FAQs
- November 24, 2020
- 0
Questions to Ask
About Chemotherapy
This section enlists various questions which may be helpful to ask your cancer care team so you can get as much information as possible.
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Before choosing chemo as a treatment option, you should learn as much as you can about your treatment, and get an idea of the expected outcome. You should understand the expected benefits, side effects, and risks.
Which chemo drugs will I be given?
The administration of chemo drugs depends upon various factors. There is a certain protocol for each cancer type which is based on the following –
1.Types of cancer
2.Stage of cancer
3.Response rate and patient’s health
Response rate
Your doctor will decide the chemo drugs by considering the response rate of a certain cancer type and the cancer stage on the drugs. The response rate depends upon the research done on cancer patients. Doctors choose the chemo drugs that have the highest response rate with a long duration of success.
Patient’s health
Patients who are old, weak, or suffering from other medical conditions are not able to tolerate certain chemo drugs. The doctor calculates the risks and benefits of certain drugs before deciding the line of treatment.
Thus, based on protocols, your doctor will decide which chemo drugs you will be given.
How will the drugs be given to me?
Chemo drugs administered through intramuscular injections
Chemo drugs are given through a large needle that penetrates deep into the muscle layers. Through this process, chemo drugs are delivered to the muscle tissues
Chemo drugs administered through intravenous
This is the most common method of giving chemo drugs. The drugs are administered by puncturing the vein as a result the medication easily reaches the body parts via the bloodstream
Chemo drugs administered intrathecally
Intrathecal chemo drugs are administered when the drugs need to reach the fluids in the brain and spinal cord.
Chemo drugs through intraperitoneal
The drugs are injected into the abdominal cavity through the catheter.
Chemo drugs through intra-arterial
The drugs are given through the arteries that supply blood to the tumor.
Chemo drugs administered topically
The drug is applied directly to the skin. It is used in skin cancers.
Chemo drugs administered through intra-vesicular
Chemo medicines are given through a catheter into the bladder.
Chemo drugs through intrapleural
The drug is given through a chest tube in the space between the lungs and the lung membrane.
Chemo drugs administered by implanting
Medicine is left in the cavity removing the tumor from the brain.Chemotherapy drugs can be given by your doctor in various ways mentioned below.
Chemo drugs administered orally
These are the drugs that you can swallow. It can be in the form of pills, capsules, liquid, or tablets. Oral chemo drugs are either absorbed by the stomach or by keeping under the tongue. The drugs that are absorbed under the tongue are sub-lingual chemo drugs.
Chemo drugs administered through subcutaneous injection
The chemo drugs are administered through a short needle that is injected between the skin
How often will I need to get chemo?
How often you will need chemotherapy depends on
- The type of cancer and its stage
- If chemo is used to cure cancer or control growth or manage the symptoms
- Type of chemo you may receive
- Your body’s response to chemo
Chemotherapy drugs are usually given in cycles which may be daily, weekly, or monthly. Chemotherapy is usually administered in fixed cycles with rest between the cycle. Your doctor may recommend chemotherapy in fixed intervals or for certain consecutive days or every day.
How long will my treatments last?
How long your chemo last depends upon the following factors-
- Stage of cancer
- The type of cancer
- The type of drugs
- Toxicity of the drug
- Time is taken to recover from the side effect of drugs given
Chemo drugs are usually given in cycles and may take 3-6 months. The treatment includes the use of one or more drugs. Your oncologist will plan a certain set of the chemo cycle.
How long the chemo treatment lasts depends majorly on the body’s response to the given chemo drugs. For example – with the first dose of chemo drugs if there is any abnormality in white blood cells or platelet count drops, the next chemotherapy may be delayed.
So, one must understand that the duration of your chemo drug is subject to variation
Chemotherapy is given in various forms. Depending upon the way of administration chemo can be given to an outpatient or patient. Chemo drugs can be administered in a hospital or a clinic.
