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Frequently Asked Questions About Chemotherapy

What is chemotherapy? My surgeon has told me that he removed the cancer. Why do I need chemotherapy? How does chemotherapy work? If I receive chemotherapy, will I be free of cancer for the rest of my life? How is chemotherapy administered? Do I have to go to the hospital to receive chemotherapy? Will chemotherapy make me sick? Will I lose my hair? How long does chemotherapy treatment take? Can I continue to take my vitamins, herbs and medicines prescribed by other doctors? Can I start or continue to exercise while receiving chemotherapy? How do I know if the chemotherapy treatments are working? Can I be with people who are ill while I am receiving chemotherapy? Should I be on a special diet? Will chemotherapy interfere with my dental treatments? Is it true that chemotherapy will make me very tired and that foods will taste terrible? Will I be able to have a baby during or after chemotherapy treatment? Is it safe to have sex during treatment? Can I safely use alternative therapies while undergoing chemotherapy?

What is chemotherapy? Chemotherapy involves the utilization of a variety of medications that can be given either orally or intravenously. The purpose of the chemotherapy is to either treat existing malignancy or hopefully prevent a malignancy from recurring. Chemotherapy is administered with different schedules and methodologies, depending upon the malignancy being treated and the types of drugs being given. Each of these different regimens can be associated with it's own set of side effects and toxicities. Why do I need chemotherapy? It would be more accurate if surgeons would say they have removed

"all visible or detectable cancer". However, we know from experience that in some cases residual microscopic cancer may be present. The purpose of giving chemotherapy in many cases is to attempt to eradicate malignancy that we can't see. How does chemotherapy work? Different drugs work by different mechanisms, but underlying all the activity of the chemotherapy drugs is some propensity for the drug to interfere either with the growth or life cycle of the malignant cells. Chemotherapy drugs are selected which are more selective for cancer cells than for normal cells. If I receive chemotherapy, will I be free of cancer for the rest of my life? Unfortunately, there is no guarantee that chemotherapy will always prevent the regrowth of cancer. In fact, in some instances, we unfortunately see late cancers develop as a consequence of chemotherapy. However, for many cancers, once you have been cancer-free for five years, the likelihood of a relapse becomes significantly smaller. How is chemotherapy administered? Chemotherapy can be administered by a variety of routes. For most intense regimens, the medications are given intravenously. However, some chemotherapy drugs are very effective when given by intramuscular injection or orally in the form of pills or capsules. In rare, circumstances, the chemotherapy may be administered directly into a body cavity, such as the lung or abdominal cavities. Do I have to go to the hospital to receive chemotherapy? No, most chemotherapy regimens are given as an outpatient. There are selective programs that do require hospitalization because of the intensity of the treatment programs or because of co-existing risk factors, such as heart, renal, or lung disease that may make outpatient therapy too risky. Will chemotherapy make me sick? Reactions to chemotherapy are dependent upon two primary factors. One depends upon the individual sensitivity of the individual patient. The other factor is the type of drug being given. For the most part, the majority of chemotherapy infusions and treatments are accomplished with very little, if any, patient discomfort. Fortunately, there are very effective medications available to diminish the chances of developing nausea or vomiting, which have commonly been associated with chemotherapy. Will I lose my hair? Hair loss associated with chemotherapy is entirely dependent upon the individual medication. Your doctor and nurse will discuss with you the possibilities of hair loss. How long does chemotherapy treatment take? Chemotherapy treatments can last just a few minutes or as long as a week. However, most of the outpatient chemotherapy regimens are

accomplished within a few hours. Can I continue to take my vitamins, herbs and medicines prescribed by other doctors? Your physician will review your medications and make sure there are no problems related to conflicting drugs. For the most part, you should continue with your regularly prescribed medicines, but this needs to be discussed with each patient on a case-by-case basis. Can I start or continue to exercise while receiving chemotherapy? Patients are encouraged to continue to engage in active physical exercise and pursue their normal lifestyle as much as their disease and symptoms will allow. If any restrictions on exercise, diet, or other activities are necessary, these will be discussed with you on an individual basis. How do I know if the chemotherapy treatments are working? Response to treatment is generally measured by improvement in either measurable tumor masses or by improvement in blood tumor markers. Obviously, each patient is going to differ in how their response to treatment will be measured, but for the most part this is accomplished by follow-up blood tests, x-rays, and scans. Can I be with people who are ill while I am receiving chemotherapy? In general, it is best to avoid anyone who has an obvious illness, especially any respiratory infections such as a cold or influenza. At times you may have a very low resistance to infection, and staying away from large crowds of people will be recommended. Should I be on a special diet? Generally speaking, there are no special dietary requirements while undergoing chemotherapy. However, if your white count becomes low, your physician may recommend that you avoid raw foods, such as salads, that could be contaminated with bacteria. Will chemotherapy interfere with my dental treatments? For the most part, all elective dental procedures are best postponed until the chemotherapy is completed. However, if dental work needs to be accomplished, this should be discussed with your doctor concerning the optimum timing of the dental procedures. My friends tell me that chemotherapy will make me very tired and that foods will taste terrible. Is this true? It is true that during the course of chemotherapy some patients will experience the onset of fatigue. This generally occurs after multiple treatments rather than after the first one, and is more of a cumulative effect. However, many patients will not experience any fatigue at all. Also, many of the malignancies that are being treated by themselves cause fatigue. It is common to have alteration of taste while undergoing chemotherapy and many patients feel their food takes on a "metallic" taste. This, again, is dependent upon the drugs being administered and individual patient idiosyncrasies. If this does occur, it is a reversible process and recovers once chemotherapy is

