Chemotherapy

Chemotherapy - Procedure Indications, Side effects, Benefits

PACE Hospitals is one of the best hospital for chemotherapy in Hyderabad, Telangana, India. It has a team of experienced oncologists who are experts in the latest cancer treatments. The hospital also has a state-of-the-art chemotherapy facility that provides a comfortable and supportive environment for patients.


Department of Oncology offers a variety of chemotherapy options, including oral, injectable, and intrathecal chemotherapy. We also offers supportive care services, such as nausea and vomiting prevention, hair loss management, and pain management.

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What is chemotherapy treatment?

Chemotherapy definition


Chemotherapy is a cancer treatment that uses drugs to kill cancer cells. It is a systemic treatment, which means that the drugs travel through the bloodstream to reach cancer cells throughout the body.


Chemotherapy is used to treat many different types of cancer, but not limited to cancer of breast, lung, prostate, colon, ovarian, pancreas, stomach, and leukaemia. It can be used alone or in combination with other treatments, such as radiation therapy or surgery.


The side effects of chemotherapy can vary depending on the type of drug and the dose used.

Best Hospital for Chemotherapy in Hyderabad, India | top chemotherapy centres in hyderabad | chemotherapy cost in hyderabad

Chemotherapy meaning

The treating of cancer with chemotherapeutic agents could be the basic chemotherapy definition. Whether traditional or targeted, the ultimate goals of chemotherapy are to prevent cancer cells from multiplying, invading, metastasizing (spreading), and ultimately killing the patient.


Paul Ehrlich, a German chemist, coined the term “chemotherapy” which literally means "the treatment of diseases by chemicals" in Greek (chemo-, "chemical," and the therapeia, "healing"). He researched the usability of various chemicals as medications to treat several infectious disorders. He was also the first scientist to examine the usability of animal models to evaluate a range of compounds for their possible anti-disease activity. Due to his contributions, Paul Ehrlich is also called the “Father of Chemotherapy”


In the 1960s, radiotherapy and surgery were the cornerstones of cancer treatment. As metastases (cancer spread to other parts of body) and cancer recurrence following surgery and radiation therapy became clear, combination chemotherapy began to acquire importance. 

Why does cancer occur? 

While there are various carcinogenic risk factors and cancer triggering factors, it is ultimately the genes which cause cancer. The carcinogenesis (birth of cancer) is the process by which normal cells are transformed into cancer cells due to an imbalance in the stimulatory and inhibitory growth signals (cell production and cell death signals). 


In carcinogenesis, normal mechanisms such as apoptosis (programmed cell death) and senescence (natural aging of cell) do not function properly and cannot control excessive cell division. Telomerase is an enzyme that enable cells to proliferate endlessly. While the telomerase activity and expression in most normal human cells is suppressed, in most cancer cells it is reactivated.



Strategies to inhibit telomerase activity in cancer cells comprise one of many new molecular approaches that are currently being studied. Efforts are underway to target key genes, proteins, and receptors that facilitate cancer cell growth. 

Routes of chemotherapy administration 

Depending on the stage and type of the cancer, chemotherapeutic administration can be either 

  • Oral chemotherapy (through mouth)
  • Intravenous (injected into vein)
  • Intraarterial (injected into artery)
  • Intramuscular (injected into muscle)
  • Intraperitoneal (injected into abdomen)
  • Topical (applied on the skin)


The condition of the patient could prompt the oncologist and healthcare team to provide the chemotherapy alone or with other treatments, such as surgery, radiation therapy, or biologic therapy. 

General principles of chemotherapy 

Usually, the principles of chemotherapy are to arrest cancer growth, but depending on the type of cancer, its metastasis (spread), among other factors, the goals of chemotherapy do change.


It is common to utilise a combined chemotherapeutic approach, where chemotherapy can be given either in combination with other chemotherapeutic agents or other forms of cancer therapy. Nevertheless, oncologists often prescribe one form of chemotherapeutic agent to reduce side effects.


