INTRODUCTION

Our bodies are composed of trillions of cells, all working together. In cancer, one of those cells stops paying attention to the normal signals that tell cells to grow, stop growing or even to die. Cancer cells still share many of the same needs and properties of normal cells but they become independent of the controls that make our body function smoothly. The process by which a normal cell changes into one that behaves so abnormally can take a long time and is often triggered by outside influence. Cancer is a group of more than 100 different diseases. Cancer occurs when cells become abnormal and keep dividing and forming more cells without control or order. If cells keep dividing when new cells are not needed, a mass of tissue forms. This mass of e tra tissue, called a growth or tumor, can be benign or malignant. !ost cancers are named for the type of cell or the organ in which they begin. "hen cancer spreads, the new tumor has the same kind of abnormal cells and the same name as the primary tumor. #nother word for cancerous is malignant, so a cancerous tumor is referred to as malignant. $ut not all tumors are cancer. # tumor that is not cancer is called benign. $enign tumors do not grow and spread the way cancer does. They are usually not life threatening. %lobally the burden of new cancer cases in this decade is estimated to be around &0 million. The magnitude of problem of cancer in Indian subcontinent in terms of sheer number is most alarming. 'rom the population census data of India in 1((1, )0(,000 new cancer cases were diagnosed in the country. In &001 census it increased to *0),000. In India most common cancers found in male were cancers of the lung, pharyn , oesophagus, tongue and stomach while among female cancers of the cervi + breast, ovary, oesophagus and mouth were common.

TYPES OF CANCER

Over 100 different types of cancer found worldwide they are named on the basis of their organ of occurrence. ,ome ma-or types are described below./

0#!1

#''1CT12 O3%#0 O' $O24

Corte or outer layer of adrenal gland. #ppendi . 5air glands. $ladder and s6uamous cell. ,arcoma that arises in the bone. $rain, spinal cord or nerves. !ilk duct, lobule and dermal 0eurendocrine cells Cervi Colon 7nknown sites 1sophageous $ones of child and adolescents 1ye, eyelids and surrounding skin 'allopian Tube ,alivary gland, oral and nasal cavity ;ymphatic system of body <idney %lottis, supraglottis and subglottis $one marrow ;iver ,kin+ palms, sole of foot 8leura and pericardium and peritoneum

#drenocortical Carcinoma ./ #ppendi Cancer. / #lopecia #reata. / $ladder Cancer. / $one Cancer./ $rain Cancer./ $reast Cancer./ Carcinoid Tumors./ Cervical Cancer./ Colon Cancer./ Cancer of 7nknown 8rimary./ 1sophageal Cancer./ 1wing9s ,arcoma./ 1ye Cancer./ 'allopian Tube Cancer./ 5ead : 0eck Cancer./ 5odgkin9s ;ymphoma./ <idney Cancer./ ;aryngeal Cancer./ ;eukemia./ ;iver Cancer./ !elanoma./ !esothelioma./

 !ultiple 1ndocrine 0eoplasia./ !ultiple !yeloma./ !yelodysplastic ,yndrome./ !yeloproliferative 2isorders./ Oral Cancer./ Ovarian Cancer./ 8ancreatic Cancer./ 8arathyroid 2isease./ 8enile Cancer./ 8ituitary Tumors./ 8rostate cancer./ ,kin Cancer./ ,oft Tissue ,arcoma./ ,tomach Cancer./ Testicular Cancer./ Thyroid Cancer./ 7terine Cancer./

1ndocrine glands $one marrow and blood forming system $one marrow 3.$.C., platelets, ".$.C. !outh and oropharny Cells of ovary Tissues of pancreas 8arathyroid gland 8enis 8ituitary glands Tissues of prostate gland $asal and ,6uamous cell 1very type of soft tissue in body ,tomach Testicles and testes Thyroid 7terine lining

