Chemotherapy

   Chemotherapy is the use of drugs to kill cancer cells. Systemic chemotherapy is delivered through the bloodstream, targeting cancer cells throughout the body. Chemotherapy is given by a medical oncologist. Most chemotherapy used for lung cancer is given intravenously. The side effects of chemotherapy depend on the individual and the dose used, but can include fatigue, risk of infection, nausea and vomiting, loss of appetite, and diarrhea. Nausea and vomiting are often avoidable; for more information, read the What to Know: ASCO's Guideline on Preventing Nausea and Vomiting Caused by Cancer Treatment. These side effects usually go away once treatment is finished.

   Chemotherapy may also damage normal cells in the body, including blood cells, skin cells, and nerve cells. This may result in low blood counts, an increased risk of infection, hair loss, mouth sores, and/or numbness or tingling in the hands and feet. Your medical oncologist can often prescribe drugs to help provide relief from many side effects. Hormone injections are also used to prevent white and red blood cell counts from becoming too low.

   Newer chemotherapies cause fewer side effects and are as effective as older treatments. Chemotherapy has been shown to improve both the length and quality of life in people with lung cancer of all stages.

   The medications used to treat cancer are continually being evaluated. Talking with your doctor is the best way to learn about the medications prescribed for you, their purpose, and their potential side effects or interactions with other medications. Learn more about your prescriptions through Cancer.Net's Drug Information Resources, which provides links to searchable drug databases (Swierzewski, 2007).

CASE STUDY:

   DH is a 70 year old female with a diagnosis of small cell carcinoma of the lung limited stage disease.  The patient was diagnosed August, 2007 and treated from 10/2007 through 11/2007 with Carboplatin and VP16.  The patient had no response to the initial treatment.  She was subsequently treated Carboplatin and Taxol from 12/2007 through 3/2008.

   After completion of chemotherapy plans were made for her to receive radiation therapy. The plans for radiation were delayed due to the discovery of a parotid tumor. This tumor was identified as a Warthin’s tumor (benign neoplasm of the salivary glands).  The patient did receive radiation therapy from 7/2008 to 10/2008.  Dosing of 5,580 cGy (cGy= centigray, the gray measures the deposited energy of radiation) and 31 fractions (the smaller, divided doses of radiation that are given each day) was administered over 70 days. 

  DH has been off chemotherapy since 3/2008 and radiation therapy since 10/2008 with no further treatment. DH returns today in follow up. She has had a relatively stable weight and good appetite.  The patient had a mammogram, CT/Abd-Pelvis and chest x-ray on February 3, 2009.  All were normal with the exception of a slight prominence of the left hilum thought to be related to original tumor.  Patient also had colonoscopy and endoscopy done on 3/30/2009.  The endoscopy was negative but the colonoscopy was positive for diverticuli.  PET CT done on 3/25/2009 at local hospital showed areas of enlarged nodes located around the bronchial tree, abdomen and left axillary. DH is to return to her primary care physician (PCP) to have an area in the abdomen removed and biopsied.  She has an appointment with the PCP on Friday, April 10, 2009. She does complain of non-exertional chest pain and has a history of hypertension.  DH does have some general medical arthritis as well as paresthesias and numbness from Taxol therapy.

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