Chemotherapy is one of the best treatments for fighting cancer, but its side effects are well-known and often feared. The good news is chemotherapy has improved significantly in recent years. Erin Dunbar, M.D., a neuro-oncologist at Piedmont, shares the latest advancements in chemo and what you need to know about side effects.
What is chemotherapy?
Chemotherapy targets and kills fast-growing cancer cells. Unfortunately, it can also harm healthy cells in the body, which leads to side effects. While traditional chemotherapy is perhaps the most well-known, oncologists now have several effective methods up their sleeves to target cancer cells:
Traditional chemotherapy breaks up the DNA in fast-growing cells, affecting both cancer cells and healthy cells.
Immunotherapy harnesses the body’s own immune system to fight the tumor cells.
Precision medicine, or targeted medicine, targets a specific marker unique to the tumor. For example, for HER2-positive breast cancer, your oncologist can use chemotherapy that attacks the HER2 markers, sparing healthy cells in the breast and body.
Why is chemo still one of the best ways to treat cancer?
“Chemotherapy remains one of the best ways to treat cancer because it attacks cancer cells that we can see, but can't remove through surgery or radiation,” explains Dr. Dunbar. “In addition, it is the best and frankly, the only way to treat the cancer cells we cannot see.”
Chemotherapy more tolerable than ever
“There are so many advancements that are making chemotherapy more tolerable and safe, and less harmful to the body’s healthy cells,” says Dr. Dunbar. “Chemotherapy is now able to more precisely target the tumor, leaving the rest of the healthy cells alone.”
There are also major advancements in complementary medications that ease chemo side effects.
“We have much better preventative medicine that prevents or fixes unintended side effects,” she says. “For example, we have excellent medicine for fatigue and radiation that might result from treatment.”
What determines chemotherapy side effects?
Chemotherapy side effects vary from person to person. Dr. Dunbar says symptoms are based on a few factors:
The tissue in which the tumor is growing (e.g., the lungs or the brain)
The type of tumor
The form of chemotherapy
The patient’s health (e.g., someone with diabetes may be more likely to develop nerve damage from treatment)
If the patient is receiving other forms of treatment (e.g., radiation or surgery)
Which areas of the body are most affected by chemotherapy?
Traditional chemo targets fast-dividing cancer cells, but it can also unintentionally harm healthy, rapidly dividing cells in the process. This often affects cells in the gut, leading to nausea and diarrhea. It can also have a negative effect on bone marrow cells, reducing blood counts and increasing a person’s risk of infection.
“Now we can either stay away from those cells or use better medications to prevent or fix those side effects,” she explains.
When should you talk to your doctor about side effects?
“My most important piece of advice before starting therapy is to have your doctor paint a picture of what side effects may be like and ask them to come up with individualized plan to prevent or help side effects as soon as they occur,” she says.
Dr. Dunbar strongly recommends reporting your symptoms as they occur.
“I always tell my patients that reporting symptoms to your doctor is not complaining,” she says. “It’s giving them data that makes them smarter at how to prevent or help a side effect. I’d rather deal with a problem while it’s small before it’s dangerous. You’re not weak if you let your doctor know something is going on.”
Create your cancer “A-Team”
“Having a comprehensive care team—your ‘A-team’—is so important,” says Dr. Dunbar. “There are many specialists and therapists who can help you feel your best through chemotherapy.”
These team members can include:
Spiritual advisors or clergy
“These days, people are having a better-than-ever, unparalleled quality of life during chemotherapy,” says Dr. Dunbar. “They are living better and longer than ever before.”
Learn more about the specific ways chemotherapy can affect the body.