What is chemotherapy in oncology? Chemotherapy for oncology. What is chemotherapy and how is it done? Examples of treatment for various tumors

06.04.2017

Chemotherapy is a special method of treating malignant neoplasms.

It involves the introduction of antitumor drugs that have the ability to stop the development of cancer cells or cause their irreversible damage and death.

Chemotherapy planning

When planning the optimal chemotherapy treatment regimen, your doctor will consider a number of different factors.

The most important are the location of the neoplasm, its type and prevalence, and the general condition of the patient.

The goal of this treatment is to suppress metabolism, growth and destruction of malignant cells. Chemotherapy is not carried out according to the same scheme, but is selected individually for each specific patient.

Chemotherapy treatment can involve either the introduction of certain drugs or various combinations. To date, more than fifty different antitumor agents are known. Chemotherapy can be used as an independent treatment or as a complex treatment, together with surgery and radiation therapy.

Types of chemotherapy

There are two types of chemotherapy used to treat cancer:

Monochemotherapy (treatment with one drug).
Polychemotherapy (treatment with several drugs simultaneously or in sequential order).

In modern oncology treatment, complex combinations consisting of several chemotherapy drugs are used for maximum effect. If chemotherapy is part of a complex treatment, then the following types are distinguished:

Adjuvant chemotherapy (used after surgery or after a course of radiotherapy).
Neoadjuvant chemotherapy (used after radical treatment).

Chemotherapy often includes immunotherapy and targeted therapy. But recently, these types have demonstrated rapid development and are classified as independent types of oncology treatment.

The effects of chemotherapy on the body

Chemotherapy has a destructive effect on malignant cells by interfering with certain processes of their development. Cells that live for a short time and divide quickly are sensitive to the effects of chemotherapeutic agents.

Chemicals can also have side effects on healthy cells in the body. There are many side effects from chemotherapy, which include weakness (due to decreased hemoglobin levels), nausea, vomiting and bowel movements.

Commonly encountered: ulceration of the oral mucosa, hair loss, neuropathy. Chemotherapy treatment is carried out by a trained team of specialists with extensive experience and knowledge of the body’s reactions to taking cytotoxic drugs.

Cytostatic drugs are produced from plants, fungi, and also chemically. Thanks to them, cell division stops and has a strong effect on fast-growing tissues, such as cancerous tumors.

With the help of cytostatics, you can stop the growth of the tumor and bring the disease under control. Thanks to therapeutic treatment, the formation may decrease in size or disappear. Depending on the type of cancer, stage and speed of development, a complete cure is possible.

There are many drugs for chemotherapy treatment, differing in their modes of action and release forms (in the form of tablets, capsules, injection ampoules, infusion solutions, ointments). In some cases, drugs are used simultaneously or in a certain sequence in order to achieve maximum effect.

Treatment is carried out according to an individual scheme, which is specially compiled for a particular patient. According to the scheme, the type of medications, their dosage, and duration of administration are established. Therapeutic regimens are usually applied in courses at regular intervals.

During treatment, based on examinations of the patient, doctors check the effects of medications and their tolerability. If the desired result is not observed or the side effects are very severe, the chemotherapy regimen is adjusted (other drugs are prescribed, their dosage is changed, the dosage schedule is changed, or chemotherapy treatment is completely canceled).

The interval between treatment cycles is determined based on the treatment plan, which for some patients may not always be strictly followed. Depending on the tolerability/intolerance of the drugs and their components, the results of blood tests and examinations of other organs, the interval between treatment cycles may be increased or decreased.

It is impossible to predict how a chemotherapy treatment regimen should be repeated. First, two to four cycles are carried out. Depending on the effect, the feasibility of carrying out this type of chemotherapy, its termination, or drawing up another treatment plan is determined.

Chemotherapy treatment

Chemotherapy drugs are administered intravenously into the patient's body. The chemotherapy treatment regimen determines the number of doses of drugs. For each patient, the regimen is selected individually by the attending physician based on protocols.

Between courses of chemotherapy, a break must be taken in order to restore the body and reduce the symptoms of side effects.

Special accompanying therapy can improve the patient’s quality of life and allows side effects to be partially or completely avoided even with intensive chemotherapy treatment for any type of oncology.

Before each course of treatment, the patient must be examined and certain tests are prescribed. After the examination, the attending physician adjusts the subsequent treatment regimen (may reduce the dosage of the drug in order to reduce unpleasant symptoms or postpone the course of treatment for a couple of days until the body is completely restored).

Treatment regimens depend on the stage and type of the disease and are strictly regulated by international methods and rules. Chemotherapy drugs are constantly being improved; for each type of cancer, protocols include a variety of cytotoxic drugs. Nowadays a huge number of drugs and their various combinations are used. Complex treatment with chemotherapy drugs is aimed at affecting the tumor.

The duration of treatment and the number of courses is determined depending on the type of cancer, the specific course of the disease, the type of drugs and the body’s reaction to them. Chemotherapy treatment can last from six months to two years. During the treatment period, the patient must be under the supervision of specialists and undergo all necessary examinations.

Chemotherapy regimens

Chemotherapy regimens are selected in accordance with the diagnosis, stages of the cancer process and international regulations.

Many chemotherapy drugs are used as monotherapy or in various combinations. Combinations are selected according to the principle of minimal sufficiency, taking into account all possible effects on malignant neoplasms.

The following drug regimens are prescribed:

anthracyclines;
alkylating agents;
antibiotic antitumor drugs;
antimetabolites;
vinkalkaloids;
taxanes;
platinum drugs;
epipodophyllotoxins, etc.

Any regimen has its own contraindications and indications, so a qualified oncologist can prescribe it.

The number of courses is also determined by the doctor individually based on analyzes of the tolerability of the anticancer drug. The most effective and minimally complicated chemotherapy is treatment given twice a week. This fact is based on research, but, unfortunately, not all patients are able to withstand such a load. If complications occur, the doctor reduces the dosage, which may affect the duration and effectiveness of treatment.

There are certain medications and some nutritional supplements that affect the effectiveness of treatment. Therefore, all additional medications should be selected only by the attending physician.

Lifestyle during chemotherapy

The patient may experience fatigue during therapy. Therefore, the patient is recommended to slow down the rhythm of life for a while and get maximum rest. Work is not a contraindication, but a reduction in working hours does occur.

Feeling tired is a common side effect of chemotherapy. To improve your well-being, it is necessary to organize frequent rest breaks throughout the day. Nutrition for this type of therapy should be complete.

Since most drugs are eliminated through the kidneys, acting on the organs of the urinary system, it is necessary that the drugs are removed from the body in a timely manner. To do this, you should drink plenty of water, especially on the days you receive treatment. It is recommended to drink at least ten glasses of liquid per day.

It is important to prevent the development of nausea, vomiting and bowel dysfunction. Because side effects can wash away the necessary minerals from the body, and lead to the loss of a large amount of fluid, which will affect the patient’s condition.

The dosage of drugs, the duration and number of courses of treatment depend on the type of cancer process, the stage of cancer and the response of the individual patient to the drugs.

For certain types of neoplasms, there are treatment standards that require the use of specific medications. But there are many types of oncology, the treatment of which does not lend itself to standards and requires an exclusively individual approach, taking into account many factors.

