Radiotherapy is a local treatment which can only kill cancer cells within the field of the radiation beam. Chemotherapy is a systemic (whole body) treatment. The cytotoxic drugs circulate around the whole body, via the blood-stream, and can destroy cancer cells in different parts of the body. Some cancers are more sensitive to one treatment than to the other, depending on particular type of cell(s) involved. Also, treatment may vary depending on whether a cancer is contained in one location or has spread, or is likely to spread, to another area of the body. Children with the same cancer may have different treatments, based on the information available about their individual situation. Chemotherapy means "chemical treatment" and is the use of "cytotoxic" drugs to treat cancer by destroying or damaging the growth of cancer cells. There are many different chemotherapy drugs used to treat paediatric tumours, and they may be used on their own or as part of a combination protocol. Yes, they are called medical oncologists. Medical oncologists who specialise in children's cancers are called paediatric oncologists. Yes. There are over 30 cytotoxic drugs used to treat children's cancer, and scientists are constantly researching to find new agents which are either more effective or have fewer side effects than existing drugs. There are several groups of chemotherapy drugs which impact cancer cells in various ways at different stages of cell development. Alkaloids, derived from plants, interrupt cell division. Alkylating agents. poison cancer cells by interacting with DNA (the building blocks used by all cells to replicate themselves) to prevent cell reproduction. Antimetabolites starve cancer cells by destroying essential cell nutrients. Antibiotics prevent cell growth by blocking repro-duction. Enzymes interfere with cancer cells' ability to reproduce. Hormones create a hostile environment that slows cell growth. Not necessarily. Drugs may be given singly or as part or a combination protocol in which several drugs are delivered together or at different times. The treatment protocol will be prescribed and explained by your child's doctor. The most common ways drugs are given during treatment for cancer are: Intravenous (IV). Medicine is delivered directly into the bloodstream via an IV needle in the arm or hand, or through a port-a-cath or hickman catheter. Oral (PO). Drugs are taken by mouth in liquid, capsule or tablet form, and absorbed into the blood through the lining of the stomach and intestines. Intramuscular (IM). Drugs that need to seep slowly into the blood-stream are injected into a large muscle such as the thigh or buttocks. Less common routes of administration are: Intrathecal (IT). During a spinal tap, drugs are injected directly into the cerebrospinal fluid (fluid surrounding the brain and spinal cord), circumventing the blood-brain barrier. Intraperitoneal (IP). Drugs are delivered directly into the abdominal cavity Intracavitary (IC). Drugs are delivered directly into a body cavity through a catheter. Arterial perfusion. Blood is removed from the child and chemotherapy drugs are added. The blood is then returned through a major artery in the area that is being treated. Sometimes chemotherapy is delivered via an arterial catheter. Yes, but whereas radiotherapy is planned over a few weeks, chemotherapy usually continues for a period of months. The length of treatment usually depends on how well your child's tumour(s) responds to the drugs. Doctors will be constantly checking this using blood tests, EUAs (for Rb), x-rays, MRI scans and other investigations. Most children receive chemotherapy for between six months and 14 months. No, although this will depend on the specific treatment or regime chosen for your child. Usually each course of treatment is followed by a 'rest' period. This rest period is often longer than the treatment time and its purpose is to allow the body to recover from the effects of the drugs. For example, your child may have an injection one week, another the following week and then three weeks off treatment. This is unlikely. The cytotoxic effect of the drugs carries on after the treatment days. As cancer cells do not recover as quickly as normal cells, the repeated treatments gradually reduce the number of cancer cells which are, or maybe, present in your child's body. Dosages vary among individual drugs and protocols. However, most are based on your child's weight or body surface area (BSA), which is calculated from your child's weight and height and measured in meters squared (M2). In these instances, height and/or weight may be measured each time chemotherapy begins. Therefore, the actual dosage may vary throughout treatment. Cancer cells multiply rapidly, and are therefore more susceptible to chemotherapy, as the drugs work by damaging the cells' ability to grow or reproduce themselves. However, various types of rapidly dividing healthy cells can also be damaged by chemotherapy drugs, causing side effects. These include cells found in bone marrow, hair follicles, the mouth, stomach, intestines, and skin. Fortunately, normal cells recover quickly so side effects of treatment are usually temporary. Not always. Some children experience few side effects during chemotherapy and are able to continue with their normal activities. For others, chemotherapy is a miserable experience and the effect on their lives is considerable. Any side effects which occur depend on which of the many drugs are prescribed for your child. In addition each person reacts in an individual way to chemotherapy. Two children receiving the same combination of drugs may feel completely different during their courses of treatment. It