Chemotherapy - Treatment, Procedure And Side Effects

Breast cancer is a very common form of cancer that develops in the cells of your breast. The cancer typically forms in either the ducts of your breast (the pathway through which milk reaches the nipples from the glands) or the lobules (the glands which produce milk).

Breast cancer can affect both males and females. However, it is more commonly observed in women aged between 45-55 years.

Look out for these symptoms!
Signs and symptoms of breast cancer include the following-

1. Discharge of blood from the nipples
2. A lump near the breast or the armpit
3. Scaling or peeling of skin around the breasts
4. Sore nipple
5. Breast pain
6. Swelling of lymph nodes in the armpit or on the neck
7. Change in the shape and size of the nipple or the breast
8. An inverted nipple

What are the risk factors?

1. Age- Breast cancer usually strikes at an older age. Women aged over 55 years are most often diagnosed with invasive breast cancer.
2. Family history- If you have someone in your family who’ve had a history of breast cancer, then you too may develop this disease later in life.
3. Inherited genes- Mutation of certain genes- BRCA1 and BRCA2- can put you at a higher risk of developing breast cancer.
4. Obesity- People with Body Mass Index (BMI) higher than or equal to 30 are at risk of developing breast cancer.
5. Alcohol consumption- Aggressive or frequent alcohol consumption can make you prone to breast cancer.
6. Early menstruation- Those who’ve had their first menstrual cycle before the age of 12, are more likely to get affected by breast cancer in the later stage.
7. Postmenopausal therapy- Women undergoing hormonal therapy or medications combining progesterone and estrogen to treat menopause have greater risk of having breast cancer.

What is the treatment for breast cancer?
After a thorough evaluation of your overall health condition, your doctor will determine the options to treat your breast cancer depending on the type, size and stage of the cancer. The usual methods of curing breast cancer are-

1. Lumpectomy- This is a minimally invasive surgical procedure whereby smaller tumors are removed from the lumps of your breast. Your doctor will only remove a portion of the cancerous lump, leaving the remaining portion of the breast intact. This allows for better symmetry of your breast. However, you may need to undergo chemotherapy or radiation therapy following a lumpectomy to make sure that all the cancer cells are destroyed.
2. Mastectomy- This surgical procedure is performed to remove all of the breast tissues including the ducts, lobules, nipples and areola.
3. Sentinel Node Biopsy- In order to determine whether or not the cancer has metastasized to other body parts including the lymph nodes, your doctor will first discuss with you the importance of removing the lymph nodes which are likely to be in the receipt of the lymph drainage from the tumor.
4. Breast removal- In certain cases where people have a greater risk of developing breast cancer due to family history or a genetic susceptibility, removal of both the breasts are prescribed by doctors.

The rate of survival for breast cancer has increased in recent times owing to modern treatment techniques. Nearly 90% of breast cancer patients survive for at least 5 years after the treatment is done.

Ok, so now that cancer has been diagnosed, and the uncomfortable news that chemotherapy has to be undergone has been put across to the patient, what does a person do? What are his options? Can his/her life ever get back the same meaning and luxury as it had before? These are some of the common queries that would get formed in the mind of the person before undergoing chemotherapy. While chemotherapy itself can be physically daunting, preparing for it and acknowledging it can reduce the hardships and make us less vulnerable. There are also a series of questions to ask the physician before opting for it.

Before that, there is one basic fact that we should acknowledge. It is simply that chemotherapy is not 100% efficient. It has never been, and there are reasons it could never be. The simple fact being that chemotherapy destroys healthy cells along with cancerous cells. It is not selective in killing cancerous cells. The treatment also hampers the immune system to an extent thus making the body prone to a wide variety of infections and diseases. This can inflict serious damage if not properly prepared for. Now let us take a look at some important questions and queries that should be asked to a physician before opting for a chemotherapy treatment.

12 Things you must ask your doctor
1. Why is chemotherapy being recommended for me?
This is the first question to ask and to know why it has been suggested for you instead of other alternative methods.

2. How successful is it for my type of cancer?
Chemotherapy has to be successful or at least minimize the symptoms to an extent. Else there is no reason for you to undergo chemotherapy. Make sure that this aspect is discussed in detail with the physician.

3. What are the side effects?
This is one of the most important queries to be addressed. Chemotherapy is always with side effects - both short term and long term. They have to be addressed before opting for the treatment.

4. What will the treatment involve?
It is mandatory to know the treatment plan and the type of drugs that will be used.

5. What will be the duration of each treatment?
It is important to know the length of each treatment and duration. Some of the treatments have to be done in the hospital, and proper planning needs to be done before each cycle.