"aldenstrom9s !acroglobulinemia./ Chronic lymphoma of blood plasma

CANCER REGISTRATION IN INDIA

The cancer registration is a mechanism to collect and classify information on all cancer cases in order to produce statistics on the occurrence of cancer and to provide a framework for assessing and controlling the impact of cancer on the community. The population based cancer registries collect and process data relating to a defined geographical area while the hospital based cancer registries relate to data available with a specific hospital. 8opulation based cancer registries record all the new cancer cases occurring in a defined population =generally a geographic area>,with epidemiological and public health aspects in mind. The hospital based cancer registries record information on cancer patients attending a particular hospital, with focus on clinical care and hospital administration. If all the health care facilities in a defined geographic area collect the data on cancer cases as per standardi?ed proforma, the pooling of data =with elimination of duplicates> would result into a population based cancer registry. In areas with no population based cancer registry, the information from hospital based cancer registries or from special patient series =as pathological record>, help in assessing the public health re6uirements, and the impact of control measures. 7ntil 1()@, information on cancer occurrence in India was available from surveys. Initiation of population based cancer registries at

$ombay in 1()@, at 8une in 1(AB, at #urangabad in 1(A*, and at #hmedabad : 0agpur in 1(*0, started the availability of data on cancer incidence on a continuous basis. 5owever, the boost for cancer registration in India was in 1(*&, through initiation of 0ational Cancer 3egistry 8rogramme =0C38> by Indian Council of !edical 3esearch. The 0C38 began with three population based =e isting $ombay registry and new registries at $angalore and !adras>, and three hospital based registries =at Chandigarh, 2ibrugarh : Trivandrum>. 'urther, e pansion of 0C38 saw the initiation of urban population based cancer registries at $hopal : 2elhi in 1(*A+ rural population based cancer registries at $arshi =!aharashtra> in 1(*A+ and hospital based cancer registries at main hospital of 8$C3s at $angalore, $ombay : !adras in 1(*). # hospital based cancer registry functioned at Chandigarh from 1(*& till 1((&. Coordinating unit of 0C38 provides guidelines and 6uality control checks to the current network of si population based and five hospital based cancer registries of 0C38. The data from cancer registries helped in highlighting the magnitude and common sites of cancer in India, and was useful in planning the0ational Cancer Control 8rogramme. The network of population based cancer registries under 0C38 is proposed to be e panded. $esides the above mentioned registries population based cancer registries are also functioning at <olkatta, Thiruvananthapuram, <arunagapally =rural <erala> and #mbillikai =rural Tamil 0adu>. The crude incidence rates of cancer in 1((A as recorded by the urban population based cancer registries under 0C38, varied between C&.( and *1.C per 100,000 men+ and between C).* and (C.) per 100,000 women. The age standardi?ed incidence rates in these registries ranged from *1.* to 1&&.* per 100,000 men+ and from (B.C to 1BA.A per 100,000 women. The rural registry at $arshi =!aharashtra> showed crude incidence rates of B&.) per 100,000 men : @&.( per 100,000 women+ and age standardi?ed rates of B*.& per 100,000 men : @(.* per 100,000 women. # global comparison shows that India has high incidence rates of cancers of oral cavity, pharyn , : cervi .

CANCER OCCURRENCE IN MALE

CANCER OCCURRENCE IN FEMALE

ETIOLOGY

The current strategy against cancer is to eradicate the disease after detection. The ideal strategy is prevention, but this is not possible in most cases because the e act cause or causes of most cancers are unknown. The ma-or e ception to this is lung cancer+ in which there is no doubt that cigarette smoking is the ma-or contributing factor thus, lung cancer is largely a preventable cancer. !ore and more studies are revealing highly suggestive clues about the causes of cancer. The known and suspected causes of cancer, fall into two broad categories. environmental and hereditary. In addition, the oncogene concept, which is the most recent theory of cancer etiology, will be reviewed.

ENVIRONMENTAL FACTORS
The role of environmental factors in human cancer was demonstrated more than &00 years ago by the 1nglish physician 8ercival 8ott. In those days, young boys hung on ropes to clean the soot from inside chimneys. In 1AAC, 8ott recogni?ed a relationship between prolonged e posure to the irritating effects of chimney soot and the subse6uent development of scrotal cancer in these young boys. ,ince then, evidence documenting environmental factors in the etiology of cancer has continued to accumulate. Today, it is estimated that environmental factors may be involved in a significant percentage of cancers. THE INDUSTRIAL ENVIRONMENT ,ome occupations have been implicated in the etiology of cancer. 'or e ample, workers in the #niline dye industry have an increased risk of developing bladder cancer. ;ung cancer is more 8revalent among those who mine or work with asbestos and those working with chromate or uranium ores, especially if they also smoke cigarettes. "orkers in nickel/ refining plants are more likely to develop cancer of the nasal sinuses than are average individuals. 1 posure to certain solvents, eg, ben?ene, has been associated with an incidence of leukemia. #sbestos workers may develop mesotheliomas of the pleural or peritoneal cavities. HIGH-RISK FACTORS FOR SPECIFIC CANCERS ,IT1 8312I,8O,I0% '#CTO3

