Course of chemotherapy
When cancer is diagnosed, it is important to determine the type, size and stage of the tumor. The most suitable treatment method for the patient is then selected. If chemotherapy is carried out, an individual treatment plan is drawn up for each patient.
Monotherapy or combination therapy
Before the start of chemotherapy, it is determined which cytostatic drugs are to be administered to the patient. A large number of different drugs are available here, which can be administered either individually (monotherapy) or in combination (combination therapy). In combination therapy, the different modes of action of different cytostatics are used in order to be able to fight the tumor cells particularly effectively.
In addition to the cytostatics, ancillary drugs are often administered that increase their effect without being toxic themselves. Drugs are also used to alleviate the unpleasant side effects of chemotherapy, such as severe nausea .
port or infusion
In addition to the type of cytostatics, the form of administration of the drugs is also determined before the start of therapy. Some cytostatics can be administered to the patient in the form of tablets or by injection, but the administration is usually through an infusion.
If cytostatics are administered more frequently or over a longer period of time, the use of a so-called port should be considered. This is a fixed access into the vein. This is inserted under the skin, usually near the collarbone, during a surgical procedure. From there there is a connection to the vein via a thin tube. This means that a vein no longer has to be punctured every time during the treatment.
Dosage of cytostatics
The amount of medication used in chemotherapy depends primarily on the patient’s body surface area, which is determined by height and weight. However, other factors also play a role: if the patient suffers from liver or kidney dysfunction, for example, the degradation or excretion of cytostatics is slowed down. Therefore, the dosage of the medication must be adjusted accordingly.
During the treatment, the dosage of the cytostatics can be re-determined if necessary. This can be necessary, for example, if the patient suffers from very severe side effects or if his body recovers only poorly from the stress of the treatment during the breaks in therapy.
Three to six treatment cycles
The duration of the treatment and the time between the individual treatment phases are also specified in the treatment plan. Chemotherapy is usually carried out in several treatment cycles – often there are between three and six cycles.
A treatment cycle consists of several doses of cytostatics, which are given at intervals of a few days. This is followed by a longer break during which no medication is administered. Several treatment cycles are usually necessary in order to also combat the tumor tissue that was not active during the previous cycle and was therefore not influenced by the cytostatics.
In the breaks between the individual treatments, the body can recover from the effects of the cytostatics. Because these not only fight the cancer cells, but also damage healthy cells that divide quickly. These cells can regenerate during the breaks, because this process runs much faster in healthy tissue than in tumor cells.
Outpatient or inpatient
Chemotherapy can be done on an outpatient or inpatient basis. As a rule, the treatment is nowadays carried out on an outpatient basis, so that the patients can recover at home between the individual sessions. Treatment is carried out either on an outpatient basis in the hospital or in the office of an oncologist.
Under certain circumstances, however, inpatient treatment may also be necessary. This is the case, for example, with particularly intensive treatments where kidney function or other physical functions must be checked regularly. Likewise, patients who are classified as particularly at risk of infection during treatment are also treated in the hospital.