Chemotherapy Indications

Chemotherapy is used to kill cancer cells in people with cancer.

There are a variety of settings in which chemotherapy may be used in people with cancer:

  • To cure the cancer without other treatments. Chemotherapy can be used as the primary or sole treatment for cancer.
  • After other treatments, to kill hidden cancer cells. Chemotherapy can be used after other treatments, such as surgery, to kill any cancer cells that might remain in the body. Doctors call this adjuvant therapy.
  • To prepare the patient for other treatments. Chemotherapy can be used to shrink a tumor so that other treatments, such as radiation and surgery, are possible. Doctors call this neoadjuvant therapy.
  • To ease signs and symptoms. Chemotherapy may help relieve signs and symptoms of cancer by killing some of the cancer cells. Doctors call this palliative chemotherapy.

Chemotherapy for conditions other than cancer

Some chemotherapy drugs have proved useful in treating other conditions, such as:

  • Bone marrow diseases. Diseases that affect the bone marrow and blood cells may be treated with a bone marrow transplant, also known as a stem cell transplant. Chemotherapy is often used to prepare for a bone marrow transplant.
  • Immune system disorders. Lower doses of chemotherapy drugs can help control an overactive immune system in certain diseases, such as lupus and rheumatoid arthritis.


Chemotherapy can produce adverse effects that range from mild to severe, depending on the type and extent of the treatment. Some people may experience few to no adverse effects. A wide range of adverse effects can occur, including:

  • Nausea and vomiting- Nausea and vomiting are typical side effects. Doctors may prescribe antiemetic drugs to help reduce the symptoms.
  • Hair, nails, and skin
    • Some people may experience hair loss, or their hair may become thin or brittle a few weeks after starting some types of chemotherapy. It can affect any part of the body.
    • Wearing a special cap can keep the scalp cool during chemotherapy treatment, which may help prevent or reduce hair loss. However, if the treatment needs to reach the scalp, this will not be possible.
    • Most people find that their hair grows back once they have finished treatment. Nails, too, can become flaky and brittle.
    • The skin may become dry and sore and oversensitive to sunlight. People should take care in direct sunlight, including:
      • avoiding the sun around midday
      • using sunblock
      • wearing clothes that provide maximum protection
  • Fatigue- Some people may experience fatigue. They may experience this most of the time or only after certain activities.
  • Hearing impairment- The toxins in some types of chemotherapy can affect the nervous system, leading to:
    • tinnitus , or ringing in the ears
    • temporary or permanent hearing loss
    • balance problems
  • Infections- Chemotherapy can cause a fall in the number of white blood cells, which help protect the body from infection. This leads to a weakening of the immune system and a higher risk of infections.
    Patients to reduce the risk of infection are asked to
    • wash hands regularly
    • keep wounds clean
    • following appropriate food hygiene guidelines
    • getting early treatment if a person suspects an infection
  • Bleeding problems- Chemotherapy can reduce a person’s platelet count. This means the blood will no longer clot as well as it usually does.
    The person may experience:
    • easy bruising
    • more bleeding than usual from a small cut
    • frequent nosebleeds or bleeding gums
  • Anemia- Chemotherapy can cause levels of red blood cells to fall. This leads to anemia.
    Symptoms include:
    • tiredness
    • shortness of breath
    • heart palpitations
    • Some people may need a blood transfusion.
  • Mucositis-Mucositis, or inflammation of the mucous membrane, can affect any part of the digestive system, from the mouth to the anus.
    Oral mucositis affects the mouth. Symptoms, which can vary according to the chemotherapy dose, it can make it painful to eat or talk. Some people experience a burning pain in their mouth or on their lips.
  • Loss of appetite-Chemotherapy, cancer or both can affect how the body processes nutrients, which can lead to a loss of appetite and weight loss.
    The severity depends on the type of cancer and chemotherapy treatment, but the person usually regains their appetite after treatment.
    Tips to resolve this include:
    • eating smaller, more frequent meals
    • consuming nutrient rich drinks, such as smoothies, through a straw, to help maintain fluid and nutrient intake

    People who find it too difficult to eat may need to spend time in the hospital, where healthcare professionals can provide nutrition intravenously or through a feeding tube.

  • Pregnancy and fertility-People often lose interest in sex during chemotherapy, but this usually returns after treatment.
    • Fertility- Some types of chemotherapy can reduce fertility in men and women. This often, but not always, returns after treatment is over. However, people who wish to have children in the future may consider freezing sperm or embryos for later use.
    • Pregnancy- It is not entirely clear how different types of chemotherapy may affect a growing fetus. If a woman needs chemotherapy during pregnancy, a doctor may recommend waiting until after the first 12-14 weeks because this is the time when the fetus’s organs are developing rapidly. Chemotherapy can begin after the first trimester if a doctor considers it necessary.

    Because chemotherapy can have severe adverse side effects, it may be best to avoid becoming pregnant while having treatment. A doctor can advise on suitable birth control methods.

  • Bowel problems- Chemotherapy can also lead to diarrhea or constipation ,symptoms often begin a few days after treatment starts.
  • Cognitive and mental health problems- Patients report problems with attention, thinking, and short term memory during chemotherapy. Chemotherapy can also lead to difficulty with reasoning, organizing, and multitasking. Some people experience mood swings and depression.
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