29.10.2018

Chemotherapy for oncology is one of the methods of treating cancer. Treatment consists of taking medications.

Why does chemotherapy scare people so much? The problem is that the drugs cause various side effects.

Such drugs are strong poisons; along with the sick, they also kill healthy cells. So, how is the treatment done and what do you need to know during chemotherapy?

What is chemotherapy used for?

The procedure is needed for the following purposes:

to slow down tumor growth;
as the main treatment for the complete destruction of formation;
to reduce cancer cells to prevent metastases;
to reduce the size of cancer (before surgery).

Why is chemotherapy given? First of all, it should be noted that it is necessary for complex treatment. It is performed before and after surgery. Sometimes it remains the only treatment option.

How Chemotherapy Works

Chemistry is a special medicine that can destroy cancer cells, inhibiting their growth. This happens as a result of the fact that the drugs are able to affect the membranes of tumor cells or destroy them from the inside. There is a certain group of medications that can increase immunity against cancer.

In medicine, one patient is prescribed a complex that includes several drugs for a tumor. This treatment option is effective.

Some drugs can enhance the antitumor effect of radiation therapy. Others may be able to deal with eliminating irradiated cancer cells. A patient with cancer is prescribed chemotherapy and radiation therapy.

Contraindications

Chemotherapy for cancer is not possible in all cases. Sometimes the patient may have contraindications to such treatment. Why is this happening? Common reasons include:

organic intoxication;
cachexia;
spread of metastases to the liver;
a large amount of bilirubin;
spread of metastases to the brain area.

Speaking about contraindications, we note that they depend on each patient and their body, as well as on the stages of the tumor process, the presence of metastases and the location of the malignancy.

Types of chemotherapy

Depending on the drug used and their combination, medical staff distinguish several types of this method of therapy. The patient is prescribed treatment regimens, which are designated in Latin letters. And patients divide the type of chemotherapy by color.

What color is chemotherapy?

If you are going to undergo treatment, you need to know everything about chemotherapy, including what color it may be. So, chemotherapy can be of the following colors:

white chemotherapy includes Taxol and Taxotel;
blue chemotherapy. This treatment option includes drugs such as mitoxantrone and mitomycin;
yellow chemotherapy. Yellow substances are used. Such drugs are easily tolerated by patients, in comparison with antacyclines. The yellow chemotherapy regimen includes fluorouracil, methotrexate, cyclophosphamide;
red chemotherapy. This type of therapy is considered toxic to the body. During treatment, antacyclines are used - a solution that has a characteristic red color. Red chemotherapy causes neutropenia - a decrease in the level of neutrophils. As a result, there is a decrease in the body's infectious defense.

If there is oncology, then several types of chemotherapy are used. This is necessary to have the maximum effect on cancer cells.

Method of treatment

If an oncological diagnosis has been made, then such drugs must be administered intravenously. This could be an IV or a regular injection. In the first option, the drug will be administered over several days, for which a catheter is installed in a vein.

Other options for administering chemotherapy to a patient may be as follows:

intramuscularly;
into the artery that leads directly to the tumor;
orally, that is, directly into the mouth;
locally;
subcutaneously;
injection directly into the tumor;
into the spinal fluid, pleural or abdominal cavity.

Consequences of chemotherapy

Knowing what chemotherapy is, it is necessary to note the consequences of its use. First of all, after treatment, the growth of the tumor stops, it decreases in size, and the patient returns to normal life, at least for a certain period of time. The chemotherapy drugs used are highly toxic, so in addition to positive effects, they have various negative effects. Noticeable deterioration after using therapy makes this procedure a serious challenge for many patients.

Chemotherapy for cancer can cause side effects such as:

nausea, vomiting;
hair loss;
weakness;
hearing loss;
loss of appetite;
bowel dysfunction;
disturbances in intestinal function;
numbness of the limbs;
noise in ears;
blood composition disorder;
impaired coordination of movements.

These problems can be observed in different combinations in different patients. They can appear weakly or be pronounced. Some of them, such as hair loss, appear two to three weeks after treatment. Some, for example, vomiting, may occur immediately after taking the drug.

While taking conventional medications, the occurrence of side effects indicates the need to discontinue them. In the case of chemotherapy in oncology, this rule does not apply. Treatment must be continued in accordance with the course of chemotherapy prescribed by the doctor. Although in some cases patients experience a sharp deterioration in their health, this phenomenon does not happen to everyone.

It all depends on the condition of the tumor, the dosage of the drug and the characteristics of the individual person’s body. To complete a full course of chemotherapy, you need to stay in hospital for a long time. But there are treatment regimens in which therapy is carried out on an outpatient basis. After completing the course of treatment, the restoration of all negative consequences for the body is gradually observed. The functioning of the intestines and stomach is normalized, and hair restoration is observed.

Treatment for different tumor locations

Chemotherapy for colon cancer is an auxiliary treatment method. It is carried out after removal of a cancerous tumor, when there is a possibility of its recurrence. In this situation, it is recommended to destroy all cancer cells that could be in the lymph nodes and blood. Therapy can be carried out both on an outpatient basis and in a hospital setting. Chemotherapy for rectal cancer can reduce the likelihood of death by 40%.

For ovarian cancer, it is recommended to carry out systemic chemotherapy, that is, the drug is introduced into the bloodstream, affecting all cells and tissues. In some cases, when the tumor is localized in this area, drugs are injected into the abdominal cavity through a catheter.

In the presence of cervical cancer, this method of treatment is recommended at the initial stage of oncology, after surgical intervention aimed at removing the uterus. Doctors note that chemotherapy for cervical cancer will be more effective if the patient has not undergone radiation therapy.

If a patient has lung cancer, chemotherapy can be carried out not only after, but also before surgery. If the tumor is inoperable, then it may be the only possible way to prolong the patient’s life. This method of therapy cannot completely get rid of the disease.

The effectiveness of chemotherapy for liver cancer is low; the drugs are not able to affect cancer cells located in this organ. Recently, new medications have been available that can change the situation. A good effect can be achieved by injecting the drug into the hepatic artery.

The main feature of chemotherapy for pancreatic cancer is that it is prescribed after surgery and has contraindications. This type of oncology has a high mortality rate, so the correct choice of therapy that can prolong the patient’s life is of great importance.

Depending on the response to the medicine of a particular person, the stage of the disease and the type of oncology, the duration of treatment courses and the dosage of the drug depend. For certain types of tumors, there is a standard of treatment that includes medication. There are also diseases in patients whose treatment cannot be standard, requiring individual consideration of various factors.

Diet during chemotherapy

There is no special diet for those patients undergoing chemotherapy. It is recommended to avoid eating spicy and fatty foods, garlic, onions and seasonings. Salads, fruits and vegetables can be eaten after washing them thoroughly.

Before eating, peel fruits and vegetables. In order for the body to recover faster after chemotherapy, it is recommended to eat foods containing a lot of protein. This includes red meat, chicken, fish and cottage cheese.

