Administration of the chemotherapeutic agents | Chemotherapy for breast cancer

Administration of the chemotherapeutic agents

In most cases, the cytostatic drugs are administered into a vein, i.e. by infusion. In this way, they can be easily distributed in the blood and hence throughout the entire body and also kill tumour cells where they have not yet been discovered. Some preparations are also available in tablet form.

This oral administration has the advantage that patients are spared the frequent trip to hospital and the invasive procedures on the veins, but recent studies suggest that therapy with oral cytostatic drugs alone is not as effective as infusion therapy. Since chemotherapeutic drugs are often drugs that strongly irritate the peripheral veins, the patient is often given a so-called PORT. A PORT is a central venous access that can be surgically placed, especially in the case of cancer but also in other chronic diseases.

The port has a small chamber that lies under the skin and can be used for quick infusions, drug administration or blood sampling. During short hospital stays, a normal central venous catheter, a so-called “ZVK”, can also be inserted. After more than 10 days, there is an increased risk of infection and the connections are located outside the body, making it impractical for long-term use.

Although the port is more difficult to install, the port can be used for several years. In exceptional cases, the port may remain in the body for up to five years. The port can be punctured through the skin each time the patient is hospitalized and can be used for blood collection, infusions and chemotherapy.

Because the port is under the skin, complications are reduced. Nevertheless, in rare cases, infections or thromboses of the port and chamber may occur. Injuries to the pleura or lungs can also occur when the port is applied or removed. In general, however, the port installation ensures that fast and good venous access is always possible and that drugs can be administered easily and safely in emergencies or during chemotherapy.

Side effects of chemotherapy

Side effects of chemotherapy are many and varied, but can now be relatively well controlled by various drugs. Since cytostatic drugs are not completely specific for tumour cells, they always damage the body’s own tissue, in particular those cells that divide quickly, just like cancer cells. These include hair cells, which is why patients suffer from hair loss; cells of the gastrointestinal tract, which often lead to nausea, diarrhoea and vomiting; and cells of the body’s defence system, which makes patients more susceptible to infections.

As a preventive measure, a medication against vomiting and nausea is always given, such as ondansetron. In addition, there are unspecific complaints, such as lack of concentration, tiredness and exhaustion or loss of appetite. These side effects can occur either directly after the therapy or days or months later and are usually only temporary.

Whether side effects occur and if so, which ones and to what extent, varies from patient to patient and is difficult to predict in advance. . Hair loss is a side effect that can be expected with almost all chemotherapies.

However, hair loss also shows that the chemotherapy is effective. Most chemotherapy drugs are directed against cells that divide and multiply quickly. In addition to cancer cells, which often grow particularly fast due to defects in cell division, hair root cells are also affected. Blood-forming cells and immune cells can also be affected, as they divide just as quickly. After treatment, the hair root cells recover and normal hair growth returns.