suspended. Will I be able to have a baby during or after chemotherapy treatment? It is a general recommendation that women not become pregnant during the period of receiving active chemotherapy. This is also true for many hormonal manipulations done for breast cancer. Be sure to discuss this very important issue with your oncologist. Is it safe to have sex during treatment? Unless special circumstances are present, it is completely possible to have a healthy and normal sex life while receiving chemotherapy. However, there may be special circumstances where your oncologist may recommend that intimacy would be best postponed until the clinical situation has improved. Can I safely use alternative therapies while undergoing chemotherapy? Alternative therapies are generally untested and unproven, and their effect when mixed with chemotherapy is not really known or understood. While it is probable that alternative therapies will not interfere with treatment, that is not a known fact. Alternative therapies are not given in standardized fashion and the toxicities and problems associated with concurrent chemotherapy have not been defined. For the most part, the oncologist would prefer that you do not take alternative substances, but certainly many patients do, and if this is the situation in your case, be sure to notify your physician of the fact that you are taking alternative medications.

This page was last modified on 03/13/2001 07:43:37 A.M.


Information Common questions Resources

Published by Bupas Health Information Team, July 2011. This factsheet is for people who are planning to have chemotherapy as a treatment for cancer, or who would like information about it. Chemotherapy is a treatment to destroy cancer cells with medicines. There are more than 90 chemotherapy medicines available that can be used in a variety of ways according to the type of cancer, how advanced it is and a persons general health.

Your care may differ from what is described here as it will be designed to meet your individual needs. Its important that you discuss your chemotherapy with your doctor.

About chemotherapy Preparing for chemotherapy What happens during chemotherapy? Recovering from chemotherapy What are the risks?

About chemotherapy
Chemotherapy is used to destroy many different types of cancer at various stages. Chemotherapy medicines can stop cancer cells dividing and reproducing. Your healthy cells can repair the damage caused by chemotherapy, but cancer cells cant and eventually die. Its used to treat solid tumours (cancerous lumps) affecting organs such as the breast or bowel, as well as blood cancers such as leukaemia. It can be used on its own or alongside other treatments such as radiotherapy, surgery or hormonal, biological and immune therapies. You may have chemotherapy to:

shrink a cancer before surgery or radiotherapy stop a cancer coming back after surgery or radiotherapy treat a cancer on its own, for example some cancers are very sensitive to chemotherapy treat cancer that has spread from where it first started

The type of chemotherapy medicine you have will depend on a number of factors including:

the type of cancer where the cancer started what the cancer cells look like under a microscope whether the cancer has spread to other parts of your body your general health

Preparing for chemotherapy

In most hospitals, a number of different health professionals are involved in your treatment. An oncologist (a doctor who specialises in cancer care) and a specialist nurse will usually oversee your chemotherapy. A dietitian, pharmacist, psychologist and physiotherapist may also be involved in your treatment. Your doctor will explain why youre having chemotherapy and how to prepare for your treatment. The length of your chemotherapy depends on the type of cancer you have, how much it has

spread through your body, types of medicine used, severity of side-effects and how successful the treatment is. You may have a number of tests before, during and after your chemotherapy. These may include:

blood and urine tests to check your blood count (the number of various blood cells in your blood) and how well your kidneys and liver are working blood pressure checks an ECG or echocardiogram to see how well your heart is working lung function tests to see how well your lungs are working an X-ray, CT scan, or MRI scan

Your height and weight may also be checked to work out the right dose of chemotherapy for you. You can take chemotherapy tablets or apply creams at home, whereas injections or infusions are usually given in hospital. However, some people may be able to have chemotherapy at home. Your doctor will discuss with you what will happen before, during and after your chemotherapy. This is your opportunity to understand what will happen, and you can help yourself by preparing questions to ask about the risks, benefits and any alternatives to chemotherapy. This will help you to be informed, so you can give your consent for the treatment to go ahead, which you may be asked to do so by signing a consent form.