You need a balanced diet. For the intake of vitamins into the body and normal bowel function, it is recommended to consume fresh fruits and vegetables, freshly squeezed juices. It is recommended to contact a nutritionist, who should be in the oncology hospital. After preliminary consultation with your doctor, you can take additional nutritional supplements and vitamins in tablet form. You should not abuse vitamins C and E in large quantities.

Eating right is very important. Only proper nutrition allows you to restore and preserve the body’s defense mechanisms. In the morning, before undergoing chemotherapy, it is recommended to eat a light meal. It is recommended to drink plenty of fluids before, during and after chemotherapy. Proper nutrition is one of the main components of treatment. With food you can get the strength you need to heal quickly, so nutrition is also considered part of the therapy.

Many people who don’t know what chemotherapy is consider it something scary, almost on a par with cancer. In fact, everything here is individual. Some people are able to tolerate treatment normally, with virtually no side effects.

You should not refuse chemotherapy if it is recommended by your doctor, because in this way you can reduce the likelihood of cancer recurrence or prolong your life. In any case, you should not be afraid of chemotherapy, because it is aimed at treating cancer.

Chemotherapy is one of the main methods of treating malignant oncopathologies and involves the use of special antitumor drugs that destroy malignant cellular structures or prevent their division.

Many people have heard about chemotherapy; almost everyone knows that this anti-cancer method is accompanied by many side reactions and disturbances in the functioning of the body. Many, fearing such consequences, refuse such treatment, which is not at all correct, because oncology cannot always be cured with surgery or radiation.

In what cases is chemotherapy prescribed?

Not all malignant oncopathologies are treated with chemotherapy drugs.

Indications for chemotherapy treatment are as follows:

, remission of which can only be achieved through chemotherapy. The same applies to, or, etc.;
The need to reduce the tumor in order to achieve its operability for subsequent removal;
To prevent the spread of metastases;
As an additional therapeutic method to radiation or surgical therapy.

Chemotherapy is indicated in all clinical cases accompanied by damage to the lymph nodes, and the size of the formations does not matter at all.

Contraindications

After a thorough examination of the patient, the oncologist makes a conclusion about the effectiveness of chemotherapy treatment or finds out that such treatment is contraindicated. What could be the reason for prohibiting chemotherapy?

Spread of metastasis to brain structures;
Excessive bilirubin content;
Metastatic lesions in the liver;
Organic intoxication.

In general, contraindications depend on the characteristics of the patient and his body, the location of the malignancy, the presence of metastases, the stage of the tumor process, etc.

Kinds

Types of chemotherapy treatment in oncology are conventionally divided by color by patients. There are red, blue, yellow and white chemotherapy, depending on the color of the drug administered.

Red Chemotherapy is considered the most powerful and toxic treatment for organic structures, which uses drugs of the antacycline group such as Doxorubicin, Idarubicin or Epirubicin. After such treatment, neutropenia is observed, leading to a decrease in immunity and anti-infective defense.
Blue chemotherapy is carried out with the drugs Mitoxantrone, Mitomycin, etc.
Yellow Chemotherapy is carried out with yellow drugs. This regimen includes anti-cancer drugs such as Fluorouracil, Methotrexate or Cyclophosphamide.
To the diagram white Chemotherapy includes drugs such as Taxol or Tacosel.

Photo of chemotherapy treatment course

Typically, antitumor chemotherapy is carried out using several types of drugs, i.e. it is polychemotherapeutic in nature.

Neoadjuvant

Neoadjuvant (or preoperative) chemotherapy is prescribed to patients before radical surgical removal of the tumor. T

This chemotherapy treatment is aimed at suppressing the aggression and growth of the primary tumor focus. This technique also reduces the risk of developing metastasis.

Adjuvant

This type of chemotherapy is given after surgery.

In essence, adjuvant chemotherapy is a preventive measure that prevents the further development of the cancer process. This type of treatment is used for all types of cancer tumors.

Adjuvant chemotherapy is complementary to the main treatment. It is aimed at eliminating possible hidden or micrometastases, which are not always detected by modern diagnostic methods.

Induction

This type of chemotherapy is also called curative. Induction chemotherapy is prescribed in those clinical cases when the tumor formation is highly sensitive or moderately sensitive to anticancer drugs, as well as when there are contraindications to surgical treatment of oncology.

Induction chemotherapy is prescribed:

For therapeutic purposes in such tumor processes as lymphomas and leukemia, trophoblastic formations and germ cell tumors of the testicle;
As a palliative treatment necessary to prolong the life of a cancer patient by improving its quality and reducing cancer symptoms (relieving pain, eliminating shortness of breath, etc.).

Target

Targeted chemotherapy is one of the most modern and rapidly developing methods of treating oncological pathologies today.

With the help of special antitumor drugs, molecular genetic cellular disorders are affected.

The use of targeted drugs can significantly inhibit cell growth or provoke cell self-destruction. Before using targeted drugs, preliminary genetic and immunohistochemical studies are necessary.

Hyperthermic

Hyperthermic or hot chemotherapy is a therapeutic method of complex action on cancer cells, including high temperatures and antitumor drugs.

Such therapy is most effective against large tumors and intraorganic metastasis.

Through hyperthermic chemotherapy, it is possible to rid a cancer patient of a 1-2 mm tumor by exposing it to a temperature of 41°C.

The undoubted advantage of such anticancer treatment is the reduction of toxic effects. In addition, experts say that in some cases such treatment is much more effective than traditional systemic chemotherapy.

Platinum

Platinum chemotherapy involves the use of platinum-based antitumor drugs - Cisplatin, Phenanthriplatin, etc. Such chemotherapy is prescribed in cases where other methods are useless.

Typically, platinum antitumor treatment is indicated for both, and.

There is a widespread belief among ordinary people that if platinum chemotherapy is prescribed, then the picture of the disease is very bad. This is wrong. It’s just that platinum drugs are able to work where other antitumor drugs are powerless.

In addition, it is platinum-based drugs in oncology that have the most pronounced therapeutic effect.

Gentle

Gentle chemotherapy is a treatment that uses antitumor drugs with a minimal set of side effects. The disadvantage of this treatment is the fact that such medications are less effective against cancer.

High dose

This type of chemotherapy involves prescribing increased doses of anticancer drugs to a cancer patient. Typically, such treatment is used for various types of lymphomas such as mantle cell or etc.

The use of high doses of cytostatics leads to a proportional increase in efficiency in the treatment of malignant lymphomas and avoids the resistance of tumor cells to the effects of drugs. But at the same time, a more pronounced toxic effect on the body occurs.

Palliative

If there is no chance of cure, patients are prescribed palliative chemotherapy.

This treatment method is aimed at:

Containment of further progression of the tumor process;
Blocking pain symptoms;
Increasing the life expectancy of a cancer patient;
Reducing the severity of the toxic effect of anticancer drugs and tumor activity;
Stopping the growth or shrinking of the tumor.

The prescription of palliative therapy does not always indicate an unfavorable prognosis.

On the contrary, such chemotherapy is indicated for people who can still take care of themselves, their condition does not cause concern among doctors, and they will be able to tolerate chemotherapy treatment to relieve pain and improve their quality of life.

Preparation

During treatment with antitumor drugs, it is necessary to reduce physical activity as much as possible. That is why oncologists recommend taking sick leave or vacation during treatment.

