What is Chemotherapy?

Don Dizon, MD

Many of us know someone who has been diagnosed with cancer. For many of these patients, whether a friend, loved one, or co-worker, chemotherapy was a part of treatment. Yet, while you may be familiar with the term, not everyone understands just what chemotherapy is.

Chemotherapy is a form of anti-cancer treatment that uses drugs designed to kill cancer cells. These drugs work because they usually disrupt the cells’ ability to multiply, which causes the cells to die.

Unfortunately, each of the numerous types of chemotherapy drugs is toxic. That is because they are not made to specifically target cancer cells. As a result, any cells that normally divide rapidly, like cells that give rise to hair follicles, line our gut, and make up our nerves, may be targeted. This attack on healthy cells is what can cause side effects from chemotherapy, which can include vomiting, diarrhea, numbness and tingling, and loss of hair.

It is not for everyone

Treatment with chemotherapy is not appropriate for every person diagnosed or living with cancer. For some, especially if the cancer was caught early, surgery or other ways to locally treat their specific cancer may be enough. For others, chemotherapy can be a very risky proposition, especially if one is too frail or too sick (from cancer or from another illness). For such individuals, chemotherapy might make their condition worse instead of better.

Changes in how we treat cancer

While chemotherapy has been a helpful treatment for many patients, cancer researchers are always looking for better ways to approach cancer care. There is a focus on trying to limit who gets chemotherapy or other forms of toxic treatment by tailoring approaches specific to the individual’s situation, rather than taking a “one size fits all” approach. As we learn more through research, we are focusing on ways to personalize treatment. That means taking the person’s individual tumor and trying to find a specific plan for that patient.

In lung cancer, for example, we now know that if a tumor has a certain genetic defect, known as a mutation, then chemotherapy need not be given. These patients can instead be treated with a drug targeted just for that specific mutation.

Another treatment now being studied is one that uses drugs that heighten a patient’s immune response. Through this form of treatment, the focus is on building the body’s own defenses to combat the cancer. This is called “precision medicine,” and it may very well be the future of cancer treatment.

I also believe that in the future we will see more proactive management of patients. Asking how patients are doing in between office visits has been shown to improve outcomes, both in quality of life and survival.

If you are diagnosed with cancer

The first step is to learn about your cancer. I have heard from many people diagnosed and living with cancer, both on social media and in person, that receiving a cancer diagnosis means having to learn how to be a patient with cancer.

My advice to anyone who receives a cancer diagnosis is to ask about your options. Become informed. Ask about your options and any trials that you might be able to join. If chemotherapy is recommended, learn about the side effects and how to treat or even prevent them.

Most importantly, talk to your medical team if you start to feel sick. Remember, there is no such thing as a silly question when it comes to cancer and chemotherapy.

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