Chemotherapy is a term we're all familiar with, but what exactly is it? Unsure? 
- We've got you covered.

Chemotherapy is a broad term to include all medications that target killing cancer cells. When we receive “chemo”, we are often receiving multiple medications working towards that goal. 

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Neoadjuvant chemotherapy is chemo given, usually before a surgery, in an attempt to shrink the tumour .

Adjuvant chemotherapy is chemo given, usually after a surgery, in an attempt to kill off remaining cancer cells after the tumour is removed. 

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These medications are “cytotoxic”, meaning toxic to cells - not just cancer cells. This is why patients often feel so unwell during chemotherapy, and their immune system is compromised. Chemo drugs tend to affect the cells that are replicating the fastest (which is why they are good for treating cancer). They do so by interrupting the cell division process (mitosis) and initiate cell death (apoptosis). This is why we lose our hair in the early stages - as our hair follicle cells replicate very quickly. 

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Pharmaceutical companies are constantly working on targeting the malignant and eliminating the damage to healthy cells. We have taken vast leaps of progress since the early chemos - but we’re not there just yet. Chemotherapy is often described as a necessary poison. It’s a rather overly-simplistic way of describing it…but fair it it’s own right. 

Because of the toxic effects, chemotherapy is nearly always given in cycles. 

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A common treatment plan is six cycles of chemotherapy over 18 weeks. The chemo cocktail is given during the first week, and week two/three are for recovery before the next lot. 

Individuals tend to feel their most unwell in week two. By then, the chemo has taken its toll and lowered the individual’s immune system. Generally, it is in this week that infections are most common. 

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By week three, the patient should feel a little better. Their bloods will be taken, and if deemed acceptable by the oncologist, the next cycle will begin. 

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What bloods exactly? Well, chemo drugs cause a temporary drop in the productive capacity of the bone marrow. The bone marrow makes your red blood cells and your immune cells. The oncologist will keep a close eye on your haemoglobin (Hb) - red blood cells, and your neutrophils (Neut) - white blood cells. The hope is that they will have recovered enough by week three to give another bout of chemo. 

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If the bloods aren’t good enough, or you just feel terrible, the oncologist will likely delay your next cycle. Your next cycle may also be delayed by infection, common in week 2 when you are likely to be neutropenic (low in neutrophils - immune cells). 

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If you develop a temperature at home, you will be asked to come to hospital. You will be given IV antibiotics as a precaution if your neutrophils are low, as your immune system is severely depleted. 

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In a bid to prevent infection from occurring, your oncologist may have you on oral antibiotics or anti-fungals throughout your chemotherapy treatment. 

If your next cycle is delayed, try not to worry too much. It is quite rare for an individual to make it through several chemotherapy cycles without a hiccup. It’s not a walk in the park! And remember, the oncologist knows what they’re doing. 

 

Speaking of walks in the park, try to keep yourself as active as you can. It is hard to keep your strength up during this time - so eat as well as you can and keep moving.