There can be no talk of bad habits; every cigarette in cancer patients reduces life expectancy.

Before starting treatment with chemotherapy drugs, it is necessary to undergo premedication and prepare the body.

Complete a course of treatment for concomitant oncological diseases.
Cleanse the body of toxins accumulated due to the tumor and taking medications. This is necessary to obtain the maximum effect from anticancer drugs.
Ensure, with the help of medications, the protection of the gastrointestinal tract, liver and kidney structures, as well as bone marrow.

It is recommended to talk in advance about chemotherapy with people who have undergone similar treatment, with psychologists and loved ones. Such communication will help you mentally prepare for chemotherapy and provide significant psychological support.

How is chemotherapy administered?

Typically, anticancer drugs are given to patients intravenously through infusion or in the form of a traditional injection. But these are not all methods of administering drugs.

They can be prescribed subcutaneously and orally, intramuscularly and into the artery supplying the tumor, locally and into the pleura, into the spinal fluid, into tumor tissue and the abdominal cavity.

Treatment regimens for cancer

The chemotherapy regimen is selected in accordance with the diagnosis, stage of the tumor process and international regulations.

Today, a huge number of chemotherapy drugs are used in the form of monotherapy or in various combinations. Combinations are selected in accordance with the principle of minimal sufficiency, taking into account the maximum possible therapeutic effect on tumor formation.

In general, regimens using the following drugs are prescribed:

Anthracyclines;
Alkylating agents;
Antibiotic antitumor drugs;
Antimetabolites;
Vinkalkaloids;
Taxanes;
Platinum drugs;
Epipodophyllotoxins, etc.

Each regimen has its own indications and contraindications, so the prescription should only be made by a qualified oncologist.

Duration

The number of chemotherapy courses is determined solely by the doctor on an individual basis. The medications can be taken daily (usually tablets) or weekly.

The number of courses is also determined individually based on an analysis of the tolerability of the antitumor drug. Chemotherapy administered every two weeks is considered the most effective and least complicated.

This has been proven by research, but, unfortunately, not every cancer patient is able to withstand such a load. If complications arise, the doctor is forced to reduce the dosage, which also affects the duration of treatment.

How much does a course of treatment cost in Moscow?

The cost of a course of chemotherapy in Moscow clinics can vary from several tens of thousands of rubles to a million.

Vincalkaloids and anthracyclines are considered the most expensive antitumor drugs.

The final cost of a chemotherapy course depends on the type of tumor and its location.

The most expensive treatment is considered to be treatment of oncopathologies of the head, blood, and pancreas.

How does a person feel after chemotherapy and how to alleviate the condition?

The main disadvantage of chemotherapy is a complex of adverse reactions. It will never be possible to avoid the consequences of chemotherapy, despite the fact that modern medicine offers a lot of rational regimens and routes of administration.

The most common side effects after chemotherapy are:

Nausea and vomiting symptoms are relieved by taking antinausea and antiemetic drugs;
Loss of hair, nail plates and changes in the skin - these consequences cannot be avoided. But a few weeks after the end of treatment, everything will begin to grow back, both hair and nails;
Gastrointestinal disorders, manifested by diarrhea, constipation, problems with appetite. Special diet therapy will help to cope with this problem.

To restore blood and immunity, liver and kidneys, and eliminate anemia, patients are prescribed special medications.

Why is this therapy dangerous?

Complications of chemotherapy treatment occur quite often. The most dangerous of them are:

Pneumonia – develops against the background of a pathologically low immune status. With timely diagnosis and treatment of pneumonia, it is possible to avoid death for the cancer patient;
Anorectal infectious lesions. About 25-40% of patients die from such a complication, which is approximately 8% of all cancer patients;
Typhlitis or inflammatory lesion of the cecum. It manifests itself as slight pain in the abdomen, progresses quite quickly, turning into gangrene and perforation. The mortality rate among cancer patients due to this complication is quite high.

Tumor disintegration

Tumor decay is considered a fairly common occurrence after chemotherapy treatment.

As a result of this process, the well-being of cancer patients worsens even more, since the body is additionally poisoned by the decay products of malignant structures and their toxic metabolites.

It is impossible to say for sure whether this is good or bad. Decay is a result of treatment, but has toxic consequences for the body.

One thing is clear: in the process of decay, a cancer patient needs emergency help from specialists.

Chemotherapy for cancer is a treatment method that involves administering various medications to the patient.

In addition, after using chemotherapy, the patient will experience a number of side effects - hair loss, bleeding, nausea and others. Side effects appear due to the effect of drugs on healthy cells of the body. Another feature of chemotherapy for cancer is that for complete treatment it is necessary to undergo several courses, since a one-time administration of drugs will not give the desired effect.

Complete or partial destruction of cancer cells.
Cancer control - chemotherapy drugs slow down the growth of cancer cells, which allows you to control the process of their spread and destroy foci of metastasis in a timely manner.
Chemotherapy relieves the painful symptoms of the disease. During treatment, the cancer tumor decreases in size and volume, which means it no longer puts pressure on neighboring organs and tissues and does not cause pain.
Chemotherapy can be used as the only treatment for cancer or in combination with radiation therapy or surgery.

Does chemotherapy help?

Does chemotherapy help with cancer is a pressing question for patients diagnosed with cancer. The effectiveness of chemotherapy depends on the stage of cancer and its location, the age of the patient and the individual characteristics of his body. Chemotherapy can be used as the sole treatment or combined with surgery and other therapies to significantly improve the chances of recovery.

Chemotherapy drugs are selected individually for each patient. The choice of drug and the effectiveness of treatment depend on factors such as: the type of cancer, previous similar treatment, the presence of medical disorders and chronic diseases. The treatment regimen depends on the purpose of the course of treatment. Thus, chemotherapy can be used to control cancer cells, alleviate symptoms of the disease, or completely destroy them.

In order for chemotherapy to help cure the disease, drugs are prescribed in courses with breaks. So, for example, after a week’s course of therapy, the patient is given a month’s break, and then several more repeated courses are given. Breaks are necessary for the body to create new healthy cells and tissues.

To make sure that chemotherapy is helping, the attending oncologist periodically conducts examinations and takes tests. The patient can determine the effectiveness of treatment by how he feels. Some patients mistakenly believe that if severe side symptoms begin after a course of treatment, then the treatment is effective. But this is not always the case, since each patient has an individual reaction to the drugs. And the effectiveness of treatment can only be determined after several courses of chemotherapy.

Indications for chemotherapy

Indications for chemotherapy depend on the type of cancer and its stage. Treatment is carried out in cycles that alternate with periods of recovery. A course of chemotherapy can last from three months to six months. There are a number of factors that influence the indications for chemotherapy, let's look at them:

Features of a cancer tumor, its size, stage of development, growth rate, degree of differentiation, expression, degree of metastasis and involvement of regional lymph nodes, hormonal status.
Individual characteristics of the patient’s body, such as: age, localization of malignant cancer, the presence of chronic diseases, condition of regional lymph nodes and general health.
Possible complications and positive effects of chemotherapy. The doctor assesses the risks, complications and likelihood of treatment effectiveness.

