living with cancer and getting treatment can be stressful.
Chemotherapy Side Effects
What are side effects?
Side effects are problems caused by cancer treatment. Some common side effects from chemotherapy are fatigue, nausea, vomiting, decreased blood cell counts, hair loss, mouth sores, and pain.
What causes side effects?
Chemotherapy is designed to kill fast-growing cancer cells. But it can also affect healthy cells that grow quickly. These include cells that line your mouth and intestines, cells in your bone marrow that make blood cells, and cells that make your hair grow. Chemotherapy causes side effects when it harms these healthy cells.
Will I get side effects from chemotherapy?
You may have a lot of side effects, some, or none at all. This depends on the type and amount of chemotherapy you get and how your body reacts. Before you start chemotherapy, talk with your doctor or nurse about which side effects to expect.
How long do side effects last?
How long side effects last depends on your health and the kind of chemotherapy you get. Most side effects go away after chemotherapy is over. But sometimes it can take months or even years for them to go away.
Sometimes, chemotherapy causes long-term side effects that do not go away. These may include damage to your heart, lungs, nerves, kidneys, or reproductive organs. Some types of chemotherapy may cause a second cancer years later. Ask your doctor or nurse about your chance of having long-term side effects.
What can be done about side effects?
Doctors have many ways to prevent or treat chemotherapy side effects and help you heal after each treatment session. For example: drugs to prevent or control nausea and vomiting are much more effective now than they used to be. Talk with your doctor or nurse about which side effects to expect, when they are likely to occur, and what to do about them. Make sure to let your doctor or nurse know about any changes you notice - they may be signs of a side effect.
As another example: chemotherapy can lower your white blood cell count. White blood cells are an important way to fight infection. If you get a fever when your white blood cell count is low it can be very dangerous. Development of a fever after office hours should always be called about right away. Your doctor and staff should teach you what to watch for- such as chills or sweats, and the importance of having a thermometer on hand.
Doctors have many ways to prevent or treat chemotherapy side effects and help you heal after each treatment session. Talk with your doctor or nurse about which ones to expect and what to do about them. Make sure to let your doctor or nurse know about any changes you notice - they may be signs of a side effect.
Chemotherapy As a Good Option
In order to keep things "on balance", here is a positive view of chemotherapy taken from the Science Blog website.
Chemotherapy drugs are, by their very nature, extremely toxic and typically work against your body's natural ability to fight cancer, e.g. destroying host immunity instead of supporting it.
One of the biggest drawbacks to chemotherapy is the fact that it destroys healthy cells throughout your body right along with cancer cells, a "side effect" that often leads to accelerated death, not healing.
Another devastating side effect of chemotherapy is the way it actually supports the more chemo resistant and malignant cell subpopulations within tumors (e.g. cancer stem cells), both killing the more benign cells and/or senescent cells within the tumor that keep it slow-growing, or even harmless.
As a result, this unleashes a more aggressive, treatment-resistant type of cancer to wreak havoc on the body.
A handful of natural compounds have been discovered, however, which exhibit an effect called "selective cytotoxicity." This means they are able to kill cancer cells while leaving healthy cells and tissue unharmed.
This type of cancer treatment is intelligent, targeted and will not result in the death of the patient from "collateral damage" in what is increasingly a failed war not against the cancer being treated, but the patient's own irreversibly devastated body.
Make no mistake about it, chemotherapy can be rough. Very rough. But what is often forgotten is that it can also be life-saving, particularly in the case of hematologic malignancies, where it is the primary therapy.
What is also often forgotten or intentionally ignored is that doctors don’t use chemotherapy because they love “torturing” patients or because they’re in the pockets of big pharma and looking for cash or because they are too lazy to find another way. They do it because, at least right now, it’s the best scientific medicine has. And in the case of Hodgkin’s lymphoma, for example, it’s life-saving.
Yes, chemotherapy can make you feel nauseated and make you throw up. It can make your hair fall out. It can temporarily depress the immune system. It can cause bleeding complications, such as GI bleeding. It can cause kidney damage. It can cause heart damage. It can cause lung damage. it can cause nerve damage. It can make you lose weight. It can even result in your death from complications. In short, it is not something to be taken lightly.
Unfortunately, the disease it’s meant to fight is a formidable foe indeed. It is your own cells, and often the difference between the toxicity of chemotherapy against the cancer and against normal cells is all too often not that great.
