What is Systemic Chemotherapy?

Systemic chemotherapy is an approach to chemotherapy where the drugs are allowed to travel throughout the body to eradicate the cancer, rather than being applied directly to the cancer for the delivery of targeted therapy. The delivery method appropriate for a patient depends on the cancer and the situation. Patients with cancer will meet with oncologists to discuss treatment options and develop the most effective treatment plan. Treatment usually includes multiple forms of treatment to attack the cancer from several angles.

Physicians can deliver systemic chemotherapy intravenously or by mouth. Intravenous drugs go directly to the bloodstream and are often highly concentrated. Oral medications are absorbed through the patient's digestive tract, eventually reaching the blood. As the medications move through the body, they latch on to suspected cancer cells and destroy them or flag them for the body to destroy.

One problem with systemic chemotherapy is the high probability of collateral damage. These medications cannot distinguish between good, neutral, and bad cells, and may cause cell death in healthy cells as they attack cancerous cells. This can result in significant side effects for the patient, including disabling side effects like extreme fatigue, bone marrow depletion, and chronic nausea and vomiting. The medications are carefully calibrated to strike a balance between not getting enough cancer cells because the drugs are too weak, and taking out too many healthy cells because the drugs are too strong.

This type of chemotherapy may be recommended when a cancer has metastasized or there are concerns about metastasis and when it is impossible to deliver targeted medications directly to the tumor. The chemotherapy regimen can include a combination of drugs delivered in cycles, or a single drug, depending on the nature of the cancer. Surgical treatment to remove tumors and radiation to target tumors can also be included in cancer treatment.

Systemic chemotherapy can be very toxic. Patients are usually given treatments in a clinical environment in case they experience complications requiring medical intervention. When treatments are taken at home, patients are advised carefully about side effects and are encouraged to call a physician if they start to experience complications. The drugs are also carefully controlled, as they can be very dangerous for people who do not have cancer.

Success rates with systemic chemotherapy are highly variable. Some cancers respond very well to chemotherapy and the treatment may be curative in nature. Others are highly aggressive, and the chemotherapy may be intended primarily as a palliative measure to increase patient comfort without actually eradicating the cancer.

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Post 3

@Fa5t3r - I can definitely see why people might try an alternative cancer treatment. I've heard that many doctors, when they hear that they are terminal and chemo can only extend their life by a little while, will opt not to have it. They prefer to spend their last few months without the devastating effects.

It's even sadder that systemic chemotherapy is usually used in those last ditch efforts, when most hope is already gone, because it makes you much more ill than normal chemo does.

I think it's a tough call though, because the family can be very disappointed and angry if the patient refuses to "fight" for their life. I just think it's a complex and personal decision and should be respected whatever the patient decides.

Post 2

@pleonasm - I think that people also feel sick because of the general chemo side effects and not just because of the chemicals attacking the stomach lining.

Chemotherapy really is a horrible thing. I just wish that, for all the pain it causes, it was a more certain cure. It makes me sad and kind of angry that people end up having to go through that and then it turns out to not help all that much.

Post 1

I never used to understand how chemotherapy could work without killing the patient altogether. I didn't think that scientists were advanced enough to really target particular cells and I didn't understand how any healthy cells could escape.

When my mother had cancer, I read up on it and discovered that chemotherapy works because the chemicals target quick growing cells. It really explains pretty much every chemotherapy side effect, and it all makes sense.

Cancer cells are quick growing and that's why they are dangerous. They are basically normal cells that grow too fast and don't die when they are supposed to. But some other quick growing cells are hair cells and stomach cells. So it's no wonder that people lose their hair and feel very ill on chemo.

Thankfully my mother has been cancer free for a while now.

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