Chemotherapy

If you or a loved one received a cancer diagnosis, you’re likely processing a range of emotions, and you may feel overwhelmed about the number of treatment options available. Remember, you are not alone. Together with your doctor, you will choose from a number of different options, including chemotherapy, to formulate a plan that provides you with the best possible outcome.

At Memorial Hermann Cancer Centers, we partner with a multidisciplinary team of affiliated surgeons, radiation and medical oncologists, dietitians, physical therapists and nurse navigators (experienced oncology clinicians who serve as patient  advocates) to create a treatment program that is tailored to your situation and built around your individual needs.

What is Chemotherapy?

Chemotherapy is used to treat patients with cancer at any stage – from early to advanced. The treatment involves the use of drugs to stop the growth of cancer cells, by killing the cells or simply preventing them from dividing. Different chemotherapy drugs may be given at the same time, or one after the other to treat your cancer, keep it from spreading or ease your symptoms.

Other cancer treatments may also be paired with chemotherapy to increase the likelihood of a positive outcome, including:

• Surgery
• Radiation therapy (radiotherapy)
• Targeted therapy
• Immunotherapy

Radiotherapy is perhaps most commonly paired with chemotherapy (called chemoradiation) it is either performed during or after chemotherapy treatment. In some cases, a specific chemotherapy drug is used that enhances the effect of the radiation (called a chemosensitizing drug).

Chemotherapy can be broken down into two different methods: systemic and regional.

Systemic chemotherapy: Ingested orally or injected into a vein or muscle, chemotherapy drugs enter the bloodstream, reaching cancer cells throughout the body. This is the most common type of chemotherapy.

Regional chemotherapy: Chemotherapy medicine is administered directly into the affected region or area, ensuring the treatment and any side effects are confined mainly to that area. Although less common than systemic chemotherapy, regional chemotherapy is often used in special circumstances, such as treating cancer present in a limb or organ. Liver perfusion, which utilizes an implantable pump in the abdomen to administer chemo into the liver’s blood supply, is a type of regional chemotherapy sometimes used to treat metastatic colon cancer.

How Does Chemotherapy Work?

According to the American Cancer Society, there are more than 100 chemotherapy drugs currently available to treat cancer. These medicines differ in several ways, including:

• Their chemical composition
• How they are administered
• Their effectiveness  in treating specific types of cancer

Your medical oncologist will determine which drug or combination of drugs is best to treat your specific type of cancer.

When Is Chemotherapy Typically Used?

Depending on your condition and type of cancer, several different types of chemotherapy can be administered at specific times over the course of your treatment. Each type has a specific purpose and goal. Curative chemotherapy aims to eliminate all cancer cells from the body to achieve a permanent cure.

• Neoadjuvant chemotherapy is given before surgery to shrink tumors that are too big, making their removal surgically possible and less invasive. Adjuvant chemotherapy is a supportive therapy that helps to prevent cancer from recurring by targeting cancer cells that may remain undetected in the body after surgery.
• Palliative chemotherapy is a treatment option utilized when removing all cancer cells is no longer possible. Palliative chemotherapy can help relieve symptoms of cancer, slow down or temporarily halt the progress of the disease, avoid complications and possibly increase survival times.

What to Expect from Chemotherapy

If you have been diagnosed with cancer, you’ll be given a few options for treatment based on your type of cancer and current condition. Chemotherapy may be one of those options.

The process of receiving chemotherapy is rather simple, but the treatment can cause difficult side effects. Your cancer care team will work with you to develop a treatment plan that you are comfortable with and offers you the greatest chance at a successful outcome.

While everyone reacts to chemotherapy differently, patients in good physical condition are more likely to tolerate their treatments well. If possible, it’s best to remain active before, during and after chemotherapy treatment.

How is Chemotherapy Administered?

Depending on your condition, chemotherapy can be administered as an inpatient or outpatient procedure. As recently as a few decades ago, most chemotherapy treatments were inpatient procedures, but thanks to advances in medical technology, many chemotherapy options can be administered in an outpatient setting. New advances in drug manufacturing have also made oral administration of chemotherapy a much more preferred option compared to IV perfusion.

At Memorial Hermann Cancer Centers, we offer both inpatient and outpatient chemotherapy services at locations across the Greater Houston area. Our Centers are staffed by experienced, caring oncology nurses, committed to helping you feel as comfortable as possible with your choice of amenities like private recliner infusion chairs and entertainment materials.

How Long Will I Need to Take Chemotherapy?

The length of time needed to complete chemotherapy treatment depends on a number of factors, including:

• The type of cancer
• The type of treatment you are receiving (curative, palliative, etc.)
• The type of chemotherapy drugs used
• How your body responds to treatment

In general, treatments are administered daily, weekly or monthly in on-and-off cycles. For example, you may receive treatment five days a week for two weeks, with the third week off to allow your body to recover. This is considered one cycle.

Frequent checkups with your cancer care team will help them to determine the effectiveness of each chemotherapy cycle and whether your treatment needs to be scaled up or down.

Cancer cells tend to form faster than other cells in the body, and chemotherapy drugs are designed to target these faster-growing cells. The drugs, however, cannot differentiate between cancer cells and other fast-growing cells, like those found in hair follicles, fingernails, the lining of the gastrointestinal tract and red and white blood cells. When these normal cells are damaged, you may experience the following:

• Fatigue
• Hair loss
• Easy bruising and bleeding
• Infection
• Anemia (low red blood cell counts)
• Nausea and vomiting
• Appetite changes

While common, not every patient undergoing chemotherapy will have these side effects. To decrease your risk, your cancer care team at Memorial Hermann will ensure you receive current therapies, including medicines that increase blood counts and prevent nausea and vomiting. The use of these therapies, along with new delivery devices, can help make chemotherapy much easier for patients to tolerate.

What Happens if Chemotherapy Does Not Work?

Not every cancer responds well to chemotherapy. Throughout your treatment, your cancer care team will use different approaches, including blood tests, tissue samples and imaging, such as computed tomography, also called CT scans, to monitor how your cancer is responding to chemotherapy.

In some instances, switching to a different chemotherapy medication is all that is needed. Other options, such as radiotherapy, immunotherapy, stem cell therapy and hormone therapy, may also be considered. Your treatment team will strive to find the optimal treatments to help you fight your cancer.

Some cancer medications can be prohibitively expensive in the United States. At Memorial Hermann, we do our best to minimize your costs through our integrated Specialty Pharmacy. Our pharmacists can help troubleshoot  insurance issues and help to quicken the insurance coverage decision for your specialty cancer medication.

Our Specialty Pharmacy’s financial coordinators  focus on how to make your cancer  medications as affordable as possible for you. They can help connect you with third-party financial assistance programs, including medication manufacturer-provided insurance and trial programs, as well as nonprofit foundations, such as the Patient Advocate Foundation, for low-income and uninsured patients.

Memorial Hermann Specialty Pharmacy offers the latest adjuvant, neoadjuvant and palliative chemotherapy medications to help you manage symptoms and complete your physician-designated treatment. Our experienced pharmacists offer personalized care and support, meeting with you before you begin your therapy. They will teach you how to use your medication and follow up with you to support you throughout the treatment process. They’re here to help you better understand your cancer medications and ease any concerns you may have.

Memorial Hermann Cancer Centers are accredited by the American College of Surgeons’ (ACoS) Commission on Cancer (CoC). This rare distinction is given to cancer programs that uphold the highest standard of care for patients. When you choose Memorial Hermann Cancer Centers for your chemotherapy treatment, you can rest assured you will receive the best possible care delivered by a compassionate team of caregivers in a calm, healing environment.