$reast history Cervi

#ge over @0+ late first full term pregnancy+ early age menarche+ late menopause+ familial of breast cancer "omen who begin se ual activity at an early age and have multiple partners+ human papilloma virus e posure 'amilial polyposis+ ulcerative colitis over many years+ diet high in fat, low in fiber Cigarette smoking+ e posure to asbestos, uranium, and nickel 'armers and other outdoor workers+ fair /skinned individuals who sunburn easily #lcohol plus smoking+ smokeless tobacco D/ray therapy of neck as infants #niline/dye e posure+ e posure to parasite Schistosoma haematobium+ cigarette smoking 1 posure to ben?ene+ ioni?ing radiation

Colon and rectum ;ung ,kin !outh Thyroid 7rinary bladder ;eukemia

ULTRAVIOLET LIGHT AND IRRADIATION 1 cessive e posure to sunlight is responsible for a high incidence of skin cancer among farmers and other outdoor workers. 'air/skinned individuals who sunburn easily also are at high risk for developing skin cancer .Cancer of the thyroid is more common in individuals who received irradiation to the

neck as children. The survivors of the #/bomb e plosions at 5iroshima and 0agasaki are sub-ect to an increased incidence of cancers, particularly acute myelogenous leukemia. #lthough not a common cause of cancer, radiation e posure does increase the risk of lung cancer in the uranium, strontium, nickel, and beryllium industries. #n increased incidence of leukemia has been reported after e posure to radiation. CIGARETTE SMOKE Cigarette smokers run a much greater risk of developing lung cancer than do nonsmokers. Increasing incidence of lung cancers in women linked to the increase in smoking of this population. ,moking/related illnesses cause more than @1(,000 premature deaths every year. "e must emphasi?e that lung cancer is largely a preventable disease. DIET #side from prostate cancer in men and breast cancer in women, the yearly number of new cases of colorectal cancer =1B1,&00> is second only to lung cancer. It is suspected that this high incidence is due, in part, to diet. #s refrigeration and processed food have led to a reduction in roughage and bulk =non digestible comple carbohydrates>. In the typical "estern diet, the incidence of colon cancer has increased and stomach cancer decreased. 8opulations who traditionally have a non/"estern diet high in fiber have a very low incidence of colorectal cancer but a high incidence of stomach cancer. The precise reasons for these epidemiologic observations are uncertain, but clearly diet influences cancer development. 3esearch in #frica, 1ngland, and India by 2r.2enis $urkitt and others has shown a direct relationship between the fiber content of food and intestinal bulk. $ulk fiber represents non absorbable sugars which increase intestinal mass and may actually change the intestinal milieu, particularly the transit time of carcinogens and the type of bacteria present. 7nlike low/fiber foods, those with a high fiber content produce greater waste bulk, which moves through the intestine faster and produces large, soft stools that are easy to e crete. ;ow/fiber foods may produce a reverse effect, resulting in greater formation of potential carcinogens in the large bowel by the action of certain bacteria on bile salts. $urkitt postulates that bile salts in the colon may be increased by the greater consumption of fat in "estern countries. It is not known whether bacteria may be affected by changes in fat, fiber, or both food constituents. In any event, a low/residue =low bulk fiber> diet produces a

