Chemotherapy and biologics
While treatments such as radiation therapy or tumor removal are best for localized cancers, chemotherapy and biologics are often the best choice when cancer has spread to other areas of the body, or "metastasized."
Chemotherapy is used to treat a wide variety of cancers. It is used in about half of all cases of cancer, and it is often used in combination with other therapies. It works by killing cancer cells throughout the body as they are in the process of duplicating. Different drugs target specific aspects of the replication process. Hundreds of chemotherapy drugs exist, and generally a combination of several drugs will be used in an individual's treatment.
Biologics include a wide range of drugs that are developed for their ability to specifically target cancer cells, stimulate the immune response, and/or aid in your recovery from cancer treatment. Biologics are often used in combination with other therapies, including chemotherapy.
There are three main categories of biologics:
- Substances that are nearly identical to the body's own key signaling proteins. These signals can either act to activate your immune system to fight the cancer or act to stimulate blood production.
- Monoclonal antibodies designed to target a specific cell type. These specialized antibodies are similar to the antibodies the human immune system uses to fight off bacteria and viruses, but their targeting mechanism is custom-designed to fight cancer cells.
- Agents that interfere with chemical processes in cancer cells, including those regulating their growth, survival, and blood supply.
What to expect
No two experiences with chemotherapy or biologics are the same. If your doctor recommends chemotherapy or biologics as part of your cancer treatment, he or she will discuss the specifics of your treatment and answer any questions you may have before and throughout your treatment. The following is some very basic information about what you might expect during treatment.
Chemotherapy/ Biologic drugs
Chemotherapy can be delivered intravenously, through injections, or in pill form. Biologics can be delivered intravenously or through injections. Depending on the combination of drugs, more than one method of delivery may be used.
Your treatment plan will most likely include chemotherapy drugs in combination with drugs that will help minimize side effects and help you to complete your chemotherapy on schedule.
Cycles and schedules
Chemotherapy and biologics can be administered alone or in combination, generally over a period of 3 to 6 months. Your treatment will most likely include 4 to 8 cycles.
A cycle refers to the time when your treatment is administered and the rest period that follows. For example, if your cycles are 2 weeks long, you may receive treatment on days 1 and 2, then no treatment will be given on days 3 through 14. The next cycle would begin on day 15.
Keeping to the schedule is important, as the timing is carefully planned to achieve the best results. There are two main reasons for the schedule of cycles:
- The chemotherapy can kill more cancer cells when it is given in cycles. Chemotherapy is most effective at attacking cancer cells as they divide. At any given time some cells are resting and will not be destroyed by the chemo, but chances are good that they will be destroyed during one of the following cycles when they are active. Your oncologist will determine the number and length of cycles needed based on the rate of growth seen in the cancer cells in your body.
- The rest period between cycles allows your body time to recover from the side effects of chemotherapy and biologics. Normal cells repair themselves faster than cancer cells, so the chemotherapy and biologics can effectively wipe out the cancer cells without causing long-lasting damage to normal cells.
If your treatment includes intravenous (IV) delivery, your doctor may recommend using an implanted vascular access device (VAD). The device is essentially a catheter placed in a large vein near the heart; it is where the IV will be inserted. It can remain in place for several weeks, which helps prevent wear and tear on a smaller vein from repeatedly inserting an IV. If used, the VAD will remain in place through the course of your treatment, and it will be removed when treatment is complete.
Depending on the treatment prescribed, it can take a relatively short amount of time for individual chemotherapy drugs or biologics to be delivered through your IV, or it can take several hours on a slow IV drip.
Many patients are apprehensive about starting chemotherapy or biologics because they are afraid of the side effects, most notably extreme nausea and hair loss. While it is normal and expected for patients to experience moderate side effects, the good news is that the side effects are often not as severe as patients expect. Chemotherapy and biologics and the management of their side effects have come a long way, and some patients even get through treatment with no side effects at all.
At the Comprehensive Cancer Center, helping you manage side effects is a priority. Your care team will work closely with you to monitor the side effects you experience during the course of your treatment, and they will help you find ways to manage side effects, from adjusting medications to complementary therapies.
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