Chemotherapy procedure: Chemotherapy procedure can be administered to the patient through various modalities. These modalities are distinctive in their goals. The various modalities are: 

  • Curative chemotherapy
  • Neoadjuvant chemotherapy
  • Adjuvant chemotherapy
  • Palliative chemotherapy


Curative chemotherapy: The principle of chemotherapy treatment is getting rid of the cancer and avoid remission (coming back). The chemotherapy used alone with curative intent in: 

  • Acute lymphocytic leukaemia 
  • Acute myelogenous leukaemia
  • Burkitt’s lymphoma

Neoadjuvant chemotherapy: If the general principle of chemotherapy is to be given before other treatments, it is a neoadjuvant chemotherapy. It could be given before surgery or radiation therapy to shrink tumours. Cancers in which chemotherapy used as neoadjuvant therapy are: 

  • Anal carcinoma 
  • Bladder cancer
  • Breast cancer (locally advanced)

Adjuvant chemotherapy: If the general principle of chemotherapy is to be given to terminate any existential cancer cells after all the other modalities of treatments are given, it is called adjuvant chemotherapy. Chemotherapy is used as adjuvant therapy with curative intent in: 

  • Breast cancer 
  • Colorectal cancer
  • Osteosarcoma

Palliative chemotherapy: This type of chemotherapy not only relieves the symptoms but also slows the progression of cancer as it can partially shrink tumours, prevent carcinogenesis and metastasis. Thus, the general principle of palliative chemotherapy extends not only the overall and progression free survival but also improves quality of life of the patients. The chemotherapy which can be used to palliate symptoms in advanced cancer diseases such as: 

  • Bladder cancers 
  • Brain tumours
  • Cervical cancer

How does chemotherapy work? 

With the ever-developing field of oncology and the discovery of newer information helped in understanding carcinogenesis (cancer growth) and their milestones. The newer information enabled the discovery/invention of certain chemotherapy drugs and medicines which can stop the carcinogenesis at various milestones.


Chemotherapy drugs classification: The chemotherapeutic drugs are classified based on their mechanism. The various types of chemotherapeutic agents are: 

  • Alkylating agents 
  • Platinum analogues
  • Anti-metabolites
  • Microtubule damaging agents 
  • Topoisomerase inhibitors 
  • Chemotherapy antibiotic drugs 
  • Steroidal chemotherapy 
  • Chemo-irradiation


Alkylating agents:  In short it can be said that alkylating agents deal with deoxyribonucleic acid (DNA) thus preventing the cancer cells from dividing and replicating.

 

To understand further, DNA must be understood. DNA is the hereditary material in almost all the life forms present in the cells. During organisms reproduce, a portion of the parent’s DNA is passed along to the offspring. It exists in the double helix structure, and every strand of DNA can serve as a pattern for duplication during cell division.


Alkylating agents damage the DNA of cancer cells in 2 ways. They are: 

  1. Monofunctional alkylation: these kinds of chemotherapy drugs react with a single strand, separating it from its partner in DNA, eventually causing permanent cell damage.
  2. Bifunctional alkylation: through an irreversible bond, the drug attaches between two base pairs in the DNA chain, causing cytotoxic effects (destroying or poisoning cells). 


The six types of alkylating agents are used in the chemotherapy of cancer are: 

  • Nitrogen Mustards
  • Ethyleneimines
  • Alkyl Sulfonates
  • Nitrosoureas
  • Triazenes
  • Methylhydrazines


Platinum analogues: These platinums based chemotherapy drugs display broad antineoplastic (anticancer) activity especially in ovarian, head and neck, bladder, oesophagus, lung, and colon cancers. Similar to alkylating agents, these drugs work by binding to the DNA of cancer cells, the difference is that these platinum analogues form covalent bonds.

 

Anti-metabolites: The antimetabolites in cancer chemotherapy interfere the synthesis of DNA and RNA by appearing as metabolites.


To understand further, the compounds which are necessary for the synthesis of DNA and RNA must be studied. Purines and pyrimidines are the building blocks of DNA and RNA. Folic acid is an essential vitamin that helps in cell replication. Since antimetabolites resemble these compounds, the cancer cells often take antimetabolites rather than the original compounds, thus disrupting carcinogenesis. The three types of antimetabolites in cancer chemotherapy treatment are: 

  • Purine antagonists
  • Cytidine analogues
  • Pyrimidine analogues
  • Folic acid analogues (antifolates) 


Microtubule-Damaging Agents: Microtubule chemotherapy constitute a diverse group of drugs that bind to microtubules affecting their function and properties. 


