Questions to Ask
About Chemotherapy

The administration of chemo drugs depends upon various factors. There is a certain protocol for each cancer type which is based on the following –

1.Types of cancer 

2.Stage of cancer 

3.Response rate and patient’s health 

Response rate

Your doctor will decide the chemo drugs by considering the response rate of a certain cancer type and the cancer stage on the drugs. The response rate depends upon the research done on cancer patients. Doctors choose the chemo drugs that have the highest response rate with a long duration of success.

Patient’s health

Patients who are old, weak, or suffering from other medical conditions are not able to tolerate certain chemo drugs. The doctor calculates the risks and benefits of certain drugs before deciding the line of treatment.

Thus, based on protocols, your doctor will decide which chemo drugs you will be given. 

Chemo drugs administered through intramuscular injections

Chemo drugs are given through a large needle that penetrates deep into the muscle layers. Through this process, chemo drugs are delivered to the muscle tissues

Chemo drugs administered through intravenous

This is the most common method of giving chemo drugs. The drugs are administered by puncturing the vein as a result the medication easily reaches the body parts via the bloodstream

Chemo drugs administered intrathecally 

Intrathecal chemo drugs are administered when the drugs need to reach the fluids in the brain and spinal cord.

Chemo drugs through intraperitoneal

The drugs are injected into the abdominal cavity through the catheter.

Chemo drugs through intra-arterial

The drugs are given through the arteries that supply blood to the tumor.

Chemo drugs administered topically

The drug is applied directly to the skin. It is used in skin cancers.

Chemo drugs administered through intra-vesicular

Chemo medicines are given through a catheter into the bladder.

Chemo drugs through intrapleural

The drug is given through a chest tube in the space between the lungs and the lung membrane.

Chemo drugs administered by implanting 

Medicine is left in the cavity removing the tumor from the brain.Chemotherapy drugs can be given by your doctor in various ways mentioned below.

Chemo drugs administered orally

These are the drugs that you can swallow. It can be in the form of pills, capsules, liquid, or tablets. Oral chemo drugs are either absorbed by the stomach or by keeping under the tongue. The drugs that are absorbed under the tongue are sub-lingual chemo drugs.

Chemo drugs administered through subcutaneous injection

The chemo drugs are administered through a short needle that is injected between the skin 

How often you will need chemotherapy depends on 

• The type of cancer and its stage
• If chemo is used to cure cancer or control growth or manage the symptoms
• Type of chemo you may receive
• Your body’s response to chemo

Chemotherapy drugs are usually given in cycles which may be daily, weekly, or monthly. Chemotherapy is usually administered in fixed cycles with rest between the cycle. Your doctor may recommend chemotherapy in fixed intervals or for certain consecutive days or every day. 

How long your chemo last depends upon the following factors-

• Stage of cancer 
• The type of cancer 
• The type of drugs 
• Toxicity of the drug
• Time is taken to recover from the side effect of drugs given

Chemo drugs are usually given in cycles and may take 3-6 months. The treatment includes the use of one or more drugs. Your oncologist will plan a certain set of the chemo cycle. 

How long the chemo treatment lasts depends majorly on the body’s response to the given chemo drugs. For example – with the first dose of chemo drugs if there is any abnormality in white blood cells or platelet count drops, the next chemotherapy may be delayed.

So, one must understand that the duration of your chemo drug is subject to variation

Chemotherapy is given in various forms. Depending upon the way of administration chemo can be given to an outpatient or patient. Chemo drugs can be administered in a hospital or a clinic. 

Depending upon the chemotherapy regimen, your doctor will decide where you can get the chemo done. The places where you can get your chemo are –

At home

Certain chemo drugs that are administered orally can be taken at home. Patients having portable pumps can also take chemo at home.

Inpatient

In certain situations, the patient may have to stay in a hospital. Those who need constant monitoring especially in patients where the immune system is suppressed after the treatment, need to stay in the hospital. 

Outpatient

Chemo can be given to outpatients in a clinic or a doctor’s office

Chemotherapy is given in various forms. Depending upon the way of administration chemo can be given to an outpatient or patient. Chemo drugs can be administered in a hospital or a clinic. 

Depending upon the chemotherapy regimen, your doctor will decide where you can get the chemo done. The places where you can get your chemo are –

At home

Certain chemo drugs that are administered orally can be taken at home. Patients having portable pumps can also take chemo at home.

Inpatient

In certain situations, the patient may have to stay in a hospital. Those who need constant monitoring especially in patients where the immune system is suppressed after the treatment, need to stay in the hospital. 