is impossible to say because so much depends on the drug or drugs your child is to receive. The doctors and nurses will be able to tell you what to expect and also offer advice on how to cope with any side effects. Side effects will be examined in detail in the Side Effects of Chemotherapy section (currently under construction). In general, chemotherapy is no more painful than having an injection or a blood test. During a course of treatment your child's veins may become sensitive or sore and you should tell the doctor or nurse if this happens so that these areas can be avoided. There are different ways of administering the chemotherapy drugs. Some can be delivered over a few minutes, whilst others must be infused over a period of hours, or given in staggered doses to avoid toxicity. Extra fluids and drugs often need to be given together with the chemotherapy, particularly for very young children, and a hospital stay of 24-72 hours may be necessary. Hospitalisation may also help in the prevention and/or management of expected side effects. A central line is a special catheter (tube) which is inserted into a large vein, through the chest wall. It can be left in place for many months. Drugs and fluids can be given through the catheter and blood samples can also be taken from it. It removes the need for repeated injections into veins in the arm or hand. It is not limited to children: some adults will also have a central line also.. Yes. You may find your child's appetite decreases for a few days after treatment, but when it returns to normal you can serve the usual foods. Try to get your child to drink about twice as much as normal during chemotherapy. You will be told if there are any foods your child should avoid. If your child encounters any problems with eating, tell the doctor or nurse. They may be able to offer some suggestions or ask the dietician to advise you. Usually the doctors are quite willing to change treatment dates by a few days to fit in with special occasions like a birthday or Christmas, or so your child can have a short holiday. Ask your doctor if it's possible to reorganise your dates. Yes: you will see the doctor every time your child comes into hospital for chemotherapy and when each course of outpatient treatment begins. She or he will ask for regular tests, like x-rays or scans, to check general health and how the chemotherapy is affecting your child. The doctor will want to know how your child feels. Talk about anything unusual you may be aware of, whether it was expected or not. Also use this time to discuss any worries you may have and to ask questions. Don't worry if a physical change or a concern that you have seems trivial - it is always best to check. Always ask the doctor before taking other medicines and, if you wish to try a complementary therapy, find out if there is any reason why you should not use it at this time. When a child has adjuvant therapy, there is no immediate way of knowing if it is working because there is no disease to assess. Your doctor will have considered two things: the results of research which show that chemotherapy can reduce the risk of the cancer spreading/coming back and also, from that research, how long chemotherapy needs to be given to children in similar circumstances to your own in order to be most effective. Usually, yes. The doctors now know which drugs work with different types of cancer and they can put these together in different combinations until the best one is found for your child. It may be necessary to try one or two regimes before the most effective combination is discovered. - What are both the trade and generic names? - How long will the protocol last? - What is the dosage? - Will this remain the same throughout the protocol? - Will my child be admitted to hospital for chemo treatment? - How many times a day should it be given? - What should I do if I forget to give my child the drug? - Will the drug interact with any over-the-counter drugs and/or vitamins? - What are the common, and the rare but serious, side effects? - What should I do if my child experiences any of the side effects? The most commonly used drugs to treat both Rb and OG are Carboplatin and Vincristine, used in combination, sometimes with the addition of Etoposide. Other drugs commonly used are Vinblastine, Temozolomide and Cisplatin. Cytotoxic drugs are known by a variety of names. You may hear the same drug referred to by its generic name, abbreviation, or several brand names, depending on whom you talk to. Other names are listed with the information about each drug. Click on the name of the drug below for individual explanations. Go back to GENERAL TREATMENT Index. Go back to ORbIT TREATMENT index. Go back to SONGS TREATMENT index. |
| "Do not go where the path may lead, go instead where there is no path - and leave a trail." ~ Ralph Waldo Emerson ~ |
| Chemotherapy |
| ORPHANS OF THE CANCER STORM |
| Disclaimer This information page has been prepared by an individual who does not have medical training. However its contents have been reviewed by appropriately qualified medical professionals for accuracy and quality. This page is intended for information purposes only and should not be used as a guide to diagnosis or treatment. If this information raises any concerns about your child’s condition or care protocol, discuss them with his or her paediatrician, oncologist, or other appropriate medical professional who has knowledge of the case. |
| My child is about to start chemotherapy and this will be given through a central line. What is that exactly? |
| My daughter's birthday is approaching, but the date coincides with her treatment. Can I change the day of her treatment? |