small stool that tends to take longer to pass through the intestine, allowing the bacteria more time to degrade bile salts. Thus, any carcinogen formed has longer contact with the bowel lining and a greater opportunity to cause cancer. 2iet also seems to be related to the high incidence of liver cancer among certain groups of black #fricans living in #frica, compared to #merican blacks. The high incidence among black #fricans in #frica correlates with the eating of foods =especially peanuts> contaminated with a fungus known as Aspergillus flavus. This fungus produces a highly carcinogenic substance known as a flato in. On the other hand, chronic hepatitis is known to predispose to the development of liver cancer, and chronic hepatitis is very common in #frica and #sia. #n association between high/fat diets and breast cancer has been suggested from several different sources of data. 1pidemiologic data cannot, however establish a firm cause/effect relationship, and the resolution of this issue must await clinical studies of the influence of a reduced/fat diet on breast cancer incidence. ;ung cancer has been associated with low intake of vitamin #. #ttempts to reduce the incidence of lung cancer by administration of vitamin #Elike compounds =retinoids> have not been successful. OTHER ENVIRONMENTAL FACTORS The parasite Schistosoma haematobium, common in some parts of the world such as 1gypt, can cause bladder cancer. The parasite enters the body through the skin as workers stand in infested waters. It then migrates to the bladder. ;ong/term infestation is associated with an increased incidence of bladder cancer. ,moking is also implicated in the risk of developing bladder cancer. The e act mechanism is unknown, but statistics show that there is a correlation between smoking and an increased incidence of bladder cancer. #lcohol is thought to be a carcinogen or co carcinogen =along with cigarette smoke> for cancers of the head, neck, and esophagus. It may also play a role in the etiology of liver cancer. "omen who become se ually active at an early age and who have multiple partners are at greater Than normal risk of developing cervical cancer.

NUTRITION AND CANCER: DIETARY RECOMMENDATIONS

Choose most of the foods you eat from plant sources.

F 1at five or more servings of fruits and vegetables each day. F 1at other foods from plant sources, such as breads, cereals, grain products, rice, pasta, or beans several times each day. Limit your intake of high-fat foods, particularly from animal sources. F Choose foods low in fat. F ;imit consumption of meats, especially high/fat meats. Be physically active: achieve and maintain a healthy eight. F $e at least moderately active for B0 minutes or more on most days of the week. F ,tay within your healthy weight range. Limit consumption of alcoholic beverages, if you drink at all.

DRUGS INDUCED CANCER

IMMUNOSUPPRESSIVE AND CYTOTOXIC INDUCED CANCER # number of drugs in clinical use have also been rarely associated with cancer. The ma-ority of the highly implicated agents are immunosuppressive agents, principally the antimetabolites and glucocorticosteroids. It should be kept in mind that the risk of developing drug/induced cancer is dependent on several non drugs 'actors. 1> #ge at first e posure =younger age increases risk> &> The long latency period between e posure and cancer development =an average of @0EC0 years in industrial e posures, CE10 years for drugs>

B> The presence of co carcinogens =such as cigarette smoking or ioni?ing radiation>. The most highly implicated carcinogenic drugs are anticancer agents, and the ma-or cancers produced are leukemias and lymphomas. #cute myelocytic leukemia is an unfortunate and rare complication of alkylating agents such as melphalan and cyclophosphamide. The drugs most commonly associated with second neoplasms are the alkylating agents. These drugs bind to 20# and induce mutations. 3adiotherapy potentiates the leukemogenic action of alkylating agents. Immunosuppression secondary to chemotherapy, #I2,, or immunosuppressive drugs may lead to 1pstein/$arr virus =1$G>Einduced non/ 5odgkinHs lymphoma.

CANCERS ASSOCIATED WITH DRUGS IN COMMON CLINICAL USAGE Patient Po !"ation Cancer

Agent Cyclophosphamide myelogenous leukemia =#!;> !elphalan #?athioprine and cyclosporine

A##o$iate% Can$e&# $ladder cancer acute

!ultiple myeloma #llotransplant recipients

#!; 0on/5odgkinHs lymphomas,

skin cancers 0itrogen mustard, procarba?ine, ioni?ing radiation ,ynthetic =diethylstilbestrol> 8henacetin/containing 2rugs

Cancer

#!;

'emales Over/the/counter pain treatment

Gagina, cervi =adenocarcinoma> 3enal pelvis carcinoma

HORMONES INDUCED CANCER

,ome hormones are thought to possess carcinogenic potential and this is important in three cancers. 1. Breast Cancer: ;arge doses of estrogens, when given continuously, can cause breast cancer in susceptible strains of mice. #nimal studies also show that estrogen is a cocarcinogen+ eg, it is carcinogenic when administered e perimentally along with another cancer/causing agent such as /rays or the chemical methylcholanthrene. The animal data have raised concern that women who take birth control pills, or who receive estrogen supplements at menopause, might incuran increased risk of cancer. !ost of the largescalestudies suggest that e ogenous estrogen probably is not a significant factor in human breast cancer, although some e perts still feel that the safety of estrogen has not been proven.

