What are the limitations of chemotherapy?
Although chemotherapy is an important strategy in cancer treatment, it presents some limitations.
1. Side effects
Chemotherapy does not distinguish cancer cells from healthy cells. Therefore, it also attacks normal cells that are undergoing cell division, such as hair follicle cells, gastrointestinal cells and bone marrow cells. This action on healthy tissues is the cause of side effects such as hair loss, nausea, fatigue and immunosuppression, which can have impact on the patient’s quality of life. However, it should be noted that the side effects of chemotherapy vary from treatment to treatment and develop differently for each person. The same procedure may cause different reactions or of different intensity, depending on each patient’s response.
2. Resistance to treatment
In some cases, cancer cells can develop resistance to chemotherapy, making the drugs less effective. This occurs when cells undergo mutations, becoming accustomed and adapting to the effects of the treatments. In these situations, the chemotherapy’s success is compromised and, most of the time, it is necessary to change to another treatment with a different activating mechanism that is able to overcome this resistance.
3. Impact on the immune system
Chemotherapy can weaken the immune system by affecting bone marrow, where blood cells are produced. This effect can diminish the production of white blood cells, which are essential for the body’s defence system. As a result, the body becomes more vulnerable to infections and additional precautions may be necessary to protect the patient.
4. Limitations in some types of cancer
While chemotherapy is effective in many types of cancer, it does not perform the same way for all patients or every type of tumour. Some types of cancer can be more resistant to treatment and chemotherapy may not be the most suitable treatment for certain tumours.
5. Need for combined therapeutic approaches
In most cases, chemotherapy alone is not enough. To improve results, it is often necessary to combine chemotherapy with other therapeutic strategies, such as surgery, radiation therapy, immunotherapy or targeted therapy. This combined approach can make treatment more complex and, sometimes, more aggressive, requiring multidisciplinary patient care throughout all treatments.
6. Fertility problems
By interfering with rapidly dividing cells, chemotherapy can affect the reproductive organs and compromise fertility. In women, this treatment can cause early menopause, and in men, it can reduce sperm production. Therefore, reproductive-aged patients should discuss fertility preservation before beginning treatment.
7. Slow recovery
Recovery from chemotherapy can be a progressive process that varies from person to person. Aside from the immediate side effects, patients can also feel changes in their energy level, general well-being or in some bodily functions. Therefore, it’s essential to maintain regular medical follow-ups to detect and manage any delayed side effects and ensure a healthy and effective recovery.
How is chemotherapy administered?
Chemotherapy can be administered in several ways, depending on the type of cancer, the patient’s condition and the approach selected by the physician.
1. Intravenously
The most common way of administering chemotherapy is intravenously, usually through a vein in the arm or hand. In many cases, especially for long-term treatment, an implantable catheter with a subcutaneous port (Implantofix or port-a-cath) may be used, making access to veins easier and reducing the discomfort of repeated punctures. The drugs are delivered directly into the blood stream. This procedure should be performed in a hospital or specialised clinic, and sessions can last several hours, depending on the prescribed treatment protocol.
2. Pills or capsules (orally)
Some drugs can be taken orally, in pills or capsules. This is the most comfortable method, as the patient can perform the treatment at home. However, the effectiveness of oral chemotherapy depends on strict adherence to the prescribed treatment, taking exact doses at exact times.
3. Injections (intramuscular or subcutaneous)
In some cases, cancer treatment can be administered by injection directly into the muscle (intramuscular) or under the skin (subcutaneously). These forms of administration are usually quicker and present less risk of reaction during the procedure.
4. Local delivery
In some types of cancer, the drugs can be delivered directly to the affected area. This method is known as local chemotherapy and can be performed by injection into the tumour or using a specific technique, such as intrathecal chemotherapy (delivered to the space around the spinal cord), intraperitoneal chemotherapy (to the abdominal cavity) or intravesical (into the bladder). This method allows a greater concentration of drugs to the tumour site, helping reduce the effects on the rest of the body.
5. Catheter or implantofix
For patients who need continuous or frequent treatments, a device called an implantable catheter, also known as Implantofix or port-a-cath, may be used. This device is placed under the skin, usually in the chest area, and enables drugs to be administered directly into the vein, avoiding repeated punctures and providing greater comfort and safety throughout the treatment.