The indications for chemotherapy depend on the factors described above. But do not forget that the indications for this type of treatment are different in each specific case. Thus, chemotherapy will never be prescribed for patients with non-invasive cancer or in cases where the likelihood of tumor metastasis is very low or absent. In these cases, the patient is given hormonal therapy. Chemotherapy is indicated in all cases of lymph node involvement. In this case, the size of the tumor does not matter.

Main indications for a course of chemotherapy:

Cancers, the remission of which occurs only after a course of chemotherapy (leukemia, hematological malignancies, rhabdomyosarcomas, chorionic carcinomas and others).
Prevention of metastasis and adjunct to other therapeutic treatments for cancer.
Transferring the tumor to an operable state for more effective treatment, that is, complete removal of the cancer.

Chemotherapy for breast cancer is a complex treatment method. The goal of this method is to slow down the development of malignant cells in the mammary gland. As a rule, cytotoxic drugs are used for treatment. Chemotherapy can be used as a stand-alone treatment or used after or before surgery. Chemotherapy can prevent relapses of the disease and stop metastasis.

Chemotherapy for lung cancer

Chemotherapy for lung cancer is aimed at completely destroying cancer cells. Treatment with anticancer drugs can be used either as monotherapy or as part of a therapeutic anticancer complex. Chemotherapy involves several courses of administering cytostatics by drip. Chemotherapy drugs are selected individually for each patient. In addition to chemotherapy, patients are prescribed therapy to reduce the side effects of the drugs used.

Chemotherapy for stomach cancer

Chemotherapy for stomach cancer has several directions. Thus, drugs can be used after radical surgery, for postoperative intraperitoneal therapy, before surgery, or as a treatment for disseminated gastric cancer. Chemotherapy is carried out in a hospital setting, under the supervision of an oncologist. The drugs are administered intravenously and are used in tablet forms. The consequences of chemotherapy are devastating to the entire body, so the rehabilitation period after such treatment can last several years.

Chemotherapy for ovarian cancer

Chemotherapy for ovarian cancer is used to stop metastasis and prevent recurrence of the disease. Chemotherapy can be used before and after radical surgery to slow tumor growth, relieve painful symptoms and reduce the amount of surgical treatment. Chemotherapy drugs are given intravenously, taken orally, or injected into the abdominal cavity. There are many different medications and treatment regimens, each with varying degrees of effectiveness and side effects. The oncologist selects the optimal treatment option for a high chance of a complete recovery for the patient.

Chemotherapy for colorectal cancer

Chemotherapy for rectal cancer takes place in a hospital setting, under the supervision of a chemotherapy oncologist. The doctor selects a treatment regimen, determines how many courses of chemotherapy are needed and monitors the patient’s condition during the treatment process. The drugs can be administered intravenously, but most often orally, that is, through the mouth. If chemotherapy is used in the early stages of the disease, it can completely stop the cancer process and prevent its relapses in the future.

Chemotherapy for stage 4 cancer

Chemotherapy for stage 4 cancer is a method of treating the irreversible, uncontrolled process of spread and growth of tumor cells throughout the body. A properly designed chemotherapy regimen can prolong the patient’s life and significantly improve it. The survival rate of patients after chemotherapy for stage 4 cancer ranges from 30-70%, and life expectancy from six months to five years. It all depends on the type of tumor, the presence of concomitant diseases and the degree of damage to vital organs.

The key indicator of the effectiveness of chemotherapy for stage 4 cancer is five-year survival. This concept refers to the patient’s survival from the moment of diagnosis – stage 4 cancer. Let's look at the effectiveness of chemotherapy at stage 4 oncology, at various locations of cancer.

When chemotherapy is administered at stage 4 lung cancer, the five-year survival rate among patients is 10%. In addition to chemotherapy, radiation therapy may be used to relieve symptoms of the disease and reduce the size of the tumor. This allows you to significantly reduce the size of the tumor and destroy metastases in vital organs.

Chemotherapy for stage 4 liver cancer is effective for 6% of patients. At this stage, chemotherapy allows you to destroy some of the metastases. But classical chemotherapy is not effective in combating the source of the disease.

This disease, when given a course of chemotherapy at the last stage, has a high favorable prognosis of 15-20%. Palliative chemotherapy is used for treatment, which allows to achieve stabilization of the course of the cancer.

Pancreas cancer

At stage 4 cancer, chemotherapy is not effective. The five-year survival rate of patients ranges from 2-5%. Chemotherapy is used to alleviate the patient’s condition, reduce the size of the tumor, which compresses neighboring organs and tissues, and also to destroy metastases.

For stage 4 colon cancer, chemotherapy is used only after palliative surgical treatment. Patient survival is about 5%.

Chemotherapy is used to destroy metastases, relieve cancer symptoms, or after surgery.

Prostate cancer

For this disease, chemotherapy has a positive result. Thus, the survival rate of patients at stage 4 cancer after a course of chemotherapy is about 30%. Of particular danger are metastases that disrupt the functioning of the liver, kidneys and lungs.

The effectiveness of chemotherapy is 8-9%. The danger of stage 4 cancer is that the process affects the pelvic organs.

The therapeutic effect of chemotherapy for stage 4 cancer depends on a number of factors. Thus, the effectiveness of treatment is influenced by the development of metastasis to the brain, dysfunction of vital organs, blood clotting disorders, severe pain, arterial thrombosis and other pathologies.

The main goal of chemotherapy for stage 4 cancer is to limit the spread of the tumor, reduce its growth rate, preserve the functioning of organs and systems, and also prevent life-threatening complications.

Chemotherapy drugs

Chemotherapy drugs are anticancer drugs that destroy cancer cells and kill them. When treating cancer, two types of chemotherapy can be used. The first type is cancer treatment with one drug or monochemotherapy, and the second is treatment with several drugs or polychemotherapy. The second type of chemotherapy is more effective. Very often I combine chemotherapy with other treatment methods - surgery, radiation therapy.

There are many chemotherapy drugs and they all have a similar mechanism of action. Thus, the faster cancer cells divide and grow, the more sensitive they are to anticancer drugs and the more effective chemotherapy is. All chemotherapy drugs are divided into certain groups. There are anticancer drugs that act on all phases of the cell cycle, drugs that are effective in a certain phase of cancer, and cytostatics with a different mechanism of action. Let's take a closer look at some groups of drugs used in chemotherapy.

Alkylating agents

The drugs act on cancer cells at the molecular level. The most popular anticancer drugs from this group: Cyclophosphamide, Embiquin, Nitrosourea drugs.

Antibiotics

Some antibiotics have antitumor activity and effectively destroy cancer cells at different phases of the cell cycle.

Antimetabolites

Medicines block metabolic processes in cancer cells, which leads to their destruction. The most effective drugs from this group: Methotrexate, Cytarabine, 5-fluorouracil

Anthracyclines

The drug contains active ingredients that interact with DNA and destroy cancer cells. This group of drugs includes: Rubomycin, Adriblastin.

Vincalcaloids

Plant-based anticancer drugs. They destroy the division of cancer cells and destroy them. This group of drugs includes: Vinblastine, Vincristine, Vindesine.

