The purpose of chemotherapy depends on the type, stage, and location of the tumor. But generally, chemotherapy is used to shrink or kill a tumor or any disease that is able to spread through the body. Another purpose of chemo is to stop the growth of the cancer cells for a period of time in order for the rest of the cancer to be removed through surgery. If the elimination of cancer can not be completed with the use of chemotherapy, then it could be used along with a different type of treatment for the destruction of the cancer cells throughout the body.
Sunday, 4 November 2012
How does chemotherapy work?
Chemotherapy
consists of a wide variety of drugs. These drugs are inserted into the body
using injections or pills which each have a specific function to help destroy
the cancer by stopping the growth of the cells. Because of the rapid pace that
cancer cells divide, they are most sensitive to these drugs and cannot fight
them off. Chemotherapy stops the reproduction of cancerous cells so that they
will decrease and should eventually eliminate the cancer.
The drugs could affect the functions of normal cells because some normal cells do divide a lot faster than other cells such as the skin cells, stomach, bladder, intestines. When normal cells are affected, side effects occur. Blood cells are the most affected cells from chemotherapy and since these cells fight infections, carry oxygen through the body, and assist in blood clotting, a decrease in these cells could cause anemia, neutropenia, thrombocytopenia, hair loss, and memory changes.
Anemia is a condition where the body has a shortage of healthy red blood cells. When having anemia, you should have blood transfusions to increase the amount of red blood cells. Neutropenia is where you have a decrease in white blood cells. White blood cells are needed to fight off bacteria and infections. Thrombocytopenia is a decrease in platelets, therefore patients should avoid any activities which could result in blood loss or internal bleeding. Hair loss occurs from the drugs having an effect on the fast growing cells in the hair roots. Memory loss is caused by the medications given, by stress, or other health problems. Patients using the process of chemotherapy must watch for different symptoms of these side effects for they could result in life-threatening issues.
The drugs could affect the functions of normal cells because some normal cells do divide a lot faster than other cells such as the skin cells, stomach, bladder, intestines. When normal cells are affected, side effects occur. Blood cells are the most affected cells from chemotherapy and since these cells fight infections, carry oxygen through the body, and assist in blood clotting, a decrease in these cells could cause anemia, neutropenia, thrombocytopenia, hair loss, and memory changes.
Anemia is a condition where the body has a shortage of healthy red blood cells. When having anemia, you should have blood transfusions to increase the amount of red blood cells. Neutropenia is where you have a decrease in white blood cells. White blood cells are needed to fight off bacteria and infections. Thrombocytopenia is a decrease in platelets, therefore patients should avoid any activities which could result in blood loss or internal bleeding. Hair loss occurs from the drugs having an effect on the fast growing cells in the hair roots. Memory loss is caused by the medications given, by stress, or other health problems. Patients using the process of chemotherapy must watch for different symptoms of these side effects for they could result in life-threatening issues.
Drugs used in Chemotherapy
The word chemotherapy is capable of being divided into two parts,
the word chemo being the prefix and therapy being the suffix. The word chemo
refers to chemicals, therefore chemotherapy means to treat a specific disease
using chemicals, in this case, cancer. Chemicals are used to stop the growth of
cancer cells within the body. The chemicals used could be put into four
different categories: alkylating agents, anti-metabolites, vinca alkaloids,
cytotoxic antibiotics. Alkylating agents are used to attack the DNA within the
cells. During the synthesis stage in mitosis, anti-metabolites would block the
growth of cells. During the metaphase stage in mitosis, the plant(vinca)
alkaloids help stop the formation of mitotic spindles which prevents the cell
from dividing. During the interphase stage, cytotoxic antibiotics help stop the
duplication of the DNA. The chemicals in these four categories all help assist
in stopping cell division.
Analysis of Scan
The
scan displays the brain of a 16 year old girl who contained a disease called
lymphoma. She was given a PET/CT scan for evaluation before beginning preparations
for chemotherapy. The PET/CT scan identified the extent of the patient’s disease. We interpreted that after the
chemotherapy treatment, a gross decrease in uptake in the tumor suggesting a
significant response to chemotherapy.
Chemotherapy
helps treat tumors such as lymphoma. This treatment is a drug that that
terminates tumor cells including lymphoma tumor cells. As chemotherapy
treatment is delivered (either in the form of oral medication, or injection)
the drug travels through the blood until it reaches its destination (tumor).
There it can act on the lymphoma tumor cell in a variety of ways.In CT scan
image precycle 1, the pleural thickness pre-treatment was 13.3 mm (B). In CT
scan image post cycle 2 of chemotherapy, the pleural thickness was 9.19 mm.
Analysis of Scan
Chemotherapy
is one of the most useful types of treatment for treating leukemia.
Oncologist's make patients ingest a drug to help treat leukemia by inserting it
through the mouth, through a catheter, by injection through a vein, cerebrospinal
fluid, or into the spine.
Ethical Issues
1) An ethical issue related to
chemotherapy is that there is a probability that it will do more damage
than the cancer would have done if it was left untreated. In other words, if
administering chemotherapy does not provide considerable benefit to increasing quality
of life and life span then there is a potential conflict of interest.
At what point should the oncologist step in and say we aren't going to treat this cancer with chemotherapy while still providing treatment in keeping with the wishes of the patient? This is a very debatable area and usually the oncologist will go ahead with the chemotherapy just to satisfy the patient and family even though the doctor knows better.
It is also a lot of money to give these unnecessary treatments if the patient will die in the end. We find the insurance company adjusters getting involved and pressuring the oncologists to try and save money by using the least expensive drugs and possibly not treating with the expensive but more effective chemotherapy agents. On the other side we have the drug makers advertising to the families that they have this great medicine available that MAY cure their loved one with advanced disease. It puts terrible pressure on the doctors.
2) Another ethical issue is when a cure is not realistic; there is no good evidence that shows us that chemotherapy is helpful. Therefore, the argument of whether chemotherapy treatment is necessary with all the given side effects for it and the very large chance of it not working as well would make doctors and patients hesitant.
3) A third ethical issue may be that the drugs might have been tested on animals which some patients would not be comfortable with.
4) Also, as with any treatment, whether the risks outweigh the benefits plays a huge role in chemotherapy. Some patients may take any chance of living a longer life and maybe less pain to slowing down the disease is worth the side effects. For others, when a cure is no longer achievable then further treatment is questioned. If the patient will not gain much from the treatment, is it ethical to put them through a harsh course of treatment which is going to be so painful to their body?
5) Another issue is with the
process of declining the treatment of chemotherapy as it would not be an easy
decision to make. There is some evidence to show that getting informed consent
puts more pressure on the patient and it does have an impact on the decision a
patient would make. It is easy to put a lot of pressure on a vulnerable patient
that is coping with the stress of everything they are going through when having
cancer.
This
is important as informed consent is a basic ethical principle behind any medical
or nursing involvement. As a result, it is thought that the following ethical
issue is possibly distressing and capable of seriously compromising the quality
of life for the patient.
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