Chemotherapy

One of the most well-known ways to treat cancer is with chemotherapy. It involves taking special medicines that kill cancer cells or stop them from growing. These drugs can move through the body and kill abnormal cells wherever they are. Chemotherapy can be used on its own or with other treatments like surgery, radiation therapy, targeted therapy, or immunotherapy (National Cancer Institute, 2021) [1].

Chemotherapy is a potent and foundational cancer treatment. Modern oncology teams design treatment schedules to be both safe and maximally effective. Achieving positive patient outcomes relies on advanced drug protocols, comprehensive supportive care, and continuous monitoring.

What is Chemotherapy and How Does it Work?

Chemotherapy, often shortened to “chemo,” is a way to treat cancer by using drugs to kill or stop cancer cells from growing. These chemical-based drugs, known as cytotoxic agents, move through the blood and can reach cancer cells throughout the body, even tiny groups of disease that imaging tests might not be able to detect [2].

Chemotherapy works by targeting and interfering with the process of rapid cell growth and division. Since cancer cells typically divide much faster than normal cells, chemotherapy drugs are designed to be most destructive to these rapidly proliferating cells. The specific mechanism depends on the drug, but common actions include damaging the cell’s DNA, disrupting the cell cycle, or inhibiting nutrient uptake, ultimately leading to programmed cell death (apoptosis) [3].

Some healthy tissues that also divide quickly—such as hair roots, bone marrow (which produces blood cells), and the lining of the digestive tract—may be affected for a short time, leading to common side effects. However, most of these side effects are temporary and typically resolve after treatment ends. Chemotherapy is a key part of a full cancer treatment plan, used with the goal to cure the disease (curative intent), control its spread, or ease symptoms when a cure is not possible (palliative intent).

Different Types and Uses of Chemotherapy

Chemotherapy comes in many forms, each tailored for a specific therapeutic goal or delivery method [4].

• Systemic Chemotherapy: Medicines are either injected into a vein (intravenously) or taken by mouth (orally). This allows the drugs to circulate through the bloodstream, reaching cancer cells all over the body.
• Regional/Local Chemotherapy: This involves putting drugs directly into a specific area to target cancer cells locally and minimize systemic exposure. Examples include:
  • Intraperitoneal chemotherapy: Injected into the space inside the abdomen to treat abdominal cancers.
  • Intrathecal chemotherapy: Given through the fluid that surrounds the brain and spinal cord to treat central nervous system cancers.
• Treatment Timing (Adjuvant, Neoadjuvant, Palliative):
  • Adjuvant therapy is used after the primary treatment (like surgery or radiation) to kill any remaining, hidden cancer cells and prevent recurrence.
  • Neoadjuvant therapy is given before the main treatment (e.g., surgery) to shrink the tumour, making it easier and less extensive to remove.
  • Primary or Palliative therapy focuses on slowing the spread of the disease, easing cancer-related symptoms, and improving quality of life, typically when surgery is not an option.
• Delivery Method:
  • Oral Chemotherapy (Pills): Some medications are taken as pills at home, offering convenience.
  • Intravenous (IV) Chemotherapy: Drugs are administered through a drip or pump, typically in a hospital or clinic setting. Both methods, when prescribed and monitored correctly, are effective means of delivery.

Details About Chemotherapy Treatment

Getting Ready for Treatment

Before starting chemotherapy, doctors perform thorough tests, including blood tests, heart and kidney function checks, and imaging scans, to ensure the patient is fit for the protocol [5]. Patients receive counseling about the specific chemotherapy regimen, potential side effects, and preparation strategies.

Preparation often involves:

• Medical and Dental Checkups: Addressing any potential sources of infection beforehand.
• Logistical Planning: Making arrangements for nutrition, travel to the clinic, and work adjustments.
• Organizing Access: Placing an implanted port or peripherally inserted central catheter (PICC line) may be necessary to simplify intravenous access and protect peripheral veins.
• Mental and Emotional Preparation: Learning stress management techniques and establishing a strong support system.

Receiving chemotherapy at a specialized cancer care hospital ensures proper evaluation, safe administration, and continuous monitoring.

What Happens During the Treatment

Chemotherapy is delivered in various ways:

• Intravenous Infusion: Drugs are administered through an IV line, catheter, or implanted port.
• Oral Chemotherapy: Taking prescribed pills or capsules at home.
• Specialized Methods: Depending on the cancer, this may include intra-arterial delivery (into an artery feeding the tumour) or Hyperthermic Intraperitoneal Chemotherapy (HIPEC) for certain abdominal cancers.

During infusion, oncology nurses check vital signs and monitor the safe delivery of drugs. The environment, whether an outpatient unit or inpatient ward, is designed for patient comfort and infection control.

Length of Time and Schedule

Chemotherapy is typically administered in cycles, which are periods of treatment followed by days or weeks of rest.

