Coping with Side Effects of Chemotherapy

Some patients who experience certain side effects of chemotherapy Chemotherapy | Breast Cancer Treatment | Imaginis - The Women's Health & Wellness Resource Network

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Chemotherapy

Coping with Side Effects of Chemotherapy

Some patients who experience certain side effects of chemotherapy may be prescribed medications to counteract these effects. For example, several drugs are now available for use alone or in combination to help reduce nausea and vomiting or fatigue, a few of the most common side effects of chemotherapy. Some of these drugs include:

  • Anzemet (generic name, dolasetron mesylate) helps prevent and relieve nausea and vomiting from surgery or chemotherapy. Researchers believe that nausea and vomiting during chemotherapy is associated with the release of serotonin from enterochromaffin cells in the small intestine. Anzemet blocks these nerve endings in the intestine and prevents signals to the central nervous system. Anzemet is available in tablet form and by injection. Visit the sanofi-aventis Web site for more information on Anzemet, http://www.anzemet.com/
  • Compazine (generic name, prochlorperazine) helps control nausea and vomiting after surgery or chemotherapy. Compazine is available in capsule, tablet, and liquid form, and by suppository or injection. Compazine can interact with other medications or with alcohol. Visit the GlaxoSmithKline Web site for more information on Compazine (Adobe Acrobat Required), http://www.gsk.com/
  • Kyril (generic name, granisetron hydrochloride) is an anti-nausea medicine FDA approved for patients undergoing chemotherapy. Kytril is typically given 60 minutes before chemotherapy. In some cases, a second dose is given about 12 hours after the first dose. Kytril is available in tablet form and by injection. Visit the Roche Laboratories Web site for more information on Kytril (Adobe Acrobat required), http://www.kytril.com/
  • Phenergan (generic name, promethazine) has sedative, antihistamine, and mild anti-nausea properties. It may be used to help prevent or treat nausea due to chemotherapy. Phenergan may be available in tablet form or as an oral syrup, suppository or injection. Visit the Baxter Healthcare Web site for more information on Phenergan (Adobe PDF required), http://www.wyeth.com/products/phenergan.asp
  • Procrit (generic name, epoetin alfa) helps the body produce more red blood cells, which help relieve fatigue due to chemotherapy. Since chemotherapy affects both normal and cancerous cells, it can decrease the number of red blood cells, causing anemia (feeling of extreme tiredness). Visit the Ortho Biotech website for more information on Procrit, http://www.procrit.com/
  • Zofran helps to relieve nausea and vomiting associated with chemotherapy. Zofran is available in pill form, as a liquid solution, and by injection. The first dose of Zofran (pill form) is usually administered 30 minutes before chemotherapy and then at regular intervals for one to two days after chemotherapy. Visit the GlaxoSmithKline Web site for more information on Zofran, http://www.gsk.com/

Patients who experience low blood cells counts during chemotherapy may also be given medications to help raise blood cell or platelet counts. For example, patients who suffer from neutropenia, a decrease in the number of neutrophils (a type of white blood cell), may be given certain growth factors, such as the granulocyte-macrophage colony stimulating factor (GM-CSF, generic name sargramostim, brand name Leukine) or granulocyte colony stimulating factor (G-CSF, generic name filgrastim, brand name Neupogen). Click here to learn more about neutropenia.

High-Dose Chemotherapy/Bone Marrow Transplants/Stem Cell Rescues

Breast cancer treatment with high doses of chemotherapy remains a controversial subject among members of the medical community. In January 2000, a breast cancer researcher from South Africa admitted to falsifying the results of a study that showed high-dose chemotherapy followed by bone marrow transplants benefits patients with advanced breast cancer. A team of American scientists became suspicious about the results of Dr. Werner Bezwoda's study after four similar studies showed no benefit. However, other studies have shown high-dose chemotherapy to be a promising treatment for some patients with advanced breast cancer. Currently, the treatment is only available to eligible patients in closely monitored clinical trials.

Because prolonged high doses of chemotherapy may damage bone marrow cells, which in turn can result is dangerously low blood cell counts, physicians may need to perform bone marrow transplants (or stem cell rescues) on patients who are given high-dose chemotherapy.

Steps to a Typical Bone Marrow Transplant:
  • sample of bone marrow cells are extracted from the body and frozen
  • high-dose chemotherapy is administered
  • preserved bone marrow cells are thawed and surgically re-injected into the body
  • re-injected bone marrow cells multiply and produce blood cells

If a bone marrow transplant seems likely, physicians will take a sample of bone marrow from a bone in the leg or pelvis before high-dose chemotherapy is begun. These extracted stem cells are immediately frozen for preservation. Next, the patient will begin receiving high-dose chemotherapy (which may destroy the body's remaining bone marrow). After chemotherapy is completed, the preserved bone marrow cells are thawed and re-injected into the body where they will multiply. Bone marrow is responsible for the production of white and red blood cells.

Recently, physicians have been performing autologous stem cell rescues after high-dose chemotherapy instead of bone marrow transplants. Autologous stem cell rescues involve using the patient's own blood to obtain stem cells, the precursors of all blood cells. Stem cells will regenerate bone marrow function in the patient after high-dose chemotherapy. Studies have shown that stem cell rescue may be associated with lower mortality rates than traditional bone marrow transplants.

Conclusion

Chemotherapy can be very effective at treating cancer and preventing a recurrence of breast cancer. Researchers have been making significant advances in the field of chemotherapy and cancer treatment. As research continues, physicians predict that new chemotherapy drugs with greater effectiveness and fewer side effects will become common. Also, more drugs used to counteract the side effects of chemotherapy are being developed. An expert panel that convened at the National Institutes of Health Consensus Development Conference on Adjuvant Therapy for Breast Cancer in November 2000 recommended that most women with localized breast cancer be offered chemotherapy to help prevent a recurrence of breast cancer. Women with breast cancer are encouraged to discuss chemotherapy with their physicians.

Additional Resources and References

Updated: October 18, 2009