Chemotherapy (chemo) is the use of certain types of medicines to treat cancer. Chemo medications are usually given by mouth or an injection into the blood stream. Sometimes chemo is the only treatment required but it may be used with surgery or radiation therapy, or with both.

There are more than 100 chemotherapy medications and although a single chemo medication can be used to treat cancer, they generally work better when used in certain combinations.

Depending on the type of cancer and its stage of development, chemo can be used to :

• Shrink the tumour prior to surgery or radiation
• Get the cancer into remission
• Prevent the cancer form spreading
• Slow the growth of the cancer
• Kill cancer cells that may have spread to other parts of the body
• Improve your quality of life or relieve the symptoms which may be caused by the cancer

Depending on the medicine used and the type of cancer, you may receive your chemotherapy via one or more of the following methods:

• Intravenous (IV) – The medicine is injected through a needle or catheter directly into the vein. This can be done as:
• An IV Push – Through a syringe over a few minutes.
• An IV Infusion – From a plastic bag over 30 minutes to a few hours.
• Continuous IV Infusions – Sometimes lasting 1 to 7 days
• Through a Central Venous Catheter (CVC) which is surgically placed in the chest or upper arm to give access to a large vein.
• Orally – by mouth. The patient swallows medicine in a pill, liquid or capsule form
• Intracavitary – Via a catheter into the abdominal or chest cavity.
• Intrathecal (IT) – The medicine is injected into the fluid surrounding the spinal cord
• Intra-arterial – The medicine is injected directly into an artery to treat a specific area ie arm or leg.
• Intramuscular (IM) – Medication is injected into the muscle.
• Intralesional- Injected directly into a tumour in or under the skin, or into an internal organ.
• Topical – The medicine is applied to an area of cancer on the skin.

When one has a lack of appetite there is nothing worse than being presented with a large meal. Small frequent meals are far more palatable. 

Some of the chemos used are platinum based, we usually inform the patients of this. We then a suggest that they eat with plastic utensils or their hands as metal utensils set off an unpleasant metallic taste. To combat this “taste” we recommend taking aniseed drops. 

If you experience the following symptoms, please contact your doctor or nurse immediately:

• Fever
• Bleeding or unexplained bruising
• A rash or allergic reaction ie swelling, severe itching, or wheezing
• Intense chills
• Shortness of breath
• Prolonged diarrhoea or vomiting
• Blood in your urine or stool
• Severe abdominal pain
• Intense headaches
• Pain at the ‘chemo” injection site or catheter site
• Inability to pass urine for more than 12 hours

Anti-nausea medication has come a long way. We administer intravenously both an anti-nausea drug as well as a steroid which act on the vomit centre in the brain reducing vomiting. This medication lasts for approximately 3 days. 

We also give the patients anti-nausea medication to take home with them. Do not wait until you feel nauseous rather take the tablets at regular intervals. 

One of the main reasons for nausea is an empty stomach so we advise patients to snack on small frequent meals throughout the day. Ginger biscuits in between meals also assist. In the first 24 hours after chemo, we recommend an increase in fluid intake as this assists in flushing the excess chemo from the system. 

Unfortunately, regular use of anti-nausea medication does cause constipation so one may need to seek medical care to assist with this. 

Unfortunately, hair loss does occur whilst undergoing chemo as chemotherapy attacks the fast growing cells which are those that divide and multiply quickly i.e. The cancer cells, hair cells, skin cells as well as the lining of the mucous membranes of the throat and stomach.  

On the positive side if this is happening imagine how the chemo is killing the cancer cells! 

Hair loss occurs with some, but not all, chemotherapy drugs. The amount of hair loss varies from a slight thinning to complete baldness and affects the scalp, eyelashes and eyebrows, legs, armpits, and pubic area. 

Hair loss will typically begin two or three weeks after your first treatment. The amount of hair that you lose will depend on the type of chemotherapy drug you are taking. Hair typically begins to grow back approximately 2-3 weeks after treatment is finished. The hair may grow back differently than it was before treatment. For example the colour or texture (curly or straight) may be different.  

Remember that hair loss associated with chemotherapy is temporary and the hair WILL grow back. In the meantime, here are a few tips to help you cope with the loss: 

• You may wish to cut your hair before it starts falling out. The experience of losing the hair is sometimes worse than dealing with it once it’s gone. If you expect to lose all or a lot of your hair, cutting it first may be easier to cope with. 
• Plan ahead; shop for a wig before your hair is gone, especially if you wish to match your natural colour.  Or, take this opportunity to try something different. 
• Try hats or head scarves; these are good alternatives or a compliment to a wig. 
• Remember to cover your head or use sunscreen on your scalp. Skin that has been covered with hair may be particularly sensitive to UV rays of the sun. 

Ask your medical aid if they cover the cost of the wig. 

We recommend natural products such as Henna as the new hair needs to be given a chance to flourish before being treated with harsh chemicals or hair dyes. 

On the upside, hair is much thicker than prior to chemo and the skin is a lot younger looking!