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Chemotherapy is the use of drugs to stop the growth of cancer cells that may have spread outside the main site of the cancer to other areas of the body. This treatment works by preventing cancer cells from multiplying, by eliminating the nutrients the cancer cells need to survive or by eliminating them.
Chemotherapy can be administered into the bloodstream to reach cancer cells anywhere in the body; this is known as systemic chemotherapy. It also can be administered directly into specific areas of the body, such as the abdomen or a particular organ. This is known as regional chemotherapy because the drugs mainly affect the cancer cells in that area.
Chemotherapy may be used for three purposes:
To prevent or postpone cancer from coming back after surgery or radiation have removed all known cancer, by attempting to kill any cancer cells that have separated from the original tumor. (Known as adjuvant therapy.)
To shrink large cancers, for easier surgery. (Known as neo-adjuvant therapy.)
To treat metastatic disease, where the cancer cells have shown up in parts of the body other than the primary site of the cancer.
Chemotherapy may be delivered intravenously, in pill form, or both. It can last from a few minutes to over an hour. To alleviate anxiety, you may bring music, or ask a friend or family member to stay with you during treatment.
Surgeons also perform port-a-caths; these are devices inserted into the vein with an opening to the skin for chemotherapy drugs. These ports also can be used to take blood and administer fluids, and are placed on an outpatient basis. They can be removed once treatment is finished.
A typical course of chemotherapy can last up to six months. It's given in cycles, which are followed by a recovery period. Cycles are two to four weeks, but some courses can involve weekly treatment.
In adjuvant and neo-adjuvant therapies, chemotherapy is usually given in combinations of two or more drugs. Chemotherapy given with one drug at a time (known as single agent) can be useful in treating metastatic cancer.
If you do not experience side effects, this is not a sign that the chemotherapy isn't working. If you are receiving treatment for metastatic disease, your doctor will monitor your progress through blood tests, scans and/or x-rays.
If you are undergoing adjuvant chemotherapy, your doctor will evaluate your progress. It will be measured through physical exams and other tests as needed.