&. !ndometrial Cancer: !any scientists now suspect that estrogen increases the ha?ard of developing cancer of the uterine endometrium. This is based upon several case/control studies reporting an increased risk of malignancy in women receiving estrogen supplementsIthough other studies report no such increases, and still other studies find an actual decrease in the risk. 2espite the possible ha?ard of increased malignancy, many doctors now feel that low/dose estrogen supplementation is safe for menopausal or oophorectomi?ed women who have symptoms of estrogen deficiency. One conse6uence of low estrogen levels is osteoporosis, which greatly increases the risk of serious in-ury from bone fractures. B. "aginal Adenocarcinoma: In 1(@A, it was thought that synthetic estrogens such as 21, =diethylstilbestrol> were well tolerated in pregnancy, safe for the fetus, and effective for preventing abortion. #s a result, 21, and related synthetic estrogens were widely prescribeduntil a 1(AA study showed that the daughters of 21,/treated mothers had an increased incidence of vaginal dysplasia and carcinoma. $ecause the use of 21, in pregnancy has been stopped, this complication will cease to be aproblem in a few years. @. #rostate Cancer: The most important risk factor in prostate cancer is age, but testosterone after being metaboli?ed to dihydrotestosterone is a potent stimulator of cell division in prostate cells. 2ihydrotestosterone may be involved in malignant transformation, and studies are under way to determine whether inhibition of dihydrotestosterone production will reduce the incidence of prostate cancer.

HEREDITARY FACTORS
1vidence supporting the role of genetic factors in cancer comes primarily from animal studies. $reeding e periments with mice led to the development of mouse families with very high incidences of specific cancers, such as lung and breast cancer. Other selected matings of mice produced families that were essentially cancer/free. ,tatistical evidence supports the genetic etiology of cancer in humans. The best e ample of a hereditary cancer in man is retinoblastoma, a relatively uncommon neoplasm of children. 5owever, genetic factors probably play an important role in the familial tendencies toward some common cancers such as cancer of the colon =familial polyposis>, hereditary non polyposis

colorectal cancer =508CC>, breast cancer, and stomach cancer. # genetic history is an essential part of every cancer patientHs medical history. $reast cancer is one of the best e amples of a malignancy for which a genetic predisposition influences clinical practice. The incidence of breast cancer may double or more than double when one or more female relatives of a woman have had breast cancer. 5ence, knowledge of a familyHs cancer history can help in planning early detection programs for high/risk sub-ects. The recent identification of two genes associated with an increased risk of breast cancer, ovarian cancer, and prostate cancer =$3C#1, $3C#&> has raised the possibility of testing for genetic susceptibility. #s yet, the technological advances necessary to move this from a research to a practical clinical setting have not been made.

ONCOGENES
The most enduring hypothesis concerning the origin of cancer is that some genetic alteration, induced by elements in the environment, acts on a genetically determined predisposition and results in the unregulated proliferation of cells. One very e citing new area of cancer research, which serves to combine hereditary and environmental factors, is the study of oncogenes. $ncogene is derived from two %reek words. $nkos means bulk or mass and refers to a tumor, or has some relationship to a tumor, while gene, which is the functional unit of heredity, is derived from the word genos, meaning birth. Therefore, something that causes a tumor is said to be oncogenic and a gene that when activated causes a cancer is an oncogene. 1ach cell contains a set of genes that are essential for embryonic tissue development, tissue repair, and normal proliferation. The control of stem cell proliferation is e ercised via these special genes. It now appears that these genes are activated by radiation, chemicals, viruses, and other as yet undefined factors. These oncogenes then act as cellular transforming genes, causing uncontrolled proliferation of previously normal cells. Certain proteins produced by oncogenes have been identified, and in some cases the proteins form cell surface receptors for growth factors,