What happens during chemotherapy?

Chemotherapy medicines can be given to you in different ways. Most commonly chemotherapy is given through a drip into your bloodstream (intravenous chemotherapy) or as tablets or capsules that you swallow. Other ways of having chemotherapy medicines include:

injections into the area around your spinal cord (intrathecal injection) injections into a muscle usually your thigh or buttocks (intramuscular injection) injection under your skin (subcutaneous injection) injections into an affected body cavity such as your bladder (intracavity chemotherapy) creams for skin cancers

If youre having intravenous chemotherapy, medicines are given to you through a drip into your bloodstream and can be given through:

a small tube in a vein in your arm or the back of your hand a thin tube inserted through the skin of your chest into a main vein near your heart (central line) this can be left in for many months so medicines can be injected through it a thin tube placed into a vein in the crook of your arm and threaded through until its in a vein near your heart (a PICC peripherally inserted central catheter line) this can also stay in place for many months

a thin tube put into a vein ending in an opening (port) just under the skin on your arm or chest (called an implantable port or portcath) medicines are passed via needles through the port an infusion pump this is a portable pump that attaches to a PICC line or a central line and feeds in the correct dose of chemotherapy over a period of time

Chemotherapy will usually be given as several sessions. These may take between 30 minutes and a few hours at a time. You will then have a rest period, which could be anything from a few days to several weeks, to allow your body to recover. Treatment and rest periods make up a cycle. You may have a number of cycles depending on how well your cancer is responding to chemotherapy. Your doctor will explain the treatment to you.

Recovering from chemotherapy

Your doctor or nurse will advise you on what to expect after chemotherapy and the side-effects you may have. Some people manage to continue with their lives as usual during and after chemotherapy. A small number of people even feel better as the symptoms of their cancer decrease. However, for most people chemotherapy can have an impact on everyday life. In particular, tiredness often prevents people from working full-time or doing their usual levels of physical activity. Take things at your own pace and dont overdo it, particularly after you have just had treatment (see our common questions for more information).

What are the risks?

There are some risks associated with chemotherapy. We have not included the chance of these happening as they are specific to you and differ for every person. Ask your doctor to explain how these risks apply to you.

Side-effects are the unwanted but mostly temporary effects of a successful treatment. Chemotherapy doesnt only target cancer cells, but any cells that divide rapidly. This includes those in your bone marrow and skin, cells that produce hair and those lining your mouth and digestive system. Damage to these healthy cells may produce possible side-effects, including:

tiredness feeling sick or vomiting diarrhoea thinning of hair or hair loss sore mouth, mouth ulcers or changes in your sense of taste numbness or pins and needles in your hands and feet breathlessness

skin changes your skin may become dry or discoloured changes in hearing some people get tinnitus (a ringing sound in your ears)

Side-effects vary greatly between the different types of chemotherapy and from person to person. Your doctor will discuss the possible side-effects of your specific treatment with you. Many side-effects can be controlled using other medicines. For example, sickness can be reduced by taking antisickness medicines alongside your chemotherapy. The side-effects of chemotherapy, such as sickness and diarrhoea, can make the contraceptive pill less effective. Women shouldnt try to become pregnant during treatment because the chemotherapy medicines may damage a developing baby. Some chemotherapy medicines can affect your fertility. For some women it brings on early menopause. Its important that you discuss these risks with your doctor before you start the treatment. You may be offered the opportunity to store eggs, embryos, ovarian tissue or sperm for future fertility treatment (see our common questions for more information). Treatment with certain chemotherapy medicines can slightly increase your risk of developing a type of blood cancer called acute myeloid leukaemia in later life. Your risk of developing leukaemia years later will vary depending on how much chemotherapy you have. Your doctor will be able to give you more information about this. Different chemotherapy medicines cause different side-effects, so its important to discuss your specific treatment with your doctor.