Depending upon the chemotherapy regimen, your doctor will decide where you can get the chemo done. The places where you can get your chemo are –
At home
Certain chemo drugs that are administered orally can be taken at home. Patients having portable pumps can also take chemo at home.
Inpatient
In certain situations, the patient may have to stay in a hospital. Those who need constant monitoring especially in patients where the immune system is suppressed after the treatment, need to stay in the hospital.
Outpatient
Chemo can be given to outpatients in a clinic or a doctor’s office
What’s the goal of chemo for my cancer?
Chemotherapy is given in various forms. Depending upon the way of administration chemo can be given to an outpatient or patient. Chemo drugs can be administered in a hospital or a clinic.
Depending upon the chemotherapy regimen, your doctor will decide where you can get the chemo done. The places where you can get your chemo are –
At home
Certain chemo drugs that are administered orally can be taken at home. Patients having portable pumps can also take chemo at home.
Inpatient
In certain situations, the patient may have to stay in a hospital. Those who need constant monitoring especially in patients where the immune system is suppressed after the treatment, need to stay in the hospital.
Outpatient
Chemo can be given to outpatients in a clinic or a doctor’s office
What are the chances that the chemo will work?
Various factors decide the chances of chemo’s work. The success of chemotherapy depends upon the following factor –
1.Cancer survival rates – It is the percentage of people who survive after cancer is diagnosed. The rate indicates the effectiveness of certain chemo drugs.
2.Cancer grade – It is a measure of abnormality in the cells that appears under a microscope.
3.Cancer stage – It reflects how much the tumor has grown and to what extent it has spread.
4.Other factors – include the patient’s age, overall health, and other medical conditions.
One cannot determine the chances of how much will chemo work. As cancer patients usually receive chemo along with treatment such as surgery and radiotherapy. This makes it difficult to determine which therapy has worked for the patient.
Are there other ways to reach the same treatment goals?
When it comes to cancer treatment, chemotherapy is the word that strikes first. However, it may not always be the first course of treatment. Other treatments can help achieve the same treatment goal.
With the advancement in medicine and technology, other ways can reach the same goal as chemo.
For example – surgery, immunotherapy, targeted therapies, watchful waiting, and supportive care can be used to reach the same treatment goal. Your doctor will decide the ways to reach the same treatment goal depending upon the type of cancer.
How will I know if the chemo is working?
The working of chemo is measured in terms of how well the patient responds to the treatment. The response is measured in terms of certain words that indicate how chemo is working.
Your doctor may use the following words to indicate if chemo is working.
1.Partial response – It indicates that the tumor has decreased by a certain size but the disease persists.
2.Complete response – It indicates elimination of disease or disappearance of cancer.
3.Stable – It indicates that cancer has neither grown nor shrunk. There is no change in cancer disease.
4.Progression of the disease – It indicates the disease has progressed. Cancer has grown when compared to cancer before the treatment.
A certain test is done to help you and your doctor understand if chemo is working. Some of the tests are – blood tests, tumor markers, X-ray, CT scan, positron emission tomography (PET).
These tests measure the tumor and indicate if chemo is working
What will we do if this chemo doesn’t work?
Chemotherapy is not always successful. There are times when cancer may occur again after treatment. Chemo shows different results in different people.
If the first line of treatment does not work your doctor will suggest you the second line of treatment. You need to discuss all the possibilities of the treatment with your oncologist and other healthcare providers to make the best decisions.
At some point in time, patients may want to end the chemo. In such cases, the focus diverts from the treatment of cancer to managing the symptoms of cancer. You may opt for palliative care or hospice care.
What are the risks and side effects of the chemo I will be taking?
Chemotherapy causes various side effects which can be prevented and treated. The risk and side effects of chemo depend upon the type of chemotherapy you are taking.
Some of the common side effects are – tiredness, feeling sick, hair loss, infections, anemia, bruises and bleeding, sore mouth, loss of appetite, changes in skin and nails, memory problem, sleep issues, sexual problems, fertility issues, diarrhea, constipation, emotional issues.