intracellular signals that turn on or turn off cell growth, and factors that alter the e pression of 20#. Our understanding of the biochemical mechanisms involved in cancer offers the potential for improved detection, prognosis, and treatment. Table * lists some of the oncogenes that have been associated with specific human cancers. !any of these oncogenes are silent until the gene moves or translocates from one chromosome to another. This chromosomal breakage and reunion is known to occur in several cancers, including chronic leukemias and lymphomas. ,ome genes suppress abnormal cell growth and when they are damaged or missing, cancer is more likely to develop. The best e ample of this type of gene is the retinoblastoma =3$> gene.

VIRUSES Oncogenes were first identified in viruses that cause cancer in animals. ;ater it was learned that the viruses had captured a normal host gene that regulated stem cell proliferation. These oncogenic viruses caused cancer by activating that normal host gene inside a host cell. lt is known that members of a group of small 20# viruses called papovaviruses cause a variety of animal tumors. #mong them are the papilloma viruses, responsible for papillomas in rabbits, and the polyoma virus, which causes malignant tumors of the parotid gland, mammary gland, and kidney as well as subcutaneous fibrosarcomas when in-ected into mice. #lso, ribonucleic acid =30#> viruses have been shown to cause leukemias in chickens, mice, and cats, and mammary carcinomas in mice. # human retrovirus, human T/cell lymphotropic virus =5T;G/1>, has been recogni?ed as the etiologic agent of an aggressive form of leukemia known as adult T/cell leukemiaJlymphoma =#T;;>. #lso, in #frican $urkittHs lymphoma, a viral etiology seems possible. %enerally, it occurs between the ages of & and 1@, with a peak incidence at age A. It is a cancer of the $/cell lymphocytes, and it is common in areas of the world where malaria is endemic. Giral involvement in $urkittHs lymphoma is difficult to discount because cells from nearly every biopsy of #frican $urkittHs lymphoma contain a herpes virus. the 1pstein/$arr virus. 1$G is also associated with carcinoma of the nasopharyn , a common malignancy in ,outhern China, !alaysia, Indonesia, and parts of #frica.

1$G has also been implicated in the etiology at 5odgkinHs disease and in non/5odgkinHs lymphoma in patients who are immunosuppressed. #nother factor implicating viruses in causing human cancers is that carcinomas of the cervi are more common after infection by the type II herpes virus. In spite of such data, however, more research is needed to prove conclusively that viruses cause human cancers. 'urthermore, we need to determine whether these viruses cause human cancer directly or indirectly by activating a host oncogene.

HUMAN VIRUSES ASSOCIATED

ITH CANCER

VIRUS COFACTORS Herpes Papillomavirus

TYPE Epstein-Barr

ASSOCIATED CANCER Burkitts lymphoma Lymphoma Malaria Immunodeficiency %mokin$! other factors %unli$ht! $enetic *isorders! immune %uppression #flato,in! alcohol /ncertain /nkno2n

HPV-1 ! -1"! #no$enital cancers &&! &' HPV-(! -1"! -1) %kin cancer

Hepatitis -etrovirus

HBV! H+V H.LV-1 H.LV-1

Hepatocellular +arcinoma #dult .-cell Leukemia0lymphoma Hairy cell leukemia

CHEMOTHEREPY

Chemotherapy is a cancer treatment method, which uses, what are termed as KanticancerL drugs to help control and cure cancer =and certain non/ cancerous symptoms too>. #t present there are &00 kinds of cancer known to man that are treated using about C0 different types of cancer chemotherapy drugs following different treatment techni6ues. 7nder normal conditions the cells of the body grow and die naturally, and a balance is thus maintained. 5owever in case of a cancer patient, these cells start multiplying at a very fast rate. This is where the anticancer drugs come into picture, to help destroy this unnatural growth. "hen these drugs are allowed to run through the bloodstream, they can reach the cancer cells at an enormous speed. "hile chemotherapy drugs are capable of destroying the cancer cells using various techni6ues, there are other cancer treatment drugs too, that aim at directly blocking the conse6uences of the body hormones. $iological therapies can also help boost oneHs immune system, while affecting certain MsubstancesH in the body. These MsubstancesH are actually natural inputs of the bodyHs defense mechanism that are available for fighting diseases including cancer, but are present in small amounts. "hen such artificially made MsubstancesH =that resemble the natural ones in the body> are infused in the system, it makes the body capable of destroying the cells or controlling the effects of the tumor. If the therapy works, the cancer cells usually disappear forever. 0evertheless, a

