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Chemotherapy for Childhood Cancer

What is Chemotherapy?

Chemotherapy, or “chemo,” is the treatment of cancer using powerful medicines. These medicines work to kill cancer cells or stop them from growing. The specific type of medicine and how it is given depends on many factors. Chemotherapy is planned based on the type and stage of cancer, the goals of treatment, and other therapies that are used.

Chemotherapy works by attacking cells that grow and multiply quickly, like cancer cells. Each drug works a bit differently. But, in general, chemotherapy drugs work by interfering with cells as they divide.

Why is Chemotherapy Used?

Chemotherapy can be used to cure cancer, control cancer, or ease the symptoms of cancer. It may be used alone or in combination with other treatments such as surgery and radiation therapy. For example, some patients receive chemotherapy to make a tumor smaller before surgery or radiation therapy. Chemotherapy is also used after surgery or radiation to kill any cancer cells that remain. Chemotherapy can also be used in combination with radiation therapy to enhance its effects.

Chemotherapy works by attacking cells that grow and multiply quickly, like cancer cells. In this video, a chemotherapy agent attacks the cancer cells (blue) causing them to undergo a form of cell death called apoptosis.

How is Chemotherapy Given?

Chemotherapy can be given in several ways. The method depends on the type of cancer, the location of the cancer, and the specific drug used. 

Most often, chemotherapy is given by mouth or through a vein. This is called systemic chemotherapy because the drugs travel throughout the entire body. The chemotherapy can kill cancer cells that have traveled away from the main tumor.

  • Intravenous (IV) chemotherapy – Chemotherapy is given through an IV in a vein. This is the most common form of chemotherapy in childhood cancer.
  • Oral chemotherapy – Chemotherapy is given by a pill or liquid that you swallow.

Sometimes, medicine is given near the tumor. Examples are giving chemotherapy into the spinal fluid or abdominal cavity.

Nurse adjusts monitors for a childhood cancer patient.

Most often, chemotherapy is given by mouth or through a vein.

When is Chemotherapy Given?

Chemotherapy usually involves multiple doses of treatment over a period of time. These treatments are given on a specific schedule. The goal of the schedule is to maximize the work of the medicine and to give the body a chance to recover.

An illustration of a patient in a chair in a hospital room receiving chemotherapy.

The medical team will decide:

  • How many days in a row the medication is given
  • Number of “rest days” between doses of chemotherapy
  • Number of cycles

A chemotherapy cycle is the number of days in a row of treatment plus the number of rest days. The number of cycles that are prescribed make up a course of chemotherapy.

Depending on the type of chemotherapy and patient health, chemotherapy may be given in a hospital, clinic, or at home.

Side Effects of Chemotherapy

Side effects are problems caused by cancer treatments. Many of the side effects of chemotherapy go away after the treatment is over. But, sometimes side effects don’t go away for a long time or even develop later in life. These are called long-term side effects or late effects.

Chemotherapy targets cells that grow and divide quickly – like cancer. But, it can harm other fast-growing cells in the body. These include the cells that line the mouth and intestines and cells that cause hair to grow. This is why side effects like mouth sores, nausea, and hair loss are common. 

Chemotherapy can also damage cells in the bone marrow where new blood cells are made. Low blood cell counts can increase risk for infection, bruising, and fatigue.

Medicines can have different side effects, and not all children respond to medicines in the same way. The care team will discuss common side effects, when they might occur, and some ways to manage them.

An illustration of a patient standing on the left, with three version of the patients face on the right. The top version is a closeup of the patient's mouth showing mouth sores. The middle version shows the patient with a green face indicating nausea. The bottom version show the patient with a bald head.

Chemotherapy targets cells that grow and divide quickly – like cancer. But, it can harm other fast-growing cells in the body. These include the cells that line the mouth and intestines and cells that cause hair to grow. This is why side effects like mouth sores, nausea, and hair loss are common.


Reviewed: June 2018

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