Chemotherapy
Chemotherapy works by stopping or slowing the growth of cancer cells, which grow and divide quickly, such as those that line your mouth and intestines or cause your hair to grow. Damage to healthy cells may result in side effects. Often the side effects of chemo get better or go away after chemotherapy is completed.
About Chemotherapy
1What does Chemotherapy do?
Depending on your type of cancer and how advanced it is, chemotherapy can:
- Cure cancer – when chemotherapy destroys cancer cells to the point that your doctor can no longer detect them in your body, and they will not grow back.
- Control cancer – when chemotherapy keeps cancer from spreading, slows its growth or destroys cancer cells that have spread to other parts of your body.
- Ease cancer symptoms (also called palliative care) – when chemotherapy shrinks tumours that are causing pain or pressure.
2How is Chemotherapy used?
Typically, chemotherapy is used in conjunction with surgery, radiation therapy or biological therapy. However, in certain cases, chemotherapy alone may be sufficient.
Chemotherapy can:
- Make a tumour smaller before surgery or radiation therapy (neo-adjuvant therapy).
- Destroy cancer cells that may remain after surgery or radiation therapy (adjuvant therapy).
- 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).
3How is Chemotherapy administered?
There are many ways of administering chemotherapy.
- Injection: Chemotherapy is injected into a muscle in your arm, thigh, hip, or under the skin in the fatty part of your arm, leg or stomach.
- Intravenous (IV): Chemotherapy is administered directly into a vein.
- Topically: Chemotherapy comes in a cream that you rub onto your skin.
- Orally: Chemotherapy comes in pills, capsules or liquids that you swallow.
4How is intravenous Chemotherapy administered?
Chemotherapy is either delivered through a thin needle that is placed into a vein in your hand or lower arm. Your nurse will put the needle in at the start of each treatment and remove it when treatment is over.
- Catheters and ports: A catheter is a soft, thin tube that connects to a small port (a round disc made of plastic or metal placed under your skin). A port and catheter are attached with minor surgery. A surgeon places one end of the catheter into a large vein (under the collar bone). The port and catheter are designed to make the administration of chemotherapy and drawing of blood easier. Ports are discreet. They are either totally invisible or appear as a small bump below the skin. A port-needle is placed in the port to administer chemotherapy or draw blood. This needle may be left in place for chemotherapy administered more than once a day. Be sure to watch for signs of infection around the port. For more information on infections, see “Infection”.
- Pumps: Pumps are often attached to ports, and serve to control the delivery of chemotherapy into the bloodstream. Most people can carry these pumps in their pocket.
5How will I feel during Chemotherapy?
Chemotherapy affects people in different ways. How you feel during treatment often depends on how healthy you are before treatment, your type of cancer, how advanced it is, the kind of chemotherapy you are getting, and the dose. Doctors and nurses can not know for certain how you will feel during chemotherapy. Let your doctor or nurse know right away if you feel pain or burning while you are getting IV chemotherapy.
Some people do not feel well right after chemotherapy. The most common side effect is fatigue, feeling exhausted or worn out.
You can prepare for fatigue by:
- Arranging a lift to and from your chemotherapy appointment.
- Planning time to rest on the day of your chemotherapy and the next day.
- Arranging help with meals and childcare the day of your chemotherapy and the next day.
6Can I work during Chemotherapy?
Many people continue to work during their chemotherapy treatment as long as they match their schedules to how they feel. Whether you can work may depend on what kind of work you do. If your job allows, you may want to work part-time or from home on days you do not feel well.
South Africa’s legislation requires many employers to change your work schedule to meet your needs during cancer treatment. Talk with your employer about ways to adjust your job during chemotherapy. You can learn more about these laws by speaking with a social worker.
7Can I take cver-the-counter and prescription drugs while I get Chemotherapy?
Take only medication that is approved by your doctor or nurse. Tell your doctor or nurse about all the over-the-counter and prescription drugs you take, including laxatives, allergy medicines, cold medicines, pain relievers, aspirin, and ibuprofen. Your doctor will advise you on which drugs you can take.
One way to let your doctor or nurse know about these drugs is by bringing in all your pill bottles. Your doctor or nurse needs to know:
- The name of each drug
- The reason you take it
- How much you take
8Can I take vitamins, minerals, dietary supplements or herbs while I get Chemotherapy?
Some of these products can change how chemotherapy works. For this reason, it is
important to tell your doctor or nurse about all the vitamins, minerals, dietary supplements, and herbs that you take before you start chemotherapy. During chemotherapy, talk with your doctor before you take any of these products.
9How will I know if my Chemotherapy is working?