Outpatient

Chemo can be given to outpatients in a clinic or a doctor’s office

Various factors decide the chances of chemo’s work. The success of chemotherapy depends upon the following factor –

1.Cancer survival rates – It is the percentage of people who survive after cancer is diagnosed. The rate indicates the effectiveness of certain chemo drugs.

2.Cancer grade – It is a measure of abnormality in the cells that appears under a microscope.

3.Cancer stage – It reflects how much the tumor has grown and to what extent it has spread. 

4.Other factors – include the patient’s age, overall health, and other medical conditions.

One cannot determine the chances of how much will chemo work. As cancer patients usually receive chemo along with treatment such as surgery and radiotherapy. This makes it difficult to determine which therapy has worked for the patient.

When it comes to cancer treatment, chemotherapy is the word that strikes first. However, it may not always be the first course of treatment. Other treatments can help achieve the same treatment goal. 

With the advancement in medicine and technology, other ways can reach the same goal as chemo.

For example – surgery, immunotherapy, targeted therapies, watchful waiting, and supportive care can be used to reach the same treatment goal. Your doctor will decide the ways to reach the same treatment goal depending upon the type of cancer.

The working of chemo is measured in terms of how well the patient responds to the treatment. The response is measured in terms of certain words that indicate how chemo is working.

Your doctor may use the following words to indicate if chemo is working.

1.Partial response – It indicates that the tumor has decreased by a certain size but the disease persists.

2.Complete response – It indicates elimination of disease or disappearance of cancer.

3.Stable – It indicates that cancer has neither grown nor shrunk. There is no change in cancer disease.

4.Progression of the disease – It indicates the disease has progressed. Cancer has grown when compared to cancer before the treatment.

A certain test is done to help you and your doctor understand if chemo is working. Some of the tests are – blood tests, tumor markers, X-ray, CT scan, positron emission tomography (PET).

These tests measure the tumor and indicate if chemo is working

Chemotherapy is not always successful. There are times when cancer may occur again after treatment. Chemo shows different results in different people.

If the first line of treatment does not work your doctor will suggest you the second line of treatment. You need to discuss all the possibilities of the treatment with your oncologist and other healthcare providers to make the best decisions.

At some point in time, patients may want to end the chemo. In such cases, the focus diverts from the treatment of cancer to managing the symptoms of cancer. You may opt for palliative care or hospice care.

Chemotherapy causes various side effects which can be prevented and treated. The risk and side effects of chemo depend upon the type of chemotherapy you are taking.

Some of the common side effects are – tiredness, feeling sick, hair loss, infections, anemia, bruises and bleeding, sore mouth, loss of appetite, changes in skin and nails, memory problem, sleep issues, sexual problems, fertility issues, diarrhea, constipation, emotional issues.

You can prepare yourself for cancer treatment by taking small steps such as –

• Keep yourself aware of the treatment procedure and what you may expect out of the treatment. Take a second opinion if required.
• Plan what you need and what things need to be managed while you are in the recovery phase.
• Decide the place you want to stay at your home after the treatment.
• Make sure you eat healthy foods and exercise in your routine before you start the treatment. Stick to it as much as you can.
• Know all the side effects related to your cancer treatment.
• Talk to someone or connect with someone who has been through the same disease and treatment. This will benefit you by improving your perspective.
• Ask your healthcare provider about medicines for common side effects. Make a small kit and keep all the essentials you might require. 

All these points will prepare you for the treatment and decrease the chances of side effects.

Chemotherapy drugs are strong medicines, it is used to target cancer cells. If you are undergoing chemotherapy you need to take extra care while taking medicines, vitamins, and /or supplements. Normal medicines taken by non-cancer patients can cause a problem in cancer patients. It is important to discuss every detail with your doctor as certain medicines may interfere with chemotherapy.

Certain medicines can dangerously interact with chemo drugs. Hence, make a list of each and everything you are taking, even if it is a supplement or a vitamin or herbal supplements and over-the-counter medications. So, do not take any other medicines without approval from your doctor.

Yes, you need to change your diet during and after chemo. Some of the recommendations for the diet are –

1.Maintain a healthy BMI

Your healthcare provider will help you with the eating habits to maintain a healthy weight during and after the treatment.

2.Make sure you get all the essential nutrients from your diet 

Essential nutrients are protein, fats, carbohydrates, and water. Your diet must be nutrient-dense and plant-based diet.

3.Remain active 

Although you may feel tired and fatigued try to remain as much active as you can

Drinking alcohol may affect your treatment in various ways. Your doctor will advise you if you need to quit alcohol or consume it in moderation. Being honest with your doctor about the quantity of alcohol you consume will help you and your health team in better management of treatment and its side effects.

