Transcript New Facility Features

Chemotherapy
Basics
What is Chemotherapy?
• Sometimes referred to simply as "chemo", chemotherapy
is used most often to describe drugs that kill cancer cells
directly.
• Sometimes referred to as "anti-cancer" drugs or
"anti-neoplastics."
• Other chemo drugs such as biologic response modifiers,
hormone therapy, and monoclonal antibodies, work in
different ways to treat cancer,
• Today's therapy uses more than 100 drugs to
treat cancer.
What is Chemotherapy Used For?
• To cure a specific cancer;
• To control tumor growth when cure is not possible;
• To shrink tumors before surgery or radiation therapy;
• To relieve symptoms (such as pain); and
• To destroy microscopic cancer cells that may be present
after the known tumor is removed by surgery (called
adjuvant therapy). Adjuvant therapy is given to prevent a
possible cancer reoccurrence.
Chemotherapy Terms
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Adjuvant chemotherapy - Chemotherapy given to destroy left-over
(microscopic) cells that may be present after the known tumor is removed
by surgery. Adjuvant chemotherapy is given to prevent a possible cancer
reoccurrence.
•
Neoadjuvant chemotherapy - Chemotherapy given prior to the surgical
procedure. Neoadjuvant chemotherapy may be given to attempt to shrink
the cancer so that the surgical procedure may not need to be as
extensive.
•
Induction chemotherapy - Chemotherapy given to induce a remission.
This term is commonly used in the treatment of acute leukemias.
•
Consolidation chemotherapy - Chemotherapy given once a remission is
achieved. The goal of this therapy is to sustain a remission. Consolidation
chemotherapy may also be called intensification therapy. This term is
commonly used in the treatment of acute leukemias.
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Maintenance chemotherapy - Chemotherapy given in lower doses to
assist in prolonging a remission. Maintenance chemotherapy is used only
for certain types of cancer, most commonly acute lymphocytic leukemias
and acute promyelocytic leukemias.
Chemotherapy Terms cont’d.
•
First line chemotherapy - Chemotherapy that has, through research
studies and clinical trials, been determined to have the best probability
of treating a given cancer. This may also be called standard therapy.
•
Second line chemotherapy - Chemotherapy that is given if a disease
has not responded or reoccurred after first line chemotherapy. Second
line chemotherapy has, through research studies and clinical trials,
been determined to be effective in treating a given cancer that has not
responded or reoccurred after standard chemotherapy. In some cases,
this may also be referred to as salvage therapy.
•
Palliative chemotherapy - Palliative is a type of chemotherapy that
is given specifically to address symptom management without
expecting to significantly reduce the cancer.
Chemotherapy Protocols
• Normally, cells live, grow and die in a predictable way.
Cancer occurs when certain cells in the body keep dividing
and forming more cells without the ability to
stop this process.
• Each type of tissue has a specific look and will tell
where the primary tumor is arising from.
Cell Differentiation
How Does Chemotherapy Work?
• Chemotherapy protocols involve destroying cancer
cells by keeping the cells from further multiplying.
Unfortunately, in the process of undergoing
chemotherapy protocols, healthy cells can also
be affected, especially those that naturally should
divide quickly.
• Chemotherapy protocols strive to maximize the
elimination of cancer cells while minimizing the
negative effects that these protocols have on
healthy cells.
Chemotherapy at work…
How Is Chemotherapy Given?
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Oral chemo medications (taken by mouth)
Subcutaneous injection of chemo treatments
Intra-muscular chemo injections
Intravenous chemo treatments
- Short IV catheter
- PICC, Port-a-cath or Hickman
Intraventricular/Intrathecal chemo treatments
Intraperitoneal chemo treatments
Intra-arterial chemo treatments
Intravesicular chemo treatments
Intrapleural chemo treatments
Implantable chemotherapy treatments
Topical chemo treatments
How Do Doctors Decide Which
Chemotherapy Drugs To Give?
• Research
– Most types of cancer have standard protocols that help guide
the doctors in selecting the right chemotherapy for each patient.