Your doctor will conduct physical exams and medical tests (blood tests and x-rays). He or she will also ask you how you feel and analyse your progress.
You can not tell if chemotherapy is working based on its side effects. Some people think that severe side effects mean that chemotherapy is working well, or that no side effects means that chemotherapy is not working. The truth is that side effects have nothing to do with how well the chemotherapy is fighting your cancer.
10How much does Chemotherapy cost?
It is hard to say how much chemotherapy will cost. It depends on the below factors:
- The types and doses of chemotherapy used
- For what period and how often your chemotherapy is administered
- Whether you get chemotherapy at home, in a clinic or office or during a hospital stay.
- The part of the country where you live.
Treatment Information
1Does my medical aid pay for Chemotherapy?
Talk to your health insurance provider about what costs it will cover. Questions to ask include:
- What will my medical aid pay for?
- What do I have to pay for?
- Can I see any doctor I want or do I need to choose from a list of preferred providers?
- Do I need a written referral to see a specialist?
- Is there a co-payment each time I have an appointment?
- Is there a payment gap (a certain amount I need to pay) before my medical aid pays?
- Where should I get my prescription drugs?
- Does my insurance pay for all my tests and treatments, whether I am an inpatient or an outpatient?
2How can I best work with my insurance plan/medical aid?
- It is important to read your insurance policy carefully before treatment starts to find out what your plan will cover.
- Keep records of all your medical costs and insurance claims.
- Send your insurance company all the paperwork it requires. They may need receipts from doctors’ visits, prescriptions, and lab work. Be sure to keep a copy for your records.
- If your insurance does not pay for something you think it should pay for, please find out why the claim was refused. Talk with your doctor or nurse about your case. He or she may suggest ways to appeal the decision or other actions you can take.
Tips for meeting with your Doctor or Nurse
- Make a list of your questions before each appointment. Some people keep a “running list’ and write down new queries as they think of them. Make sure to have space on the list to write down the answers from your Doctor of Nurse.
- You are welcome to bring a family member or a trusted friend to your medical visits. This person can help you to understand what the doctor or nurse said and can talk with you about your appointment.
- Ask all your questions. There is no such thing as a stupid question. If you do not understand an answer, please ask the team to explain further until you are comfortable with the answer.
- Let your doctor or nurse know how much information you want. Some people want to learn everything they can about cancer and its treatment, others only want limited information. The choice is yours.
1Questions to ask about my treatment?
- How many cycles of chemotherapy will I get?
- How long is each treatment?
- How long between treatments?
- What types of chemotherapy will I get?
- How will these drugs be administered?
- Where will I receive my treatment?
- Should someone drive me to and from my treatments?
2Questions to ask about my cancer?
- What kind of cancer do I have?
- What is the stage of my cancer?
3Questions to ask about side effects of chemotherapy?
- What side effects can I expect right away?
- What side effects can I expect later?
- How serious are these side effects?
- How long will these side effects last?
- Will all the side effects go away when treatment is over?
- What can I do to manage or ease these side effects?
- What can my doctor or nurse do to manage or ease these side effects?
- When should I call my doctor or nurse about these side effects?
4Questions to ask about chemotherapy?
- Why do I need chemotherapy?
- What is the goal of chemotherapy?
- What are the benefits of chemotherapy?
- What are the risks of chemotherapy?
- Are there other ways to treat my type of cancer?
- What is the standard care for my type of cancer?
- Are there any clinical trials for my type of cancer?
5How can I cope with my feelings during Chemotherapy?
- Relax. Assign quiet time, think of yourself in your favourite place, breathe slowly or listen to soothing music. These techniques can help you feel more relaxed during your treatment.
- Exercise. Many people find that light exercise helps them feel better. There are many ways for you to exercise, such as walking, riding a bike or doing yoga. Talk with your doctor or nurse about ways you can exercise.
- Talk with others. Talk about your feelings with someone you trust such as a close friend, family member, chaplain, nurse or social worker. You may find it helpful to talk with other patients receiving chemotherapy and share your experiences.
- Join a support group. These groups allow you to meet others with the same disease. You will have a chance to talk about your feelings and engage with other people facing the same challenges. You can discuss how they cope with cancer, chemotherapy, and its side effects. Your doctor, nurse or social worker may know about support groups near your home. Some support groups also meet online, which is helpful if you cannot travel.
Your emotions during Chemotherapy:
Dealing with the side effects and challenges of treatment can be very emotionally draining.
At some point during treatment, you may feel anxious, depressed, afraid, angry, frustrated, helpless and even lonely.
It is normal to have a wide range of feelings while going through chemotherapy. Your treatment may cause you to feel fatigued, which can make it even harder to cope with your emotions.