patient does run the risk of developing side effects andJor damaging some otherwise healthy parts of the body including the interior mouth linings, bone marrow =responsible for creating blood cells>, the digestive system and hair follicles. Chemotherapy is done on a regular/session basis, with each session being followed by a period of rest. "hile the session/period destroys the cells, the rest/period helps in recovering the normal tissues and cells. The procedure of the treatment varies in accordance with issues like the kind of cancer to be treated, the effected body part and its intensity, the overall health and the effects of the disease. The cycles in which the treatment is given to the patient depends on the cell growth and the drugs being used. The cycle may last for days or weeks, depending on the patientHs condition. The drugs are also chosen by the doctor after taking into account various obvious factors such as the nature of cancer, etc. $y dividing at a very fast rate the cancerous cells multiply in the human body due to which the healthy cells are not allowed to grow. $ut during the Cytoto ic Chemotherapy the medicines that are given to the patients do not allow the cancer cells to grow by way of division. 7sually in all the different types of chemotherapies that are done the medicines administered is in a combination of two to three drugs, which are used to kill the cancer cells. Two or more types of drugs are used to ensure the killing of the cancer cells is more. In Cytoto ic Chemotherapy treatment process only one main medicine is given for the desired result. 8atients who are suffering from breast cancer are mainly the ones who are suggested the Cytoto ic Chemotherapy. The medicines that are used during the treatment not only destroy the cancerous cells but also the healthy cells get killed. The medicines cannot differentiate between the cancerous cells and the healthy cells and thus kills all the cells that divide. It is due to this that the patients suffer from different types of side effects. Cytoto ic Chemotherapy is also not free from side effects and there are many different side effects that a patient may undergo. #s a result of the healthy cells being destroyed the patients suffer from hair loss and nausea. The function of the ovary is also stopped which in turn is the cause of early menopause in women. #ll the side effects are dependent on the amount of the treatment that is given. #t the present times doctors have found out new ways through which side effects can be reduced to a great level. The rest period that is given to the patient between the two sessions has been increased in the cytoto ic c!em"t!era#$ as this helps the healthy cells to become healthy before the ne t session starts. %enerally there are about four to si rounds of

chemotherapy sessions that a patient has to under go. In order to treat a patient suffering from breast cancer different types of medicines are used out of which the most commonly used ones is antimetabolities and cytoto ic antibiotics. It is not essential that cytoto ic chemotherapy should be given when the cancer has reached its advanced stag e% It can also be given at the early stage of cancer as this helps to prevent the cancer cells from spreading. $y taking the cytoto ic chemotherapy at the early stage the cancer cells are killed when young thus there are very less chances of side effects. The chances to recover and live becomes more as the number of healthy cells increase. 1arlier chemotherapy was not given to the patients who were suffering from breast cancer as it was believed that cancer was only there in the breast region and it could be cured by treating it locally. The Type of Chemotherapy treatment depends upon the type and the origin of the cancer in a persons body. 5ow the cancer/cells are seen when seen under a microscope and if it has spread over the ones body Chemotherapy is also used for biological therapies, radiotherapy, hormonal therapy and surgery, or a combination of these. The way the Chemotherapy may be given depends upon the type of cancer a person is suffering from. !ostly the intravenous chemotherapy is used where in-ection is hooked in the vein. "hen medicines are given in the form of tablets and capsules it is known as oral chemotherapy. "hen the medicines are in-ected into the muscles itHs called intramuscular in-ections, and subcutaneous when in-ected -ust below the skin. Though different ways are chosen to give the medicines, all the medicines given reach the cancer affected areas through the blood . In certain types of the cancer the intrathecal chemotherapy is done which is when the medicine in-ected reach the li6uid in the spine. #part from this the intracavity chemotherapy is also done when pelvic cavity or certain body cavities like the bladder get infected. "hen chemotherapy is done through these methods the medicine stays in the area which has been in-ected only thus other areas are not infected. 'or certain types of skin cancer chemotherapy creams are also used which affect only the cells of cancerous area The chemotherapy which is done ma imum is the Intravenous chemotherapy and the oral chemotherapy. There are four ways through