How do these side effects compare with side effects of other treatments?
| Cancer treatment | Side effects |
| Radiation therapy | fatigue, skin problems, swelling, digestive problems and stiffness |
| Surgery | Pain, infection |
| Immunotherapy | Pain, swelling, soreness, redness, itchiness, rashes, flu like symptoms |
| Hormone therapy | In Men- hot flashes, nausea, loss of interest, weak bones, enlarged and tender breasts, diarrhea, etc In Women- hot flashes, vaginal dryness, loss of inters in sex, nausea, mood changes, fatigue, change in menstrual cycle, etc |
| Targeted therapy | diarrhea, liver problems, fatigue, high blood pressure, problem with blood clotting, loss of hair color, skin problems, etc |
| Stem cell transplant | mouth sore, risk of infection, anemia, risk of bleeding, diarrhea, fertility problem, tiredness, etc |
What can I do to get ready for treatment and decrease the chance of side effects?
You can prepare yourself for cancer treatment by taking small steps such as –
- Keep yourself aware of the treatment procedure and what you may expect out of the treatment. Take a second opinion if required.
- Plan what you need and what things need to be managed while you are in the recovery phase.
- Decide the place you want to stay at your home after the treatment.
- Make sure you eat healthy foods and exercise in your routine before you start the treatment. Stick to it as much as you can.
- Know all the side effects related to your cancer treatment.
- Talk to someone or connect with someone who has been through the same disease and treatment. This will benefit you by improving your perspective.
- Ask your healthcare provider about medicines for common side effects. Make a small kit and keep all the essentials you might require.
All these points will prepare you for the treatment and decrease the chances of side effects.
Can I take my other medicines, vitamins, and/or supplements while getting chemo?
Chemotherapy drugs are strong medicines, it is used to target cancer cells. If you are undergoing chemotherapy you need to take extra care while taking medicines, vitamins, and /or supplements. Normal medicines taken by non-cancer patients can cause a problem in cancer patients. It is important to discuss every detail with your doctor as certain medicines may interfere with chemotherapy.
Certain medicines can dangerously interact with chemo drugs. Hence, make a list of each and everything you are taking, even if it is a supplement or a vitamin or herbal supplements and over-the-counter medications. So, do not take any other medicines without approval from your doctor.
Will I need to change my diet in any way?
Yes, you need to change your diet during and after chemo. Some of the recommendations for the diet are –
1.Maintain a healthy BMI
Your healthcare provider will help you with the eating habits to maintain a healthy weight during and after the treatment.
2.Make sure you get all the essential nutrients from your diet
Essential nutrients are protein, fats, carbohydrates, and water. Your diet must be nutrient-dense and plant-based diet.
3.Remain active
Although you may feel tired and fatigued try to remain as much active as you can
Drinking alcohol may affect your treatment in various ways. Your doctor will advise you if you need to quit alcohol or consume it in moderation. Being honest with your doctor about the quantity of alcohol you consume will help you and your health team in better management of treatment and its side effects.
Will I need to change my activities? Exercise? Sexual activities?
Being physically active is necessary during cancer treatment. If you lead a sedentary lifestyle and you are diagnosed with cancer, it is time to change your activities.
Exercise
Your doctor will recommend you to engage in light exercise in routine. It is essential to remain active as much as you can. Even a little exercise in routine improves the physical and mental health during and after cancer treatment. As the type of exercise you do and your ability to perform such exercise depends upon certain factors. For example – if treatment affects bone health, one must avoid exercise. Consult your doctor before you start adopting any physical activity
Sexual activities
Chemo may affect the sexual activity in cancer patients. The side effects of cancer treatment such as stress, anxiety, fatigue, etc affect your sexual activity. There is no need to change your sexual activity as it will not spread to your partner neither it will affect your cancer. So, if you feel like having sex, it is safe to do so.
Will chemo affect my ability to have children?
