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Chemotherapy: Causes, Symptoms, Treatment, and Cost

Last Updated: Mar 09, 2023

What is Chemotherapy?

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Chemotherapy is a form of cancer treatment in which chemicals are used to kill cancer cells. It is frequently used as the main form of cancer treatment, although it can also be combined with other forms of care like surgery or radiation therapy.

The goal of chemotherapy is to kill as many cancer cells as possible while minimizing the damage to healthy cells in the body. Chemotherapy drugs work by attacking rapidly dividing cells, which includes cancer cells, but also includes some healthy cells like hair follicles and cells in the digestive tract.

Chemotherapy can help reduce the growth of tumors and stop cancer from spreading to other body areas in addition to destroying cancer cells. For some types of cancer, chemotherapy can even help to cure the disease entirely.

What are the different types of chemotherapy?

Chemotherapy is a medical procedure that uses chemicals to eradicate cancer cells. Chemotherapy comes in a variety of forms, and each type has a particular role. Here are the different types of chemotherapy;

Neoadjuvant Chemotherapy

This type of chemotherapy is given before surgery or radiation therapy. Neoadjuvant chemotherapy works to reduce the size of the tumor, making it simpler to remove or treat with radiation therapy.

Adjuvant Chemotherapy

After surgery or radiation therapy, adjuvant chemotherapy is administered. Adjuvant chemotherapy aims to eradicate any cancer cells that might remain following therapy.


Palliative Chemotherapy

Chemotherapy for palliative purposes is used to reduce symptoms and enhance quality of life. It is frequently used when cancer has spread and there is no cure.

Combined Therapies

Chemotherapy is frequently combined with other medical procedures like surgery or radiation therapy. This is known as combined therapy, and it is often more effective than using chemotherapy alone.

Each type of chemotherapy is administered differently, and the drugs used may be different as well. The type and stage of the cancer, as well as the patient's general condition, will all influence the choice of chemotherapy.

Here are the different types of chemotherapy drugs;

Alkylating agents

Alkylating agents are a type of chemotherapy drug that work by attaching to DNA molecules and preventing cancer cells from dividing and growing. Leukemia, lymphoma, and breast cancer are just a few of the several malignancies that these medications are frequently used to treat. Common examples of alkylating agents include;

  • Cyclophosphamide
  • Ifosfamide
  • Busulfan


Antimetabolites are a type of chemotherapy drug that interfere with the DNA synthesis process in cancer cells. They work by mimicking natural substances in the body that are involved in DNA synthesis, which disrupts the cancer cells' ability to grow and divide. Cancers like leukemia, breast cancer, and colon cancer are frequently treated using antimetabolites. Examples of antimetabolites include;

  • Methotrexate
  • Fluorouracil
  • Capecitabine


Breast cancer, leukemia, and lymphoma are just a few of the cancers that are treated with anthracyclines, a class of chemotherapy medications. These medications function by causing DNA damage in cancer cells, which stops the cells from proliferating and expanding. To boost their effectiveness, they are frequently used in conjunction with other chemotherapy medications. Common examples of anthracyclines include;

  • Doxorubicin
  • Epirubicin

Topoisomerase inhibitors

Topoisomerase inhibitors are a class of chemotherapy drugs that target an enzyme called topoisomerase, which helps to regulate DNA replication and repair. Topoisomerase inhibitors stop the growth and division of cancer cells by inhibiting this enzyme. They're commonly used to treat cancers like leukemia, lung cancer, and ovarian cancer. Examples of topoisomerase inhibitors include;

  • Etoposide
  • Irinotecan
  • Topotecan

Mitotic inhibitors

Mitotic inhibitors are a type of chemotherapy drug that interfere with the process of cell division, which is essential for the growth and spread of cancer cells. These drugs work by targeting structures called microtubules, which are involved in the formation of the cell's spindle fibers during mitosis. Cancers like breast, lung, and ovarian cancer are frequently treated with mitotic inhibitors. Examples of mitotic inhibitors include;

  • Paclitaxel
  • Docetaxel
  • Vinblastine


Corticosteroids are a type of chemotherapy drug that work by suppressing the immune system and reducing inflammation in the body. While they're not typically used as the primary treatment for cancer, they can be used in combination with other chemotherapy drugs to help manage side effects like nausea, vomiting, and swelling. Common examples of corticosteroids include;

  • Prednisone
  • Dexamethasone

Why it's done?

Chemotherapy is used to treat cancer, a condition marked by the body's unchecked growth and spread of abnormal cells. Chemotherapy drugs work by targeting and killing these abnormal cells, thereby preventing them from dividing and spreading throughout the body.

