Patient Guide to Chemotherapy - Part 1

Introduction

The Cross Cancer Institute and the Tom Baker Cancer Centre specialize in the treatment of cancer using radiotherapy, chemotherapy, immunotherapy and hormone therapy. You may be treated by one of these methods alone or by a combination of methods. If you require surgery to treat your cancer it will be done in a general hospital. Your family doctor will be kept fully informed through reports from Institute physicians. You may receive treatments as an outpatient, a daycare patient or as an inpatient. This Patient's Guide to Chemotherapy was written to help patients, their families and friends understand chemotherapy. The booklet is intended to satisfy individual patient needs. You can read it all or use it as a reference to answer specific questions. Basic information about cancer chemotherapy is provided while specific questions should be recorded and directed to your doctor, nurse or pharmacist.

What is Chemotherapy?

Chemotherapy involves the use of drugs to destroy cancer cells and is often used together with surgery, radiotherapy or immunotherapy. Specialists known as Medical Oncologists are most often the doctors who prescribe and supervise chemotherapy treatment. A Medical Oncologist is a doctor of internal medicine who has specialized training in the use of chemotherapy to control cancers.

The human body is composed of cells. Many of these cells reproduce themselves, constantly replacing cells that die. Cells normally grow in a controlled and orderly fashion. However, in cancer this process is altered and cells grow in a disorderly and uncontrolled way. Many of the symptoms of cancer arise because collections of cancer cells accumulate to the extent that they interfere with the normal organ or tissue in which they accumulate.

Chemotherapy is used to destroy or control the growth of cancer cells.

How does Chemotherapy Work?

Because different drugs act in different ways, they can be used together as well as alone. Chemotherapy may also be combined with radiotherapy. The form and length of your treatment and the time intervals between treatments are determined by the type of cancer to be treated and the different combinations of chemotherapy drugs used.

Chemotherapy can:

• interfere with abnormal cell reproduction
• destroy abnormal cells
• interfere with normal cell growth

Since chemotherapy also affects rapidly dividing normal cells in the body, drugs are often given in cycles. This allows for a drug-free rest period between treatment courses. During this time, normal cells can recover. Generally, the rate of recovery of normal cells is greater than that of cancer cells. Thus, between cycles of chemotherapy, recovery of normal cells occurs while cancer cells do not recover.

Your progress will be monitored closely during your course of treatment through physical examination, blood testing and perhaps x-rays and scans. Your doctor and nurses here at the Cross Cancer Institute will fully discuss treatment with you. Your family physician will be kept informed, by mail, of your treatment and progress and may also be involved with carrying out regular blood tests and giving you some of the medications.

How is Chemotherapy Given?

Administration of anticancer drugs depends on the kind of drug prescribed for you. Most chemotherapy is given by one of four routes:

• Oral - Medication is taken by mouth in the form of pills or liquid.
• Intramuscular - Medication is injected into a muscle. This is only rarely used for chemotherapy administration.
• Subcutaneous - Medication is injected under the skin.
• Intravenous - Medication is injected into a vein directly from a syringe or mixed with fluid in an intravenous bag and allowed to drip slowly; this drip procedure may take several hours.

Sometimes chemotherapy is given intravenously using an I.V. pump. This pump is used to regulate the flow of solutions. Alarms on the pump may go off for different reasons. For example - the pump may need to be re-charged or the solution may be finished. The pump will be attended to by a nurse.

Is Chemotherapy Painful?

There is usually no pain associated with chemotherapy other than a needle prick, if given intravenously or intramuscularly. Occasionally irritation or discoloration of the vein may develop from some medications. Inform your nurse immediately if you feel burning or see swelling or redness in the area around the needle site.

What about other medications?

It is important to tell your doctor about any other pills, injections, or medicines you are taking as they may affect the choice of drug for you. Some of the chemotherapy drugs do not mix well with other medications. Please bring in all your medications on your first visit.