Chemotherapy

Depending on factors such as the type of cancer, whether it has metastasized, how advanced the cancer is, location of tumor, age of patient, additional health issues, etc.; chemotherapy may be administered prior to surgery or radiation – neo-adjuvant in order to shrink the cancerous tumor while minimizing possible complications, or administered post-surgery or following radiation – namely adjuvant.

Even when the tumor has been removed, or most of it is not visible to the naked eye, there is still a danger that isolated tumor cells remain in the body. In these cases, the aim of treatment is to complete therapy and destroy invisible tumor cells or those tumor cells which were impossible to remove with surgery.

Chemotherapy may be given together with biological, or hormone therapy or as the sole therapeutic agent.
When a cure is not possible, chemotherapy may be used to prolong life or improve quality of life (also called palliative care) by delay progression of the disease or even bring about remission (shrinkage of the tumor).

The different types of medications vary greatly in their mechanisms of action, their effects on different tumors, and the range of their toxicity.

Chemotherapy treatment must be thoroughly planned out prior to administration. There are several factors which a physician takes into consideration when determining which treatment is the best fit for a patient, such as:

• The type of cancer. Some types of chemotherapy drugs are used for many types of cancer. Other drugs are used for just one or two types of cancer.
• Location of the cancerous tumor.
• Stage of the disease.
• Whether the patient had chemotherapy before.
• Patient’s age.
• Whether the patient has other health problems, such as diabetes or heart disease.

The treatment plan is based on this information (called the “Treatment Protocol”), and includes the combination of medications to be used, their dosage, and the duration of treatment. Dosage is usually calculated according to body surface (derived from height and weight). A series of treatments is administered (treatment cycles), called “courses.” Courses of treatment are administered at time intervals in accordance to the predetermined protocol created by the physician, and in consideration of response to treatment and side effects.

Patients are closely monitored throughout the course of treatment. Surveillance includes physical examinations, blood tests, assessment of side effects, and at times, urine tests and imaging studies (radiographs, scans, CT’s, and more). Occasionally, treatment must be discontinued or changed based on decisions made by the medical team.  It is important to report side effects to the medical team.

Chemotherapy may be administered in several ways:

• Intravenously – most common.
• Orally – in this case, the dose is smaller but given daily for several weeks or months until remission is achieved.
• Injected – into organs or various cavities in the body, such as cerebrospinal fluid, the urinary bladder or the peritoneum. This is not commonly used.

Each medication is administered according specific instructions. Some medications require preparation or special arrangements to be made in consideration of known side effects.

Chemotherapy medications are designed to destroy cancer cells that divide and grow quickly. Occasionally, medications may also damage dividing healthy cells. Some medications may even damage vital organs, such as the heart, kidneys, urinary bladder, lungs, and nervous system.
The extent to which side effects affect each patient is individual and is dependent both on the body’s reaction to the medication as well as the type of medication and dose administered.
Possible side effects include fatigue, low red blood cell count to possible anemia, low platelet count, nausea and vomiting, loss of appetite, constipation, diarrhea, hair loss, a burning sensation and infections in the mouth, vulnerability, and a tendency to develop infections and pain.
Today, there are several medications available which are effective in reducing or preventing nausea and vomiting. These medications may be delivered intravenously during chemotherapy, or by prescription for tabs to be taken at home as required.
Side effects gradually subside as healthy cells overcome the effects of chemotherapy and begin to develop normally. Usually, patients do not suffer long term side effects from medication.
Today, the diagnosis and treatment of cancer are no longer determined by only one doctor, rather a group of doctors decides in concert on the manner of diagnosis and according to the results, on the appropriate treatment as well.

At Tel Aviv Sourasky Medical Center (Ichilov) you will find a multidisciplinary team of world-leading experts with extensive experience in the treatment of cancer, including the use of chemotherapy. Choosing the best medical center will help you achieve the best results for the near and distant future. We will be by your side providing the best in medical care and helping you deal with cancer in the most advanced and humane way possible.