• Response rates
– Refer to the number of people whose tumors will respond
(shrink or disappear) to the drug or drugs given.
• The health of the patient
– Chemotherapy has toxicities, some patients may not be able to tolerate
certain chemotherapy protocols.
– The potential risks versus benefits must be discussed before deciding
which treatment will be of benefit
•
There is usually no one correct choice in choosing chemotherapy, your
physician and you will come to this through shared decision making
discussions. *
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Each treatment protocol has advantages and disadvantages, and there
may be more than one good option. In addition, treatment choices can
change over time.
What are the Short and Long Term
Side Effects of Chemotherapy?
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Side effects of chemotherapy are unwanted things that happen as
a direct result of taking a drug.
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Chemotherapy damages cells that are dividing, so the parts of the
body where normal cells divide frequently are likely to be affected
by chemotherapy.
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Mouth, intestines, skin, hair, bone marrow (the spongy material that
fills your bones and produces new blood cells) are commonly affected
by chemotherapy.
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Hair is growing all the time. The skin is constantly renewing itself.
So are the lining of the mouth and digestive system. To do this,
the cells of all these body tissues must constantly divide to
produce a steady supply of new cells. And when cells are
dividing, chemotherapy drugs can attack them.
Nadir: What is Nadir?
• When discussing chemotherapy side effects often you will hear
the word nadir, in reference to the blood counts,
– Nadir basically means low point, however further explanation
may clarify this term in connection with chemotherapy
treatment.
• Nadir is usually about 10 days after treatment.
Blood Cell Types: What are They?
• White blood cell (WBC) count is a count of the actual number of
white blood cells per volume of blood. Both increases and
decreases can be significant.
• White blood cell differential looks at the types of white blood cells
present. There are five different types of white blood cells, each
with its own function in protecting us from infection. The
differential classifies a person's white blood cells into each type:
neutrophils (also known as segs, PMNs, granulocytes, grans),
lymphocytes, monocytes, eosinophils, and basophils.
• Neutrophils are the important infection fighting cells we
need to remain healthy.
Blood Cell Types cont’d.
• Red blood cell (RBC) count is a count of the actual number
of red blood cells per volume of blood. Both increases and
decreases can point to abnormal conditions.
• Hemoglobin measures the amount of oxygen-carrying protein
in the blood.
• Hematocrit measures the percentage of red blood cells in a given
volume of whole blood.
• Platelet count is the number of platelets in a given volume of
blood. Both increases and decreases can point to abnormal
conditions of excess bleeding or clotting.
Which Drugs Will You Receive?
• Handouts will be given on each individual medication
you will receive and cover what side effects you
MAY experience
• Additional medications will be given to keep you
from experiencing the side effects of nausea
• Some medications are given to keep you from having
a possible reaction to a medication that is known to
increase the possibility of reactions
We are Here for You
• You should call the oncology office with any questions
or concerns
• We will review this information at each visit you are
not expected to memorize everything you are told.
• We can usually keep most side effects from
happening or becoming worse so you must let us
know about them.
Thank you!
Cancer Center of Western Wisconsin
Westfields Hospital 715-243-2800 / Radiation 715-243-2950
Gary R. Shapiro, MD, Medical Oncology Director
Clayton Chen, MD, Radiation Oncology Director
Steven McCormack, MD, Medical Oncology
Amery Regional Medical Center 715-268-0294
Dan Anderson, MD, Medical Oncology
Baldwin Area Medical Center 715-684-8683
Randy Hurley, MD, Medical Oncology
Hudson Hospital & Clinics 715-531-6700
Gretchen Ibele, MD, Medical Oncology
Osceola Medical Center 715-294-5706
Dan Anderson, MD, Medical Oncology
St Croix Regional Medical Center 715-483-0326
Daniel Schneider, MD, Medical Oncology
Kurt Demel, MD, Medical Oncology
References
• www.chemocare.com
• Copyright 2005 by The Cleveland Clinic Foundation