Chemotherapy and side effects
What is chemotherapy?
Chemotherapy is a medicine that uses natural and artificial chemicals to kill fast-growing cells in your body. Over the years, new chemo medicines have been used to help treat people with all sorts of cancer.1 Chemo medicines block functions needed for cell growth and replication, which is what cancer thrives on and needs to survive. When a new cell forms, it goes through a process (cell cycle) to become a fully functioning (mature) cell. Chemo medicines target cells at different phases of the cell cycle. Unfortunately, chemo may not know the difference between a healthy cell and a cancer cell, so it usually damages both. Most healthy cells recover from chemo treatment, but cancer cells may not. You can think of a normal, healthy cell as being strong and resilient, where a cancer cell is mutated and more vulnerable.2, 3
Chemo can be used on its own or along with other treatments. It’s often used to:4
- Help shrink a tumor before surgery or radiation
- Destroy any remaining cancer cells after surgery or radiation
- Enhance other cancer treatments
- Kill cancer cells that have come back or spread
Any medicine this chemically powerful may be effective — but since it kills some healthy cells, that may also cause side effects (like common hair loss). Let’s get to know the different types of chemotherapy.
Today, there are many different types of chemotherapy. Each has a unique chemical structure and relationship to other medicines. To help doctors understand which types of chemo might work well together, the different chemo medicines are categorized by similarities. And because there are so many, we’ll just break down some of the more common types of chemotherapy.3
- Alkylating agents: These medicines prevent cells from reproducing by damaging their DNA in every stage of the cell cycle. This is the type of chemo was discovered right around World War II. There’s a special subtype called nitrosoureas medicines, which have the ability to cross the blood-brain barrier and reach cancers inside the brain. 3
- Plant alkaloids: These chemo treatments are made from plants and they attack cells during different phases of division. For example, topoisomerase inhibitors and mitotic inhibitors are common plant alkaloids. They help interfere with enzymes needed for cancer to separate its DNA so it can reproduce and spread.5
- Antimetabolites: These kinds of chemo sneak into the building blocks of cells (DNA and RNA) and pretend to be one of them. This makes it so the cell can’t make copies of itself and reproduce. 3
- Anti-tumor antibiotics: These powerful meds actually change the DNA inside cancer cells to help keep them from growing and reproducing. They’re so powerful that they may permanently damage the heart, so there’s a lifetime dose limit to help keep people safe.3
- Corticosteroids: You might know these as steroids. They’re natural hormone and hormone-like medicines used in the treatment of cancers and other illnesses. For example, some help prevent nausea and vomiting that happens with chemo treatment.3
It’s clear how powerful these medicines are. So, it may be no surprise that chemo is often only given for a certain amount of time — like 6 months to a year. Or, depending how your body reacts to the chemotherapy, you might be able to stay on your treatment longer, or for as long as the chemo is working. Your doctor and care team can keep a close eye on you and any side effects you may have to decide the best duration for your treatment. Each person’s treatment plan is different depending on their type and stage of cancer, overall health and personal preferences. An example of a treatment course may be receiving chemo the first Monday of every month so your body has a few weeks to let its healthy cells recover. Typically, the closer you receive chemotherapy treatment, the better it could work — but the more side effects you might have. It’s all about balance. How do we kill as many cancer cells as possible without damaging too many healthy cells?6
It’s normal to be concerned about the possible side effects of chemotherapy. In fact, maybe it’s the first thing you think about. We know that side effects happen because healthy cells may get damaged. The cells that are most likely to get damaged are blood-forming cells in bone marrow, hair follicles, and cells in your mouth, digestive tract and reproductive system. Many side effects go away quickly, but some might take months or years to totally vanish. And some of those really powerful meds might leave a permanent damage. Here’s a list of common side effects:7
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Fatigue
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Hair loss
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Bruising and bleeding easily
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Anemia
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Nausea and vomiting
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Changes in appetite
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Changes in bowel movements (constipation or diarrhea)
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Mouth, tongue and throat problems, like painful swallowing
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Nerve problems, like numbness, tingling or pain
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Changes in weight, mood, libido and sexual function
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Fertility problems
Did you notice that a lot of these tie in to the cells that are most commonly damaged? It’s important to keep in mind that not everyone may have these side effects. In fact, some people may not get any at all. Be sure to talk with your doctor and care team about which side effects are most common with your treatment, how long they could last, how difficult they might be and when you should call your doctor. And, ask about the option to get medicine that may help prevent or help relieve certain side effects.
If you’re having regular chemo treatments and you notice side effects, there are lots of resources available to help you manage them. The most important thing is to have a support system around to keep your spirits up. Here are things you might consider trying to make living with chemotherapy side effects a little easier.8, 9
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Eat five or six small meals a day
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Stay hydrated throughout the day
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Avoid foods with a strong smell
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Try to stay away from sweets and fried, fatty foods
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Exercise (a quick walk could boost your energy)
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Rest or take naps during the day
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To slow hair loss, let your natural hair flow without colors, heat, perms or other chemicals
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Use a gentle lotion on your scalp if it gets itchy
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Keep your brain active with puzzles — or consider learning a new hobby
Check in with your body each day and be patient with yourself. If you’re having strong side effects, reach out to your doctor to see if there’s anything specific they recommend. Or, if there are other medicines you can take to help relieve your symptoms. Living through chemotherapy treatment and its side effects can be tough. And while you’ll likely have good days and not-so-good days, a positive attitude can be more powerful than you think.
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