Cancer itself may affect fertility but more than that cancer treatment is more likely to affect your fertility or your ability to have children. How severely chemo may affect your ability to have children depends on –
- The age of the patient and stage of cancer
- Type and severity of the surgery performed
- Type of treatment administered
- Dosage of treatment
You need to talk to your doctor and know how your treatment will affect your ability to have children
Will I be able to work while getting chemo?
Yes, you can work while getting chemo but you need to first figure out your treatment routine with your doctor and employer. This will help you manage the work schedule and will help your doctor design the medicines to be administered and the timing of side effects.
However, whether you will be able to work while getting chemo depends upon the type and stage of cancer, the treatment you are undergoing, side effects you may experience as a result of treatment, your overall health, and the nature of your job.
Will I also need surgery, radiation, or both? If so, when and why? What results can I expect?
Surgery is done in cancer patients to remove the tumor and nearby tissues. Radiation therapy is done to kill cancer cells. Depending upon the type of cancer your doctor will decide if you will have surgery alone or with radiation therapy. You may either have surgery or radiation or both. Usually, surgery and radiation accompany each other.
Radiation may be given before or after the surgery. Radiation is done before surgery to shrink the cancer size and after surgery to kill the remaining cancer cells. Cancer such as breast cancer involves the removal of the tumor by surgery followed by radiation therapy. Radiation kills the cancer cells in or near the breast. Your healthcare provider will suggest the treatment depending on cancer type and stage.
You can expect a positive result if your treatment involves surgery and radiation. With radiation therapy the risk of re-occurrence of cancer reduces
Chemo done after surgery or radiation lowers the risk of recurrence of cancer in the future. Chemotherapy kills the cancer cells that might have spread from the tumor before the surgery.
Yes, chemo can be alone without any surgery. Chemo alone is done in cancer types that are sensitive to chemotherapy. Example – blood cancer
After you are diagnosed with cancer, you and your family need to decide on the treatment. If treatment is not required urgently then take time to do some research and consult your near ones. Depending on the stage of cancer your doctor will inform you of the time you can take to decide when to start the treatment.
Usually, cancer patients start treatment within a month after diagnosis.
If it is primary cancer then you should not wait more than 2 months to start the treatment. However, the time may vary depending upon the type, stage, and treatment of cancer.
Can I take part in a clinical trial?
There are eligibility criteria, mentioned in the trial protocol to take part in a clinical trial. Common criteria to take part in clinical trial includes –
- Stage of cancer
- Received any previous treatment
- Age (must be above 18 years)
- Overall health status
- Other medical conditions
- Life expectancy (less than 3-6 months)
- Any genetic changes in your tumor
Your approval for clinical trial depends upon the above factors and other medical tests recommended by your healthcare provider. The result of the tests will decide if you can take part in a clinical trial or not.
How much will chemo cost? Will my health insurance cover it?
Your chemo cost includes clinical visits, lab tests, imaging tests, drug costs, hospital stays, surgery, etc. The cost of chemo depends upon –
- The type and stage of cancer you are suffering from
- It may differ from city to city
- Hospital where you are getting your treatment
- Sessions required for treatment
Various health insurance companies in the market will cover your chemo. With the surge in cancer cases, insurance companies have come with a higher cover. Your health insurance covers chemo or not depends upon the health insurance company you have opted for.
Are you and your team experienced in caring for patients who are getting this treatment?
Yes, we have the best healthcare professionals that specialize in various aspects of cancer care. We are equipped with specialists for each type of cancer treatment. Treatment options will be given and can be discussed with other health professionals.
We look after the physical and emotional side effects of cancer itself and cancer treatment. Our healthcare team is highly experienced and qualified for caring the cancer patients. Patients we are dealing with is the most important member of our healthcare team.
The second opinion is a medical process where the diagnosis and plan of treatment are reviewed by other oncologists. A second opinion helps to correct the cancer stage, make a better treatment plan and accurate prognosis.
We provide a platform to help you recommend the best doctors and hospitals for a second opinion. Some of the factors that contribute to our suggestion are your accessibility to the referred doctor, the type of cancer you are suffering from, etc. You can always reach us for any suggestion you need regarding a second opinion.
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