If a cancer is diagnosed, it is important to determine the type, size and stage of the tumor. Subsequently, the most appropriate treatment method for the patient is selected. When chemotherapy is given, an individual treatment plan is set up for each patient.
Monotherapy or combination therapy
Before beginning chemotherapy, it is determined which cytotoxic drugs are administered to the patient. Here are a variety of different drugs available that can be administered either individually (monotherapy) or in combination (combination therapy). In the combination therapy, the different modes of action of different cytostatics are used to fight the tumor cells particularly effectively.
In addition to the cytostatics auxiliary medicines are often still administered, which enhance their effect, but without being themselves toxic. 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 cytostatics, the form of administration of the drugs is determined before the start of therapy. Some cytostatics can be administered to the patient in the form of tablets or by syringe, but most of the administration is by infusion.
If cytostatics are administered more frequently or over a longer period of time, the use of a so-called port should be considered. This is a firm entry into the vein. This is used during a surgical procedure under the skin, usually in the vicinity of the clavicle. From there, there is a connection to the vein via a thin tube. As a result, it is no longer necessary to puncture a vein during treatment.
Dosage of cytostatics
The amount of medication that is dosed during chemotherapy depends primarily on the patient's body surface, which is determined by body size and weight. In addition, other factors also play a role: If the patient suffers from, for example, a liver or kidney dysfunction, the breakdown or elimination of the cytostatic drugs is slowed down. Therefore, the dosage of the medication must be adjusted accordingly.
During treatment, the dosage of the cytostatics can be redetermined when needed. This may be necessary, for example, if the patient suffers from very severe side effects, or if his body recovers poorly during the treatment breaks from the strains of the treatment.
Three to six treatment cycles
The treatment plan also defines the duration of the treatment and the time interval between the individual treatment phases. In most cases, chemotherapy takes place in several treatment cycles - often between three and six cycles.
A treatment cycle consists of several cytostatic doses, which take place every few days. Thereafter, a longer break takes place in which no medication is administered. In most cases, several treatment cycles are needed to combat the tumor tissue, which was not active during the previous cycle and thus was not affected by the cytostatic drugs.
In the intervals between treatments, the body can recover from the effects of cytostatics. Because these not only fight the cancer cells, but also harm healthy cells that divide quickly. During the breaks, these cells can regenerate, for healthy tissue, this process is much faster than the tumor cells.
Outpatient or inpatient
Chemotherapy can be done both outpatient and inpatient. As a rule, treatment is nowadays performed on an outpatient basis so that patients can recover at home between sessions. The treatment is either outpatient in the hospital or in the office of an oncologist.
However, under certain circumstances, in-patient treatment may also be necessary. This is the case, for example, for particularly intensive treatments in which the kidney function or other bodily functions must be checked regularly. Similarly, patients who are classified as particularly susceptible to infection during treatment are treated in the hospital.