Numerous medical advances have helped health care professionals manage, lessen, and prevent certain side effects of cancer treatments. But parents whose kids need chemotherapy — one of the most common treatments for childhood cancer — often have many questions and concerns about it.
Chemotherapy (often just called "chemo") refers to medications that kill actively dividing cells. Unlike healthy cells, cancer cells reproduce continuously because they don't respond to the normal signals that control cell growth. Chemotherapy works by disrupting cell division and killing these actively dividing cancer cells. In contrast to radiation therapy, which destroys the cancerous cells of a tumor in a specific area of the body, chemotherapy works to treat cancer throughout the body.
If your child has been diagnosed with cancer, doctors will likely develop a customized treatment plan that takes into account your child's age, the type of cancer, and where it's located. A pediatric oncologist (a doctor who specializes in the treatment of childhood cancer) will work with other health care professionals to determine the chemotherapy regimen that's best for your child.
How Chemotherapy Is Given
Just as other medicines can be taken in various forms, there are several ways to get chemotherapy. In most cases, it's given intravenously into a vein, also referred to as an IV. An IV is a tiny tube inserted into a vein through the skin, usually in the arm. The IV is attached to a bag that holds the medicine. The chemo medicine flows from the bag into the vein, which puts the medicine into the bloodstream. Once the medicine is in the blood, it can travel through the body and attack cancer cells.
Sometimes, a permanent IV called a catheter is placed under the skin into a larger blood vessel of the upper chest. That way, a child can get chemotherapy and other medicines through the catheter without having to always use a vein in the arm. The catheter remains under the skin until all the cancer treatment is completed. It can also be used to obtain blood samples and for other treatments, such as blood transfusions, without repeated needle sticks.
Chemo also can be:
- taken as a pill, capsule, or liquid that is swallowed
- given by injection into a muscle or the skin
- injected into spinal fluid through a needle inserted into a fluid-filled space in the lower spine (below the spinal cord)
Chemotherapy is sometimes used along with other cancer treatments, such as radiation therapy, surgery, or biological therapy (the use of substances to boost the body's immune system while fighting cancer).
Lots of kids and teens receive combination therapy, which is the use of two or more cancer-fighting drugs. In many cases, combination therapy lessens the chance that a child's cancer will become resistant to one type of drug — and improves the chances that the cancer will be cured.
When and Where Chemotherapy Is Given
Depending on the method used to administer chemotherapy, it may be given at a hospital, cancer treatment center, doctor's office, or at home. Many kids receive chemotherapy on an outpatient basis at a clinic or hospital. Others may need to be hospitalized to monitor or treat side effects.
Kids may receive chemotherapy every day, every week, or every month. Doctors sometimes use the term "cycles" to describe a child's chemotherapy because the treatment periods are interspersed with periods of rest so the child can recover and regain strength.
Common Side Effects of Chemotherapy
Although chemo often effectively damages or eliminates cancer cells, it also can damage normal, healthy cells. And this can lead to some uncomfortable side effects. Chemotherapy side effects are different for each child. The type of anticancer drug used, the dosage, and a child's general health affect the risk of developing unpleasant side effects. The good news is that most side effects are temporary — as the body's normal cells recover, the side effects gradually go away.
Cancer treatment is multifaceted — that is, patients receive a lot of care (i.e., fluid and nutrition support, transfusion support, physical therapy, and medicines) to help them tolerate the treatments and treat or prevent side effects such as nausea and vomiting. It's difficult to pinpoint which side effects a child might experience, how long they'll last, and when they'll end. Talk to your doctor if your child has side effects about how to cope with them.
Fatigue is the most common side effect of chemotherapy. Kids may need to reduce or eliminate all but the most essential activities during chemo, and may feel very tired even after sleeping and resting. Fatigue may last for days, weeks, or months, but it does go away once treatment is over. Encourage your child to rest and sleep as often as possible — even if it doesn't immediately result in more energy — because rest helps the body recover from chemo. Short naps or breaks from activity may be more beneficial than longer ones.