Platinum preparations

The drugs contain toxic substances, elements of one of the heaviest metals. According to the mechanism of action, platinum preparations are similar to alkylating agents.

Epipodophyllotoxins

Antitumor drugs, which are a synthetic analogue of the active ingredients of mandrake extract. The most popular of them: Etoposide, Tniposide.

Each group of chemotherapy drugs has its own advantages and disadvantages. The oncologist selects drugs for treatment, focusing on the location of the cancer, the stage and type of cancer, as well as the patient’s age and characteristics of his body.

Contraindications to chemotherapy

Contraindications to chemotherapy, as well as indications for treatment, depend on the stage of cancer, the location of the tumor and the individual characteristics of the patient’s body. So the main contraindications to a course of chemotherapy are:

Intoxication of the body.
Metastasis to the liver.
High bilirubin level.
Metastasis to the brain.
Cachexia.

The attending oncologist, after conducting examinations and studying test results, makes conclusions about the effectiveness of chemotherapy or prohibits the use of this treatment method.

Side effects of chemotherapy

Side effects of chemotherapy are the main disadvantage of this type of treatment. Adverse symptoms appear due to the fact that chemotherapy drugs act on the entire body, affecting not only cancerous but also healthy cells of the body. Chemotherapy affects the cells of the hematopoietic system and blood, gastrointestinal tract, nose, hair follicles, nails, appendages, vagina, skin, and oral mucosa. But unlike cancer cells, these cells can recover. That is why the side symptoms of chemotherapy disappear after stopping the administration of drugs. Some chemotherapy side effects go away quickly, but others last for several years or take several years to become apparent.

The following side effects of chemotherapy are identified:

Osteoporosis is thinning and weakening of bone tissue. A side symptom occurs due to combination chemotherapy, when using drugs: Cyclophosphamide, Methotrexate, Fluorouracil.
Nausea, vomiting, diarrhea - chemotherapy affects all cells of the body. These side symptoms are caused by disturbances in the gastrointestinal tract, but the symptoms disappear after stopping chemotherapy.
Hair loss (alopecia) – after chemotherapy, hair may fall out partially or completely. Hair loss can occur both at the beginning of treatment and after several courses of chemotherapy. Hair growth returns after treatment is stopped.
Side effects on the skin and nails - some patients may experience rashes all over the skin, dryness, itching, peeling. Nails become brittle, and the skin is sensitive to temperature changes and mechanical damage.
Fatigue and anemia are the most common side effects of chemotherapy. Fatigue and anemia occur due to a decrease in red blood cells.
Infectious complications – chemotherapy significantly weakens the immune system, making it susceptible to various infections and viruses.
Blood clotting disorder – most often caused by chemotherapy treatment for blood cancer. The main cause of the disorder is a decrease in the number of platelets in the blood. The patient develops bleeding and bruises on the body.
Stomatitis - chemotherapy has a detrimental effect on the oral mucosa. Ulcerations and stomatitis appear in the oral cavity. The wounds become open to any infection, fungi and viruses.
Changes in taste and smell – chemotherapy may change the way you smell and taste. Many patients note the appearance of a metallic taste in the mouth. This happens because the tongue contains taste buds that transmit taste sensations to the brain. But due to the action of chemotherapy drugs, this process is disrupted.
Effect on the reproductive system - chemotherapy causes menstrual irregularities and negatively affects the performance of the ovaries. As a result, a woman experiences temporary or complete infertility. This side effect also applies to men undergoing chemotherapy.

In addition to the side effects described above, sleep disturbances, temporary memory loss or deterioration, hormonal disorders, insomnia or increased sleepiness, frequent headaches and other consequences of chemotherapy are possible.

Complications of chemotherapy

Complications of chemotherapy occur very often, as a rule, with aggressive chemotherapy and a weakened patient’s body. The most severe complications of chemotherapy manifest themselves as typhlitis, that is, inflammation of the cecum, anorectal infections and pneumonia. Let's take a closer look at each of the chemotherapy complications.

A very serious complication that manifests itself as minor abdominal pain. The peculiarity of this disease is that it progresses rapidly, causing inflammation of the cecum, gangrene or perforation. Among patients with cancer, mortality from this side effect is high. The main task of an oncologist is to diagnose the disease in a timely manner and prescribe treatment.

Infection in the anus occurs in 8% of patients undergoing chemotherapy. A complication may occur due to taking chemotherapy drugs by mouth. The disease affects patients with a weakened immune system; the mortality rate for this lesion is 20-40%.

Inflammatory complications usually appear in patients with a weakened immune system. Timely diagnosis and treatment can prevent the death of this complication of chemotherapy.

Nutrition during chemotherapy

Nutrition during chemotherapy is aimed at restoring the body and maintaining its normal functions. Thus, a balanced diet should include such food groups as: protein, bread and cereals, fruits and vegetables and dairy groups.

Chemotherapy has adverse effects on the digestive and gastrointestinal tract. It is because of this that patients begin to have problems with nutrition. The main rule for recovery and maintenance of the body during cancer is a balanced diet. Regular meals will help alleviate the side symptoms of chemotherapy and other treatments. Let's take a closer look at each of the food groups that should be included in the diet of a patient with cancer.

Protein products - during chemotherapy treatment, it is recommended to consume soy products, meat, liver, fish, eggs, legumes. All of these foods are rich in protein, B vitamins and iron.
Dairy products – lactic acid products have a beneficial effect on the gastrointestinal tract of patients and overall well-being. It is recommended to consume kefir, milk, cheese, butter, sour milk, yogurt and other dairy products.
Fruits and vegetables – During chemotherapy, patients should consume both cooked and raw vegetables and fruits. It is recommended to make salads, juices, fresh juices, and eat dried fruits. Don’t forget about greens, which can be added to all dishes.
Bakery Products and Cereals – Patients with cancer should consume a variety of cereals, grains and cereal products.

Before each course of chemotherapy, the patient should have a snack. It is not recommended to take medications on an empty or overloaded stomach. During chemotherapy, it is necessary to exclude spicy foods, as well as fried and fatty foods from the diet. But after a course of chemotherapy, food should be plentiful in order to restore strength.

Chemotherapy for cancer is an effective treatment method that destroys cancer cells, reduces the volume of malignant tumors and fights distant lymph nodes. Chemotherapy is selected individually for each patient. The effectiveness of this type of treatment depends on the stage of cancer, the degree of damage to the body and other individual characteristics of the patient’s body.

Is it true that chemotherapy is “outdated”? Because it does more harm than good? Have progressive clinics been treating cancer for a long time without “chemistry”? Commented by a resident of the Higher School of Oncology of the National Medical Research Center of Oncology named after. N.N. Petrova Katerina Korobeynikova.

Myth one: chemotherapy is ineffective

In support of this opinion, they refer to a study cited on the Internet by Harvard University professor John Cairns, allegedly published in Scientific American and the Journal of Clinical Oncology in 2004, that in fact chemotherapy only helps 2.3-5% cases. But it is “chemistry” that causes “tumor resistance, which is expressed in metastases.”

Photo from verywell.com

About the myth

To talk about the effectiveness of chemotherapy “for cancer”, it is necessary to clarify that the concept of “oncology” includes many different diseases.

