Oncological pathologies occupy one of the first places in terms of the number of deaths worldwide. Unfortunately, the incidence of cancer is not decreasing, but only increasing. Scientists are trying to find ways to treat oncological pathologies that would completely cope with the disease. To date, 3 methods of fighting cancer are being performed: surgery, chemotherapy and radiation therapy. All of them are aimed at removing the tumor itself and reducing the risk of recurrence. Adjuvant and neoadjuvant chemotherapy is used to stop the growth of abnormal cells. These methods are used both as a complex treatment and independently (for some oncological pathologies).
Adjuvant chemotherapy - what does it mean?
Chemotherapy is a medical method of treatment. For its implementation, cytostatic agents are used to kill tumor cells. Patients often ask the question: adjuvant chemotherapy - what is it? This term implies the conduct of courses of drug treatment after surgery. Based on thisadjuvant chemotherapy is a measure necessary to avoid further development of cancer. This type of treatment is used for almost all tumors. It is used for cancer of the lungs, breast, stomach, intestines and other organs. Chemotherapy is given before and after surgery. For some types of cancer (Hodgkin's disease, tumor of the red border of the lips, skin), it is the only treatment.
Varieties of chemotherapy drugs
All chemotherapy drugs are classified as cytostatics. Their action is aimed at the inevitable death of the tumor cell. This is done in various ways. In most cases, drugs interfere with cell DNA synthesis. As a result, it loses the ability to divide. Violation of the synthesis or function of DNA is carried out by embedding in the chain, breaking bonds between nucleotides.
Chemotherapeutic drugs have different structures. Some of them are plant-based (drug "Vincristine"), others are classified as alkylating agents (solution or tablets "Cyclophosphamide"). Also, the groups of chemotherapeutic agents include special antibiotics, anthracyclines and platinum preparations. Representatives of these groups are the medicines "Rubomycin", "Adriamycin". Adjuvant chemotherapy is administered by intravenous drip. Ointment and tablet forms are considered less effective, therefore they are used extremely rarely. In some cases, drugs are administered intraperitoneally, that is, intoabdominal cavity. Sometimes intra-arterial access is used for injections.
What is chemotherapy done for?
Like all other treatments, adjuvant chemotherapy has certain indications. Before starting treatment with cytostatic agents, it is necessary to conduct a complete examination of the patient. After that, the doctor evaluates all the risks and decides on chemotherapy. The following indications for treatment with cytostatics are distinguished:
- Tumours of the hematopoietic system (leukemia). With this type of cancer, chemotherapy is the only way to deal with atypical cells.
- Tumor of muscle tissue - rhabdomyosarcoma.
- Chorioncarcinoma.
- Wilms and Burkitt tumors.
- Malignant neoplasms of the breast, uterus and appendages, digestive tract, genitourinary system, lungs, etc. In these cases, adjuvant chemotherapy is an additional method of treatment. It is performed after the removal of the tumor.
- With inoperable cancer. In some cases, treatment with cytostatic agents can reduce the size of the tumor. This is necessary for surgical treatment (for example, ovarian cancer). Also, this method can be used in order to reduce the scale of surgery (for breast tumors). In these cases, neoadjuvant chemotherapy is used.
- Palliative care. With advanced forms of cancer, chemotherapy is used to alleviate the patient's condition. Most often it is used in children. It is also used as a palliative care for colon, brain or neck cancer.
Chemotherapy procedure
As you know, chemotherapy is not always easily tolerated by patients. In most cases, patients experience many adverse reactions that occur due to the introduction of cytostatic agents. Some patients refuse treatment.
Adjuvant chemotherapy is given in cycles. The duration of treatment is from 3 to 6 months (sometimes more). The selection of the course is determined by the doctor, taking into account the patient's condition. Most often, about 6-7 courses of chemotherapy are carried out in six months. It is believed that the more often the patient receives treatment, the more effective the result. For example, a course of chemotherapy can last 3 days every 2-4 weeks. At the time of treatment, it is necessary to carefully monitor the patient's condition. Also, the blood count is checked in the break between courses.
Contraindications for chemotherapy treatment
Despite the effectiveness of treatment with cytostatic agents, they are not always prescribed. Every doctor knows that adjuvant chemotherapy affects not only the tumor process, but also he althy cells. In particular, this applies to leukocytes. Some drugs have harmful effects on the cardiovascular system and lungs. Severe kidney and liver diseases are considered contraindications for chemotherapy. This is due to the fact that the risk of developing insufficiency of these organs is too great. Also, chemotherapy should not be given to patients witha history of calculous cholecystitis (gallstones). Contraindications for therapy with cytostatic drugs are changes in the general blood test. Special parameters have been established under which treatment is impossible. These include: a platelet count less than 10010⁹, a decrease in hematocrit and hemoglobin. It is also impossible to conduct chemotherapy in patients with severe asthenia syndrome. A body weight of 40 kg or more is considered acceptable for treatment.
