Chemotherapy Cancer is a disease of the body's cells. Cells in all the tissues and organs of the body constantly grow and divide to swap old and damaged cells and maintain the health of the body. Normally, all cells divide and reproduce themselves in a systematic and controlled manner. In cancer, however, some cells keep dividing without proper control, forming a lump (which is called a tumor). In leukemia, too many white blood cells are formed. Chemotherapy is the use of anti-cancer (cytotoxic) drugs to destroy cancer cells (including leukemia's and lymphomas). There are over 50 different chemotherapy drugs and some are given on their own, but often numerous drugs may be combined (this is known as combination chemotherapy). The type of treatment one are given for ones cancer depends on many things, particularly the type of disease one have, where in the body it started, what the cancer cells look like under the microscope and how far they have spread, if at all. Cancer chemotherapy is not new. It has been helping people ever since the early 1950s. The chemotherapy drugs ones doctor suggests have been tested repeatedly. Careful research shows they work. Partly because of chemotherapy, many people with cancer live full and happy lives. (Holland, et al., 2000)

Side Effects of Chemotherapy

Different chemotherapy drugs root different side effects, and some people may have very few. Cancer treatments cause different reactions in different people and any reaction can diverge from treatment to treatment. It may be helpful to remember that almost all side effects are only short-term and will gradually disappear once the treatment has stopped. The main areas of ones body that may be affected by chemotherapy are those where normal cells swiftly divide and grow, such as the lining of ones mouth, the digestive system, ones skin, hair and bone marrow. (National Cancer Institute)

Short-Term Side Effects of Chemotherapy

Although chemotherapy is treatment a to kill cancer cells, it also can injure normal cells. Most likely to be damaged are normal cells that are rapidly dividing:

Blood cells

Cells of hair follicles

Cells in the reproductive and digestive tracts

Damage to these cells accounts for many of the side effects of chemotherapy drugs. Side effects are different for each chemotherapy drug, and they differ based on the dosage, the route the drug is given, and how the drug influence one individually.

Bone Marrow Suppression

The bone marrow is the tissue inside bones that produces white blood cells (WBCs), red blood cells (RBCs), and blood platelets. Damage to the blood cell-producing tissues of the bone marrow is called bone marrow suppression, or myelo suppression, and is one of the most common side effects of chemotherapy. As blood cells normally wear out, they are frequently replaced by the bone marrow. Following chemotherapy, as these cells wear out, they are not replaced as they would be normally do, and the blood cell levels will begin to drop. The type and dose of the chemotherapy will influence how low the blood cell continue to drop and how long it will take the reduce drop of cell counts. (Goodman, et al., 1997)

Hair Loss

Chemotherapy affects the rapidly growing cells of hair follicles. Ones hair may become brittle and break off at the surface of the scalp, or it may fall out from the hair follicle. Hair loss can be very individually. Some people may have complete loss of hair while others may see just a thinning of their hair. Loss of eyebrows, eyelashes, pubic hair, and body hair is usually less severe because the growth is less active in these hair follicles than in the scalp.

Appetite Loss and Weight Loss

Anorexia describes a decrease or complete loss of appetite. Most chemotherapy medications can cause some degree of anorexia. Anorexia may be mild, or it may direct to cachexia, a form of malnutrition. Loss of appetite, as well as weight loss, may result directly from effects of the cancer on the body's metabolism.

Taste Changes

Cancer treatments and the cancer itself can alter the food tastes. Taste changes can contribute to anorexia and malnutrition. With taste changes caused by chemotherapy, one may observe:

Either a dislike for or an increased desire for sweet foods

Dislike of foods with bitter tastes

Dislike for tomatoes and tomato products

Dislike for beef or pork

Constant metallic or medicinal taste in ones mouth

These changes occur because chemotherapy drugs can alter the taste receptor cells in ones mouth that are responsible for significance of what flavor one is tasting. Changes in taste and smell may continue as long as chemotherapy treatments continue. Several weeks after chemotherapy has ended, taste and smell feelings should return to normal.

Stomatitis and Esophagitis

Stomatitis refers to the inflammation and sores within ones mouth that may result from chemotherapy. Similar changes in the throat or the esophagus...