Depending on the type and stage of the cancer, chemotherapy may be administered either alone or in conjunction with other treatments like surgery or radiation therapy. It can be used to reduce tumor size prior to surgery, eliminate any cancer cells that remain after surgery, or delay the growth of cancer cells that have already spread to other body regions.

In addition to its primary use in cancer treatment, chemotherapy may also be used to alleviate symptoms of cancer, such as pain and discomfort. Some types of chemotherapy drugs may be used to treat non-cancerous conditions like rheumatoid arthritis and lupus.

Is Chemotherapy used for conditions other than cancer?

Yes, chemotherapy is sometimes used to treat conditions other than cancer. While chemotherapy drugs are primarily designed to target and kill rapidly dividing cancer cells, they may also be effective in treating other conditions where cell growth and division is abnormal.

For instance, certain chemotherapy medications may be used to treat autoimmune conditions like lupus and rheumatoid arthritis. By inhibiting the immune system, these medications work to reduce inflammation and treat the condition's symptoms.

Additionally, some types of chemotherapy drugs may be used to treat non-cancerous tumors, such as those found in the pituitary gland or the adrenal gland. These tumors are often benign, meaning they're not cancerous, but they can still cause health problems if left untreated. These tumors may be reduced in size and the symptoms treated with chemotherapy medicines.

It's important to note, however, that while chemotherapy drugs may be effective in treating some non-cancerous conditions, they can still have significant side effects. As with any medical treatment, the decision to use chemotherapy for a non-cancerous condition should be made on a case-by-case basis, with careful consideration of the potential risks and benefits.

What types of cancer can chemotherapy treat?

Chemotherapy can be used to treat a wide range of different types of cancer. Chemotherapy will be used to treat different types of cancer depending on the cancer's type and stage, the patient's general condition, and their medical history.

Some of the most common types of cancer that may be treated with chemotherapy include;

These are just a few examples of the many types of cancer that chemotherapy may be used to treat. The decision to employ chemotherapy as a cancer treatment will rely on a number of variables and should be discussed with a licensed healthcare professional.

How is chemotherapy done?

Depending on the type and stage of cancer being treated, the patient's general health, and medical history, chemotherapy can be administered in a variety of methods. In general, chemotherapy is administered in one of three ways: orally, intravenously (IV), or topically.

Oral chemotherapy involves taking chemotherapy drugs in pill or capsule form. This can be done at home, and patients may need to take the medication on a daily basis or as directed by their healthcare provider.

Intravenous chemotherapy, is done by inserting a needle or catheter to inject the drug directly into a vein.

This may be done in a hospital or outpatient clinic setting, and the medication may be delivered continuously over a period of hours or days.

Topical chemotherapy involves applying chemotherapy drugs directly to the skin, typically in the form of a cream or gel. This may be done for certain types of skin cancer, and is generally done on an outpatient basis.

While the specific process for administering chemotherapy will depend on the type and stage of cancer being treated, as well as the patient's overall health and medical history, the following is a general step-by-step guide to the process of receiving chemotherapy;

  • Pre-treatment: Before chemotherapy begins, patients will typically undergo a series of tests to determine the type and stage of cancer, as well as to assess their overall health and any potential side effects of the treatment. This may involve blood tests, imaging tests (such as CT scans or MRIs), and other diagnostic procedures.
  • Drug selection: Once the type and stage of cancer has been determined, a healthcare provider will select the appropriate chemotherapy drugs for the patient's treatment. This will rely on factors like the cancer's type and stage, the patient's general condition, and their medical background.
  • Administration: Chemotherapy may be administered orally, intravenously, or topically, depending on the specific treatment plan. If the medication is being administered intravenously, the patient will typically have a needle or catheter inserted into a vein in their arm or hand. Depending on the particular treatment plan, the drug will then be administered over a period of hours or days.
  • Monitoring: Patients will be constantly watched for any potential side effects or complications while getting chemotherapy. This may involve regular blood tests or other diagnostic procedures to assess the patient's overall health and response to treatment.
  • Post-treatment: After completing a course of chemotherapy, patients will typically undergo follow-up tests to assess the effectiveness of the treatment and monitor for any potential side effects or complications. This may involve blood tests, imaging tests, or other diagnostic procedures.

At what stage of cancer is chemotherapy used?

Chemotherapy is a type of cancer treatment that may be used at different stages of cancer, depending on various factors such as the type and stage of cancer, as well as the patient's overall health and medical history. Chemotherapy may be the main form of treatment for cancer at more advanced stages, such as the third or fourth.

