Chemothera

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Prepared by:
Erma Novea R. Amante

Cancer
also known as a malignant tumor, is a group of diseases involving
abnormal cell growth with the potential to invade or spread to other
parts of the body.
Cancer harms the body when damaged cells divide uncontrollably to
form lumps or masses of tissue called tumors (except in the case of
leukemia where cancer prohibits normal blood function by abnormal
cell division in the blood stream). Tumors can grow and interfere
with the digestive, nervous, and circulatory systems, and they can
release hormones that alter body function. Tumors that stay in one
spot and demonstrate limited growth are generally considered to be
benign.
Cancer is often treated with some combination of radiation therapy,
surgery, chemotherapy, and targeted therapy.

What is Chemotherapy?
The term was coined in the
early 1900s by Paul Ehrlich as meaning any use of
chemicals to treat any disease (chemo- + -therapy),
such as the use of antibiotics (antibacterial
chemotherapy).
often abbreviated to chemo and sometimes CTX or
CTx; is a category of cancer treatment that uses
chemical substances, especially one or more anticancer drugs (chemotherapeutic agents) that are
given as part of a standardized chemotherapy
regimen.
Chemotherapy (also called chemo) is a type of
cancer treatment that uses drugs to destroy cancer

How does Chemotherapy

works?
Chemotherapy works by:
o stopping or slowing the growth of cancer cells,
which grow and divide quickly.
o It can also harm healthy cells that divide quickly,
such as those that line your mouth and intestines or
cause your hair to grow.
o Damage to healthy cells may cause side effects.

What does Chemotherapy

do?
Depending on your type of cancer
and how advanced it is, chemotherapy can:
Cure Cancer
Control Cancer
Ease Cancer Symptoms (also called palliative care)
Help radiation therapy and biological therapy work
better.
Destroy cancer cells that have come back (recurrent
cancer) or spread to other parts of your body
(metastatic cancer).

Chemotherapy may given at

different stages:
Neo-adjuvant chemotherapy - Make a
tumor smaller before surgery or radiation
therapy.
Adjuvant chemotherapy - Destroy cancer
cells that may remain after surgery or radiation
therapy.
Chemoradiation therapy - the chemotherapy
is given in combination with radiotherapy.

How is chemotherapy
given?
How is chemotherapy given?
Injection.
Intra-arterial (IA).
Intraperitoneal (IP).
Intravenous (IV).
Topically.
Orally.

Things to know about getting

chemotherapy through an IV
IV chemotherapy is often given through
catheters or ports, sometimes with the help of a pump.
Catheters. A catheter is a soft, thin tube. A surgeon
places one end of the catheter in a large vein, often
in your chest area. The other end of the catheter
stays outside your body.
Ports. A port is a small, round disc made of plastic or
metal that is placed under your skin. A catheter
connects the port to a large vein, most often in your
chest.
Pumps. Pumps are often attached to catheters or
ports. They control how much and how fast

How often will a patient receive chemotherapy?

Treatment schedules for chemotherapy vary widely.

What type of cancer and how advanced it is
The goals of treatment (whether chemotherapy is used to cure
your cancer, control its growth, or ease the symptoms)
The type of chemotherapy
How your body reacts to chemotherapy
A Cancer Patient may receive chemotherapy in cycles. A cycle is
a period of chemotherapy treatment followed by a period of rest.
For instance, you might receive 1 week of chemotherapy followed
by 3 weeks of rest. These 4 weeks make up one cycle. The rest
period gives your body a chance to build new healthy cells.

4 Phases of cell cycle

Types of Chemotherapy
drugs
Alkylating agents
Alkylating agents directly damage DNA to prevent the cancer
cell from reproducing. As a class of drugs, these agents are not
phase-specific; in other words, they work in all phases of the cell
cycle.
There are different classes of alkylating agents, including:
Nitrogen mustards
Nitrosoureas
Alkyl sulfonates
Triazines
Ethylenimines

 Anti-metabolites
Antimetabolites are a class of drugs that interfere with DNA
and RNA growth by substituting for the normal building blocks of
RNA and DNA. These agents damage cells during the S phase.
Examples of antimetabolites include:

5-fluorouracil (5-FU)
6-mercaptopurine (6-MP)
Capecitabine (Xeloda)
Cladribine
Clofarabine
Cytarabine (Ara-C)
Floxuridine
Fludarabine
Gemcitabine (Gemzar)
Hydroxyurea
Methotrexate
Pemetrexed (Alimta)
Pentostatin
Thioguanine

 Anti-microtubule agents
Anti-microtubule agents are plant-derived chemicals that
block cell division by preventing microtubule function.
Microtubules are an important cellular structure composed of two
proteins; -tubulin and -tubulin. These drugs are cell cyclespecific. They bind to the tubulin molecules in S-phase and
prevent proper microtubule formation required for M-phase.

Topoisomerase inhibitors
These drugs interfere with enzymes called topoisomerases,
which help separate the strands of DNA so they can be copied.
They are used to treat certain leukemias, as well as lung, ovarian,
gastrointestinal, and other cancers.

Cytotoxic antibiotics
The cytotoxic antibiotics are a varied group of drugs that have

Common combination
chemotherapy regimens
Cancer type

Drugs

Acronym

Cyclophosphamide,
methotrexate,5-fluorouracil

CMF

Doxorubicin,
cyclophosphamide

AC

Mustine,vincristine,
procarbazine,prednisolone

MOPP

Doxorubicin,bleomycin,
vinblastine,dacarbazine

ABVD

Non-Hodgkin's lymphoma

Cyclophosphamide,
doxorubicin, vincristine,
prednisolone

CHOP

Germ cell tumor

Bleomycin,etoposide,
cisplatin

BEP

Epirubicin, cisplatin, 5fluorouracil

ECF

Epirubicin, cisplatin,
capecitabine

ECX

Methotrexate, vincristine,
doxorubicin, cisplatin

MVAC

Breast cancer

Hodgkin's disease

Stomach cancer

Bladder cancer

Chemotherapy side effects

Chemotherapy is designed
to kill fast-growing cancer cells. But it can also affect
healthy cells that grow quickly. These include cells
that line your mouth and intestines, cells in your
bone marrow that make blood cells, and cells that
make your hair grow. Chemotherapy causes side
effects when it harms these healthy cells.

Fatigue.
Pain.
Sores in the mouth and throat.
Diarrhea.
Nausea and vomiting.
Constipation.
Blood disorders.
Nervous system effects.
Changes in thinking and memory.
Sexual and reproductive issues.
Appetite loss.
Hair loss.

Feelings during
Chemotherapy
At some point during chemotherapy, you may feel:

Anxious
Depressed
Afraid
Angry
Frustrated
Helpless
Lonely
How can a patient cope with their feelings during
chemotherapy?

 Relax. Find some quiet time and think of yourself in

a favorite place. Breathe slowly or listen to soothing
music. This may help you feel calmer and less
stressed.
Exercise. Many people find that light exercise
helps them feel better.
Talk with others. Talk about your feelings with
someone you trust.
Join a support group. Cancer support groups
provide support for people with cancer. These
groups allow you to meet others with the same
problems.