Chemotherapy

Chemotherapy is a type of systemic cancer treatment that uses medicines to destroy cancer cells, slow their growth or prevent them from multiplying.

It can be used to treat many different types of cancer and may be given on its own or together with other treatments such as surgery, radiotherapy, immunotherapy or targeted therapy.

At Melna Oncology Centre, Dr Thandeka Buthelezi-Zulu, Specialist Clinical & Radiation Oncologist, assesses each patient’s diagnosis and individual circumstances when recommending and planning cancer treatment.

Chemotherapy refers to a broad group of medicines used in cancer treatment.

Because chemotherapy travels through the bloodstream, it can reach cancer cells in different parts of the body. This is why it is described as a systemic treatment.

There are many different chemotherapy medicines. Some are used individually, while others are given in combinations.

The particular medicine or combination recommended depends on factors including the type of cancer, its stage and characteristics, previous treatment, the patient’s general health and the purpose of treatment.

Chemotherapy can be administered in different ways depending on the medicines being used.

Some chemotherapy medicines are given intravenously, through a vein. Others are taken orally as tablets or capsules. Less commonly, chemotherapy may be administered in other ways depending on the cancer being treated.

Treatment is often organised into cycles.

A cycle consists of a period of treatment followed by a period of rest. The rest period allows the body time to recover before the next treatment.

The number and frequency of cycles vary according to the treatment plan.

There is no single chemotherapy regimen suitable for everyone.

Before recommending treatment, Dr Buthelezi-Zulu considers the clinical information relevant to your diagnosis.

This may include:

• The type of cancer
• The stage of the cancer
• The characteristics of the cancer cells
• Where the cancer is located
• Whether it has spread
• Previous cancer treatment
• Your general health
• Other medical conditions
• Current medications
• Blood test results
• The purpose and goals of treatment

Your treatment plan will explain which medicines are being recommended, how they will be given, how frequently treatment is planned and the expected duration of treatment.

Before starting chemotherapy, you will usually undergo an assessment to make sure treatment can be given as safely as possible.

Depending on your treatment plan, this may include blood tests and other investigations.

Your oncology team will explain the chemotherapy being recommended, why it is being used and the side effects that may occur.

This is a good time to ask questions about your treatment, medications, work, diet, daily activities or anything else that concerns you.

What you experience during chemotherapy depends on the particular medicines and how they are administered.

If treatment is given intravenously, the time required for an appointment can vary considerably depending on the treatment regimen.

During the course of chemotherapy, your healthcare team will monitor how you are responding to treatment and whether you are experiencing side effects.

Blood tests or other investigations may be required at different points during treatment.

Your treatment plan may occasionally need to be adjusted depending on your response, blood results, side effects or other clinical considerations.

Chemotherapy can affect healthy cells as well as cancer cells, which can cause side effects.

The side effects experienced vary considerably between medicines and between patients. Not everyone experiences the same side effects, and not every chemotherapy medicine causes all of them.

Possible side effects may include:

• Tiredness or fatigue
• Nausea or vomiting
• Changes in appetite or taste
• Mouth or throat problems
• Diarrhoea or constipation
• Hair thinning or hair loss with certain medicines
• Changes to the skin or nails
• Increased risk of infection
• Bruising or bleeding more easily
• Changes in blood cell counts
• Numbness or tingling in the hands or feet with certain medicines

Other side effects are possible depending on the chemotherapy being used.

Before treatment begins, your oncology team will discuss the side effects particularly relevant to your treatment and how they may be managed.

Not necessarily.

Some chemotherapy medicines commonly cause hair loss, while others may cause thinning or little noticeable change.

Whether you are likely to lose your hair depends on the particular medicine, dose and treatment regimen.

Your oncology team can explain what is expected with your specific treatment.

Nausea and vomiting can occur with some chemotherapy medicines, but the likelihood and severity depend on the treatment being used.

Medicines known as antiemetics may be prescribed to help prevent or control nausea and vomiting.

Tell your healthcare team if nausea or vomiting is difficult to control so that your symptoms can be assessed and your supportive medication reviewed where appropriate.

Some chemotherapy treatments can temporarily reduce the number of white blood cells that help the body fight infection.

This may increase your risk of developing an infection during certain periods of your treatment cycle.

Your oncology team will explain whether this is likely with your particular treatment and what warning signs you should watch for.

If you develop a fever or feel acutely unwell while receiving chemotherapy, follow the instructions provided by your treating oncology team and seek medical advice promptly.

Many people continue with at least some of their usual activities during chemotherapy, but this varies considerably.

You may experience days when you feel relatively well and others when tiredness or other side effects make normal activities more difficult.

Your ability to work, exercise, drive or perform other activities depends on your treatment, your health and how you respond.

Discuss your usual activities with your oncology team if you are uncertain about what is appropriate during treatment.

Maintaining adequate nutrition and hydration can be important during cancer treatment, although appetite and eating patterns may change.

There is no single diet that is appropriate for every person receiving chemotherapy.

If you experience difficulty eating, significant weight changes or treatment-related symptoms affecting your nutrition, discuss this with your healthcare team. Appropriate nutritional support can be recommended when necessary.

You should also tell your oncology team about any vitamins, supplements, herbal remedies or complementary medicines you use, as some may interact with cancer treatments.

Monitoring is an important part of chemotherapy.

Depending on your treatment, this may involve clinical assessments, blood tests and imaging at appropriate points during your care.

These assessments help your oncology team monitor your health, manage side effects and evaluate your response to treatment.

Starting chemotherapy can feel daunting, particularly when you do not know what to expect.

You are encouraged to ask questions about your treatment and tell your oncology team about symptoms, side effects or concerns throughout your care.

Understanding why you are receiving chemotherapy and what to expect can make an unfamiliar process easier to navigate.

If chemotherapy has been recommended as part of your cancer treatment, or you have been referred for specialist oncology care, you can request a consultation with Dr Thandeka Buthelezi-Zulu at Melna Oncology Centre.

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