To reduce the tumor or stop the disease from spreading further, chemotherapy may occasionally be used in conjunction with other therapies like surgery or radiation therapy. The decision to use chemotherapy as a treatment option is based on the individual patient's case and is determined by the oncologist after considering several factors.

How long is chemotherapy given?

Chemotherapy treatment can vary from person to person and is typically given in a course or series of sessions that depend on the type and stage of cancer being treated. The length of a session or course can be determined by the drug being administered and the recommendation of the oncologist.

The course may consist of daily sessions for a week or only a single session once a week for eight weeks or even longer. Chemotherapy is often administered in cycles, with each cycle lasting a few weeks and ending with a recovery interval before the next cycle begins. Depending on the patient's overall health and response to treatment, the total length of the treatment may range from a few months to several years.

Who needs chemotherapy?

Chemotherapy may be recommended for individuals with cancer who are at various stages of the disease. For some cancer types, it may be used alone or in conjunction with other therapies including surgery or radiation therapy. Moreover, chemotherapy may be used to treat cancer that has spread to other bodily regions or to lessen the likelihood of cancer recurrence.

How does chemotherapy treat cancer?

Chemotherapy works by targeting rapidly dividing cells, which are characteristic of cancer cells. The medication travels throughout the body via the bloodstream and attacks cancer cells as well as healthy cells that are rapidly dividing, such as those in the hair follicles and digestive tract. Chemotherapy can help reduce or stop the growth of cancer cells by specifically targeting these cells.

Who is not eligible for the treatment?

Chemotherapy may not be appropriate for everyone with cancer. Certain factors may make an individual ineligible for chemotherapy, including;

What should you not do during Chemotherapy?

To reduce the risk of side effects and complications during chemotherapy, it is crucial to take specific precautions. Here are some things that you should avoid or limit during chemotherapy;

  • Avoid close contact with people who are sick, as chemotherapy can weaken your immune system and increase your risk of infection
  • Do not receive any vaccinations without first consulting with your healthcare provider, as some vaccines may not be safe to receive during chemotherapy
  • Steer clear of raw or undercooked meals to reduce your chance of contracting a foodborne illness. Stick to well-cooked meats and vegetables, and avoid unpasteurized dairy products
  • Do not consume alcohol, as it can interfere with the effectiveness of chemotherapy and may increase your risk of liver damage
  • Avoid smoking or exposure to secondhand smoke, as smoking can interfere with the effectiveness of chemotherapy and increase the risk of lung damage
  • Do not engage in strenuous physical activity or heavy lifting, as chemotherapy can cause fatigue and weaken your muscles
  • Avoid exposure to extreme temperatures, as chemotherapy can increase your sensitivity to heat and cold
  • Do not take any over-the-counter medications or supplements without first consulting with your healthcare provider, as they may interact with chemotherapy drugs or interfere with your treatment
  • Do not skip any scheduled appointments or follow-up tests, as these are important for monitoring your progress and adjusting your treatment plan as needed.

What is the success rate of Chemotherapy?

The success rate of chemotherapy varies depending on a number of factors, including the type and stage of cancer being treated, as well as the individual's overall health and response to treatment. In general, chemotherapy can be effective in shrinking or slowing the growth of cancer cells, which can help improve quality of life and extend survival time. However, the success rate of chemotherapy is not 100%, and there is always the possibility that the treatment may not be effective in eliminating all cancer cells.

What happens if chemo doesn't work?

If chemotherapy does not work, it may be necessary to explore other treatment options, such as targeted therapy, immunotherapy, radiation therapy, or surgery. In some cases, a combination of treatments may be used to help control the growth and spread of cancer cells. If chemotherapy is ineffective, it's crucial to consult with a medical professional frequently to decide the best course of action. In order to assess the cancer's severity and the most effective course of treatment, they could advise additional tests or imaging. Palliative care may also be advised in some circumstances to assist in symptom management and enhance quality of life.

What are the side effects of chemotherapy?

Chemotherapy can cause a range of side effects, which can vary depending on the type and dosage of drugs being used, as well as the individual's overall health and response to treatment. Here are some common side effects of chemotherapy;

  • Nausea and vomiting
  • Fatigue
  • Hair loss
  • Anemia
  • Infection
  • Mouth sores
  • Loss of appetite and weight loss
  • Diarrhea or constipation
  • Neuropathy (numbness, tingling, or pain in the hands and feet)
  • Skin and nail changes
  • Cognitive changes, such as confusion or difficulty concentrating
  • Mood changes, such as depression or anxiety
  • Fertility problems
  • Increased risk of bleeding or bruising
  • Heart and lung problems

Is Chemotherapy painful?

