Chemotherapy for Cancer: Drugs, Dose, Costs, and Treatment

Cancer stands as the second leading cause of morbidity and mortality in India. It involves the uncontrolled division and spread of abnormal cells throughout the body. Chemotherapy can control the multiplication of these cells.

A diverse range of chemotherapy drugs is used to treat various cancers. The dosage administered is specific to the type and stage of the disease. Explore this blog to gain insights into different chemotherapy drugs, the procedure, and potential side effects.

Chemotherapy is a procedure to stop the multiplication of cancer-causing cells in the body. A broad spectrum of drugs is employed to treat cancer, either independently or in conjunction with other medications or therapies. 

These drugs exhibit variations in chemical composition, prescription and administration methods, efficacy against specific cancer types, and potential side effects.

This cancer treatment is frequently combined with other therapeutic approaches, including surgery, radiation, or hormone therapy. The decision for adjunct therapy considers factors such as:

1. The cancer stage and type

2. Overall health prior to treatments

3. Cancer cell location

4. Individual treatment preferences

Physiology of Cancer

Delving into the physiology of cancer unveils abnormal cellular behaviour marked by uncontrolled growth and invasive tendencies. Chemotherapy, a pivotal intervention, disrupts cancer cells' cycle, impeding their proliferation and promoting programmed cell death.

Cancer vs Normal Cells:

1. Cancer cells differ in behaviour, evading normal growth controls.

2. Uninhibited division, invasion, and metastasis are hallmarks of cancer cells.

Cell Anatomy in Cancer:

1. Abnormal morphology and tumour formation characterise cancer cells.

2. Genetic mutations impact cell cycle regulation and apoptosis (the process of programmed cell death).

Unhindered Cell Division:

1. Cancer cells bypass normal cell cycle checkpoints.

2. Unchecked cell multiplication contributes to tumour growth.

Chemotherapy Mechanism:

1. Drugs disrupt various cell cycle stages in cancer cells.

2. Aimed at halting rapid division and promoting cell death.

Types of chemotherapy

Chemotherapy includes diverse strategies customised to combat different aspects of cancer. Understanding the types is crucial in exploring targeted approaches for effective cancer management.

1. Neoadjuvant Chemotherapy: Administered before surgery or radiation to reduce tumour size.

2. Adjuvant Chemotherapy: Given after operation or radiotherapy to eliminate any remaining cancer cells and prevent recurrence.

3. Curative Chemotherapy: Employed as an alternative to surgery or radiation to eradicate all cancer cells.

4. Palliative Chemotherapy: Provided to alleviate symptoms or extend a patient's life, acknowledging the eventual fatality of the cancer.

Chemotherapy is commonly used to treat various types of cancer and some non-cancerous conditions. It is crucial for healthcare professionals to carefully evaluate and customise chemotherapy treatment based on individual patient needs and conditions.

Conditions treated with chemotherapy include: 

1. Benign and Malignant Tumours: It is a primary treatment for various cancers, such as breast cancer, lung cancer, leukaemia, lymphoma, and many others.

2. Preventing Cancer Recurrence: Chemotherapy may be employed after surgery or radiation therapy to prevent the return of cancer cells.

3. Autoimmune Diseases: In some cases, chemo drugs may be used to suppress an overactive immune system (Example: Rheumatoid arthritis).

4. Organ Transplant: Chemotherapy is sometimes used with other treatments to suppress the immune system. This is done before transplantation to prevent rejection.

The decision to undergo chemotherapy is influenced by several factors related to the type and stage of cancer. Here's when chemotherapy might be considered:

1. Eliminating Cancer: Aim to treat the disease with the goal of achieving complete remission.

2. Reduce Recurrence Risk: Those who want to lessen the chance of cancer returning after initial treatment.

3. Impede Growth: Need to stop or slow down the proliferation of malignant cells.

4. Failed Previous Treatments: Have undergone other interventions like surgery or radiation without success.

5. Biomarkers and Genetics: Exhibit specific indicators or genetic factors suggesting responsiveness to chemotherapy.

Note: Understanding the specifics of cancer and considering individual health factors helps determine the most appropriate course of action.

