What is the purpose of surgery followed by chemotherapy?
The purpose of the surgery is to remove as much disease
as possible. Surgeons refer to this as debulking. Optimal debulking
means there is no disease bigger than 1 cm left behind. Surgeons
will try to leave no visible disease, if possible. Chemo given
after the surgery is designed to kill any cancer cells that are
in circulation that surgery may have missed.
How is chemotherapy given?
Although most chemotherapy is given intravenously,
some drugs may be taken by mouth or put directly into the peritoneal
cavity. Your physician will determine which route is best for
your type of cancer. Many times, intravenous chemotherapy is given
through a temporary catheter or port placed in a patient's chest.
How does chemotherapy work?
Chemotherapy is treatment of cancer with strong chemicals.
It usually is systemic (involving the whole body) or can be targeted
to specific areas. The goal of the chemo is to get rid of any
cells that remain after surgery, shrink tumors before surgery,
destroy cells that have spread to other parts of the body or control
tumor growth.. Chemotherapy works by interfering with the growth
and reproductive process of cancer cells.
Chemo is designed to go after rapidly dividing cells.
Unfortunately, these drugs can also attack rapidly dividing normal
cells such as hair follicles and cells of the digestive and intestinal
track. As a result side effects can occur.
What side effects will I have?
It is hard to predict what side effects a patient
will have. Every person doesn't get every side effect and some
people get few. In addition the severity of the side effects varies
greatly from person to person.
Generally, the most common side effects are hair
loss, nausea and vomiting and fatigue. Medications can be given
before, during and after each treatment to minimize side effects
such as nausea, vomiting and diarrhea. Other side effects include
anemia , low white cell or low platelets. These conditions can
make you fatigued or put you at risk for infection and/or bleeding.
There are other side effects that are drug-related. Your doctor
or oncology nurse will describe these to you.
Although most of these side effects will resolve
once the treatment is over, occasionally chemo can cause permanent
Ask your doctor to walk you through the process and
explain the side effects. Remember if you have any side effects
report them to your doctor or oncology nurse. There are many new
drugs that can be given to help alleviate your symptoms.
Will I lose my hair?
Chemotherapy can cause hair loss all over the body.
For many women this can be very traumatic. How we see ourselves and
how we want others to see us is often linked to our hair color
and style. Hair loss can cause a wide range of emotions from
anger to grief.
Many woman create a ritual before undergoing chemo.
They invite close friends over and shave their heads. It makes
losing the hair for them more manageable as they feel they have
Consider a wig before treatment begins. Pick one
out that closely matches your hair color. For free wigs contact
the American Cancer Society in your community. Some insurance
companies will even pay for wigs as they may be considered a head
prosthesis. Check with your insurance company and if necessary
have your doctor write a prescription.
Other hair coverings include scarves, turbans and
hats. Because they come in many colors and shapes they can be
used to help you express your style. Look for them in department
How can I protect my body from infection?
Chemotherapy can reduce the number of white blood
cells making it easier for you to develop an infection. Your white
blood cell count will vary throughout treatment. When it is at
its lowest you will be more susceptible to infection.
Good hygiene is key. Wash your hands frequently with
warm, soapy water. Stay away from people who are sick. Cut your
nails carefully. Clean cuts or scrapes right away and use an antiseptic
ointment. Take a warm (not hot) bath or shower every day. Drink
plenty of fluids. Do not clean cat litter boxes or pet cages.
Wear protective gloves while gardening.
Call your doctor if you have any of the following
- Fever over 100
- Sore throat
- Redness, tenderness or swelling around a cut or IV site
- Coughing, shortness of breath
- Diarrhea, especially if it is bloody
- Burning pain when urinating
How often will I be given chemotherapy?
Chemotherapy agents can be given according to many
different schedules. Your doctor or oncology nurse will keep you
informed of the scheduling needs. Unfortunately, the need may
arise for unplanned appointments in the event of severe side effects.
Where will the chemotherapy be given and how long
will it take?
Most chemotherapy is given in the oncology outpatient
clinic, although a few regimens may require a short hospital
stay. Each regimen is different in length of infusion. Discuss
this with your doctor or oncology nurse for your specific regimen.