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Home Treatment Options Treatment Side Effects Chemotherapy, Common Side Effects

Chemotherapy, Common Side Effects

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Chemotherapy, one of the most common methods used to treat breast and other types of cancers, involves using medications to stop the growth and/or kill cancer cells.  Cancer cells are different than normal cells of the body in that they exhibit uninhibited growth, likened to removing the brakes off of a car; with this increased growth cancer cells require more cellular fuel.  Most chemotherapeutic agents take advantage of these facts – they can masquerade as cellular fuel for growth, directly affect the machinery used for growth, or alter the blueprints found in DNA needed to growth.  By hitting these three points, chemotherapeutic agents are effective at stopping and/or killing cancer cells that would normally grow uninhibited.

Unfortunately, it is currently impossible to target only the cancer cells while leaving the rest of the cells in a patient.  Cancer cells are sensitive to these drugs because they are adept at utilizing the materials needed for growth, but some normal cells of the body also need to grow quickly (and thus have a high turnover) to perform their regular healthy functions.  These include white blood cells (lifespan a few weeks), absorptive cells in the stomach (lifespan of a few days), and skin cells (lifespan of a few weeks).  Thus, adverse effects of chemotherapy may include symptoms that affect these cells:

  • Increased risk of infections
  • Hair loss
  • Nausea / vomiting
  • Loss of appetite
  • Diarrhea / constipation
  • Tendency to bleed and bruise easily

While living with breast cancer is accompanied by health complications and the deadly risk of metastasis, it is vital to keep in mind that chemotherapy carries significant adverse effects.  Most important is the increased risk of infections due to a decrease in the number of infection fighting blood cells, called neutropenia (a deficiency in a specific kind of white blood cell, the neutrophil).  Pancytopenia describes a deficiency of more than one type of blood cell line.  Infections can negatively affect the course of treatments, can cause serious medical complications, and can even lead to death if severe enough.  It is important that patients on chemotherapy take pre-cautions to guard themselves against infections such as washing hands, avoiding others with infections, taking care of their skin, and cooking food well.  Many patients on chemotherapy may experience gastrointestinal distress.  It is important that patients on chemotherapy take steps to ensure they receive a good supply of nutrients.  Special diets, eating schedules, and medicines to combat the nausea/diarrhea/constipation can be used to help keep up appetite and maintain nutritional status, with the goal of supporting the overall health of the patient and to avoid the complication of cachexia (severe weight loss and muscle wasting).  It has been shown that cancer patients who are infection-free and have good nutritional status have a better prognosis, most likely due to the ability to withstand more rounds of chemotherapy as well as allowing the body to recover better.

Newer chemotherapy drugs for breast cancer have been developed that are more specific in their targeting of cells thus reducing the risk of the above adverse effects. However, these drugs come with precautions of their own.  Herceptinâ (trastuzmab) targets a specific protein found in certain breast cancers.  Its most important and serious side effect is potential damage to the heart.  Tamoxifen is another chemotherapeutic agent that can target breast cancer cells more specifically.  It works by blocking a specific estrogen receptor in the breast, stopping the growth of the cancer cells with this particular receptor.  Important side effects with this therapy are due to its estrogen receptor-binding properties, such as changes in the uterus including an increased risk of uterine cancer, as well as menopausal symptoms (i.e. hot flashes).  Even though these breast-specific chemotherapeutic agents have a lower risk of the side effects of traditional chemotherapy, their other effects may prove to be just as undesirable.

In summary, chemotherapeutic agents carry important side effects that must be managed carefully.  These side effects can range from mild discomforts to threatening conditions, and all complicate the course of cancer treatment.  As a cancer patient or family/friend of a cancer patient, it is important to let your physician know if you are concerned about or are experiencing these side effects in order to personally optimize your patient care.

Michael Lee, Shikha Jain MD

References:

Sohal, Davendra; Baustian, Gordon H; Rao, Dinesh S; Choy, Edwin; Sweet, Kevin; Jones, Russell.  Breast Cancer.  Available at www.mdconsult.com.  Last updated 29 May 2010.

Townsend, Courtney M. Jr, et al.  Chemotherapy and Hormone Therapy for Breast Cancer.  Sabiston Textbook of Surgery, 18th ed.  Obtained fromwww.mdconsult.com

Cancer Diet and Nutrition Manual. Available athttp://www.healthcastle.com/cancerdiet.shtml