Chemotherapy, a cornerstone in cancer treatment, provides a versatile approach to combating the disease. It can shrink tumours, target cancer cells throughout the body, and offer curative or palliative benefits to patients. The benefits of chemotherapy are as follows: 

1. It is effective in reducing the size of tumours

2. Helps in eradicating cancer cells and preventing their recurrence

3. Serves as adjuvant therapy after surgery or radiation

4. Provides relief from cancer symptoms

5. Improves the quality of life for patients 

6. Enhances overall treatment efficacy when used in combination with surgery or radiation

7. Chemo drugs circulate throughout the body, reaching cancer cells in various locations

8. Manages and controls the spread of cancer to other organs, addressing metastatic disease

9. Offers customised and patient-specific approaches

10. Increases survival rates, especially when combined with other therapeutic modalities

Chemotherapy is a potent intervention for a critical health condition. It requires careful planning and anticipation of potential challenges under the guidance of the medical team. It ensures a better understanding of the treatment for improved readiness.

Explore the chemotherapy before and after steps in detail below.

Before Chemotherapy Treatment

Patients are advised to consult with their oncologists to prepare for the chemotherapy session. They need to keep the following points in mind:

Note: A thorough consultation with your medical oncologist will provide an accurate fasting duration before your chemo session. HexaHealth can help you connect with top cancer specialists and help you at every step.

On the Day of Chemotherapy

On the day of chemotherapy, patients can anticipate specific preparations to ensure a smooth and effective treatment. These preparations include

Intravenous chemotherapy procedures are customised for treatment planning. Modern practices offer outpatient sessions administered by a nurse or infusion specialist. This method allows flexibility and convenience for patients, emphasising a more accessible and streamlined approach to chemotherapy.

To explain how is chemotherapy done through the infusion process, here are the steps:

1. The team establishes intravenous access if not already present.

2. A blood sample is obtained for cell count.

3. The medical oncologist calculates the precise medication dosage.

4. The patient receives pre-chemotherapy medications, such as fluids or drugs, to prevent side effects.

5. During the infusion period, patients can rest or engage in leisure activities.

6. A nurse monitors the patient for allergic or other adverse drug reactions.

7. Post-infusion steps include IV removal, flushing, and capping for later use.

8. Vital signs are checked, and an assessment is conducted for immune response or side effects.

After chemotherapy, a crucial recovery period follows, varying for each individual. While some may swiftly regain normalcy, others might experience a more extended recovery process. Here's a general overview of what patients can anticipate during the post-chemotherapy phase:

Hospital Stay:

1. Duration varies based on treatment plan and individual response.

2. Ranges from 2-4 hours to even 2-3 weeks post-chemotherapy. The significant variation is due to a number of factors like the stage of cancer, the individual’s tolerance for the intervention, etc.

Recovery at Home:

1. Review homecare, managing side effects, and when to contact the doctor.

2. After discharge, prioritise rest and self-care.

3. Manage side effects with prescribed medications.

Lifestyle Adjustments:

1. Adopt a healthier lifestyle with balanced nutrition and guidance from an oncology nutritionist.

2. Include regular exercise and sufficient rest for the recovery process.

Monitoring for Complications:

1. Stay vigilant for any signs of complications.

2. Promptly report symptoms to the healthcare team for timely intervention.

Follow-up Appointments:

1. Regular appointments to assess treatment outcomes.

2. Address concerns and plan ongoing care.

Individuals need to collaborate closely with their medical team, following personalised recovery plans to achieve optimal well-being post-chemotherapy.

Chemotherapy is often associated with ill effects due to its impact on rapidly dividing cells in the body. These effects can vary widely and are essential to understand for comprehensive patient care.

