When you find out that you or someone you know has cancer, it's normal to feel a lot of fear and anxiety when you hear the words 'chemo'. The word 'chemo' immediately conjures up images of someone losing their hair, losing weight, and suffering. However, if we understand exactly what chemotherapy is, what drugs are used for it, and how they affect the body, this fear can be greatly reduced. So today, let's talk about it in a friendly way.
What is chemotherapy in simple terms?
Simply put, chemotherapy is a treatment that uses very powerful drugs to treat cancer. This is what we call 'chemo' for short. It is one of the most effective treatments for cancer.
To understand how this works, we first need to know a little about the cells in our body. Our bodies are made up of billions of cells. Healthy cells divide when needed, make new cells, and die when they are no longer needed. This is called the cell cycle. But cancer cells don't. They divide and multiply rapidly, without control, forming tumors.
What chemotherapy does is destroy these rapidly dividing cancer cells and stop them from dividing further. That is, it controls the growth of the cancer.
Is chemotherapy only used for cancer?
Most of the time, yes. Chemotherapy is mainly used to treat cancer. Medical oncologists recommend chemotherapy along with other treatments such as surgery and radiation therapy.
But sometimes chemotherapy is also used for other non-cancerous conditions.
- Autoimmune Diseases: In these diseases, our body's own immune system cells attack our own healthy tissues. Chemotherapy can control these rapidly dividing immune cells and reduce the damage they cause to the body.
- Blood Disorders: In some blood disorders, the bone marrow produces abnormal blood cells. In such cases, chemotherapy is given to destroy these abnormal cells in the bone marrow and make way for new healthy cells before a stem cell transplant.
Types of chemotherapy drugs and how they work
Chemotherapy drugs are not one type. They fall into several main categories based on their chemical makeup and the way they kill cancer cells. Your doctor will decide which drug or combination of drugs is best for you based on the type of cancer you have, how far it has spread (stage), and your overall health.
Sometimes, instead of just one drug, several drugs are given together. This is called combination chemotherapy. Giving different drugs together increases the success of the treatment because each drug attacks the cancer cells in different ways.
Let's look at some of the main categories of chemotherapy drugs.
| Drug category | How it works | Common examples |
|---|---|---|
| Alkylating Agents | They damage the DNA of cancer cells and stop them from dividing. These were the first types of chemo to be discovered. | Carboplatin, Cisplatin, Cyclophosphamide |
| Antimetabolites | It prevents cancer cells from making the genetic material (DNA) needed to make new cells. It's like stopping the building materials needed to build a new house. | 5-fluorouracil, Methotrexate, Gemcitabine |
| Topoisomerase Inhibitors | It blocks an enzyme (topoisomerase) that helps the cancer cell copy its DNA. This stops the cell from dividing. | Etoposide, Irinotecan, Topotecan |
| Mitotic Inhibitors | These are substances often derived from plants and interfere with the process of cancer cell division (mitosis). | Paclitaxel, Docetaxel, Vincristine |
| Antitumor Antibiotics | They stop the DNA replication of cancer cells, possibly damaging the DNA. | Doxorubicin, Bleomycin, Mitomycin-C |
Are corticosteroids also a chemotherapy drug?
No. `Corticosteroids` are not chemotherapy drugs. However, many people undergoing chemotherapy are given them to control side effects such as vomiting and nausea. Also, some `Corticosteroids` have the ability to kill cancer cells. `Dexamethasone` and `Prednisolone` are examples of this.
The side effects that everyone fears
The biggest concern everyone has when talking about chemotherapy is the side effects. It is true that chemotherapy does have side effects. The reason for this is that the chemotherapy drugs cannot distinguish between cancer cells and healthy cells. These drugs attack any rapidly dividing cell. In addition to cancer cells, there are also healthy cells in our body that divide rapidly.
For example:
- Cells in the hair roots (that's why hair grows)
- Cells lining the inside of the mouth and throat (which is why mouth sores occur)
- Cells of the digestive system (that's what causes nausea, vomiting, and stomach upset)
- Cells that make blood cells in the bone marrow (that's why anemia occurs and resistance to disease decreases)
The most common side effects that can occur due to this are:
- Extreme fatigue
- Nausea and vomiting
- Diarrhea or constipation
- Hair loss
- Mouth sores
- Appetite
- Decreased blood cells cause anemia and increased risk of infections (neutropenia).
The important thing is that not everyone will experience all of these side effects. Also, your doctor will give you other medications to control many of these side effects and reduce their impact. So don't stop treatment because of side effects. Talk openly with your doctor about any discomfort you feel.
When should I see the doctor?
It is very important to tell your doctor if you experience any side effects during chemotherapy. In particular, do not take it lightly if you experience any of the following:
- High fever (usually above 38°C / 100.4°F)
- Unstoppable vomiting or diarrhea
- Difficulty breathing or chest pain
- Persistent bleeding from anywhere in the body
- Inability to eat or drink due to severe mouth injuries
In such a case, immediately call the cancer unit of the hospital where you are being treated, or go to the emergency department (ETU) of the nearest hospital. These are not things to wait for. Your doctor may need to change the dosage of the medication, change the treatment schedule, or give you other medications for side effects.
Take-Home Message
- Chemotherapy is a very powerful and effective treatment that destroys cancer cells. Don't be unnecessarily afraid of it.
- There are many types of chemotherapy drugs. Your doctor will choose the best treatment for your cancer and health condition.
- Side effects may occur, but most of them can be controlled. Talk to your doctor about any discomfort you feel.
- During treatment, it is very important to take your medication on time and attend clinics.
- You are not alone. Your family, friends, and medical team are there to help you. Never hesitate to ask them for help.
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