Microtubules are small tube-like structures that run inside the cell. They maintain the shape and motility of the cell facilitating the intracellular transport of cellular proteins. As such, inhibition of microtubule formation has important consequences that can lead to cell death. The nine types of microtubule chemotherapy are:

  • Vinca Alkaloids
  • Taxanes
  • Vinca alkaloidconjugate
  • Macrolides
  • Peptides
  • Heterocyclic nitrogen compound
  • Combretastatin
  • Epothilones 
  • Maytansine/auristatin conjugate 


Topoisomerase Inhibitors: These drugs arrest the activity of Topoisomerase I and II, thus inhibiting cellular growth. Topoisomerase I and topoisomerase II are the enzymes found in the nucleus of nearly all mammalian cells which functions for the replication and cellular division of DNA. There are two types of topoisomerase inhibitors:

  • Camptothecin Analogues (from the bark of Chinese tree, Camptotheca acuminata)
  • Epipodophyllotoxins (from American mandrake plant Podophyllum peltatum) 


Chemotherapy Antibiotic Drugs: Although the “conventional antibiotics” are used to treat bacterial infections, there are antibiotics which restrict carcinogenesis. They achieve carcinogenesis through various methods such as: 

  • Interfering with the replication or maintenance of DNA 
  • Production of free radicals
  • Prevention of mRNA production etc 


Steroidal Chemotherapy: Steroids are compounds which are naturally produced within the bodies in small amounts to help in the control and maintenance of various functions. These can also be synthetically prepared. With the discovery of tumour regression by cortisone, the incorporation of steroids in chemotherapy treatment commenced. They achieve cytotoxicity by decreases in DNA, RNA, and protein synthesis. 


Upon further research, it was understood that the association of cancer with steroid hormones could be: 

  • Hormone responsive - tumour regression with a specific hormone administration.
  • Hormone dependent - Removal of a hormonal stimulus causes tumour regression.
  • Both Hormone responsive and Hormone dependent. 
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Radiotherapy vs Chemotherapy | Difference between radiotherapy and chemotherapy

While chemotherapy and radiation therapy and are used to treat cancer through radiation and cytotoxic chemotherapeutic drugs respectively, there are considerable differences between them such as: 

Parameters Radiotherapy Chemotherapy
Principle High energy waves, such as X-rays or subatomic particles targeted towards cancer cells and tissues Chemotherapeutic drugs can inhibit or kill tumour cells by directly binding with DNA in vivo, interfering with the synthesis of DNA proteins
Effect towards other tissues Radiotherapy can affect nearby healthy cells as the rays might not be precise. Chemotherapy drugs also kill normal tissue cells which undergo vigorous proliferation
Types Three types: external radiation, internal radiation, and systemic radiation Various types based on mechanism of action
Administered through An external source (external beam radiotherapy), An internal source (brachytherapy), Intravenous administration of radioisotopes absorbed by the targeted tissue. Oral chemotherapy (through mouth), Intravenous (injected into vein), Intraarterial (injected into artery), Intramuscular (injected into muscle), Intraperitoneal (injected into abdomen), Topical (applied on the skin).

Despite the differences, the oncologist prefers a combination therapy to treat. Since combination therapy includes surgery, chemotherapy, targeted and radiation therapy, through different mechanisms, not only the growth of cancer, but also the chances of resistant cancer can be arrested. 

History of chemotherapy treatment

Historically, the chemotherapy origin has been shrouded in secrecy due to the circumstances surrounding its discovery.


The chemotherapy origin for cancer not only relied on the results of intensive and rigorous research, but also on the accidental findings which occurred during World War I (WWI). Mustard gas, which was used as a vesicant chemical warfare weapon until then, demonstrated a silver lining in its raw path of blood, gory and destruction.

 

The autopsies of mustard gas victims shown a profound medullar damage and a very conspicuous leukopenia (low white blood cell count). This leukopenia attracted the attention of research oncologists, as leukocytes (white blood cells) are capable of rapid division during stress and infections. Any agents which can reduce their numbers could well show their effect on cancer. Cancer is just a condition of uncontrolled cytogenesis (cell birth).


