How Chemotherapy is Used to Treat Cancer

Chemotherapy, commonly called “chemo”, is a systemic treatment that involves the use of chemicals (medication) to treat a disease. Although it can be used to treat a variety of diseases like lupus or rheumatoid arthritis, chemotherapy is usually used to treat cancer.

Your doctor may use chemotherapy in conjunction with radiation or certain surgical procedures to treat cancer, two treatments that target only specific areas of the body. Chemotherapy, however, affects the entire body, which makes it a good treatment option for cancers that spread, or metastasize.

Goals of Chemotherapy

There are three goals of chemotherapy treatment:

1. Cure: In some cases, it’s possible for chemotherapy to destroy cancer in the body. Curing cancer with chemotherapy isn’t guaranteed, however, and doctors may describe treatment as “curative intent”—meaning cure is the intention, but cannot be assured.
2. Control: If cancerous cells in the body cannot be destroyed, doctors will use chemotherapy to control the cancer—chemo can be used to shrink tumors and prevent it from spreading to other areas.
3. Palliation: Doctors generally use palliative chemotherapy in advanced stages of cancer to alleviate symptoms and improve quality of life. Chemo is not the only form of palliative care; others include any type of treatment that helps reduce symptoms (e.g., pain medications, anti-nausea treatments, etc.).

There are several different kinds of chemotherapy medications, and you’ll consult with your doctor about which one (or combination) is right for you. Your doctor will look at different factors to make this decision:

Age
Stage and type of cancer, or how far cancer has spread
Overall health, including any other serious health conditions
Previous cancer treatments

Once your doctor has decided which medications are suitable for you, he or she will finalize your dosage and schedule. Dosage decisions are made based on a variety of factors, including:

Age (elderly people may need different doses)
Weight
Blood cell count
Presence of liver or kidney diseases
Other medications
Current or previous radiation therapy
Nutrition status

It’s important to follow your recommended schedule, although there may be times where side effects or other factors might require a change in your plan. Discuss any side effects you experience with your doctor.

Method of Delivery

Where you receive chemo treatment depends on the medications you’re taking, hospital policies, your insurance and the doctor’s recommendation (your own preference is also considered). Possible locations include:

Doctor’s office or hospital
At home
Clinic
Hospital outpatient infusion center

There are several different methods for administering chemotherapy:

Through a vein: Intravenous treatment involves a soft plastic tube (catheter) that is inserted into the vein using a needle. The needle can then be removed, leaving the catheter inside. Your doctor can quickly give you medication through the catheter with a syringe in a process called an IV push. You may also receive an IV infusion. This treatment can be given over a period of a few minutes to a few hours, and is done by pumping a solution of medications from a plastic bag through tubing attached to the catheter. If you need continuous infusions, your doctor may recommend an electronic IV pump. Intravenous treatments can cause scarring or vein damage in some cases, and you should speak with your doctor about the risks.
Orally: Like other medications, chemo drugs exist in pill, capsule and liquid form. If you’re taking medication orally, it’s vital that you adhere to the exact dosage your doctor prescribed and follow the medication schedule as directed.
Intrathecal: Intrathecal (IT) chemo is put in the spinal canal and enters the fluid that surrounds the brain and spinal cord—most medication administered through IV or the mouth can’t reach the brain, but IT chemotherapy can. It’s inserted using a needle, or a long-term catheter can be inserted during surgery.
Intra-arterial: This treatment involves chemo medication administered directly into the main artery that supplies blood to a given tumor. It’s also called regional chemo.
Intracavitary: During this treatment, chemo medications are inserted through a catheter into an enclosed area of the body, like the chest or abdomen.
Intramuscular: Chemo through a needle into a muscle, rather than a vein.
Intralesional: Chemo through a needle directly into the tumor itself.
Intravesical: Chemo inserted directly into the bladder through a catheter.
Topical: A gel or cream that’s placed directly on the skin.

The length of your treatment depends on a variety of factors that your doctor will discuss with you. Before your first treatment, make sure to eat something and bring a small snack or meal if you know you’ll be undergoing treatment for multiple hours. Additionally, you may want to take a few basic precautions to keep you and your loved ones safe during your treatment.

Side Effects

Because chemotherapy is a systemic treatment, it may also affect healthy cells in the body, causing side effects. Not everyone experiences side effects with the same severity or frequency, and your doctor can help prescribe medications to manage many of them.

The list of potential side effects can be daunting, but many of these can be reduced or prevented with the right medications and healthy habits. Speak to your doctor if you notice any of the following symptoms during or after chemo treatment:

Fever over 100.5 degrees Fahrenheit
Intense chills
Pain at the site of the injection, or intense headaches
Trouble breathing
Diarrhea, vomiting, bloody stool or bloody urine
Bleeding or bruising
Rash or allergic reaction

For more information on chemotherapy, or for help understanding your diagnosis and treatment plan, contact your healthcare provider.

*Note: No two cancer cases are alike. None of the statements herein are designed to suggest a “one size fits all” approach, and each case will be evaluated individually.