But what does cancer do? How do cancer patients die? They suffer and die in protean ways. Cancer can do everything chemotherapy can do (with the exception of hair loss) and more. I’ve seen more patients than I care to know suffer and die from cancer. I’ve seen family members suffer and die from cancer, most recently my mother-in-law.
One of the most frequent claims of cancer patients who opt for quackery instead of chemotherapy and effective science-based therapies is that they want to remain healthy. Some, as Abraham Cherrix did, state that, even if they end up dying, they want to “die healthy.” It’s a dangerous illusion. There is nothing “healthy” about dying from cancer. Dying from cancer is anything but “healthy.” What does dying from untreated cancer mean? What happens? What does it involve?
Dying from cancer can mean unrelenting pain that leaves you the choice of being drugged up with narcotics or being in agony.
Dying from cancer can mean unrelenting vomiting from an uncorrectable bowel obstruction. It can mean having a nasogastric tube to drain your digestive juices and prevent you from throwing up. Alternatively, it can mean having to have a tube sticking out of your stomach to drain its fluids.
Dying from cancer can mean bleeding because you don’t have enough platelets to clot. The bleeding can come in many forms. It can be bleeding into the brain, in essence a hemorrhagic stroke. It can mean bleeding from the rectum or vomiting blood incessantly. And, because so many transfusions are all too often necessary, immune reactions can chew up new platelets as fast as they’re infused. Yes, paradoxically, even when a cancer patient’s immune system is suppressed in late stage cancer, frequently it does work against the one thing you don’t want it to: Transfusions of blood products.
Dying from cancer can mean horrific cachexia. Think Nazi concentration camp survivor. think starving Africans. Think famine. Think having cheeks so sunken that your face looks like the skull underlying it.
Dying from cancer can mean your lungs progressively filling with fluid from tumor infiltration. Think choking on your own secretions. Think a progressive shortness of breath. Think an unrelenting feeling of suffocation but with no possibility of relief.
Dying from cancer can mean having your belly fill with ascites fluid due to a liver chock full of tumor.
Dying from cancer can mean so many other horrific things happening to you that they are way to numerous to include a comprehensive list in a blog post, even a post by a blogger as regularly logorrheic as Orac.
Modern medicine can alleviate many of the symptoms people with terminal cancer suffer, but it can’t reverse the disease process. However, the relief of these symptoms requires that the patient actually accept treatment. Hospice can minimize such symptoms, often for significant periods of time.
However, even with the very best hospice care, there is nothing “healthy” or pleasant about dying from cancer. It means a loss of control. It means being too weak to get up by yourself, to feed yourself, to go to the bathroom yourself, to bathe yourself, or do do much other than lie in your bed and wait for the end.
Without such treatment, a patient who chooses quackery over effective curative or palliative therapy dooms himself to a painful and unpleasant death. He in effect dooms himself to the sorts of ends untreated cancer patients suffered hundreds of years ago, before there was effective therapy.
It doesn’t have to be this way, but the seductive promise of a cure without pain, without hair falling out, without nausea lures cancer patients to havens of quackery in Tijuana or to flee from authorities trying to see that a child obtains potentially life-saving treatment, all because of a magnified fear of chemotherapy, all because of the propaganda that paints chemotherapy as “poison,” radiation as “burning,” and surgery as “slashing.”
Here’s the dirty little secret behind “alternative cancer cure” (ACC) promises. They are seductive because it is true that cancer patients who stop their chemotherapy will do feel better than they did when undergoing chemotherapy. Of course they do, at least for a while!
Often what’s happened is that the tumor shrinks, and, once the chemotherapy course is done, the patient does feel better because the tumor is no longer causing B symptoms or compressing lungs and making him short of breath or whatever. It is also true that more chemotherapy will make the patient feel lousy again for a time. Unfortunately, in the case of Hodgkin’s lymphoma, the additional chemotherapy is necessary to maximize the chance of cure. Hodgkin’s disease frequently relapses without the additional courses of chemotherapy. Science and clinical trials have told us that.
Cancer doesn’t give up. It’s like the Terminator. It can’t be bargained with. It can’t be reasoned with. It doesn’t feel pity, or remorse, or fear. And, if it is not treated, it absolutely will not stop, ever, until the patient is dead. And it won’t be a pretty end.
Chemotherapy or death by cancer? For cancers for which chemotherapy is so effective, like Hodgkin’s lymphoma, it’s really a no-brainer.