It led to the first clinical trial in which the interventional agent was nitrogen mustard – a derivative of mustard gas was used. It involved the intravenous administration of 10 low doses (0.1-1.0 mg/kg) of nitrogen mustard to counter advanced lymphosarcoma (cancer of the lymphatic system). While the result was the successful regression of tumour, it was noted that the effects were temporary, and surgery was eventually required to remove the tumours. 


Administration of nitrogen mustard stuck a cord with the researchers as it provided proof of the concept that intravenous chemotherapy could spark tumour regression, as until then cancer curbing agents and procedures include mainly surgery and radiation. 


It resonated as the era of modern cancer chemotherapy treatment and since then, numerous antineoplastic agents have been developed combined with the investigations of various chemotherapeutic regimens in every type of cancer. 

Chemotherapy for few of the most common cancers worldwide

Given below are short notes about the chemotherapies given for a few of the most common cancers worldwide.


Chemotherapy for breast cancer

In locally advanced breast cancer and early-stage breast cancer, neoadjuvant chemotherapy is extensively used to provide greater chances for breast-conserving surgery. Poly chemotherapy (combination chemotherapy) reaps higher response rates when compared with single-agent chemotherapy as it yields efficacy maintenance, toxicity reduction and delayed development of drug resistance. Nausea, vomiting and fatigue were the most frequent side effects of chemotherapy for breast cancer (1st cycle).


Chemotherapy for lung cancer

Currently, the 1st and 2nd line management for small cell lung cancer is chemotherapy, especially if the small cell lung cancer crossed the metastasis stage. While the median overall survival for metastatic small cell lung cancer treated with standard frontline chemotherapy is only approximately 10 months, most patients develop recurrent disease.


Chemotherapy for prostate cancer 

Chemotherapy in prostate cancer has undergone dramatic changes since its inception. While previous research demonstrated the use of varying chemotherapy regimens as palliative in nature, it changed with the administration of taxane drugs. A 2015 study demonstrated a promising cancer management with adjuvant chemotherapy given after radiation therapy. 


Chemotherapy for ovarian cancer

Decades of clinical trials resulted in the perfection and standardisation of platinum/taxane regimes through the intravenous route to counter the advances of ovarian cancer. Nevertheless, innovation remained in the therapeutic plateau until the introduction of chemotherapy through the intraperitoneal route. The other newer approaches include the targeted agents such as the angiogenesis inhibitors. 


Chemotherapy for colon cancer

Combination chemotherapy (especially when coupled with surgery) is the key concept for the treatment of metastatic colorectal cancer enhancing survival. Following its discovery to till date, antimetabolites are the only chemotherapy to successfully improve the 12-month survival of colorectal cancer. The chemotherapy for metastatic colorectal cancer has been palliative since for many years; managing to increase the duration and quality of the patient’s life, with little hope of cure. 


Chemotherapy for pancreatic cancer

Surgery with adjuvant chemotherapy is the only chance of cure for pancreatic ductal adenocarcinoma, but most patients are diagnosed with irresectable disease, leaving palliative chemotherapy as the mainstay of treatment for most patients. Despite major advances in surgical techniques and adjuvant chemotherapy, most patients relapse after surgery and are finally also treated with palliative chemotherapy. 


Chemotherapy for stomach cancer

Conventionally, the chemotherapeutic responses could be up to 60% of patients in phase II trials, while majority of them developed drug resistance within a few months. The median survival of usually ranged from 7-9 months. As the chemotherapeutic results are complicated with toxic effects, the administration of chemotherapy is done only after evaluating its benefit in terms of survival and/or quality of life when compared to best supportive care alone.

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Chemotherapy before and after

The following are some of the things that can happen before and after chemotherapy:

Before chemotherapy treatment

  • You will have a physical exam and blood tests to make sure you are healthy enough to receive treatment.
  • You may be given medications to help prevent or manage side effects, such as nausea and vomiting, fatigue, low blood counts, mouth sores.
  • You may need to have a central line inserted, which is a small tube that is placed in a vein in your chest. This allows the chemotherapy drugs to be given directly into your bloodstream.

After chemotherapy treatment

  • You will continue to have blood tests to monitor your side effects and make sure your blood counts are recovering.
  • You may need to take medications to help manage side effects.
  • You may need to rest and take it easy.
  • You may need to avoid certain activities, such as driving or operating machinery.


