When a cancer is diagnosed, it is important to determine the type, size and stage of the tumor. The most appropriate treatment method for the patient is then selected. If chemotherapy is administered, an individualized treatment plan is developed for each patient.
Monotherapy or combination therapy
Before chemotherapy is started, it is determined which cytostatic drugs will be administered to the patient. A variety of different drugs are available here, which can be administered either individually (monotherapy) or in combination (combination therapy). In combination therapy, the different modes of action of different cytostatic drugs are used to fight the tumor cells particularly effectively.
In addition to the cytostatic drugs, auxiliary drugs are often administered to enhance their effect, but without being toxic themselves. In addition, drugs are used to relieve the unpleasant side effects of chemotherapy, such as severe nausea.
Port or infusion
In addition to the type of cytostatic drugs, the method of administering the drugs is also determined before therapy begins. Some cytostatic drugs can be given to patients in the form of tablets or by injection, but most often they are administered by infusion.
If cytostatic drugs are administered more frequently or over a longer period of time, the insertion of a so-called port should be considered. This is a fixed access into the vein. It is inserted under the skin, usually near the collarbone, during a surgical procedure. From there, there is a connection to the vein via a thin tube. This eliminates the need to pierce a vein each time during treatment.
Dosage of cytostatic drugs
How much medication is dosed during chemotherapy depends primarily on the patient’s body surface area, which is determined by height and weight. In addition, other factors also play a role: for example, if the patient suffers from liver or kidney dysfunction, the breakdown or excretion of the cytostatic drugs is slowed. Therefore, the dosage of the drugs must be adjusted accordingly.
During treatment, the dosage of the cytostatic drugs can be redetermined if necessary. This may be necessary, for example, if the patient suffers from very severe side effects or if his or her body recovers poorly from the stresses of treatment during breaks in therapy.
Three to six treatment cycles
The treatment plan also specifies the duration of treatment and the interval between treatment phases. In fact, chemotherapy is usually given in several treatment cycles – often between three and six cycles.
A treatment cycle consists of several doses of cytostatic drugs, each administered a few days apart. This is followed by a longer break during which no drugs are administered. In most cases, several treatment cycles are necessary to also combat tumor tissue that was not active during the previous cycle and was therefore not affected by the cytostatic drugs.
In the breaks between the individual treatments, the body can recover from the effects of the cytostatic drugs. This is because these not only fight the cancer cells, but also damage healthy cells that are dividing rapidly. During the breaks, these cells can regenerate; in healthy tissue, in fact, this process is much faster than in tumor cells.
Outpatient or inpatient
Chemotherapy can be given on an outpatient or inpatient basis. As a rule, treatment nowadays is performed on an outpatient basis, allowing patients to recover at home between sessions. Treatment is performed either as an outpatient in a hospital or in an oncologist’s office.
Under certain circumstances, however, inpatient treatment may be necessary. This is the case, for example, with particularly intensive treatments in which kidney function or other physical functions must be checked regularly. Similarly, patients who are considered to be at particular risk of infection during treatment are also treated in the hospital.
