Chemotherapy and You: Self-Help Guide

by National Cancer Institute

Take Care of Yourself

How can you take care of yourself during chemotherapy? You can eat the right foods to build up your strength. Stay away from people who have colds or the flu. Get the rest you need and pace yourself. Talk about your feelings to deal with any sadness, anger, or fear you may have. Work as a team with your health care providers. Knowing how to help yourself can make you feel more in control. These are just a few of the ways that you can help yourself and begin to feel in control again.

This information is designed to help you become an informed partner in your care, but it is only a guide. Self-help can never take the place of professional health care. Ask your doctor and nurse any questions you may have about chemotherapy. Also don't hesitate to tell them about any side effects you may have. They want and need to know.

Understanding Chemotherapy

What Is Chemotherapy?

Chemotherapy is the treatment of cancer with drugs that can destroy cancer cells. These drugs often are called "anticancer" drugs.

How Does Chemotherapy Work?

Normal cells grow and die in a controlled way. When cancer occurs, cells in the body that are not normal keep dividing and forming more cells without control. Anticancer drugs destroy cancer cells by stopping them from growing or multiplying. Healthy cells can also be harmed, especially those that divide quickly. Harm to healthy cells is what causes side effects. These cells usually repair themselves after chemotherapy.

Because some drugs work better together than alone, two or more drugs are often given at the same time. This is called combination chemotherapy.

Other types of drugs may be used to treat your cancer. These may include certain drugs that can block the effect of your body's hormones. Or doctors may use biological therapy, which is treatment with substances that boost the body's own immune system against cancer. Your body usually makes these substances in small amounts to fight cancer and other diseases. These substances can be made in the laboratory and given to patients to destroy cancer cells or change the way the body reacts to a tumor. They may also help the body repair or make new cells destroyed by chemotherapy.

What Can Chemotherapy Do?

Depending on the type of cancer and how advanced it is, chemotherapy can be used for different goals:

To cure the cancer. Cancer is considered cured when the patient remains free of evidence of cancer cells.

To control the cancer. This is done by keeping the cancer from spreading; slowing the cancer's growth; and killing cancer cells that may have spread to other parts of the body from the original tumor.

To relieve symptoms that the cancer may cause. Relieving symptoms such as pain can help patients live more comfortably.

Is Chemotherapy Used With Other Treatments?

Sometimes chemotherapy is the only treatment a patient receives. More often, however, chemotherapy is used in addition to surgery, radiation therapy, and/or biological therapy to:

• Shrink a tumor before surgery or radiation therapy. This is called neo-adjuvant therapy.

• Help destroy any cancer cells that may remain after surgery and/or radiation therapy. This is called adjuvant chemotherapy.

• Make radiation therapy and biological therapy work better.

• Help destroy cancer if it recurs or has spread to other parts of the body from the original tumor.

Which Drugs Are Given?

Some chemotherapy drugs are used for many different types of cancer, while others might be used for just one or two types of cancer. Your doctor recommends a treatment plan based on:

• What kind of cancer you have.
• What part of the body the cancer is found.
• The effect of cancer on your normal body functions.
• Your general health.

What About Clinical Trials?

Clinical trials, also called cancer treatment studies or research studies, test new treatments in people with cancer. Clinical trials test many types of treatments such as new drugs, new approaches to surgery or radiation therapy, new combinations of treatments, or new methods such as gene therapy. The goal of this research is to find better ways to treat cancer and help cancer patients. There are different types of clinical trials, called Phase I, Phase II, and Phase III trials. Each is one of the final stages of a long and careful cancer research process. If your doctor does not suggest you take part in a clinical trial, you may want to ask about clinical trials as a treatment choice for you.

Possible benefits of clinical trials include:

• Clinical trials offer high-quality cancer care.
• If a new treatment approach is proven to work and you are taking it, you may be among the first to benefit.
• By looking at the pros and cons of clinical trials and other treatment choices, you are taking an active role in a decision that affects your life.
• You have the chance to help others and improve cancer treatment.

Possible drawbacks:

• New treatments under study are not always better than, or even as good as, standard treatment.
• Even if a new treatment has benefits, it may not work for you.
• In a study, if you are randomly assigned to have standard treatment instead of the new treatment being tested, it may not be as effective as the new approach.
• Health insurance and managed care providers do not always cover all patient care costs in a study.

Before deciding to join a clinical trial you will want to ask important questions such as: What are the possible short- and long-term risks, side effects, and benefits to me? How could the study affect my daily life? Will I have to pay for any treatment, tests, or other charges?

Questions to Ask Your Doctor

About Chemotherapy

• Why do I need chemotherapy?
• What are the benefits of chemotherapy?
• What are the risks of chemotherapy?
• Are there any other possible treatment methods for my type of cancer?
• What is the standard care for my type of cancer?
• Are there any clinical trials for my type of cancer?

About Your Treatment

• How many treatments will I be given?
• What drug or drugs will I be taking?
• How will the drugs be given?
• Where will I get my treatment?
• How long will each treatment last?

About Side Effects

• What are the possible side effects of the chemotherapy? When are side effects likely to occur?
• What side effects are more likely to be related to my type of cancer?
• Are there any side effects that I should report right away?
• What can I do to relieve the side effects?

About Contacting Medical Staff

How do I contact a health professional after hours, and when should I call?

Hints for Talking with Your Doctor

These tips might help you keep track of the information you learn during visits with your doctor:

• Bring a friend or family member to sit with you while you talk with your doctor. This person can help you understand what your doctor says during your visit and help refresh your memory afterward.

• Ask your doctor for printed information that is available on your cancer and treatment.

• You, or the person who goes with you, may want to take notes during your appointment.

• Ask your doctor to slow down when you need more time to write.

• You may want to ask if you can use a tape recorder during your visit. Take notes from the tape after the visit is finished. That way, you can review your conversation later as many times as you wish.

About the Author

www.nci.nih.gov
The National Cancer Institute's research programs are extensive and contain many innovative initiatives. I invite you to explore our Web site to find out more about the exciting work being conducted here at NCI and by NCI-supported scientists throughout the country.