Being physically active is necessary during cancer treatment. If you lead a sedentary lifestyle and you are diagnosed with cancer, it is time to change your activities.

Exercise

Your doctor will recommend you to engage in light exercise in routine. It is essential to remain active as much as you can. Even a little exercise in routine improves the physical and mental health during and after cancer treatment. As the type of exercise you do and your ability to perform such exercise depends upon certain factors. For example – if treatment affects bone health, one must avoid exercise. Consult your doctor before you start adopting any physical activity

Sexual activities

Chemo may affect the sexual activity in cancer patients. The side effects of cancer treatment such as stress, anxiety, fatigue, etc affect your sexual activity. There is no need to change your sexual activity as it will not spread to your partner neither it will affect your cancer. So, if you feel like having sex, it is safe to do so. 

Cancer itself may affect fertility but more than that cancer treatment is more likely to affect your fertility or your ability to have children. How severely chemo may affect your ability to have children depends on –

• The age of the patient and stage of cancer
• Type and severity of the surgery performed
• Type of treatment administered
• Dosage of treatment

You need to talk to your doctor and know how your treatment will affect your ability to have children

Yes, you can work while getting chemo but you need to first figure out your treatment routine with your doctor and employer. This will help you manage the work schedule and will help your doctor design the medicines to be administered and the timing of side effects.

However, whether you will be able to work while getting chemo depends upon the type and stage of cancer, the treatment you are undergoing, side effects you may experience as a result of treatment, your overall health, and the nature of your job.

Surgery is done in cancer patients to remove the tumor and nearby tissues. Radiation therapy is done to kill cancer cells. Depending upon the type of cancer your doctor will decide if you will have surgery alone or with radiation therapy. You may either have surgery or radiation or both. Usually, surgery and radiation accompany each other.

Radiation may be given before or after the surgery. Radiation is done before surgery to shrink the cancer size and after surgery to kill the remaining cancer cells. Cancer such as breast cancer involves the removal of the tumor by surgery followed by radiation therapy. Radiation kills the cancer cells in or near the breast. Your healthcare provider will suggest the treatment depending on cancer type and stage.

You can expect a positive result if your treatment involves surgery and radiation. With radiation therapy the risk of re-occurrence of cancer reduces

Chemo done after surgery or radiation lowers the risk of recurrence of cancer in the future. Chemotherapy kills the cancer cells that might have spread from the tumor before the surgery.

Yes, chemo can be alone without any surgery. Chemo alone is done in cancer types that are sensitive to chemotherapy. Example – blood cancer

After you are diagnosed with cancer, you and your family need to decide on the treatment. If treatment is not required urgently then take time to do some research and consult your near ones. Depending on the stage of cancer your doctor will inform you of the time you can take to decide when to start the treatment.

Usually, cancer patients start treatment within a month after diagnosis.

If it is primary cancer then you should not wait more than 2 months to start the treatment. However, the time may vary depending upon the type, stage, and treatment of cancer.

There are eligibility criteria, mentioned in the trial protocol to take part in a clinical trial. Common criteria to take part in clinical trial includes – 

• Stage of cancer
• Received any previous treatment 
• Age (must be above 18 years)
• Overall health status
• Other medical conditions  
• Life expectancy (less than 3-6 months)
• Any genetic changes in your tumor

Your approval for clinical trial depends upon the above factors and other medical tests recommended by your healthcare provider. The result of the tests will decide if you can take part in a clinical trial or not.

Your chemo cost includes clinical visits, lab tests, imaging tests, drug costs, hospital stays, surgery, etc. The cost of chemo depends upon –

• The type and stage of cancer you are suffering from
• It may differ from city to city
• Hospital where you are getting your treatment
• Sessions required for treatment

Various health insurance companies in the market will cover your chemo. With the surge in cancer cases, insurance companies have come with a higher cover. Your health insurance covers chemo or not depends upon the health insurance company you have opted for.

Yes, we have the best healthcare professionals that specialize in various aspects of cancer care. We are equipped with specialists for each type of cancer treatment. Treatment options will be given and can be discussed with other health professionals.

We look after the physical and emotional side effects of cancer itself and cancer treatment. Our healthcare team is highly experienced and qualified for caring the cancer patients. Patients we are dealing with is the most important member of our healthcare team.

The second opinion is a medical process where the diagnosis and plan of treatment are reviewed by other oncologists. A second opinion helps to correct the cancer stage, make a better treatment plan and accurate prognosis. 

We provide a platform to help you recommend the best doctors and hospitals for a second opinion. Some of the factors that contribute to our suggestion are your accessibility to the referred doctor, the type of cancer you are suffering from, etc. You can always reach us for any suggestion you need regarding a second opinion.