What is chemotherapy?

Chemotherapy, or chemical drug therapy, is a common medical treatment for diseases^[1].

Chemical drugs are administered to patients orally, by injection, or through infusion, entering the bloodstream to provide systemic treatment^[1].

What are the types of chemotherapy?

Based on the relationship with surgery^[1]:

• Adjuvant chemotherapy: Administered after surgery to eliminate residual microscopic metastases and reduce recurrence rates.
• Neoadjuvant chemotherapy: Administered before surgery to reduce tumor size and volume, increase surgical resection rates, and prevent distant metastasis.

Based on administration routes^[1]:

• Intravenous chemotherapy: Drugs are delivered via intravenous drip.
• Arterial interventional therapy: Drugs are injected into the tumor through its blood supply artery.
• Oral chemotherapy: Treatment involves taking chemotherapy drugs orally.
• Intracavitary chemotherapy: Drugs are injected into body cavities such as the pleural, peritoneal, or pericardial spaces.
• Topical chemotherapy: Drugs are applied directly to the tumor site, commonly used for skin cancer.

Based on treatment goals^[1]:

• Curative therapy: Aims to cure, often involving combination chemotherapy or combined with radiotherapy and immunotherapy.
• Palliative therapy: Aims to control symptoms and prolong survival, usually involving single-drug or low-intensity combination chemotherapy.

What diseases are commonly treated with chemotherapy?

• Malignant tumors: Osteosarcoma, leukemia, lung cancer, gastric cancer, liver cancer, esophageal cancer, and other common malignancies.
• Tuberculosis: Pulmonary tuberculosis, intestinal tuberculosis.

What are the common chemotherapy regimens?

Regimens vary depending on the disease.

1. Malignant tumors: Different cancers have different regimens, typically with 21–28-day cycles. Common combinations include paclitaxel + platinum-based drugs or gemcitabine + platinum-based drugs.
   • Curative therapy: Uses multiple chemotherapy drugs, sometimes combined with radiotherapy or immunotherapy^[1].
   • Palliative therapy: Uses single-drug chemotherapy to control symptoms and extend survival^[1].
2. Tuberculosis: Standard regimens for pulmonary or intestinal tuberculosis include isoniazid, rifampin, and pyrazinamide. Local disease control centers provide 6–8 months of free anti-tuberculosis drugs^[2].

What are the goals of chemotherapy?

Malignant tumors: Improve 5-year survival rates, reduce recurrence, alleviate symptoms, and enhance quality of life^[1].

Tuberculosis: Achieve disease control through early, regular, full-course, combined, and appropriate treatment^[2].

What are the side effects of chemotherapy?

Malignant tumors
Acute and subacute reactions: Occur during or shortly after treatment, including nausea, vomiting, allergies, diarrhea, hair loss, and bone marrow suppression (pale skin, fatigue, palpitations).

Long-term effects: Include neurotoxicity (numbness in extremities), interstitial pneumonia (difficulty breathing, cough, fever), and secondary cancers.

Common side effects are hair loss, nausea/vomiting, loss of appetite, constipation, pain, and decreased blood cell counts^[1].
Seek medical attention if vomiting affects eating/sleeping, dizziness, bruising, or nosebleeds occur.

Track side effect duration, vomiting/bleeding/diarrhea volume for doctor evaluation. Most side effects are manageable.

Tuberculosis
Common side effects include peripheral neuritis (e.g., hand numbness), liver toxicity (e.g., jaundice), gastrointestinal issues (e.g., nausea/vomiting), and ototoxicity (e.g., tinnitus, hearing loss)^[1].

Report these to your doctor for adjustments.

How to prevent or manage side effects?

• Hair loss: Avoid scratching the scalp; consider shorter hair.
• Nausea/vomiting: Stay relaxed, rest, take antiemetics as prescribed. Eat light meals (e.g., broth, egg custard) and avoid alcohol.
• Low blood cells: For low white blood cells, take prescribed boosters. For anemia, consume iron-rich foods like organ meats, spinach, grapes, eggs, and almonds^[3].
• Constipation: Eat fresh fruits and vegetables^[3].
• Loss of appetite: Try hawthorn or preserved plums before meals^[3].
• Pain: Mild-to-moderate pain may be treated with acetaminophen/codeine or tramadol. Severe pain may require morphine (under medical supervision)^[4].