6. How many sessions will the chemotherapy treatment consist of?
A key point to be addressed is the number of sessions needed to make the chemotherapy a success.

7. What are the drugs that would be taken?
Knowing the drugs will play a significant role in identifying the disease. Kindly ensure that the physician discusses in detail about the types of drug used.

8. Are there any other drugs that could be used for fewer side effects?
Consult with your physician about your aversions and check if there are other drugs that can minimize the side effects.

9. What would be the other treatment along with the chemotherapy?
Get to know the other treatments that you have to undertake along with chemotherapy. Usually, these types of treatments would be taken to minimize the side effects.

10. Are there any other drugs that are undergoing trials that could be prescribed for me?
This is a general awareness, and since research is always done for improving the treatment, the doctor can advise on the new types of drugs that are available in the market.

11. Is there any alternative treatment available than chemotherapy?
Alternative treatments are mostly rare but you can check across with the physician to get a general awareness.

12. Who is the emergency contact person if I get unwell during treatment?
Have the contact number always with you. There can be some side effects and illness that have to be addressed without losing time when undergoing the treatment.

In case you have a concern or query you can always consult an expert & get answers to your questions!

As much as you want to avoid, there are things you have no control over. Lung cancer (Bronchogenic Carcinomas) is one such nemesis that can throw life in shambles. The malignant tumor that originates in the lungs slowly spreads onto the other distinct and vital organs as well. Thought to be mostly affecting men who are chain smokers and into severe tobacco consumption, incidences of lung cancer in women are rising at an alarming rate over the past few years. Non-smokers may also be susceptible (to a lesser extent though) to lung cancer.

Lung cancer can be either

• Non-small cell lung cancers: The NSCLC, accounting for ~85% of the lung cancer is one of the most common types of lung cancer affecting people, NSCLC may further be divided into
• Adenocarcinoma: This type of NSCLC originates mostly in the peripheral regions of the lungs and may affect (spread) the lymph nodes. Non-smokers and women are mostly at the receiving end (other than the chain smokers).
• Squamous Cell Carcinoma: Also known as Epidermoid Carcinoma, often affects men, epidermoid carcinoma may originate in the tissues that line the bronchial tubes. The lymph nodes are often affected by Epidermoid Carcinoma.
• Large-cell Undifferentiated Carcinoma: The point of origin of large-cell undifferentiated carcinoma is the surface of the lungs. They have a higher probability of spreading to the lymph nodes.
• Bronchioalveolar Carcinoma: Though rare, bronchioalveolar carcinoma originates close to the air sacs.
• Small Cell Lung Cancer (SCLC, accounting for ~25% of the lung cancer): As the name suggests, SCLC is marked by the rapid proliferation of small cells into large malignant tumors. SCLC can move throughout the body (affecting vital organs).

Radiotherapy to treat Lung cancer:
Radiotherapy plays a pivotal role in the treatment of lung cancer. The radiation therapy is mainly of two types

• External beam radiation therapy (EBRT)
• Internal radiation therapy (Brachytherapy)

In external beam radiation therapy, high-energy rays are focused on the cancer cells (thereby resulting in the apoptosis of the cancer cells) externally, from outside the body. EBRT is particularly helpful in case of Non-small cell lung cancers.

The EBRT may be of the following types

• 3D-CRT (Three-dimensional conformal radiation therapy): An advanced radiation therapy, 3D-CRT accurately marks the position of the cancer cells (using advanced computers). The treatment ensures minimum damage to the other healthy cells and tissues (energy rays are directed at the affected cells from different positions).
• SBRT (Stereotactic body radiation therapy): This is a radiation therapy used in the treatment of NSCLC, when it is at a nascent stage.
• IMRT (Intensity modulated radiation therapy): As the name suggests, in IMRT, the intensity of the radiation reaching the normal tissues and cells can be modulated. Like 3D-CRT, the radiation in IMRT is directed from different angles (for maximum results).
• Internal radiation therapy (Brachytherapy): This type of radiation therapy is generally used to deal with lung cancers that tend to block the airways. In this therapy, the radiation process is carried out through a narrow tube, thereby, shrinking and collapsing the tumor.

The effect, dosage, and duration of radiation therapy depend on the stage and severity of the condition. In some cases, radiation therapy may be given together with chemotherapy.

In case you have a concern or query you can always consult an expert & get answers to your questions!

There are more than hundred varieties of blood cancer, but the most common ones are leukemia, lymphoma, and myeloma. Acute myeloid leukemia (AML), a type of leukemia, is when the white blood cells in the marrow begin to grow uncontrollably. This is an acute condition and both the onset and progress are very rapid. The cause is not known, and given the rapid progress, even treatment is often difficult. A more severe form of AML is the APML which is acute promyelocytic leukemia, which leads to reduced number of white and red blood cells and plasma.

