Chemotherapy is an established course of therapy to treat cancer and is employed in caring for half the patients who develop cancer. Drugs are used to kill the cancer cells outright, or stop their reproduction and spread by inhibiting metabolic functions of the cancer cell. This can also act on healthy cells. This is the basis for complications.

Chemotherapy is an individual treatment plan designed specifically for each patient. It consists of a particular drug or combination of drugs, administered usually by oral or intravenous route, at a precise dose based on your body weight, and given over a definitive time period. A circumscribed number of courses is scheduled and can be administered before or after any planned surgery or radiation. The drug combination chosen is determined by experience and the contemporary medical literature citing what drug(s) has been recognized as most effective. Sometimes experience with specific cancers is limited or current therapies ineffective, so experimental treatment is attempted. Millions undergo chemotherapy every year, and do well. Nevertheless, the anxiety related to the final prognosis and the fear of side effects causes heightened apprehension.

Side effects are unwanted complications of treatment, not related to the cancer. They vary in type and severity and depend on the drug(s) being used for treatment. In addition, the health status of the patient at the time of therapy can influence the degree of the side effect.

The most common difficulties involve low red and white blood counts and low platelet counts. These may lead to postponement of therapy due to bleeding and bruising or in the case of anemia, onset of fatigue and shortness of breath. Infection is more likely in face of low white cell counts. Nausea and vomiting are common and very distressing. There are drugs available to combat these problems but are not always totally effective. Hair and teeth loss can also occur. This is most commonly observed with leukemia, breast and ovary cancer therapy. Fatigue is commonly observed with patients sleeping most of the day and night. They feel totally drained and wasted. Taste can be altered so that meat or other foods become unpalatable. Foods may taste like metal, or have an unpleasant aftertaste. Weight loss due to the cancer itself may be augmented by the lack of eating.

Other lesser known dilemmas may occur. Some patients have anaphylactic-allergic reactions to the drugs after partially completing a course. A new drug must be found and substituted. Some agents cause specific neurologic damage to central and peripheral nerves. Frequently, hand and feet numbness can occur. One can’t hold a cup or dinner plate. Ataxia (walking like you are intoxicated) may materialize if nerves in the spinal cord are damaged. One does not know where the feet are when walking. Cold can affect the face and extremities causing pin prick like feelings that are extremely uncomfortable. “Chemo brain” is recently described by patients who lose their ability to concentrate and think. Other organ specific damage can be seen on the heart and lung. Pulmonary fibrosis with shortness of breath (interstitial lung disease) is a potentially fatal complication of the drugs used to treat GI cancer.

In the face of all this, many people are alarmed by chemotherapy. Some say afterwards that if they had known how bad it was going to be, they would have foregone therapy altogether. Perhaps it all depends on just how badly you want to survive.