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Chemotherapy

Anti-cancer drugs are a mainstay of modern treatment.

The term chemotherapy, which refers broadly to any drug-based treatment for disease, tends to be used most often to describe the drugs that oncologists prescribe to combat cancer. The specific combination and the way they’re delivered depend on your individual diagnosis and the approach your doctor believes will be the most effective.

You may have chemotherapy on its own or in combination with another therapy. For instance, you may receive neo-adjuvant chemotherapy before surgery or radiation to shrink the tumor and make your primary treatment more effective. Or you may receive adjuvant, or post-operative, chemotherapy to attack any undetected cancer cells still remaining after surgery and decrease the chance of a recurrence. Doctors also use adjuvant chemotherapy to help treat advanced or aggressive cancers.

As new drugs become available and doctors develop increasingly sophisticated methods of prescribing these medicines, advances in chemotherapy are improving and prolonging many people’s lives.

Effective medicine

What chemotherapy drugs all have in common is the ability to destroy rapidly reproducing cells, including cancer cells. But because cancer cells are not foreign organisms, like bacteria, it’s impossible to destroy cancer cells without affecting some of your healthy cells as well. For instance, the cells in your hair follicles, gastrointestinal tract, bone marrow, and mucous membranes normally reproduce quickly. That’s why some people with cancer experience side effects such as hair loss, nausea, ulcers, and mouth sores during treatment.

The good news is that healthy cells can repair themselves faster than cancerous ones. That’s because cancer cells often lack the internal repair mechanisms that normal cells have.

Getting better all the time

In some cases, new techniques can help make chemotherapy more effective while minimizing side effects. For instance, with metronomic chemotherapy, the cancer-fighting drugs are delivered in small amounts over several days rather than one large dose. This approach is designed to make cancer cells inactive while making the treatment more tolerable.

Plus, there are a variety of medicines and natural therapies that can dramatically lessen the severity of nausea and other common side effects of chemotherapy. Some natural therapies may even help make specific anticancer drugs more powerful.

How chemotherapy works

Chemotherapy agents work on a cellular level by inhibiting the processes that lead to cancer cell division and reproduction.

One key element of cellular division is known as DNA replication — when the genetic material in the nucleus of a cell uncoils to make an exact copy of itself to pass on to an offspring cell. Several classes of chemotherapy drugs fight the growth of cancer by restricting this process:

  • Alkalyting agents bind to the DNA in the cell to prevent it from dividing.
  • Antimetabolites replace the nutrients required for DNA reproduction with inactive substances.
  • Antitumor antibiotics prevent DNA from uncoiling and interferes with DNA structure, causing cancer cells to die.

Other classes of chemotherapy drugs halt cell division in other ways. For example:

  • Hormonal drugs suppress hormone processes that encourage the growth of cancer cells.
  • Plant alkaloids prevent cell division by interfering with the internal structure of the cell.

Weighting the risks and benefits

Some people have misgivings about chemotherapy. Certain treatments have long-term risks, including heart and liver damage. However, chemotherapy can not only be an important tool in getting cancer under control, but in some situations may also dramatically reduce symptoms related to the disease.

It’s important to investigate the specific type of chemotherapy your doctor is recommending. The side effects you may experience, and their severity, will depend on the drug, or drugs, you’re taking, the dosage, and the duration of your treatment. Ask your doctor to discuss the risks and benefits with you.