Chloes Chemoo Cows

 

What is chemotherapy?

 

Chemotherapy is one of the three main ways to treat cancer.

 

The word chemotherapy comes from two words:

 

Chemo 'chemical'

 

Therapy 'treatment'

 

Chemotherapy is the use of anti-cancer drugs to destroy cancer cells.

 

How does chemotherapy work?

 

Chemotherapy drugs are known as "cytotoxic drugs". They work by trying to stop the growth of rapidly dividing cells. Because, by their nature, cancer cells are rapidly dividing, it is hoped that they will become damaged and die.

 

Healthy cells in certain parts of the body are especially sensitive to chemotherapy drugs; these parts of the body include:

  • the bone marrow (which makes blood cells)
  • the hair follicles
  • the lining of the mouth
  • the digestive system.

The chemotherapy drugs are carried through the body in the bloodstream, so they can reach cells wherever they find them, including those that may have broken away and spread.

 

Some cancers, such as leukaemia, need chemotherapy because the cancer cells are in the blood and therefore all over the body.

 

When a solid tumour is removed with surgery, doctors may also prescribe chemotherapy to try and "mop up" any cancer cells that remain in the body.

 

Chemotherapy is usually given as a series of sessions of treatment. Each session is followed by a rest period. The session of chemotherapy and the rest period is known as a cycle of treatment. A series of cycles makes up a course of treatment.

 

Each session of chemotherapy destroys more of the cancer cells, and the rest period allows the normal cells and tissues to recover.

 

Chemotherapy has to be planned carefully so that it harms the rapidly dividing unhealthy (cancerous) cells but creates the minimum amount of harm to the healthy rapidly dividing cells in the body. Because of this doctors may use a combination of chemotherapy drugs, at high or low doses and at different times, creating an individual treatment plan for each child. The aim of this is to eliminate the cancer and minimise side effects associated with the drugs.

 

How is chemotherapy given?

 

Chemotherapy can be given by one, or a combination of the following ways:

 

Orally - in the form of liquid or tablets.

Injection - into the muscle or under the skin.

Intravenously - where the drug is diluted in fluid and given straight into the vein, via a drip.

Cannula - via a small tube put into a vein in your arm or the back of your hand.

Central line - via a thin, flexible tube inserted through the skin of the chest into a vein near the heart.

PICC line - (peripherally inserted central catheter) - a thin, flexible tube passed into a vein in the bend or upper part of the arm, and threaded through until the end of the tube lies in a vein near the heart.

Portacath – via a thin, soft plastic tube that is put into a vein. It has an opening (port) just under the skin on your chest or arm.

 

The 'central line'

 

A 'central line' - such as a Hickman ® line is another way for a child to receive chemotherapy. It is a rubber tube or catheter, which is placed under the skin and attached to a central vein in the chest. The end of the tube is on the outside of the chest and is sealed with a cap. When chemotherapy is given, the cap is removed and the drugs are injected into the line. The line can stay in place for the period of treatment.

 

The advantages of such a line are that the child does not have to have needles injected into the skin each time treatment is due. It also gives doctors easy access when taking blood samples.

 

The child will need a small operation to fit the line and special care to make sure the line does not become blocked or infected.

 

The drugs used for chemotherapy are very powerful and can cause certain side effects.

 

Side effects

 

Side effects can be very difficult for children. However not all children experience side effects and it is also important to remember that they tend to stop soon after treatment.

 

Side effects include:

 

Sickness

Chemotherapy drugs can make a child feel, or be sick. The doctor can prescribe anti-sickness drugs and there are many practical ways to help relieve sickness.

 

Diarrhoea and constipation

Chemotherapy drugs can affect the bowel, changing the way it works. This can be helped by laxatives or anti-diarrhoea drugs.

 

Mouth ulcers and taste changes

A number of chemotherapy drugs can cause a sore mouth, or mouth ulcers to develop. This can happen within a week of starting treatment. Most cases clear within four weeks. The child may also experience a metallic or bitter taste in their mouth, which should return to normal at the end of the treatment. Good dental hygiene is recommended and it is important to report mouth ulcers to a medical professional.

 

Hair Loss

This is often the side effect most people associate with cancer treatment. For some children, all of their hair may fall out. For others, it may become very thin. The hair will begin to grow back once treatment has stopped.

 

Skin problems

Chemotherapy drugs can make a child's skin very sensitive to the sun, so it should be protected from the sun and from other chemicals such as chlorine in swimming pools. Rashes and even colour changes may occur.

 

Effects on the blood

Because chemotherapy attacks rapidly reproducing cells, it can cause the number of blood cells within a child’s body to drop. This is known as a child's "blood count". The blood count is usually at its lowest 10 days into treatment but then steadily increases after that.

 

Blood cells are produced within the bone marrow which is a spongy material found in the middle of certain bones. The bone marrow is the 'production factory' for blood.

 

The blood consists of red blood cells which carry oxygen, white blood cells which fight infection, and platelets which clot the blood to prevent bleeding and bruising.

 

Red blood cells

A low number of red blood cells is called 'anaemia'. Chemotherapy can reduce the number of red blood cells produced by the bone marrow, making a child 'anaemic'. This can cause symptoms such as tiredness, breathlessness and dizziness. If a child becomes anaemic this is usually a short-term condition, which can, if necessary be treated with a blood transfusion.

 

White blood cells

Some chemotherapy drugs can reduce the number of white blood cells in the blood, which can make a child prone to infection. This is known as having a "lowered immunity".

 

A blood transfusion cannot be given to replace white blood cells so treatment may be temporarily stopped until the white cell count rises naturally.

 

There are three types of white blood cells, called Neutrophils, Lymphocytes and Monocytes. During treatment, doctors are most concerned about Neutrophils.

 

A reduction of white blood cells means that a child may become ill through any - even minor - infection (such as a cold).

 

It is important for parents to contact their child's Consultant if the child develops a temperature or feels poorly. This is so the infection can be treated quickly to prevent it from becoming serious. The child will probably be treated in hospital with antibiotics.

 

Platelets

A low number of platelets in a child's blood sample is known as 'Thrombocytooenia'.

 

This may cause the child to bruise easily or to bleed for longer if they cut themselves.

 

If the number of platelets in a child’s blood sample falls very low, they may require a platelet transfusion.

 

Sometimes chemotherapy is used to treat non-cancerous conditions, but often the doses are lower and the side effects may be reduced.

 

In recent years, a number of newer anti-cancer drugs have become available. These are often called targeted treatments. Whereas cytotoxic drugs affect the growth of both cancer cells and normal cells, these newer drugs are directed specifically against certain parts of the cancer cells. However, cytotoxic drugs are still the most widely used form of chemotherapy.

 

References:

Macmillan

Clic Sargent

NHS

Chloes Chemoo Cows