What is Chemotherapy?

Chemotherapy refers to a drug treatment that destroys fast-growing cells in your body and is most commonly used in the treatment of cancers.
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When is Chemotherapy recommended?

Chemotherapy is used in a variety of situations including the following:

As the primary and sole treatment of cancer.
As an additional treatment for cancer such as before or after surgery, or in combination with radiotherapy.
To ease the signs and symptoms of cancer.
Chemotherapy is often used to prepare for a stem cell transplant by eliminating the underlying disease in the bone marrow before the stem cells are infused.
Chemotherapy can also be used in non cancer conditions such as immunological disorders. For example, in rheumatoid arthritis and lupus, lower doses of chemotherapy are used to control an overactive immune system.

What are the side effects of Chemotherapy?

Chemotherapy works by attacking cancer cells. During the process, other normal fast growing cells are affected and this is often what causes many of the side effects of chemotherapy..

The common side effects include:

Nausea and vomiting
Hair loss
Diarrhoea
Loss of appetite
Ulcers in the mouth
Fever
Easy bruising and bleeding
Constipation
Fatigue
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How to prepare for a Chemotherapy session?

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Before you start chemotherapy, the doctor will determine that you are fit for chemotherapy. Blood tests and certain investigations such as an echocardiogram (heart scan) or lung function tests may be done. In addition, a dietary assessment is offered to ensure that you maintain good nutrition during the course of your treatment. Some chemotherapy drugs may affect your fertility, and the doctor will discuss with you whether sperm banking or egg preservation may be suitable. More than half of patients will require insertion of a temporary catheter through which the chemotherapy will be given. Generally we use PICC lines at CFCH, but occasionally a Hickman line or a port-a-cath is inserted.
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What can you expect during a Chemotherapy session?

Our haematologist will discuss with you the most appropriate chemotherapy drugs to be administered depending on the type of cancer and its severity.
Previous cancer treatments are taken into consideration for choosing the most effective chemotherapeutic drugs for a particular patient.
Depending on the type, stage of cancer, and the extent of spread, our doctor will plan the course of your chemotherapy. Chemotherapy treatments tend to be given in cycles. Each cycle typically lasts up to a month with periods of rest in between for you to recover.
Chemotherapy is usually administered in our clinic as an outpatient. Some patients require hospital admission for chemotherapy if there are any serious side effects, if a patient is frail, or if treatment is prolonged.
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How is Chemotherapy given?

Chemotherapy drugs can be administered in different ways including:
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Chemotherapy infusion
Chemotherapy is usually given intravenously as an infusion into a vein.
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Oral chemotherapy
Some chemotherapy medications can be taken orally in the form of pills or capsules.
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Chemotherapy injections
Chemotherapy drugs can be given as an injection under the skin.
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Chemotherapy drugs to treat one area
In some cases, chemotherapy drugs are administered directly into a specific part of the body. In blood cancers, chemotherapy is sometimes given intrathecally (via the spine) into the central nervous system.

Chemotherapy at CFCH

At CFCH, our haematologists will tailor your chemotherapy regimen based on the latest guidance and research as well as their extensive experience. You will be monitored closely during your course of treatment for side effects, and tests are done to assess how you are responding to treatment. Our doctors and team of nurses strive to ensure that you are fully involved and informed of your treatment and that you are as comfortable as possible during your treatment period.
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FAQs on Blood Cancers That Chemotherapy Treats

At CFCH, we offer chemotherapy as a treatment for various blood cancers including Multiple Myeloma, Leukaemia (ALL, AML), and Lymphoma. .

How is chemotherapy administered for Myeloma treatment?

Chemotherapy drugs can be taken orally as pills or administered as an injection into a vein in your arm.

How many rounds of chemo are needed for Acute Myeloid Leukaemia?

For patients who need intensive chemotherapy for treatment of their acute myeloid leukaemia, they will typically receive 4-5 cycles of intensive therapy. Each session of chemotherapy may last for 4 weeks.

Patients who are receiving intensive chemotherapy followed by transplantation typically receive 2-3 cycles of chemotherapy before undergoing the bone marrow transplantation.

Patients who are not fit for intensive chemotherapy or transplantation may receive continuous cycles of non-intensive targeted therapy.

The specific treatment protocols for each AML patient often varies based on individual factors, and our doctors at CFCH will discuss your personal AML treatment plan in detail with you.

Can AML be cured without chemotherapy?

Unfortunately, even with chemotherapy and the latest available novel therapies, only a portion of AML patients can be successfully cleared of their disease.

Even with newer, targeted novel therapies, the vast majority of leukaemia cases require a combination of novel agents with conventional chemotherapy and sometimes even a bone marrow transplantation for successful clearance of the AML.

How soon do you start chemo after your Acute Lymphoblastic Leukaemia diagnosis?

Patients with ALL usually need to commence some form of treatment soon after initial diagnosis so as to stabilise the disease and prevent the development of adverse effects. Once the diagnosis is firmly established, it is recommended that patients commence proper ALL treatment as soon as possible.

How successful is chemotherapy for Acute Lymphoblastic Leukaemia?

Modern-day treatments mean that 80-90% of children are alive and well at 5 years with current protocols. The 5-year overall survival is approximately 65% for adolescents, 40% for adults, and 15-20% for older patients.

Can Lymphoma be cured without chemotherapy?

If the Lymphoma isn’t growing at an accelerated rate or causing problems, it can be watched closely without treatment over a period. If treatment is required, it depends on the stage of the Lymphoma. When the Lymphoma is only in one lymph node or area (stage I), it may be treated with radiation therapy. The majority of patients with Lymphoma require treatment with a combination of chemotherapy and targeted drug therapy.