Common side effects include:

1. It can trigger sickness and vomiting.

2. Many patients go through temporary or permanent hair loss.

3. Profound tiredness is a common side effect.

4. A weakened immune system increases susceptibility to infections.

5. Reduced red blood cell count may lead to fatigue and weakness.

6. Chemotherapy can cause serious and painful sores in the mouth.

7. People may experience loss of appetite or weight changes.

8. Reduced platelet count can result in easy bruising and bleeding.

9. Altered bowel habits are common adverse effects.

10. Peripheral neuropathy may cause tingling or numbness in extremities.

While chemotherapy may involve side effects, its benefits in treating and managing cancer make it invaluable.

When to consult a doctor?

It's essential for patients undergoing chemotherapy to be vigilant about potential complications. Knowing when to consult a doctor ensures timely intervention and improved overall well-being during chemotherapy.

Key signs to consult a doctor include:

1. Fever, chills, or sweats may indicate an infection that requires prompt attention

2. Diarrhoea that persists or is accompanied by blood

3. Nausea and vomiting that become severe, affecting a person’s ability to eat or drink

4. Difficulty eating or drinking

5. An overwhelming weakness that hinders daily activities

6. Redness, swelling, or drainage from any site where an IV line is inserted

7. Any new skin rash or blister development

8. Yellowing of the skin or eyes

9. Persistent or intense abdominal pain 

10. A very bad headache or one that does not improve 

11. Deterioration in the cough or breathing, especially at rest or during simple tasks

12. A burning sensation while urinating

Timely initiation of chemotherapy is critical for effective cancer treatment. Delays can impact prognosis, therapeutic options, and overall health.

1. Progression: Postponing chemotherapy allows cancer to grow, reducing treatment efficacy.

2. Increased Size: Tumours may grow larger, complicating curative options.

3. Reduced Effectiveness: Timely chemotherapy is crucial for optimal response.

4. Advanced Stage Diagnosis: Holding up leads to late-stage identification, impacting prognosis (the likely course of a medical condition).

5. Missed Cure Opportunity: Early intervention improves chances of remission.

6. Limited Options: Stalling chemo may restrict available treatments.

7. Increased Intensity: Delaying may necessitate more aggressive treatment with a high dosage.

8. Impact on Overall Health: It affects general well-being and resilience.

9. Emotional Impact: Putting it off might cause heightened emotional distress.

10. Extended Recovery: Postponement prolongs the overall recovery period.

The average price range for chemotherapy is around ₹ 45,000. However, it varies considerably due to the nature and stage of cancer, individual conditions, etc. Below is an estimated cost associated with each chemo session:

Factors Affecting the Cost of Chemotherapy 

The duration, frequency, and type of chemotherapy are some of the factors affecting costs in general. It is essential to know about these elements in detail before undergoing the procedure.

1. Type of Hospital: The choice of the hospital affects the cost, with prestigious institutions often having higher fees.

2. Diagnostic Tests: Expenses include various preoperative tests to assess the patient's condition.

3. Surgeon’s Fees: The professional charges of a reputed surgeon are higher than those of other surgeons.

4. Hospital Stay: Longer stays incur additional costs for accommodation and services.

5. Post-operative Care: Expenses related to follow-up visits, medications, and rehabilitation.

6. Type of Chemotherapy: Different drugs have varying costs, influencing the overall expense.

7. Treatment Setting: Whether chemotherapy is administered in an outpatient clinic, hospital, or at home affects the total cost.

HexaHealth: Your Compassionate Partner in Cancer Care!

Chemotherapy is a prevalent cancer treatment. It can be standalone or combined with radiation, surgery, or other drug therapies. Customised to cancer stage and health, it may result in short-term and long-term side effects. Before going ahead with this therapy, discuss the risks and benefits with your healthcare provider.

Opting for HexaHealth for chemotherapy guarantees personalized support during your cancer treatment. Our experienced professionals deliver detailed guidance and connect you with healthcare experts. With HexaHealth, you gain access to a supportive network for an informed and comfortable chemotherapy experience.