The term mucositis is used to submit to inflammation of the lining layer of the mouth, throat, and esophagus. The first signs of mouth sores occur when the lining of the mouth appears pale and dry. Later, the mouth, gums, and throat feel sore, become red, and inflamed. The tongue may be "coated" and swollen, leading to difficulty swallowing, eating, and talking.
Nausea and Vomiting

Although there are new medications to both prevent and treat nausea and vomiting, it is a likely side effect of chemotherapy. Chemotherapy agents cause nausea and vomiting for a variety of reasons. They irritate the lining of the stomach and duodenum (the first section of the small intestine). This stimulates certain nerves that direct to the vomiting center in the brain.

Constipation

Constipation is the passage (usually with discomfort) of infrequent, hard, dry stool. If one experience constipation, he may also experience excessive straining, bloating increased gas, cramping, or pain. Constipation affects 50% of people with cancer and 78% with advanced disease.

Diarrhea

Diarrhea is the passage of loose or watery stools 3 or more times a day with or without discomfort. Along with diarrhea, one may have gas, cramping, and bloating. Diarrhea occurs in 75% of people who receive chemotherapy because of the damage to the rapidly dividing cells in the digestive (gastrointestinal) tract. Diarrhea can be serious and become life threatening if dehydration, malnutrition, and electrolyte imbalances occur.

Fatigue

Fatigue is a common side effect of cancer and chemotherapy. With fatigue caused by chemotherapy, one may experience these feelings:

Weariness

Weakness

Lack of energy

Decreased ability for physical and mental work

Difficulty thinking

Forgetfulness

Inability to concentrate

Fatigue experienced by a person with cancer is different from the fatigue of everyday life. It is unrelated to activity and is not resolute with rest or sleep.

Heart Damage

Certain chemotherapy drugs can damage the heart. The most common ones are daunorubicin and doxorubicin (Adriamycin). This occurs in 10% of people who receive these drugs and usually involves changes to the heart muscles. With heart damage caused by chemotherapy, one may feel these symptoms: (Yasko, 1998)

Puffiness or swelling in the hands and feet

Short of breath

Dizziness

Erratic heartbeats

Dry cough

Nervous System Changes

Some chemotherapy drugs can cause direct or indirect transform in the central nervous system (brain and spinal cord), the cranial nerves, or peripheral nerves. The cranial nerves are connected directly to the brain, are important for movement, and touch sensation of the head, face, and neck. Cranial nerves are also vital for special senses of vision, hearing, taste, and smell. Peripheral nerves lead to and from the rest of the body and are important in movement, touch sensation, and regulating activities of some internal organs. Side effects that are the result of nerve damage source by chemotherapy can occur soon after chemotherapy or years later.

Lung Damage

It is likely for some chemotherapy drugs, such as bleomycin, to cause permanent damage to the lungs. The likelihood of this happening increased if one receives radiation to the chest in addition to chemotherapy. Age seems to be an important factor in the development of lung damage. For example, people over 70 years old have 3 times the risk of developing lung problems from the drug bleomycin. Lung damage may result in symptoms such as shortness of breath, a nonproductive (dry) cough, and possibly fever. If the chemotherapy drug is stopped, the lung tissue can regenerate. Because early lung changes may not show up on a chest x-ray, tests such as pulmonary function tests.

Reproduction and Sexuality

Reproductive and sexual problems can take place after one receives chemotherapy. Which, if any, reproductive problems develop depends on ones age when one are treated, the dose and duration of the chemotherapy, and the chemotherapy drug(s) that are given. Issues of reproduction and sexuality are imperative because they have implications for ones future.

Liver Damage

The liver is the organ that metabolizes, or breaks down, most of the chemotherapy drugs that enter the body. Unfortunately, some drugs can cause liver damage. Drugs that can cause liver damage include methotrexate, cytarabine (Ara-C), high-dose cisplatin, high-dose cyclophosphamide (Cytoxan), vincristine, vinblastine, and doxorubicin (Adriamycin). Most often, the liver damage is temporary and recovers a few weeks after the drug is discontinued.

Kidney and Urinary System Damage

Many of the breakdown products of chemotherapy drugs are excreted through the kidneys. These drug byproducts can…