Anyone facing chemo should put aside the notion that it’s hell-on-earth. We all know that it can be pretty rugged and the word itself, chemo, strikes fear into the heart of most of us, but it’s “not your father’s chemo”. Newer drugs and ways of managing side-effects make it much more bearable than it used to be.

The use of chemical agents to destroy cancerous cells and tissue. www.chemotherapy.com

Chemotherapy drugs are being developed all the time. This information is just some of the common ones used in the past for head and neck cancers.

Chemotherapy may be given in many ways:

Injection

The chemotherapy is given by a shot in a muscle in your arm, thigh, or hip or right under the skin in the fatty part of your arm, leg, or belly.


Intra-arterial (IA)

The chemotherapy goes directly into the artery that is feeding the cancer.


Intravenous IV

The chemotherapy goes directly into a vein.


Topically

The chemotherapy comes in a cream that you rub onto your skin.


Orally

The chemotherapy comes in pills, capsules, or liquids that you swallow.

Chemotherapy medications commonly used to treat head and neck cancer

Fluorouracil

An antimetabolite fluoropyrimidine analog of the nucleoside pyrimidine with antineoplastic activity. Fluorouracil and its metabolites possess a number of different mechanisms of action. In vivo, fluoruracil is converted to the active metabolite 5-fluoroxyuridine monophosphate (F-UMP); replacing uracil, F-UMP incorporates into RNA and inhibits RNA processing, thereby inhibiting cell growth. Another active metabolite, 5-5-fluoro-2′-deoxyuridine-5′-O-monophosphate (F-dUMP), inhibits thymidylate synthase, resulting in the depletion of thymidine triphosphate (TTP), one of the four nucleotide triphosphates used in the in vivo synthesis of DNA. Other fluorouracil metabolites incorporate into both RNA and DNA; incorporation into RNA results in major effects on both RNA processing and functions.

Carboplatinum

A second-generation platinum compound with a broad spectrum of antineoplastic properties. Carboplatin contains a platinum atom complexed with two ammonia groups and a cyclobutane-dicarboxyl residue. This agent is activated intracellularly to form reactive platinum complexes that bind to nucleophilic groups such as GC-rich sites in DNA, thereby inducing intrastrand and interstrand DNA cross-links, as well as DNA-protein cross-links. These carboplatin-induced DNA and protein effects result in apoptosis and cell growth inhibition. This agent possesses tumoricidal activity similar to that of its parent compound, cisplatin, but is more stable and less toxic.

Cisplatinum

An inorganic platinum agent (cis-diamminedichloroplatinum) with antineoplastic activity. Cisplatin forms highly reactive, charged, platinum complexes which bind to nucleophilic groups such as GC-rich sites in DNA, inducing intrastrand and interstrand DNA cross-links, as well as DNA-protein cross-links. These cross-links result in apoptosis and cell growth inhibition.

Erbitux

A monoclonal antibody used to treat certain types of head and neck cancer, and colorectal cancer that has spread to other parts of the body. It is also being studied in the treatment of other types of cancer. Monoclonal antibodies are made in the laboratory and can locate and bind to cancer cells. Erbitux binds to the epidermal growth factor receptor (EGFR), which is found on the surface of some types of cancer cells. Also called cetuximab.

Paclitaxel

A compound extracted from the Pacific yew tree Taxus brevifolia with antineoplastic activity. Paclitaxel binds to tubulin and inhibits the disassembly of microtubules, thereby resulting in the inhibition of cell division. This agent also induces apoptosis by binding to and blocking the function of the apoptosis inhibitor protein Bcl-2 (B-cell Leukemia 2).

For those of you dealing with chemo, the following are some other excellent Internet sources that you might find useful:

Patient Resources Magazine has some good information on tracking Chemo drugs. It also includes links to phone apps that will help you keep track.

https://www.patientresource.com/Medication_Adherence_Practical_Tips.aspx?utm_source=010319&utm_campaign=010319&utm_medium=email

CANCER.GOV: CLINICAL TRIALS

There are essentially four kinds of clinical trials in cancer research, and each one serves a specific purpose. Find out how clinical trials are conducted, where they are being conducted, who is eligible to participate in them, and the latest results from ongoing trials.

CHEMOTHERAPY DRUG LIST

https://www.cancer.gov/about-cancer/treatment/drugs

Which drugs are used in chemotherapy depends on what cancer is treated. The information here is a list of older and newer drugs, plus some new drugs that are alternatives to chemotherapy. You can find information on the drugs’ use and potential side effects.

ADJUVANT CHEMOTHERAPY

https://www.mayoclinic.org/diseases-conditions/cancer/in-depth/adjuvant-therapy/art-20046687

Adjuvant chemotherapy is the use of drugs as additional treatment for patients with cancers that are thought to have spread beyond their original sites. Written so the average person can grasp the concept, this page also has some charts that might help with a better understanding of this approach.

CANCER CHEMOTHERAPY

Chemotherapy agents can be divided into three main categories based on how they attempt to slow and halt the growth and spread of a neoplasm. That is why they are also called “antineoplastic agents.”

RINSES

For Patients Receiving Chemotherapy and Radiation Therapy.  See suggestions under the radiation section.

IMMUNOTHERAPY

My chemo oncologist (not sure that’s the right title) did not go into detail.
His opinion was that my immune system was what was keeping the cancer at bay, not manifesting itself in other cells. Beyond my understanding. He just stated that boosting my immune system might help.

I found this on the web:
Immunotherapy is treatment that uses your body’s own immune system to help fight cancer. Get information about the different types of immunotherapy and the types of cancer they are used to treat.

The following links will help provide more information on immunotherapy:

http://www.cancer.net/navigating-cancer-care/how-cancer-treated/immunotherapy-and-vaccines/understanding-immunotherapy

http://www.cancerresearch.org/cancer-immunotherapy

Scott Sysum
Lary Aug 2008
Concord, CA

From Our Members

PORT-A-CATH® Implantable Venous Access Systems

I am doing chemo now with a Portacathe. I had one installed before my first cancer surgery (colon cancer) for the pre-op chemo and used it again for post-op chemo. Then it was removed.

Five years later I had a metastatic cancer and again with the portacathe and chemo. Now this year another met and a new port and chemo. If they stay in you they have to be flushed every month or so and we always hope this time will be the last and I wont need it anymore anyway.

I get the initial infusion at the oncologist and go home with a fanny pack of chemo that drips in, this time for 42 hours and then go back and they unplug and flush. The first time around I wore the pack steadily for weeks, as I remember, so either they have improved the protocol or each time is different. It saves hours of sitting there with the arm infusion and this is definitely the way to go if you can.

Removing it is even easier than installing it. A quick procedure with a minimum of local anesthesia. Good luck with it.
Barb Stratton