Starting Chemotherapy: Questions for Your Doctor
Published July 2, 2012
You hear the same scenario again and again: Once a person learns of his or her cancer diagnosis, he or she focuses solely on that word and nothing else. For many people, cancer ranks high among their worst fears. Despite the recent medical advances made to detect and treat it, the disease — let alone the myriad treatments available to rid your body of its abnormal cells — is little understood. The fact is that physicians today have more tools in their arsenal to fight and eliminate cancer than ever before: there are new methods of detection and screening, new tests to determine your specific cancer type (and how existing drugs may work to treat it), and dozens of new "personalized" medications and chemotherapies, some of which target only cancer cells while leaving healthy cells unharmed.
More important, you must first understand that your cancer treatment plan, whether it includes surgery, chemotherapy, and/or radiation, depends on many factors. Those include your age, overall health, the type of cancer you have, and if it has metastasized (spread) beyond the initial tumor site. The goal of any treatment is to rid the body of cancer, but if that is not possible, chemotherapy and other treatments may be used to control the disease to extend life.
Types of Chemotherapy
Doctors have terminology that describes the intended use of your chemotherapy; for instance, adjuvant chemotherapies are used to remove any unwanted cancer cells that may exist in the body after a surgical procedure removes the initial tumor or mass. Neo-adjuvant chemotherapy is treatment given prior to surgery or radiation, usually to shrink a large tumor. In cases where the cancer to too widespread to be operable, palliative chemotherapy may be given to decrease pain and discomfort and keep the cancer from spreading further. Other chemotherapy drugs called cytotoxic chemotherapies, can target specific types of cancer by interfering with how abnormal cancer cells multiply and communicate. Unlike traditional chemotherapy drugs, cytotoxic chemotherapy doesn't destroy healthy cells because it has far fewer side effects.
According to Dr. Matthew M. Cooney, oncologist at the University of Ohio Seidman Cancer Center, even people with advanced forms of cancer can now be treated. "People today are living longer than ever before, even with advanced cancer, though they may not necessarily be completely cured of cancer. For example, a woman with breast cancer can undergo multiple traditional and cytotoxic chemotherapy treatments over time, and she might live longer than she did five or ten years ago, but the cancer isn't cured outright."
In addition, your cancer treatment is likely to change as your disease changes. People often have the misconception that chemotherapy represents one type of cancer-killing medication when in fact there are dozens of chemotherapy drugs and hundreds of drug combinations that may be tailored to meet your specific needs. Oncologists will very often change drugs or doses throughout the course of your therapy to protect your body from harmful side effects or help support your immune system.
Your Cancer Treatment Plan
After your initial diagnosis, you will likely sit down with an oncologist to discuss your treatment options. There will likely be many choices to think about and you might feel overwhelmed or confused. It is helpful to have a family member or friend with you to listen to details, ask questions, and take notes about various treatments. You may also want to get a second opinion about your diagnosis and which treatments will offer the best outcomes.
At this stage, you want to fully understand each treatment option and its intended goal. If chemotherapy is part of your treatment plan, ask the following questions:
- What type of chemotherapy is useful in this scenario?
- What chances are that this type of chemotherapy will work?
- What immediate side effects can I expect from my chemotherapy treatments?
- Are there long-term side effects associated with this treatment?
- How many cycles of chemotherapy will I need? (A cycle is a period of time of chemo treatment and recovery before a new dose is given.)
- How will the chemotherapy be administered and by whom?
- What are the risks associated with this treatment?
- How will chemotherapy affect my ability to work or perform daily tasks?
- Are there alternative treatments, and if so, what are they?
- How do I prepare for my chemotherapy?
- Will I need to take any precautions during treatment?
- How will I know that the chemotherapy is working?
- Will I need other treatments besides chemotherapy?
- If my chemotherapy treatment doesn't meet or exceed its goal, what other treatments are available?
Remember, chemotherapy is often just one aspect of your cancer treatment. It is also extremely common to undergo multiple cycles of treatment in order to fully eliminate cancer cells and be in complete remission.
- National Institute of Health staff writers. (2012). New Personalized Drugs Show Promise Against Melanoma, Lung Cancer. Medline Plus. http://www.nlm.nih.gov/medlineplus/news/fullstory_125877.html
- The American Cancer Society. (2012). Chemotherapy Principles: An In-Depth Discussion. http://www.cancer.org/Treatment/TreatmentsandSideEffects/TreatmentTypes/Chemotherapy/ChemotherapyPrinciplesAnIn-depthDiscussionoftheTechniquesanditsRoleinTreatment/chemotherapy-principles-how-does-chemo-work
- Dr. Cooney, Matthew M., Medical Director, Ambulatory-Based Programs, University of Ohio Seidman Cancer Center, Cleveland, Ohio. Personal interview. 7 June 2012.
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