6. Continuous infusion
Some patients may require continuous chemotherapy through an infusion pump. This device provides a constant dose of drugs over an extended period and can be administered at home or in a hospital. Continuous infusion is useful for treatments that require small but constant doses over time.
Precautions to take during chemotherapy
Some precautions should be taken when undergoing chemotherapy to ensure that the treatment is as effective as possible, to minimise side effects and assist in the patient’s recovery.
1. Monitoring side effects
Chemotherapy can cause a series of side effects, such as infections, nausea, extreme fatigue, hair loss and digestive problems. The patient must be closely monitored to detect any early adverse reactions and thereby adjust the treatment or administer supportive medication.
2. Proper hydration
Chemotherapy can dehydrate the body, especially when it causes diarrhoea or vomiting. Staying well hydrated is crucial to help flush out toxins and keep organs functioning properly. Drinking plenty of water and eating water-rich foods, like soups, can help maintain the body’s balance.
3. Balanced diet
Maintaining a balanced diet rich in proteins, vitamins and minerals, is essential to help the body tolerate the effects of chemotherapy and recover more quickly. Whenever possible, nutritious and easy-to-digest foods should be prioritised. In case of gastrointestinal symptoms like nausea, heartburn or mucositis, it is advisable to avoid irritative foods, such as spicy, acidic or overly greasy food.
4. Avoid toxic substances
During chemotherapy, it’s important to avoid consuming substances such as alcohol, tobacco and recreational drugs, which can interfere with treatment and aggravate side effects. Furthermore, certain apparently harmless medications, supplements and even foods can interfere with the effectiveness of chemotherapy. Examples of this include St. John’s wort tea, which can alter how some drugs are metabolised, and grapefruit, which can interfere with the absorption of medication. Therefore, any medication or supplement should always be discussed with the care team beforehand.
5. Protection against infection
Chemotherapy can temporarily weaken the immune system, making the body more vulnerable to infections. To reduce this risk, it’s important for patients to adopt some measures in their daily routine, such frequent hand washing, especially before meals and after being in public places, avoiding close contact with sick people, paying careful attention to small cuts or wounds, keeping them clean and protected and, whenever possible, avoiding crowded or poorly ventilated environments. In some cases, the physician may recommend preventive vaccines or treatments, such as growth factors or antibiotics, depending on the type of chemotherapy and the patient’s general condition. These measures help prevent complications and keep the treatment going in safety.
6. Skin and hair care
Hair loss is one of the most visible side effects of chemotherapy and, although this is usually temporary, in can be emotionally distressing for many patients. Wearing scarves, hats or wigs are strategies that help cope with this phase and maintain comfort and self-esteem. At the same time, skin can become more sensitive, dry or reactive during treatment. It is recommended to use mild, hypoallergenic and fragrance-free hygiene products and moisturisers, and avoid prolonged exposure to the sun, always using the appropriate sunscreen.
7. Adequate rest
Extreme fatigue is one of the most common effects of chemotherapy. Resting is essential to allow the body to recover and adapt to the effects of treatment, especially on the days immediately following each session. However, it is also known that light to moderate physical activity, always adjusted to each person’s condition, can help reduce fatigue, improve mood, maintain muscle strength and support a more effective recovery. The most important thing is for patients to listen to their body, find a balance between rest and movement, and adapt their daily routine to their current needs. Walking, stretching or supervised exercise can be beneficial, provided that medical advice is followed and the patient’s general condition is respected.
8. Regular follow-up care
During treatment, the patient should keep regular medical appointments with the oncologist to assess their tolerance to chemotherapy, undergo tests and adjust the treatment plan if necessary.
9. Manage stress and anxiety
Chemotherapy can be emotionally draining and its normal for patients to feel anxiety or fear throughout their treatment. Relaxation techniques like meditation, yoga or psychotherapy, can help reduce stress and improve emotional well-being during this difficult phase.
10. Maintain a support network
Having the support of family, friends and support groups is essential during chemotherapy. The company of loved ones can help patients improve their emotional state and cope better with the challenges of treatment.