There is neuroblastoma in children or uterine chorionic carcinoma. They can be completely cured with chemotherapy. (Cure means that the person has no relapses for 5 years).

There are tumors that are highly sensitive to chemotherapy - Ewing's sarcoma, prostate cancer, bladder cancer. With the help of chemotherapy, they can be controlled - cure is possible, at least long-term remission can be achieved.

There is an intermediate group - stomach cancer, kidney cancer, osteogenic sarcoma, in which tumor reduction from chemotherapy occurs in 75-50% of cases.

And there is cancer of the liver and pancreas. These tumors are insensitive to drug therapy, but other treatment methods are now used for them - surgery or irradiation. And then there is blood cancer - a concept that patients use to refer to acute leukemia and lymphoma. They generally develop according to different laws.

Even with advanced stage cancer with metastases, the prognosis depends very much on the specific subtype of tumor you have.

For example, the hormone-sensitive subtype of breast cancer, even with metastases, can be controlled very well.

Therefore, it is simply incorrect to draw any conclusions about “chemotherapy for cancer in general.”

Recently, the approach to treating cancer patients has become increasingly individualized. Quite a long time ago they said: “You have cancer - what a horror!” - then: “You have cancer of a certain organ - this is bad.” Now the doctor will carefully look at the “passport” of the tumor from histochemical and immunogenetic markers and the characteristics of the tumor, which was given to the patient during histological examination (such a study of the tumor is now included in the examination standards) and, depending on this, will choose treatment tactics.

About the source

About the study " Harvard University Professor John Cairns", which you mention, I'm hearing for the first time. The only currently practicing doctor named John Kearns, who was found on the Internet, is a neurologist-radiologist who deals with brain problems. And all his articles are devoted specifically to the brain and MRI; he wrote nothing at all about chemotherapy.

It is possible that we are talking about the British doctor and molecular biologist John Cairns, who retired in 1991 - he was born in 1923. Kearns is the author of Cancer: Science and Society (1978) and Matters of Life and Death: Perspectives on Public Health, Molecular Biology, Cancer, and the Prospects of the Human Race (1997).

He studied cancer and worked in various laboratories in the UK and Australia. He was a professor at the Harvard University Graduate School of Public Health from 1980 to 1991. But the years of life and work of John Kearns indicate that in his works he referred to survival statistics of the 1970-1980s, and could not publish in scientific journals in the early 2000s.

And if we are talking about this particular John Kearns, then we can only talk about outdated research in oncology.

The situation was different in the 1970s, and the effectiveness of drugs has changed greatly since then. The Journal of Clinical Oncology is not one of the modern authoritative publications. And important breakthrough studies that provoke scientific debate are published in several publications. What is suspicious here is not even that the data were published in one journal, but that the scale of this publication is not so large for such loud statements.

Scientific American is an American popular science magazine. It provides popular science articles and reviews about science in general, not just medicine. And there is no trust in it as a publication that publishes the results of scientific research.

A similar skeptical study about chemotherapy was recently published by the portal geektimes.ru. It says “between 2009 and 2015, 48 different anticancer drugs were approved. Of these, 10% are effective, and 57% had no effect at all.” The name of the researcher was given - Hussein Nasi.

I started looking into it, found the original article, and it turned out that the researchers assessed only two parameters - five-year survival rate and quality of life. But at the same time, they mixed very different diseases into one pile - stomach cancer, lung cancer, and oncohematology - blood cancer. But the indicators for these tumor locations are very different, the mechanism of action of the drugs is also very different, and a sign of the effectiveness of the drug will be different survival rates. And the researchers just got the “average temperature in the hospital.”

Myth two: for a number of diagnoses, life without chemotherapy is longer than with chemotherapy

Photo from time.com

The Internet says that this was proven by certain Doctor of Medical Sciences Alan Levin and Professor Charles Mathieu. And “in fact”, the majority of patients receiving chemotherapy die from “chemotherapy”, and not from cancer.

I have not found any supporting information that doctors with such names (they exist, but they are not oncologists) expressed such an opinion.

Today, Russia, like European countries and the United States, is gradually moving towards evidence-based medicine standards. In this system, all evidence is assessed on a certain scale. And least of all trust the arguments from the “Professor Ivanov said” series.

Evidence-based medicine requires detailed descriptions of various cases of cure, reliable, confirmed by certificates and documents.

A more serious level of arguments is meta-analyses, that is, the combination of several small studies that have already been conducted into one, when their results are added and considered together.

And finally, a very serious argument is the results of a randomized clinical trial. The number of patients there varies, but in most cases there is a placebo-controlled group that is treated according to the standard, but without the new drug.

Such a study is carried out using a “double-blind” method - for the purity of the results, neither the patient nor the researcher observing him knows what particular combination of drugs this or that patient is receiving, or whether there is a new added drug among his medications that is being tested.

Thus, the statements of individual experts should be treated with caution.

Photo from npr.org

Chemotherapy is a treatment. And like any treatment, it has side effects. They happen from any medications, they happen after surgical operations.

Chemotherapy itself also varies depending on the goal. Preoperative chemotherapy is used before surgery to reduce tumor size as much as possible and make surgery as gentle as possible.

Target postoperative“chemistry” - to remove individual tumor cells that may still be circulating in the body.

Is there chemotherapy? palliative. It is used when the tumor is advanced, with multiple metastases, and it is impossible to cure the patient, but it is possible to slow down further progression and try to control the tumor. In this case, chemotherapy is intended to give the patient time, but, as a rule, it accompanies him to the end. And then it may seem that the patient died not from cancer, but from “chemotherapy,” although this is not the case.

In addition, during preoperative or postoperative chemotherapy, doctors often observe the patient not only at the moment when he receives droppers with drugs, but also between courses. Therefore, deaths are rare.

Who cares for an oncology patient?

In Russia, we are increasingly moving towards a practice where the decision on how to treat a patient is made by multidisciplinary commission. It includes a chemotherapist, a surgical oncologist, a radiologist, a radiologist and a pathologist (a pathologist, a doctor who determines the types of tumor).

Special meetings of such teams take place in large federal centers; if the patient is being treated in a less progressive dispensary, before starting treatment he will see each of these doctors separately.

Myth three: chemotherapy causes irreparable damage to the liver, hematopoietic system, nervous system and mucous membranes

Chemotherapy does affect a person's basic life support systems.

The main mechanism of action of chemotherapy drugs is their effect on the cell division mechanism. Cancer cells divide very quickly, therefore, by influencing cell division, we stop the growth of the tumor.

But, in addition to the tumor, there are many other rapidly dividing cells in the body. They are present in all systems that are actively renewed - in the blood, in the mucous membranes. Those chemotherapy drugs that do not act selectively also act on these cells.

After chemotherapy, the patient's blood counts drop as expected. Usually the peak of the decline occurs on the seventh to fourteenth day, because the “chemistry” just affected all the cells that were in the peripheral blood, and the bone marrow has not yet had time to produce new ones.

The fall occurs depending on the drug that was used; Some of them act primarily on platelets, others on leukocytes and neutrophils, and others on erythrocytes and hemoglobin.