It is important to talk to oncologist about the side effects of chemotherapy and how to manage them. Chemotherapy treatment can be a difficult experience, but it is important to remember that you are not alone. There are many people who have gone through chemotherapy and survived. With the right support, you can get through this.

Common Chemotherapy side effects

During chemotherapy the uncontrolled cell division (carcinogenesis) is restricted and in the course of time, they achieve the destruction of cancer cell. In addition to cancer cells, other tissues in the body also display varying degrees of sensitivity to chemotherapeutic drugs. Consequently, the antitumor effect is often accompanied by different degrees of adverse reactions, including side effects. The main chemotherapy side effects are:


Bone marrow suppression after chemotherapy

Bone marrow suppression is one of the commonly expected side effects of chemotherapy process. Bone marrow suppression is the reduction of one or more kinds of white blood cells, platelets, and red blood cells in a blood test, which originate from stem cells in the bone marrow.


Blood cells in the bloodstream are short-lived and often need to be replaced. Stem cells, the precursors of blood cells, must divide quickly to replenish them in time. The principle mechanism of chemotherapy antitumor therapy is it targets cell which divided quickly so that results in suppression of normal bone marrow cells. Almost all chemotherapeutic agents have myelosuppressive effects with alkylating agents and podophyllotoxins showing strong bone marrow inhibition.


Gastrointestinal adverse reactions

Gastrointestinal mucosal cells and bone marrow cells are both proliferative cells with a high growth function. Therefore, gastrointestinal mucosal cells show sensitivity to chemotherapy drugs, and toxic reactions within a few hours of medication. Gastrointestinal reactions usually appear earlier than bone marrow suppression.

  • Gastrointestinal adverse reactions can include loss of appetite, nausea, vomiting, abdominal pain, diarrhoea, and even bloody diarrhoea.
  • Vomiting is a complex pathological reflex process that is relevant with the stimulation of anticancer drug metabolites in the umbilical cord vomiting centre and chemo-sensory area. 
  • Diarrhoea and constipation during chemotherapy are also seen. Bloody diarrhoea indicates bleeding from a ruptured digestive tract.
  • Gastrointestinal toxicity gradually progresses with the passage of time. 


Chemotherapy induced neurotoxicity

Neurotoxicity results from the toxic effect of metabolism of drugs on the nervous system.

Neurotoxicity can occur in the form of numbness of the toes, loss of tendon reflexes, paresthesia and sometimes constipation or paralytic ileus. Some drugs can produce central nervous toxicity, mainly manifested as paresthesia, vibration feeling, numbness, tingling, gait disorders, ataxia, lethargy, mental abnormalities.


Neurotoxic damage is mainly due to vinca alkaloids and the alkylating agents, which produce severe neurotoxicity including confusion, disorientation, headache, auditory hallucinations, vision, drowsiness, tremor, paraparalysis, epilepsy, vertigo, etc., lasting from 1 to 76 days.


Chemotherapy hepatotoxicity

Hepatotoxicity leads to different types of liver damage, but do not have uniform hepatotoxicity. Most hepatotoxicity is usually due to specific reactions, with a low and unpredictable incidence, usually observed 1 to 4 weeks after administration.


Signs of hepatotoxicity include necrosis, inflammation, and may also be due to long-term drug use cause chronic liver injury, such as fibrosis, fatty change, granuloma formation, eosinophil infiltration. Clinical can show is liver function examination is abnormal, liver area ache, the liver is intumescent, yellow glanders to wait.