Side effects of chemotherapy drugs
The severity of chemotherapy treatment lies in its side effects. In addition to external manifestations of the adverse effects of drugs, there are changes in the analyzes. The main side effect is the suppression of the hematopoietic system. This mainly concerns the leukocyte germ. As a result of the detrimental effect on white blood cells, the body's immune system suffers. This is manifested by general weakness, the addition of various infections. Another side effect is the neurotoxic effects of the drugs. Some patients have depression, tearfulness, sleep disturbance. Patients also report nausea, vomiting, and diarrhea. The side effect of cytostatic agents also affects the appearance of patients. On examination, there is alopecia (hair loss) and pallor of the skin.
Gastric Cancer: Chemotherapy
Oncological processes in the stomach are often observed. They usually develop on the basis of polyposis or peptic ulcer. Mainmanifestations of stomach cancer are pain in the epigastric region, aversion to meat food, belching. In the initial stages of the oncological process, surgical treatment is necessary. It consists in resection of the organ and the creation of an anastomosis between the esophagus and intestines. Adjuvant chemotherapy for gastric cancer is performed in the absence of contraindications. It allows you to prolong the period of remission, and also slows down the metastasis of the tumor. Unfortunately, cytotoxic drugs are not effective in all forms of gastric cancer. Its positive effect on adenocarcinoma has been proven. It is also carried out as a measure of palliative care.
Adjuvant Therapy for Breast Cancer
Adjuvant chemotherapy for breast cancer is necessary for any histological forms of the oncological process. It is performed after surgical treatment, regardless of the extent of the surgical intervention (mastectomy or sectoral breast resection). This is necessary to avoid metastasis of atypical cells to the lymph nodes and distant organs. In rare cases, chemotherapy is not a mandatory treatment for breast cancer. For example, if the tumor is less than 1 cm in size and does not spread to the lymph nodes. It should also be used with caution in young patients. During the premenopausal period, treatment with cytostatic drugs is carried out for all patients, with the exception of those who have contraindications.
Is adjuvant chemotherapy available for borderline cystadenoma?
Manywomen are familiar with such a diagnosis as a cyst (cystadenoma) of the ovary. In most cases, the formation is benign and rarely turns into a cancerous process. However, there are some types of cystadenomas that are prone to malignancy. These include serous and papillary borderline tumors. Symptoms of these formations can be pain in the lower abdomen, menstrual irregularities. They are detected by ultrasound of the pelvic organs. An accurate diagnosis can only be made with a cystadenoma biopsy. With borderline formations, surgical treatment is necessary, the volume of which depends on the age of the patient. Adjuvant chemotherapy is performed in rare cases when the risk of tumor metastasis is high. It is also indicated for recurrence of the oncological process on the other ovary.
Chemotherapy for lung cancer
The most common cancer is lung cancer. It takes millions of lives around the world. Adjuvant chemotherapy for lung cancer is almost always indicated. It is necessary not only after surgical treatment, but also as an independent method for diffuse small cell tumors. Various drugs are used. Among them are the medicines "Cisplastin", "Vinorelbin", "Gemcitabine" and others. The main indication for chemotherapy is peripheral and central lung cancer involving the thoracic lymph nodes. Treatment with cytostatic drugs is not carried out only in case of refusal of the patient, the presence of decompensated diseases, senileage and at the 4th stage of the oncological process.
Communication of chemotherapy with the development of metastases
One of the main goals of treatment is to remove metastases with adjuvant chemotherapy. It is believed that due to the action of cytostatic drugs, the risk of recurrence of the tumor process is significantly reduced. Thanks to chemotherapy in the postoperative period with cancer of the breast, lung, uterus and appendages, metastases in the regional lymph nodes are completely removed. It also reduces the risk of their appearance in distant organs. Based on this, drug treatment of cancer helps to slow down the oncological process, and in some cases - a complete cure.
Reviews of specialists and patients about adjuvant chemotherapy
According to oncologists, chemotherapy is an aggressive method of influencing the body. It not only suppresses the patient's immunity, but is also difficult to tolerate by patients. Nevertheless, to date, treatment with cytostatic drugs has more positive aspects than disadvantages. It is noted that with a combined approach to the fight against oncology, the chances of survival increase.