Chemotherapy treatment occurs in cycles. Depending on the chemotherapy regimen, a person may receive, for example, three days of chemotherapy drips, and the next one will be 21 days later. This period is called “one cycle”; it is given specifically so that the patient’s body recovers.

Before each new chemotherapy session, the patient’s condition is monitored, they look at what happened to him during this period - they do a clinical and biochemical blood test.

Until the person has recovered, a new cycle of treatment does not begin.

If, apart from a decrease in blood counts to a certain level, nothing “bad” happened in the interval between “chemo treatments”, the blood picture will restore itself. An excessive drop in platelets creates a risk of bleeding; a patient with such indicators is given a platelet transfusion.

If the leukocytes, which are responsible for immunity, have dropped, and a person has become infected with some kind of infection, a cough begins, a runny nose, or a fever, antibiotics are immediately prescribed so that the infection does not spread. Typically, all these procedures are done on an outpatient basis.

In between chemotherapy courses, the patient is treated by an oncologist from the regional oncology clinic or clinic.

Before the very first cycle of chemotherapy, the patient should be explained all possible complications, told about each drug and its effect; and the patient can consult with his or her oncologist.

Weighing the risks is the starting point of chemotherapy. The doctor and the patient are choosing between the damage that chemotherapy can cause and the benefit that can follow - namely, extending life, sometimes by decades.

This is a key point in deciding whether to use chemotherapy: if we understand that when prescribing a particular drug, the success rate will be lower than the side effects, there is simply no point in using it.

The main complications of chemotherapy:

Falling blood counts

Liver lesions

Ulceration of mucous membranes and associated nausea and diarrhea

Hair loss and brittle nails.

This effect is explained by the fact that cytostatic chemotherapy acts not only on tumor cells, but on all rapidly fissile body cells. When the effect of the drug ends, cell division resumes and the damaged areas are restored.

Also, certain drugs that have a toxic effect on the body have specific complications. (Some chemotherapy drugs are made on the basis platinum is a heavy metal).

Toxic chemotherapy drugs can cause a number of neurological symptoms - headaches, insomnia or drowsiness, nausea, depression, confusion. Sometimes there is a feeling of numbness in the limbs, “pins and needles”. These symptoms disappear after the drug stops working.

Myth four: metastases grow not from unremoved areas of the tumor, but from “cancer stem cells”, which “chemistry” still does not kill

Photo from independent.co.uk

The reasons for the occurrence of metastases in different tumors are very different; we do not yet know how exactly metastases occur. The only thing we know now is that there are no “cancer stem cells”. A tumor in its different fragments and metastatic cells is a very heterogeneous formation, all the cells are different, they quickly divide and mutate quickly.

But in any case, chemotherapy affects all metastases, wherever they are. The exception is metastases in the brain, where not all drugs penetrate.

In these cases, special treatment is prescribed, or special injection of drugs into the spinal canal.

There are even tumors in which the primary focus cannot be found - that is, all that we see in the body are metastases. But treatment is still prescribed, and in many cases it is successfully carried out.

Who makes the "chemistry"

“Oncologist” is a general name for a number of specialties. In Russia, upon completing a residency in oncology, a graduate can choose to become a chemotherapist - a specialist in the drug treatment of cancer, or an oncological surgeon - a doctor who operates only on cancerous tumors. A radiologist—a specialist in radiation therapy—and a pathologist are separate specialties.

In the Western classification of doctors, they are all united by the specialty “medical oncologist”.

Myth five: chemotherapy is a method supported by the pharmaceutical industry.

In fact, there have been drugs that are more effective, harmless and cheaper for a long time, but they don’t talk about them, they are afraid of collapsing the pharmaceutical market

It seems to me that this myth exists about other diseases, especially HIV.

“Alternative drugs” that cancer patients take are, at best, harmless herbs that have no noticeable effect. Unfortunately, it gets worse. For example, sometimes patients start drinking “miracle” medicines based on a mixture of different oils, because oil is a very difficult product for the liver. As a result, the patient literally causes inflammation of his liver, and we cannot start a cycle of chemotherapy, because the “chemo” also affects the liver. And it’s good if the patient at least tells us what he took, and we can understand what made the situation worse. But treatment is ultimately delayed and its effectiveness decreases.

In addition, a number of new drugs for the treatment, for example, of breast cancer, are now based on plant components. For example, a drug trabectedin contains a specially processed extract from sea tulips.

So, sometimes the drugs that patients take as part of formal treatment are themselves “natural.”

As for the “giant money of the pharmaceutical industry,” some chemotherapy drugs, for example, methotrexate, are very old, long-developed drugs, they cost literally pennies. A decrease or increase in their production does not threaten any “collapse” or “rise in the industry.” In any case, patients in Russia receive drugs for oncology free of charge.

New drugs for cancer

Recently, in addition to cytostatics - chemotherapy drugs that act on the entire body, new drugs have appeared. This is a new generation of chemotherapy drugs - targeted drugs and drugs based on a fundamentally different principle of action - immunotherapy drugs.

Targeted drug is a medicine that does not act on the entire body, but specifically on tumor cells. It is important that molecules of a specific targeted drug can attach to the cell receptors of only a certain type of tumor. The specific tumor subtype is determined by genetic analysis during a molecular genetic study.

Immunotherapy affect the body’s immune system and the immune mechanisms of the tumor in its core. As a result, the body activates its own immunity, which begins to fight cancer cells.

However, in order to receive an immunodrug and a targeted drug, the patient must have a tumor with certain characteristics; these drugs do not act on all tumors, but on their specific mutations. The pathologist and molecular geneticist must write down the tumor passport in detail and write down in the prescription that the patient needs this particular drug.

A relatively new method - hormone therapy, but here the range of indications is even narrower - the tumor must be hormone sensitive. It is believed that breast and prostate tumors respond best to hormone therapy, although here too hormones can only be used for certain indications.

By the way, there is another myth associated with hormone therapy: it is most often used in the form of tablets, and patients believe that tablets are “not a cure” for a disease such as cancer.

Is it possible to do without chemotherapy?

If the tumor is sensitive and responds to immunotherapy or hormone therapy, treat the cancer patient without chemotherapy Can.

Without chemotherapy, hormones alone are sometimes used to treat, for example, breast cancer. Although it is clear that hormones are also not harmless, they have their own complications.

At the same time, we must understand: we invent new drugs, but cancer cells also mutate and adapt to them.

Even in a patient who previously benefited from treatment without chemotherapy, the tumor can progress and become insensitive to the drugs that restrained its growth.

In this case, chemotherapy is used as emergency treatment.

For example, a patient with breast cancer takes hormones for a long time, and the tumor does not grow. Suddenly she feels weak, metastases appear in the liver, her general condition worsens, and her blood test changes. This condition is called “visceral crisis.” In this case, we carry out several cycles of chemotherapy, return the body to a state where the tumor again begins to respond to hormones, and then the patient returns to the previous treatment regimen.

At the current level of development of oncology, we cannot do without chemotherapy at all.

But at the same time, we are developing a whole area called “accompanying treatment” - along with chemotherapy, the patient receives a whole set of drugs that can ease nausea, speed up the recovery of blood cells and normalize stool. So the unpleasant side effects of chemotherapy can be significantly reduced.

Daria Mendeleeva