The other common chemotherapy side effects which usually originate due to the above phenomena include: 

  • Loss of taste during chemotherapy: Altered taste is a common but unrecognized therapeutic side effect in cancer patients during chemotherapy. 
  • Chemotherapy induced anaemia: Anaemia is the reduction of red blood cells which carry the oxygen to various parts of body. Chemotherapy results in anaemia as bone marrow is supressed so new red blood cell production is dysregulated.
  • Appetite changes: Chemotherapy process can cause appetite changes because of nausea, mouth and throat problems making it painful to eat. It can alter taste or may lose the taste for food. 
  • Bleeding: Platelets help in clotting of blood clot during bleeding. A low platelet count is called thrombocytopenia. Chemotherapy can reduce platelets due to bone marrow suppression. This condition causes bruises without any insult, epistaxis (bleeding from nose), a rash of tiny, red dots, bleeding gums after chemotherapy.
  • Chemotherapy induced fatigue: Fatigue (general weakness) from chemotherapy can be presented in feeling weak, weary, worn out, heavy, or slow. Nevertheless, resting does not always help. Fatigue could be explained as a cumulative effect of all the side effects such as anaemia, pain, medications, appetite changes, stress, anxiety, depression etc. 
  • Chemotherapy induced alopecia (hair loss): Alopecia is one of the most common and prominent chemotherapy side effects. It occurs due to the chemotherapy damage inflicted in cells that cause hair growth. Hair loss could happen anywhere on your body: your head, face, arms, legs, underarms, or the pubic area between your legs.
  • Acquired infection during chemotherapy: Since chemotherapy process suppresses bone marrow, it is harder to produce new white blood cells and consequently, infections occur as these white blood cells help in fighting them. Neutropenia (neutrophil count is low) is the prime causative factor.
  • Infertility due to chemotherapy: Infertility is the inability to reproduce. As chemotherapy process can damage the ovaries in female and sperm cells in male, it could result in infertility. In females, since the number of healthy eggs in the ovaries are reduced, the female hormones are also reduced. The drop in hormones can lead to early menopause. 

Chemotherapy patient education 

The healthcare team does provide enough education to the patient about to undergo chemotherapy. Depending on the resources, the patient education could include healthcare materials regarding the self-management of cytotoxic chemotherapy and its related adverse effects. Education about the treatment to the patients could greatly help in reducing the chemotherapy side effects.



A 2023 study demonstrated that cancer patients who received standard patient education about chemotherapy including the means to deal with the adverse effects themselves etc helped in the psychological coping and support. 

Targeted therapy vs Chemotherapy | Difference between targeted therapy and chemotherapy

Targeted therapy represents a group of drugs to treat cancer which are discovered/innovated recently (when compared to chemotherapy). The main differences between targeted therapies and chemotherapy include: 

Parameters Targeted therapy Chemotherapy
Principle Function by destroying the factors which help in carcinogenesis. Functions by directly interfering with cell division or DNA synthesis.
Effect towards other tissues Less detrimental to the normal tissue and cells Chemotherapy drugs also kill normal tissue cells which undergo vigorous proliferation
Types Drugs could be divided based on its targets - I. Growth factors and receptors, II. Intracellular kinases, III. Tumour-host interactions, IV. Immune recognition of cancer, V. Other cancer behaviours Various types based on mechanism of action

Immunotherapy vs Chemotherapy | Differences between immunotherapy and chemotherapy

Both immunotherapy and chemotherapy are cancer treatments commonly administered to stop the cancer growth. The difference lies in their mechanism of action. The differences in them include: 

Parameters Immunotherapy Chemotherapy
Goal Develop highly active tumour-specific T cells that can kill and eradicate cancer cells. To interfere with cell division or DNA synthesis thus stopping cancer and carcinogenesis
Effect towards other tissues Mostly this therapy does not have any effect on other tissues but in few cases the immune system mistakenly targets normal cells. Chemotherapy drugs also kill normal tissue cells which undergo vigorous proliferation
Side effects Immune-related adverse event, or irAE could include fatigue, rash, pneumonitis, breathlessness, colitis, arthritis, hepatitis etc bruising and bleeding, hair loss, fatigue, infections, anaemia, vomiting, nausea, appetite change, constipation, diarrhoea etc
Types Checkpoint inhibitors, Chimeric antigen receptor T cell therapy, Cytokines Immunomodulators, Cancer vaccines, Monoclonal antibodies Various types based on mechanism of action
Administered through Oral chemotherapy, Intravenous (injected into vein), Topical (applied on the skin), Intraurethral (into the bladder) Oral chemotherapy (through mouth), Intravenous (injected into vein), Intraarterial (injected into artery), Intramuscular (injected into muscle), Intraperitoneal (injected into abdomen), Topical (applied on the skin).

