Cytotoxic chemotherapy is a widely used cancer treatment. It employs powerful drugs to eliminate cancer cells or inhibit their uncontrolled growth. Its primary objective is to reduce tumor size, destroy microscopic cancer cells that may have spread, or manage cancer symptoms to improve patient well-being. Chemotherapy remains a significant component of cancer care.
What is Cytotoxic Chemotherapy?
Cytotoxic chemotherapy targets and destroys rapidly dividing cells. Cancer cells are characterized by their uncontrolled, accelerated division, making them particularly susceptible. While effective against cancer, this mechanism also affects some healthy cells that naturally divide quickly.
These drugs are administered systemically, traveling through the bloodstream to reach cancer cells throughout the body. This allows chemotherapy to address the primary tumor and any cancer cells that may have spread, even those too small to be detected by imaging. Chemotherapy’s effectiveness depends on factors like tumor type, growth rate, and the proportion of cells actively dividing.
How Cytotoxic Chemotherapy Targets Cancer Cells
Cytotoxic chemotherapy drugs interfere with the cell division cycle, preventing cancer cells from multiplying. Some drugs damage cancer cell DNA, which can trigger programmed cell death (apoptosis).
Other chemotherapy drugs disrupt the synthesis of new DNA or RNA, necessary for cell growth and replication. By blocking these processes, drugs prevent cancer cells from creating the genetic material needed to divide. Another category of drugs targets the machinery involved in mitosis, the cell division process. These agents interfere with structures like microtubules, essential for separating chromosomes during cell division, halting the cancer cell’s ability to divide.
Common Side Effects and Their Management
Chemotherapy’s impact on rapidly dividing healthy cells leads to various side effects. Hair loss often occurs because hair follicle cells divide quickly. Nausea and vomiting are common, stemming from drugs affecting rapidly dividing cells lining the digestive tract. These can often be managed with anti-nausea medications prescribed before or during treatment.
Fatigue is another frequent side effect, which can be profound and affect daily activities. Chemotherapy can also suppress bone marrow activity, leading to reduced blood cell counts. This includes anemia (low red blood cells, causing fatigue), neutropenia (low white blood cells, increasing infection risk), and thrombocytopenia (low platelets, increasing bleeding risk). Growth factors can stimulate white blood cell production, and red blood cell transfusions may be given for severe anemia. Mouth sores (mucositis) result from drugs affecting rapidly dividing cells in the mouth and throat lining, and can be managed with rinses and pain relief.
Preparing for and Undergoing Treatment
Before starting chemotherapy, patients typically undergo preparatory steps to ensure safety and effectiveness. This often includes blood tests to assess overall health, organ function, and blood cell counts. In some cases, a central venous access device (e.g., port or PICC line) may be placed to provide a reliable way to administer medications and draw blood throughout treatment.
Chemotherapy can be administered through various methods, including intravenous (IV) infusion (drugs delivered directly into a vein) or orally (pills or liquids). Treatment is typically given in cycles, involving periods of medication followed by rest to allow the body to recover. The duration and frequency of these cycles vary depending on the specific drugs, cancer type, and patient response, but a typical cycle might last one to four weeks. Throughout treatment, regular monitoring, including blood tests and symptom reporting, tracks the body’s response and manages emerging side effects.