This causes the following symptoms:

• Anemia
• Increased incidence of infections
• Excessive bleeding from even minor cuts
• Bleeding from nose and gums
• Easy bruising
• Blood in the urine
• Extreme paleness and tiredness

What is different about APML?

There is one distinguishing factor with APML, which is that they contain a protein which when released into the bloodstream can cause severe bleeding, which may be very difficult to control. Chemotherapy kills these cells and so releases the proteins into the bloodstream. These cells need to be managed without chemotherapy, as the patient can even die of uncontrolled bleeding. With medical advances, two non-chemotherapy agents have been identified – all-trans retinoic acid (ATRA, vesanoid, or tretinoin) and arsenic trioxide (ATO or trisenox).

1. ATRA: This is a type of vitamin A which is used either alone, in combination with chemo, in combination with arsenic trioxide, and also in combination with both chemo and arsenic trioxide. The effect is different in different people – helps control spread, helps prevent recurrence, and helps control symptoms. In many people, it has been successfully used instead of chemotherapy. ATRA is also used as a long-term maintenance agent. Side effects from ATRA include fever, dry skin, rashes, mouth sores, increased cholesterol, and swollen feet. These go away with stoppage of the drug.
2. ATO: Arsenic is poisonous when given in large amounts. However, it was discovered that it could be used to treat APML with effects similar to ATRA. It is used alone, in combination with chemotherapy, with ATRA, or with both. It helps control the growth of cells and also helps in long-term maintenance therapy. ATO dosage needs to be monitored as it can cause heart rhythm issues.

With both these drugs, there is a significant side effect, known as differentiation syndrome. Often seen during the first cycle of treatment, this happens when the leukemia cells release a protein into the blood. Symptoms include fever, breathing, kidney damage, and severe fluid buildup. With these two drugs being widely used effectively, chemotherapy is not the only treatment option for APML. In case you have a concern or query you can always consult an expert & get answers to your questions!

In the past, cancer was a disease that could not be cured. It was a threat to mankind. But as science has developed tremendously through all these years, today it is possible to fight cancer.
Cancer therapies have evolved with time. Until the late 90s, most of the drugs worked by killing the cancer cells. Some of the normal cells were also killed by them, but it was acceptable due to the huge effect on cancer cells.

In modern days, targeted therapies are being performed. Targeted therapy is a process of cancer treatment where instead of the cancer cells, the changes in the cells are targeted. Changes that help the cells grow, divide and thus spread cancer have been observed and so researchers can diagnose the right treatment that can block these affects and prevent cancer. This therapy uses drugs and it is different from traditional chemotherapy.

There are two types of Targeted therapy.

• Small-molecule drugs: These drugs are small so that they can enter cells easily and target the changes inside the cells. They are taken as pills. They work by keeping the tissue around the tumor and starve it by stopping blood vessels that bring it nutrients.
• Monoclonal antibodies: These are used to target the outer surface of cancer cells. They work like a plastic plug in an electric socket. They help chemotherapy and radiation therapy to cure cancer cells.

Fields:

Targeted therapies are used in the fields below
Breast cancer
Lung cancer
Colorectal cancer
Melanoma
Kidney cancers

How It Works:
Targeted therapy can be used as a treatment option for cancer in the following ways:

1. Destroy cancer cells: Cancer cells hide well from the immune system. This therapy points them out so that the immune system can destroy them. It also boosts the immune system to work better.
2. Stop cancer cells growth: This therapy interferes with the proteins that divides the cancer cells and thus controls their growth.
3. Kill the tumor: Blood vessels feed the cancer tumor. This therapy surrounds the tumor and stops the blood supply so that the tumor does not grow and remains small. And if the tumor already has blood supply, then it kills the blood vessels and causes the tumor to shrink.
4. Deliver cell-killing substances: It delivers the cell-killing substances to the cancer cells. They are the monoclonal antibodies that are combined with chemotherapy drugs, toxins and radiation.
5. Cause cancer cell death: Cancer cells avoid the dying process. These therapies cause them to go through the process.

Side Effects:
Targeted therapies are less toxic than standard chemotherapy. So it is a better option but it still has some side effects.

1. Diarrhea
2. Liver problems
3. Skin problems
4. Problems with wound healing
5. Difficulty with blood clotting
6. High blood pressure
7. Gastrointestinal perforation

Even though it has some side effects, it is still way better and much more effective than traditional chemotherapy. So, cancer patients are advised to go through this modern-day therapy.

In case you have a concern or query you can always consult an expert & get answers to your questions!