Chemotherapy vs Radiation therapy |Differences between chemotherapy and radiation therapy

Chemotherapy and radiation therapy are both common treatments for cancer. They work in different ways, but both can be effective in killing cancer cells. The best treatment for you will depend on the type of cancer you have, the stage of your cancer, and your overall health. The differences in them include:

Parameters Chemotherapy Radiation therapy
Definition Chemotherapy is a systemic treatment, which means that the drugs travel through the bloodstream to reach cancer cells throughout the body. Radiation therapy is a localized treatment, which means that the radiation beams are focused on a specific area of the body where the cancer is located.
Process Kills cancer cells throughout the body Kills cancer cells in a specific area of the body
Side effects Nausea, vomiting, hair loss, fatigue, low blood counts, kidney damage, liver damage, heart damage Fatigue, skin reactions, hair loss, nausea, vomiting, diarrhea, dry mouth, difficulty swallowing, infertility, risk of secondary cancer
Uses Often used in combination with other treatments, such as surgery or radiation therapy Can be used as a primary treatment or in combination with other treatments

Frequently asked questions:


  • What is chemotherapy treatment?

    Chemotherapy treatment consists of chemicals or drugs that cause a lethal cytotoxic effect. While they are initially developed for infections, various drugs have been developed with similar mechanism of action to manage malignant (cancerous) cells so as to arrest tumour cell progression. 

  • Is chemotherapy painful?

    Unfortunately, yes. Ideally, chemotherapy is aimed at attacking the cancer cells which replicate rapidly. Since there are various tissues which contain rapidly proliferating cells for the normal maintenance of body, it could attack noncancerous cells too. Due to this various side effects are generated in which pain is one of the prominent one.

  • How is chemotherapy done?

    Once the oncologists determine the necessity for the administration of chemotherapy and its combinations chemotherapy done through various ways such as: 

    • oral (through mouth)
    • intravenous (injected into vein)
    • intraarterial (injected into artery)
    • intramuscular (injected into muscle)
    • intraperitoneal (injected into abdomen)
    • topical (applied on the skin)
  • Is chemotherapy safe?

    Yes. Chemotherapy is as safe as any standard therapy to treat cancer. Wilt it helps in the management of cancer, it also could cause various toxicities and side effects. Judging the risk benefit ratio, the oncologists administer chemotherapy to cancer patients. 

  • How chemotherapy works?

    Chemotherapy works by administering chemicals or drugs that cause a lethal cytotoxic effect on malignant (cancerous) cells to arrest tumour cell progression.

  • How to minimize chemotherapy side effects?

    The oncologists minimize chemotherapy side effects by on patients, by understanding cause of side effects and the healthcare team discusses the necessary interventions to deal with side effects. The patients usually receive more favourable help for adjuvant therapy during or after chemotherapy. 

  • How effective is chemotherapy?

    The effectiveness of chemotherapy depends on various factors such as the type of cancer, the stage, the spread of cancer (metastatic or non-metastatic), the modality of chemotherapy given, the type of chemotherapeutic agent given, the probability of side effects etc.


    Eg: The combination of platinum analogue drugs provided a median survival of 9-10 months while the combination of antimetabolite drugs provided a median survival of 6 months in gastric cancer. 

  • How many times chemotherapy can be given?

    The chemotherapy could be administered every week or every 2, 3 or 4 weeks, depending on the chemotherapeutic drug or its combination. Each session can last a few hours to a few days.  

  • At what stage of cancer is chemotherapy used?

    Usually, chemotherapy is used to treat cancer in almost all the stages of most cancer types. Rather than the stage and the type of cancer, the goals of therapy decide the utilisation ad administration of chemotherapy.

  • What is chemotherapy treatment?

    Describe the item or answer the question so that site visitors who are interested get more information. You can emphasize this text with bullets, italics or bold, and add links.
  • Is chemotherapy only for cancer?

    No, chemotherapy could be given to infections, too as they work on similar mechanisms of action. Nevertheless, chemotherapy to treat infections and cancer is greatly different in the context of side effects, toxicity origin, etc.  

  • Why is chemotherapy painful?

    Since various tissues contain rapidly proliferating cells for the normal maintenance of the body, and cancer chemotherapy attacks both cancer cells and noncancerous cells, various side effects are generated which pain is one of the prominent ones. 

