8 chemotherapy problems that cancer patients must know, this article summarizes them all! Favorites are recommended

As cancer patients, the vast majority are familiar with
chemotherapy.

Chemotherapy is currently one of the most effective means of treating cancer, and together with surgery and radiotherapy, it is called the three major treatment methods
for cancer.

However, for chemotherapy, cancer patients and their families inevitably have some questions, such as, can everyone use chemotherapy? Are the doses of chemotherapy all the same? Are chemotherapy side effects as big as possible? What should I do if there are side effects? How is the effect of chemotherapy assessed? .
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Today, Magnolia Ark has compiled some knowledge about chemotherapy, hoping to provide some help
to cancer patients and their families.

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1

Is chemotherapy suitable for everyone?

No, a thorough examination is required prior to chemotherapy to assess whether the patient is tolerated
.

I believe that many cancer patients and their families know that chemotherapy can kill tumor cells, delay recurrence, and prolong survival, but at the same time, it will be accompanied by many uncomfortable adverse reactions, such as nausea, vomiting, hair loss and so on
.
It can be temporarily uncomfortable, or it can leave long-term sequelae and even life-threatening
.

Therefore, doctors will do a lot of tests before starting chemotherapy, on the one hand, to confirm the diagnosis, and on the other hand, to assess whether the patient's physical condition can tolerate chemotherapy
.

For example, before using anthracyclines, cardiac function is evaluated by electrocardiogram, cardiac ultrasound, etc.
, renal function is focused on assessing before cisplatin, and lung function
is evaluated before using bleomycin.

Therefore, patients with cardiac dysfunction do not choose anthracycline anticancer drugs, patients with moderate to severe renal dysfunction should be cautiously selected cisplatin, and those with abnormal lung function should be cautiously selected with bleomycin
.

In addition, insufficient bone marrow reserve (low white blood cells, thrombocytopenia, etc.
), moderate to severe liver function abnormalities, general failure, severe infections, mental patients unable to cooperate, allergies are contraindications to chemotherapy
.
At the same time, if pregnancy is combined, chemotherapy should be considered depending on gestational age, the nature of the tumor, and the need for chemotherapy drugs
.

2

What is the role of preoperative and postoperative chemotherapy?

Preoperative chemotherapy, also known as neoadjuvant chemotherapy, aims to reduce the edema and adhesions between the tumor and surrounding tissues, create opportunities for surgery, improve the rate of complete surgical resection, reduce the risk of surgery, and reduce surgical complications
.

The goal of postoperative chemotherapy is to kill cancer cells
that remain from surgery more thoroughly.
As we all know, surgery is the main means of treating cancer, but tumor cells with a higher degree of malignancy are often good at invading farther places, and even metastasize to distant organs such as lungs, liver, bones, and brain, surgery may not be completely removed, in order to completely kill tumors and achieve cancer cure, systemic chemotherapy is extremely important
.

Depending on the timing of chemotherapy, the final effect will be different
.
However, whether to choose preoperative chemotherapy or postoperative chemotherapy also needs to be determined by professional and authoritative doctors according to the patient's condition, and the final choice of chemotherapy regimen is different
for different patients.

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3

Is the dose of chemotherapy the same for everyone?

No, the killing effect of chemotherapy drugs on tumor cells is positively correlated with
the size of its dose and exposure time.
If the dose intensity of chemotherapy drugs is insufficient, it will not only fail to kill tumor cells, reduce the uptake of chemotherapy drugs by tumor cells, but also increase the repair ability of damaged tumor cells and produce drug resistance, which will eventually lead to unsatisfactory
treatment effects.
Drug overdose can lead to significant adverse reactions and can even be life-threatening
.

Therefore, the dose of drugs used in chemotherapy is not the same for everyone, but is calculated based on factors such as an individual's
height and weight.

4

Are the same drugs and the same regimen given by different doctors?

Some patients will ask: Why is the same drug given differently in different hospitals and doctors?

The standard chemotherapy regimen for malignancy is the maximum tolerated dose (MTD) chemotherapy regimen
.

There is also a chemotherapy regimen: dose-intensive chemotherapy regimen
.
Dose-intensive chemotherapy regimens are chemotherapy regimens
that use MTD or smaller doses but have shorter intervals between administrations.