• Session Duration: Individual sessions can last from 30 minutes to several hours, depending on the specific drug and dose.
• Cycle Repetition: Cycles repeat regularly, usually every few days or weeks, for a total of four to eight cycles.
• Purpose of Cycles: This schedule is crucial as it gives normal, healthy tissues time to heal and recover from the effects of the drugs before the next dose, while the cumulative effect keeps attacking the cancer cells.

Also Read : Fight The Fatigue Of Chemotherapy In 7 Powerful Ways

Potential Benefits of Chemotherapy

Chemotherapy serves multiple therapeutic goals, often in combination with other modalities:

• Curative Potential: Chemotherapy alone or in combination with other treatments can lead to a complete cure for many types of cancer, including certain lymphomas, leukemias, and some germ cell tumours [6].
• Tumour Shrinkage: Reducing the size of a tumour before surgery or radiation (neoadjuvant setting).
• Disease Control: Halting or slowing the growth and spread of advanced-stage cancer, turning it into a chronic, manageable condition.
• Symptom Relief (Palliative): Decreasing pain, bleeding, or pressure caused by large tumours.
• Recurrence Prevention: Eliminating microscopic cancer cells that may remain in the body after local treatment (adjuvant setting).

Chemotherapy Side Effects and Management

Chemotherapy side effects occur because the drugs damage healthy, quickly growing cells. It is essential to understand that while many side effects are temporary, some can be serious or potentially long-lasting. Most side effects can be managed effectively with proactive supportive care protocols and medication [7].

Managing Severe or Serious Side Effects

Patients must strictly follow all prescribed medical advice. It is critical to immediately report any signs of fever (a potential sign of infection due to low white blood cells) or unexplained bleeding to the oncology team. Counseling, support groups, and nutritional guidance are vital components of ongoing care, helping patients manage the emotional and physical stress of treatment.

Significant medical advancements have led to the development of new, highly effective supportive care drugs, such as newer antiemetics and colony-stimulating factors, which have dramatically improved patient tolerance and reduced the need for treatment breaks [8].

Also Read : How to Deal With Chemotherapy Side Effect

Access to Chemotherapy

In India, chemotherapy is available at specialized oncology centers, comprehensive tertiary hospitals, and through various government and private health schemes. The cost per cycle of chemotherapy is highly variable, generally ranging from $₹15,000$ to over $₹1,00,000$, depending heavily on the specific drug regimen (standard vs. newer/targeted agents), dose, and supportive care required. Financial assistance is often available through government initiatives like the Ayushman Bharat scheme, the Mahatma Jyotiba Phule Jan Arogya Yojana (MJPJAY), and private insurance plans.

A high-quality oncology center should provide an integrated, multidisciplinary approach that includes access to experienced medical oncologists, trained nursing staff, comfortable and sterile infusion units, and holistic services like nutrition and mental health support.

For patients seeking chemotherapy treatment, consulting a specialist oncologist is an important step for timely evaluation and safe care.

• Oncologist | Cancer Specialist in Pune
• Oncologist | Cancer Specialist in Mumbai

Conclusion

Chemotherapy remains a cornerstone of modern, multidisciplinary cancer treatment. By specifically targeting and eliminating rapidly dividing cells, it can significantly reduce tumour burden, prevent metastasis, and improve overall survival rates. While side effects are a reality, they are increasingly manageable due to advancements in supportive care and monitoring protocols. 

Every patient’s experience is unique, but with personalized medical guidance, robust emotional support, and nutritional care, most individuals can successfully complete their chemotherapy regimen and work towards recovery.

Disclaimer

The content of this blog is for informational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your qualified healthcare provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. Cancer diagnosis and treatment protocols, including chemotherapy, are complex and highly personalized.

References

1. National Cancer Institute. (2021). Chemotherapy to Treat Cancer. Contextual Link:
2. American Cancer Society. (2023). How Chemotherapy Drugs Work. Contextual Link:
3. Zhang, J., & Zhang, Q. (2020). Cell cycle regulation and the effects of chemotherapy drugs. Cell Biology International, 44(2), 241-253. Contextual Link:
4. National Comprehensive Cancer Network (NCCN). (2024). NCCN Guidelines for Patients: Chemotherapy Side Effects. Contextual Link:
5. Oncology Nursing Society. (2022). Preparing for Chemotherapy. Contextual Link:
6. DeVita, V. T., Lawrence, T. S., & Rosenberg, S. A. (2019). DeVita, Hellman, and Rosenberg’s Cancer: Principles & Practice of Oncology (11th ed.). Wolters Kluwer. Contextual Link: (Note: This is a reference to a core oncology textbook that supports curative claims for specific cancers.)
7. Hesketh, P. J. (2008). Chemotherapy-induced nausea and vomiting. The New England Journal of Medicine, 358(23), 2482-2494. Contextual Link:
8. Crawford, J., Ozer, H., Stoller, R., Johnson, D., Lyman, G., Vaickus, L., … & Armitage, J. (1991). Reduction by granulocyte colony-stimulating factor of fever and neutropenia induced by chemotherapy in patients with small-cell lung cancer. New England Journal of Medicine, 325(3), 164-170. Contextual Link:

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