Chemotherapy is one of the most common and effective ways of treating cancer, yet the process can often seem intimidating or complicated for someone who has never experienced it. Stephanie Duffy, a nurse clinician at the Tom Baker Cancer Centre who supports patients for systemic treatment and radiation treatment, explains what chemotherapy entails and what a cancer patient can expect while receiving treatment.
Q: What is chemotherapy?
There are many different ways to treat cancer: there’s surgery, radiation, and systemic treatment. Systemic treatment is any medication that travels through your body in the bloodstream to find, damage and destroy cancer cells. Chemotherapy, or chemo, is one type of systemic treatment. Chemotherapy is a medication that finds cancer cells, attacks them and causes the cancer cells to die. Chemotherapy also prevents the cancer cells from dividing and making more cancer cells. The three main goals of chemotherapy are to become cancer-free; to get control of and stop the cancer from growing or spreading to other parts of the body; or to relieve or reduce the symptoms caused by cancer, such as pain or shortness of breath.
Q: What does the process entail?
Before each chemotherapy treatment, people will have blood work completed and will be assessed by the medical oncology health-care team. Supportive medications, such as anti-nausea medications, are often prescribed for people to take before and after receiving chemotherapy. Chemotherapy can be made up of a single drug or a combination of drugs. In general, it is given in cycles, which means the chemotherapy is given and then there is a rest period of days or weeks before giving the next treatment. This allows the chemotherapy to attack the cancer cells and also gives the body a break to recover from the side-effects before the next cycle.
Q: How is it administered?
Chemotherapy is given in many ways. It can be given through an intravenous, or an IV, which is when the medicine is put directly into a vein. Most patients get a temporary IV inserted that is removed at the end of the treatment appointment. Others get a central line that is inserted into a vein and stays in until the treatment is no longer needed, so it is more of a long-term option. Sometimes we administer the chemotherapy by a needle into a muscle or just under the skin tissue. Occasionally, chemotherapy is given as an oral medication in pill form or liquid swallowed by mouth. An oncologist will prescribe accordingly based on your treatment needs.
Q: What does a typical day-in-the-life look like for someone going through chemotherapy?
In Calgary, most chemotherapy is given at the Tom Baker Cancer Centre in our Systemic Treatment Unit by nurses. Every treatment is very different. Some people get one medication, and others will get several. Appointments can range anywhere from 30 minutes to several hours. Some people receive all their medication in one day, while others will come in for several days in a row or get different medications on different days. It varies depending on the type of cancer and the treatment prescribed.
Q: What are the most common side-effects of chemotherapy, and what causes them?
Chemotherapy works on the fast dividing cells in our bodies. Cancer cells divide quickly, but so do some of the healthy cells in our body, such as our hair, skin, nails and blood. Chemotherapy cannot tell the difference between cancer cells and healthy cells, so side-effects happen when the chemo attacks the healthy cells. Side-effects are very different for everyone. Each chemotherapy causes [varying] side-effects, and they can happen anytime during treatment. Regardless of the type of chemotherapy, fatigue seems to be a common side-effect. It’s best treated with regular exercise and good nutrition, but our health-care team has many strategies to help cancer-related fatigue.
Other common side-effects include decreased blood counts, appetite changes, nausea, hair loss and skin and nail changes. Side-effects, regardless of what they are, are usually temporary. The health-care team goes into great detail explaining what side-effects to expect, and how to manage or prevent them before we start the actual treatment.
Q: How has chemotherapy evolved or changed over the years?
[One example is] in recent years we have seen more immunotherapy given for the treatment of cancer. Immunotherapy is a different type of systemic treatment. It is an intravenous medication that helps the body’s immune system find, fight and kill cancer cells.