Chemotherapy

Chemotherapy is a type of cancer treatment that uses one or more anti-cancer drugs (chemotherapeutic agents) as part of a standardized chemotherapy regimen. The main aim of these drugs, often referred to as "anticancer" drugs, is to destroy cancer cells by preventing them from growing and multiplying. However, because these drugs can also affect healthy cells, especially those that divide quickly, they often lead to various side effects. Fortunately, most healthy cells usually repair themselves after chemotherapy.

File:Patient receives chemotherapy.jpg

Patient receives chemotherapy

Chemotherapy was first introduced in the 1940s and has since been a mainstay in cancer treatment. The use of anticancer drugs is based on the understanding that cancer cells grow and divide more rapidly than most normal cells. By targeting these rapidly dividing cells, chemotherapy aims to slow or stop cancer growth.

File:Pediatric patients receiving chemotherapy.jpg

Pediatric patients receiving chemotherapy

Mechanism of Action

Chemotherapy drugs function by targeting the cell cycle, the process by which cells grow and divide. Many of these drugs are cell cycle-specific, meaning they target cells at different stages of the cell cycle. Others are cell cycle-nonspecific and can work at any stage of the cell cycle. They act by damaging the DNA or the machinery involved in cell division, thereby causing cell death or preventing further cell division.

File:Nurse administers chemotherapy (2).jpg

Nurse administers chemotherapy (2)

Types of Chemotherapy

There are several types of chemotherapy, classified based on their mechanism of action. These include alkylating agents, antimetabolites, antineoplastic antibiotics, topoisomerase inhibitors, and mitotic inhibitors. Each class of drugs has a unique way of interrupting the cancer cell's life cycle, either by damaging its DNA or by hindering its ability to divide.

Side Effects

While chemotherapy can be effective in treating cancer, it also causes side effects due to its impact on healthy cells. Common side effects include fatigue, nausea and vomiting, hair loss, anemia, and neutropenia. Many of these side effects can be managed with supportive care and usually resolve after treatment ends.

Administration and Dosing

Chemotherapy drugs can be administered in several ways, including oral, intravenous, intramuscular, and intrathecal routes. The dosing and schedule of chemotherapy can vary widely depending on the type of cancer, the specific drug or combination of drugs, the goal of therapy (curative vs. palliative), and the patient's overall health status.

Efficacy

The efficacy of chemotherapy depends on many factors, including the type and stage of cancer, the patient's overall health, and the specific drugs used. In some cases, chemotherapy can cure cancer outright. In others, it can control cancer growth or reduce symptoms, improving quality of life.

See Also

• List of cancer drugs
• Cancer
• Radiation therapy
• Immunotherapy
• Targeted therapy
• Side effects of chemotherapy

References

• DeVita Jr, Vincent T., et al. Cancer: Principles & Practice of Oncology. 10th edition. Wolters Kluwer Health, 2015.
• Longley DB, Harkin DP, Johnston PG. 5-Fluorouracil: mechanisms of action and clinical strategies. Nature Reviews Cancer. 2003 May;3(5):330-8.
• Chabner BA, Roberts TG Jr Chemotherapy and the war on cancer. Nature Reviews Cancer. 2005 Jan;5(1):65-72.
• DiMaio, Michael. Chemotherapy. Medscape. Updated: Oct 30, 2020.
• Lennan E. Chemotherapy and cycle management. Nursing Standard. 2016 May 18;30(38):53-63.

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