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What is chemotherapy?
Chemotherapy is a term used by doctors to refer to drugs that can kill
cancer cells. Chemotherapy drugs can be given in a variety of ways, including
intravenously by injection, intravenously with a pump, or even in pill form
taken by mouth. Each drug works against a specific cancer and each drug has
specific doses and schedules for taking it. Chemotherapy can be given in a
variety of situations:
Primary chemotherapy is used when colorectal cancer is advanced and has
already spread to different parts of your body. In this situation, surgery
cannot eliminate the cancer so the best approach is to be treated with chemotherapy,
which can shrink tumor nodules, alleviate symptoms, and prolong life.
Adjuvant therapy is preventative chemotherapy that is given after
the cancer is surgically removed. The surgery may not eliminate all the cancer
and the adjuvant chemotherapy is used to kill any cancer cells that may have been
missed, such as cells that may have moved to the liver, but are too small to
detect.
Neo-adjuvant therapy is preventative chemotherapy that is given
before surgery. Chemotherapy may be given prior to surgery in order to shrink the tumor
so that the surgeon can completely remove the tumor with fewer complications.
Chemotherapy is also given with radiation, as it makes the radiation more
effective.
Talk to your doctor to determine the best treatment strategy for you.
Chemotherapy for colorectal cancer
5 Fluorouracil (5FU) has been the first-choice chemotherapy drug for
colorectal cancer for many years. It is used in combination with leucovorin (a
vitamin), which makes 5FU more effective. 5FU is always given intravenously.
Recently, a pill form of 5FU has been developed, capecitabine (Xeloda), which is
used for colorectal cancer that has spread. Two new chemotherapy drugs also are
used for the treatment of colorectal cancer that has spread. These are
irinotecan (Camptosar) and oxaliplatin (Eloxatin). They are usually given along
with 5FU for metastatic colorectal cancer.
What are the side effects of chemotherapy?
Because the mechanism of chemotherapy is to kill rapidly dividing cancer
cells, it also kills other rapidly dividing healthy cells in our bodies, such as
the membranes lining the mouth, the lining of the gastrointestinal tract, the
hair follicles, and the bone marrow. As a result, the side effects of
chemotherapy relate to these areas of damaged cells.
The side effects of chemotherapy can include nausea, vomiting, loss of
appetite, hair loss, mouth sores, hand and foot rash, and diarrhea. Other side
effects associated with chemotherapy’s effects on the bone marrow include an
increased risk of infection (due to low white blood cell counts), bleeding or
bruising from minor injuries (due to low blood platelet counts), and anemia-related fatigue (due to low red blood cell counts).
The side effects of chemotherapy depend upon the drugs given and the
individual. For example, hair loss is not common in most chemotherapy currently
offered for colorectal cancer. However, some people may experience some hair
thinning. Although it may take some time, side effects related to chemotherapy
will resolve when chemotherapy is stopped.
If you are experiencing any side effects, tell your doctor. In many cases
side effects can be treated or prevented with medications or change in diet.
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