  • Is chemotherapy worth it?

    Yes, chemotherapy is definitely of worth. It is used as a combination with various types of therapies to subdue cancer.  

  • What are the safety considerations for chemotherapy patients?

    Safety considerations for chemotherapy patients can depend on various factors such as the type of cancer, the course of therapy, the type of cancer etc. Nevertheless, the healthcare team provides the chemotherapy only after taking the essential measures to mitigate the risks associated with the treatments such as either capping off the chemotherapeutic drug or adding newer drugs to therapeutic regimen to counteract the side effects. 

  • What precautions should chemo caregivers take?

    The chemotherapy drugs are toxic and must be handled with care. Gloves must be worn while the drugs are being handled and must be disposed of at once. Washing with soap and water may be deemed necessary for certain drugs.


    Sheets or soiled clothes with oozing bodily fluids could be machine-washed with hot water and regular laundry detergent. Instructions from the healthcare team could help in various other aspects. 

  • Is it safe to touch someone after chemo?

    Yes. It is certainly safe to touch other people while attending chemotherapy. Nevertheless, it must be understood that extreme care must be taken to protect others from coming into contact with chemotherapeutic drugs. 

  • Can chemo affect family members?

    Chemotherapies are potent medicines which may cause adverse effects when it gets contact with skin. So, caution must be maintained during handling the drugs. The American Cancer Society (ACS) reported that within 48–72 hours of treatment, chemotherapeutic medications leave the body. Nevertheless, drug waste may be seen in bodily fluids, such as urine, vomit, and sweat. Therefore, specific precautions can help in avoiding the same. 

  • What is the main problem with chemotherapy?

    Side effects with chemotherapy could vary depending on the type of cancer, the chemotherapeutic agent used, the duration etc. At times it could lead to permanent damage to the lungs, liver, heart, kidneys, or the reproductive system. An oncological team tries its best to mitigate the effects.

  • Can you live a normal life on chemo?

    Yes. It can be possible to lead a normal life taking chemotherapy, by following certain precautions. Feeling a bit unwell immediately after each session is common but with precautions quick recovery can be achieved and the patients can return to the usual activities.

  • What are the best foods for chemotherapy patients?

    During chemotherapy, any light, bland foods can be taken such as:  plain yogurt, fresh fruits, cheese, eggs, cereal, and milk etc. 

How much does chemotherapy cost in Hyderabad, Telangana?

The average chemotherapy cost in Hyderabad ranges varies from ₹ 4,500 to ₹ 8,000 (INR four thousand five hundred to eight thousand) per session excluding chemotherapy drugs charges. 


However, chemotherapy price in Hyderabad depends upon the multiple factors such as patient age, condition, type of cancer, the stage of the disease, the type of chemotherapy drugs used, the duration of treatment, and CGHS, ESI, EHS, insurance or corporate approvals for cashless facility.

How much does a chemotherapy cost in India?

The average chemotherapy cost in India ranges from ₹ 4,000 to ₹ 10,000 (INR four thousand to ten thousand) per session excluding chemotherapy drugs price. However, chemotherapy treatment price in India vary in different private hospitals in different cities. There are some cases where the cost can be higher, such as for rare types of cancer or for patients who need to undergo multiple rounds of chemotherapy treatment.


These are some factors that can affect the cost of chemotherapy in India:

  • The type of cancer: The cost of chemotherapy for different types of cancer can vary significantly. For example, the cost of chemotherapy for breast cancer is typically higher than the cost of chemotherapy for lung cancer.
  • The stage of the disease: The cost of chemotherapy is also affected by the stage of the disease. For example, the cost of chemotherapy for early-stage cancer is typically lower than the cost of chemotherapy for advanced-stage cancer.
  • The type of chemotherapy drugs used: The cost of chemotherapy drugs can vary depending on the type of drug and the dosage used. Some chemotherapy drugs are more expensive than others.
  • The duration of treatment: The cost of chemotherapy also depends on the duration of treatment. Chemotherapy treatment for a few weeks is typically less expensive than chemotherapy treatment for several months.
  • The hospital where the treatment is being done: The cost of chemotherapy can also vary depending on the hospital where the treatment is being done. Private hospitals typically charge more than government hospitals.

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