Most Cancer Patients Die of Chemotherapy

Andreas Moritz, July 23, 2008 Former White House press secretary Tony Snow died in July 2008 at the age of 53, following a series of chemotherapy treatments for colon cancer. In 2005, Snow had his colon removed and underwent six months of chemotherapy after being diagnosed with colon cancer. Two years later (2007), Snow underwent surgery to remove a growth in his abdominal area, near the site of the original cancer. This is a very treatable

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condition, said Dr. Allyson Ocean, a gastrointestinal oncologist at Weill Cornell Medical College. Many patients, because of the therapies we have, are able to work and live full lives with quality while they're being treated. Anyone who looks at this as a death sentence is wrong. But of course we now know, Dr. Ocean was dead wrong. The media headlines proclaimed Snow died from colon cancer, although they knew he didnt have a colon anymore. Apparently, the malignant cancer had returned (from where?) and spread to the liver and elsewhere in his body. In actual fact, the colon surgery severely restricted his normal eliminative functions, thereby overburdening the liver and tissue fluids with toxic waste. The previous series of chemo-treatments inflamed and irreversibly damaged a large number of cells in his body, and also impaired his immune system -a perfect recipe for growing new cancers. Now unable to heal the causes of the original cancer (in addition to the newly created ones), Snows body developed new cancers in the liver and other parts of the body. The mainstream media, of course, still insist Snow died from colon cancer, thus perpetuating the myth that it is only the cancer that kills people, not the treatment. Nobody seems to raise the important point that it is extremely difficult for a cancer patient to actually heal from this condition while being subjected to the systemic poisons of chemotherapy and deadly radiation. If you are bitten by a poisonous snake and dont get an antidote for it, isnt it likely that your body becomes overwhelmed by the poison and, therefore, cannot function anymore? Before Tony Snow began his chemo-treatments for his second colon cancer, he still looked healthy and strong. But after a few weeks into his treatment, he started to develop a coarse voice, looked frail, turned gray and lost his hair. Did the cancer do all this to him? Certainly not. Cancer doesnt do such a thing, but chemical poisoning does. He actually looked more ill than someone who has been bitten by a poisonous snake. Does the mainstream media ever report about the overwhelming scientific evidence that shows

chemotherapy has zero benefits in the five-year survival rate of colon cancer patients? Or how many oncologists stand up for their cancer patients and protect them against chemotherapy treatment which they very well know can cause them to die far more quickly than if they received no treatment at all? Can you trustingly place your life into their hands when you know that most of them would not even consider chemotherapy for themselves if they were diagnosed with cancer? What do they know that you don't? The news is spreading fast that in the United States physician-caused fatalities now exceed 750,000 each year. Perhaps, many doctors no longer trust in what they practice, for good reasons. Most cancer patients in this country die of chemotherapy... Chemotherapy does not eliminate breast, colon or lung cancers. This fact has been documented for over a decade. Yet doctors still use chemotherapy for these tumors... Women with breast cancer are likely to die faster with chemo than without it. - Alan Levin, M.D. An investigation by the Department of Radiation Oncology, Northern Sydney Cancer Centre, Australia, into the contribution of chemotherapy to 5-year survival in 22 major adult malignancies, showed startling results: The overall contribution of curative and adjuvant cytotoxic chemotherapy to 5-year survival in adults was estimated to be 2.3% in Australia and 2.1% in the USA. [Royal North Shore Hospital Clin Oncol (R Coll Radiol) 2005 Jun;17(4):294.] The research covered data from the Cancer Registry in Australia and the Surveillance Epidemiology and End Results in the USA for the year 1998. The current 5-year relative adult survival rate for cancer in Australia is over 60%, and no less than that in the USA. By comparison, a mere 2.3% contribution of chemotherapy to cancer survival does not justify the massive expense involved and the tremendous suffering patients experience because of severe, toxic side effects resulting from this treatment. With a meager success rate of 2.3%, selling chemotherapy as a medical treatment (instead of a scam), is one of the greatest fraudulent acts ever committed. The average chemotherapy earns the medical establishment a whopping $300,000 to

$1,000,000 each year, and has so far earned those who promote this pseudo-medication (poison) over 1 trillion dollars. Its no surprise that the medical establishment tries to keep this scam alive for as long as possible. In 1990, the highly respected German epidemiologist, Dr. Ulrich Abel from the Tumor Clinic of the University of Heidelberg, conducted the most comprehensive investigation of every major clinical study on chemotherapy drugs ever done. Abel contacted 350 medical centers and asked them to send him anything they had ever published on chemotherapy. He also reviewed and analyzed thousands of scientific articles published in the most prestigious medical journals. It took Abel several years to collect and evaluate the data. Abels epidemiological study, which was published on August 10, 1991 in The Lancet, should have alerted every doctor and cancer patient about the risks of one of the most common treatments used for cancer and other diseases. In his paper, Abel came to the conclusion that the overall success rate of chemotherapy was appalling. According to this report, there was no scientific evidence available in any existing study to show that chemotherapy can extend in any appreciable way the lives of patients suffering from the most common organic cancers. Abel points out that chemotherapy rarely improves the quality of life. He describes chemotherapy as a scientific wasteland and states that even though there is no scientific evidence that chemotherapy works, neither doctor nor patient is willing to give up on it. The mainstream media has never reported on this hugely important study, which is hardly surprising, given the enormous vested interests of the groups that sponsor the media, that is, the pharmaceutical companies. A recent search turned up exactly zero reviews of Abels work in American journals, even though it was published in 1990. I believe this is not because his work was unimportant -but because it is irrefutable. The truth of the matter would be far too costly for the pharmaceutical industry to bear, thus making it unacceptable. If the mass media reported the truth that medical drugs, including chemotherapy drugs, are used to practically commit genocide in the U.S. and the