Because the growth process of human tumors in vivo conforms to the Gompertzian growth curve, the tumor initially grows rapidly in small size, then reaches a plateau and the rate of proliferation slows
.
Tumors that shrink in size after chemotherapy but are not completely killed proliferate faster
between chemotherapy.

Dose-intensive chemotherapy regimens may be more effective than increasing doses by shortening the interval between chemotherapy and more frequent toxic cell killing early in tumor growth, while the chance of developing resistance is reduced
because dose-intensive chemotherapy exposes tumor cells to cytotoxic drugs more frequently.

However, dose-intensive chemotherapy regimens are not necessarily beneficial to all patients, and in addition to different disease conditions, different regimens are suitable for tumors in different stages
.

Dose-intensive regimens disrupt the balance between efficacy and safety to some extent, and the trade-off between the two places higher demands
on clinicians.
This is one of
the reasons why different doctors can give different chemotherapy regimens.

5

Are chemotherapy side effects as big as possible?

There is no necessary link
between the adverse effects of chemotherapy and the efficacy of chemotherapy.

The severity of adverse effects of chemotherapy depends on the patient's constitution, ability to tolerate, and the drugs used
.

Some patients may be more sensitive to chemotherapy drugs, resulting in more serious
adverse effects of chemotherapy.
If the patient is not sensitive to chemotherapy drugs, adverse effects will be relatively rare
.

For example, the same car is driving on the road, but some people get motion sickness and vomit badly, and some people do not
react at all.
But it turns out that both men can reach their destination
by car.

The same is true for chemotherapy, where adverse effects vary from person to person
.
Don't worry that if there are no side effects, there is no therapeutic effect
.

In addition, although the side effects of chemotherapy are not as scary as cancer, in the long run, they wear down the patient's mental strength, affect their quality of life and survival, and the harm is actually great, so it is very important
to correctly understand the adverse reactions of chemotherapy and pay attention to the treatment of adverse reactions of chemotherapy.
Recommended reading: To chemotherapy, it is necessary to safely and smoothly chemotherapy - 9 common adverse reactions and treatment plans of chemotherapy

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6

Can I reduce or stop the dose during chemotherapy?

During chemotherapy, some patients can reduce the dose or even stop using the drug without authorization because they cannot tolerate serious adverse reactions or feel that their physical condition has improved
.

The attending physician formulates the medication plan
according to the patient's own situation.
Unauthorized dose reduction by patients will destroy the blood concentration, not reaching the peak of treatment, and the tumor may wait for the opportunity to "make a comeback", making the previous treatment fail
.

If serious adverse reactions occur during the medication, the doctor will adjust the dose or even change the drug after evaluation, but it is not appropriate for the patient to reduce or stop the drug
.

7

Why do I have to come to the hospital if I don't treat during chemotherapy?

Many patients have similar doubts, why do you have to come to the hospital when you don't take chemotherapy drugs, is the condition more serious or the treatment effect is not good?

In fact, the main purpose of visiting the hospital between chemotherapy is to assess the patient's tolerance to chemotherapy
.
Under normal circumstances, the doctor will check the blood routine, liver and kidney function, electrolytes, etc.
to see the effect of chemotherapy drugs on bone marrow hematopoiesis, liver and kidney function, and ask whether side reactions such as vomiting occur and their severity, so as to intervene and adjust the chemotherapy time and medication
in time.

At the same time, after every 2-3 courses, the effect of chemotherapy (symptoms and signs, tumor markers and imaging tumor changes), the degree of drug toxicity and side effects, in order to better determine the follow-up treatment plan
.

8

How is the effect of chemotherapy assessed?

In the process of chemotherapy, the correct evaluation of the treatment effect is a key issue
affecting survival and prognosis.
Therefore, patients are often required to do detailed blood tests and imaging tests before and after chemotherapy, in order to compare the tumor inhibition before
and after chemotherapy.

In addition, doctors will also use medical terms such as complete tumor remission (CR), partial tumor remission (PR), tumor stabilization (SD), tumor progression (PD) to summarize the volume change of tumor and summarize the treatment effect
during this period.

However, for patients who are not sensitive to drug treatment, it is not practical
to blindly emphasize the theoretical complete tumor remission (CR) and partial tumor remission (PR).
Some patients with advanced tumors can achieve "survival with tumors" and improve the quality of life through comprehensive treatment, which is no less effective and practical than the objective results
of complete tumor remission (CR) and partial tumor remission (PR).

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