The administration of chemotherapy drugs itself is not usually painful, as it is typically given through an IV infusion or injection. However, chemotherapy can cause a range of side effects, some of which may be painful or uncomfortable, such as;

The pain caused by these side effects can be managed with medication or other treatments, and healthcare providers can work with individuals to find the most effective methods for pain relief.

In some cases, the administration of chemotherapy drugs may cause discomfort or pain if the IV catheter or injection site is not properly placed or if the drug infiltrates the surrounding tissue. If this occurs, individuals should notify their healthcare provider immediately so that they can take appropriate steps to minimize pain and prevent complications.

Overall, while chemotherapy can cause some pain or discomfort, healthcare providers can work with individuals to manage these symptoms and help them maintain the best possible quality of life during treatment.

What are the best foods to eat while on chemotherapy?

When undergoing chemotherapy, it is important to maintain a healthy and balanced diet to help support your body's immune system and overall health.

Some of the best foods to eat while on chemotherapy include;

  • High-protein foods such as lean meats, fish, eggs, dairy products, and legumes to help maintain muscle mass and strength
  • Colorful fruits and vegetables such as berries, citrus fruits, leafy greens, carrots, and squash for their antioxidant and anti-inflammatory properties, as well as their fiber content
  • Whole grains such as brown rice, quinoa, and whole-wheat bread for their fiber content and to help keep energy levels stable
  • Healthy fats such as avocados, nuts, seeds, and olive oil to help reduce inflammation and support brain health
  • Hydrating fluids such as water, herbal teas, and clear broths to help prevent dehydration and maintain electrolyte balance
  • Small, frequent meals and snacks throughout the day to help maintain energy levels and prevent nausea or vomiting.

How long does it take to recover?

The time it takes to recover after chemotherapy can vary based on a variety of variables, such as the kind and quantity of medications used, the duration of the treatment, and the patient's general health and response to the medication. Some people may experience side effects that linger for weeks or months after treatment has ended, while others may recover more quickly.

In general, the immediate side effects of chemotherapy, such as nausea, fatigue, and hair loss, tend to improve within a few weeks after treatment has ended. However, some side effects, such as neuropathy or cognitive changes, may persist for longer periods of time or even become permanent.

The recovery process may also depend on the individual's overall health and ability to tolerate treatment. For example, individuals with weakened immune systems or other medical conditions may take longer to recover from chemotherapy than those who are otherwise healthy.

It is important for individuals to work closely with their healthcare providers during and after chemotherapy treatment to monitor their progress and address any lingering side effects or complications. In order to aid in rehabilitation and maintain general health, they may also be recommended to undertake lifestyle adjustments, such as eating a balanced diet and exercising frequently.

How much does a chemotherapy session cost in India?

In India, the cost of each chemotherapy session can vary widely depending on the specific drugs used, the length of treatment, and other factors. Patients should expect paying between Rs. 15,000 and Rs. 1,000,000 each session on average. This cost can add up quickly, as most patients will require a series of 6 to 8 sessions, or possibly more, depending on their individual treatment plan.

It is important to note that the cost of chemotherapy can vary depending on the hospital or treatment center, and some facilities may offer discounts or financial assistance to patients who cannot afford to pay for treatment out of pocket. Patients may also be eligible for government programs or insurance coverage to help offset the cost of chemotherapy.

It is recommended that patients speak with their healthcare providers and treatment centers to get a better understanding of the specific costs associated with their treatment plan, as well as any financial assistance programs that may be available to them.

How much is a session of Chemotherapy?

The cost of a session of chemotherapy can vary widely depending on the specific drugs used, the length of treatment, and other factors such as the location of the treatment center. However, on average, the overall monthly expenditure for chemotherapy can range from 1000 USD to 12000 USD.

The exact cost of each chemotherapy session will depend on the drugs used and the length of treatment. In some cases, patients may require multiple sessions per week, while in other cases, sessions may be spread out over several weeks or months. In general, the cost of chemotherapy can add up quickly, with a total of four sessions costing up to 48000 USD, which can be difficult for an average-earning person to afford.

How long do the effects of chemo last?

The effects of chemotherapy can last for varying lengths of time depending on the individual and the specific drugs used. Some side effects, such as hair loss and nausea, may begin to improve within a few weeks after treatment ends, while others, such as fatigue and cognitive changes, may persist for longer periods of time. In some cases, certain side effects may even become permanent.


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Written ByDr. Jagdish Shinde MD - Radiothrapy,MBBSOncology
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