world, their best sponsors (the pharmaceutical companies) would have to withdraw their misleading advertisements from the television media, radio stations, magazines, and newspapers. But neither group wants to go bankrupt. Many doctors go as far as prescribing chemotherapy drugs to patients for malignancies that are far too advanced for surgery, with the full knowledge that there are no benefits at all. Yet they claim chemotherapy to be an effective cancer treatment, and their unsuspecting patients believe that effective equals cure. The doctors, of course, refer to the FDAs definition of an effective drug, one which achieves a 50% or more reduction in tumor size for 28 days. They neglect to tell their patients that there is no correlation whatsoever between shrinking tumors for 28 days and curing the cancer or extending life. Temporary tumor shrinkage through chemotherapy has never been shown to cure cancer or to extend life. In other words, you can live with an untreated tumor for just as long as you would with one that has been shrunken or been eliminated by chemotherapy (or radiation). Chemotherapy has never been shown to have curative effects for cancer. By contrast, the body can still cure itself, which it actually tries to do by developing cancer. Cancer is more a healing response than it is a disease. The disease is the bodys attempt to cure itself of an existing imbalance. And sometimes, this healing response continues even if a person is subjected to chemotherapy (and/or radiation). Unfortunately, as the previously mentioned research has demonstrated, the chances for a real cure are greatly reduced when patients are treated with chemotherapy drugs. The side effects of the treatment can be horrendous and heartbreaking for both patients and their loved ones, all in the name of trustworthy medical treatment. Although the drug treatment comes with the promise to improve the patients quality of life, it is just common sense that a drug that makes them throw up and lose their hair, while wrecking their immune system, is doing the exact opposite. Chemo-therapy can give the patient lifethreatening mouth sores. It attacks the immune system by destroying billions of immune cells (white blood

cells). Its deadly poisons inflame every part of the body. The drugs can slough off the entire lining of their intestines. The most common side effect experienced among chemo patients is their complete lack of energy. The new additional drugs now given to many chemo patients may prevent the patient from noticing some of the side effects, but they hardly reduce the immensely destructive and suppressive effect of the chemotherapy itself. Remember, the reason chemotherapy can shrink some tumors is because it causes massive destruction in the body. If you have cancer, you may think that feeling tired is just part of the disease. This rarely is the case. Feeling unusually tired is more likely due to anemia, a common side effect of most chemotherapy drugs. Chemo drugs can dramatically decrease your red blood cell levels, and this reduces oxygen availability to the 60-100 trillion cells of your body. You can literally feel the energy being zapped from every cell of your body -- a physical death without dying. Chemo-caused fatigue has a negative impact on day-to-day activities in 89% of all patients. With no energy, there can be no joy and no hope, and all bodily functions become subdued. One long-term side effect is that these patients' bodies can no longer respond to nutritional or immunestrengthening approaches to cancerous tumors. All of this may explain why cancer patients who do not receive any treatment at all, have an up to four times higher remission rate than those who receive treatment. The sad thing is that chemotherapy does not cure 96% to 98% of all cancers anyway. Conclusive evidence (for the majority of cancers) that chemotherapy has any positive influence on survival or quality of life does not exist. To promote chemotherapy as a treatment for cancer is misleading, to say the least. By permanently damaging the bodys immune system and other important parts, chemo-therapy has become a leading cause of treatment-caused diseases such as heart disease, liver disease, intestinal diseases, diseases of the immune system, infections, brain diseases, pain disorders, and rapid aging. Before committing themselves to being poisoned, cancer

patients need to question their doctors and ask them to produce the research or evidence that shrinking a tumor actually translates to any increase in survival. If they tell you that chemotherapy is your best chance of surviving, you will know they are lying or are simply misinformed. As Abels research clearly demonstrated, there is no such evidence anywhere to be found in the medical literature. Subjecting patients to chemotherapy robs them of a fair chance of finding or responding to a real cure and deserves criminal prosecution.

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