Chemotherapy (chemo) is a treatment that involves the management of anti-cancer medications via a vein (IV) or by mouth. These medications pass through the circulation and reach almost every part of the body. On the other hand, many chemotherapy medications are unable to penetrate the brain and reach tumor cells.
Drugs may be injected directly into the cerebrospinal fluid (CSF), the fluid that bathes the brain and spinal cord, or into the spinal canal below the spinal cord for certain brain cancers. In addition, during a minor procedure, a thin tube known as a ventricular access catheter may be placed through a tiny hole in the skull and into a brain ventricle to assist with this.
When you have chemotherapy
Chemotherapy is often used to treat faster-growing brain tumors. Some brain cancers react better to chemotherapy than others, such as medulloblastoma and lymphoma. Chemotherapy is less often used to treat other cancers, such as spinal cord tumors since it is less effective.
Chemotherapy is often combined with other therapies, including surgery and/or radiation therapy. In addition, chemotherapy may sometimes be administered on its own, particularly for more advanced malignancies or tumors that have returned after prior treatments.
How chemotherapy is given
Chemotherapy treatment programs may include a single medicine or a mix of medications administered in many ways. Chemotherapy may take one or more of the following forms:
- Injection: The following are examples of injections:
- Subcutaneous (SQ): Chemotherapy is administered as an injection just under the skin.
- Intramuscular (IM): Chemotherapy is given as an injection into a muscle.
- Intravenous (IV): Chemotherapy administered as an injection straight into a vein
- IV infusion: Chemotherapy drugs are injected into a vein using a tube linked to a needle.
- Oral: Chemotherapy is a medication taken by mouth as a tablet or a liquid.
- Intra-arterial (IA): Chemotherapy is delivered via an artery linked to the tumor.
Types of chemotherapy
One of the main methods of classifying chemo drugs is the cell cycle. The cell cycle outlines the various stages and processes that cancer cells undergo to create new cells.
As far as the cell cycle is considered, there are chemotherapy drugs that work best when the cells are actively dividing. In contrast, other drugs better destroy cancer cells at specific stages of the cell cycle. Some drugs even affect cancer cells while they are in their resting stage.
Certain drugs are most effective when the cancer cells are actively dividing, but the cells do not have to be in a specific phase for them to work. Therefore, these drugs are classified as phase nonspecific drugs.
Phase-specific drugs are most effective when the cancer cells are in a given phase of the cell cycle.
Chemotherapy Drugs of Other Types
These medications function by causing cancer cells’ DNA to be damaged. As a result, they obstruct DNA replication and restrict it from being replicated. In addition, because cancer cells proliferate so fast, they will not have enough time to rectify the DNA mutations.
The following are some examples of medications that belong within this category:
- Busulfan is an alkylsulfonate compound
- Metal salts such as Cisplatin and Carboplatin
- Hexamethylmelamine is categorized as an ethylenimine.
- Hydrazines such as Dacarbazine, Temozolomide, and Altretamine
- Lomustine, for example, is a nitrosurea. Because nitrosureas may pass the blood-brain barrier, they effectively treat brain malignancies.
As the name implies, these medications function by masquerading as replacements in a human’s regular metabolic processes. They interfere with tumor cells by replacing normal metabolites. As a result, these medications have a stronger effect on cancer cells than normal cells.
Methotrexate, Foxuridine, Capecitabine, Fludarabine, Pentostatin, and 5-Fluoroouracil are examples of such medications.
These are constructed from natural components produced by Streptomyces, a species of soil fungus. They also stop cancer cells from multiplying. These are some examples of such drugs:
- Anthracycines such as Idarubicin and Doxorubicin are anthracycines
- Plicamycin falls under Chromomycin
These are plant-based pharmaceuticals. They kill cancer cells at every stage of their life cycle. Here are several examples:
- Paclitaxel and docetaxel are two examples of taxanes
- Irinotecan, for example, is a Camptothecan analog
- Vinca alkaloids such as vinblastine and vincristine
They’re also composed of natural materials. They prevent cancer cells from multiplying by interfering with cell division.
These medications stop cancer cells from expanding by inhibiting enzymes that are required for cell proliferation from reaching them.
Other medications that don’t fit into any of the other categories are included. They have a one-of-a-kind personality.
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How often do you have chemotherapy?
Chemotherapy is frequently given in cycles. This implies you’ll get the medications every few weeks for a few days. After that, there is a time when you are not receiving therapy, and you recover from the adverse effects. The frequency of therapy is determined by the medicine or drugs you are taking.
Possible side effects of chemotherapy
Chemotherapy has the following most common side effects:
- Diarrhea: Diarrhea must be addressed as soon as possible since it may rapidly progress to dehydration.
- Vomiting and nausea
- Sore throats and mouth: This usually occurs for a few days after therapy begins. Always keep an eye on the sores to ensure they don’t get infected.
- Pain: Chemotherapy may be very painful, particularly when nerves are damaged.
- Being exhausted: Chemotherapy causes a reduction in red blood cells, which causes fatigue. As a result, less oxygen enters your blood cells, making you more exhausted.
- Problems with sexuality: Chemotherapy might impact a person’s sexual performance.
- Loss of appetite
- Chemo brain, also known as mental fog, is a condition that impairs cognitive abilities such as focus and memory.
When you go home
Chemotherapy for a brain tumor may be a challenging experience. Any concerns or adverse effects should be reported to your doctor or nurse. If you have any issues at home, the nurse will provide you with phone numbers to contact.
Dr. Eshan Nerkar
Neurologist And NeurosuegeonDr. Eshan Nerkar, Consultant Brain & Spine Surgeon in Nashik specializes in Spine Surgery. He practices at AXON Brain & Spine Clinic. He is one of the best neurosurgeons in Nashik with more than 10 years of experience. He has performed more than 1000 surgeries related to brain and spinal surgery procedures.