which the medicine used during Chemotherapy reaches the vein directly. Cannula is the process where a little tube is inserted behind ones hand or on ones arm. "hen central ;ine chemotherapy is done a thin tube which can be stretched is placed in the skin of a personHs chest near the heart. The portacath or the Implantable port chemotherapy is done by inserting a soft synthetic tube in the vein. The hole that is made is below the skin of the personHs chest or arm. "hen chemotherapy is done orally instructions are given to the patients to take the medicines which are in the form of capsules and tablets at home. The medicine can either be for the whole body or only for the affected regions. The medicines need to be taken with or without food according to the instructions given by the doctor. The health care personnel can be contacted in case there are any problems or difficulty relating to the consumption of medicines. The medicines that are given by the doctor is the full coarse for the treatment and they have to be taken properly according to the prescribtion."hen taking the medicines if there is any doubt regarding the informationHs provided, the nurse, doctor or the pharmacist should be contacted for clarification.

PROTOCAL&S OF CHEMOTHERAPY In the human body the cells get generated, they grow and ultimately they die. $ut when someone gets cancer the human cells keep on growing and diving without stopping Thus by the administration of chemotherapy treatment the cells are destroyed by not letting the cells multiply further. $ut unfortunately it has been observed that during the chemotherapy session the cells which are healthy can also get affected. "hen chemotherapy is taken it not only helps to kill the cancer producing cells but also lessens the bad effects that the chemotherapy can have on the cells. !any new chemotherapy protocols have been developed successfully with the advent of new researches and also different types of cancer have also been found out. !any new chemotherapy protocols that match the different types of cancer have also been developed. Cancer is a very difficult disease and hard to be treated as the chemotherapy medicines can only kill some of the cancer cells. If the latest finding and researchHs relating to cancer were included in the medicine the cancer chemotherapy treatment would have been much more effective. The ob-ectives of the -ournals is to give the cancer patients more options and help them have discussions with the oncologist as to how different approaches have been found out for the treatment of Cancer through chemotherapy successfully. # single protocol for chemotherapy which is effective is impossible to be made. The oncologist needs to give the chemotherapy drugs through different doses as the tumor cells can survive through many different factors. #s the finding are from well researched studies the patients can have a logical base to reduce the side effects as well as learn about the effects of chemotherapy. The chemotherapy process follows a certain protocol. # process called apoptosis is when normal cells grow and die on their own. In order for the normal apoptosis to take place the cancer cells keep on dividing and more and more new cells are created. The medicine that is used as an anti/ cancer drug kills the cells that cause cancer by not letting them grow and divide. 2uring the Chemotherapy process the medicine that is given

consists of one or many of the Cytoto ic drugs which is used to kill the cancer germs. The Oncologists try to make the damage which is caused to the normal cells less and increase the effect of Cytoto ic on the cells that cause cancer. $ut it has been observed that at many times a proper balance could not be achieved. The lives of the patients can be prolonged by following the different types of clinical studies which deal with the different types of cancer chemotherapy. Through the radiological studies the reduction of the growth of tumor as well as a partial remission of about fifty percent can be found out. The success rate of the chemotherapy treatment can also be known through blood tests and urine test. The 3emissions that occur are measured in accordance to weeks and not years but some types of cancer however are seen not to respond to ay sort of chemotherapy

TYPES OF CHEMOTHERAPY

There are various types of chemotherapy which are being fallowed in the hospitals and various organi?ations across all over India where cancer patients are being treated. The types of chemotherapy are being decided either on the basis of the route by which it is being takes or on the combination of drugs taken in it. They are classified as fallows./ O0 T51 $#,I, O' 3O7T1./ 1. Topical Chemotherapy &. ,ystemic Chemotherapy B. Oral Chemotherapy @. Chemotherapy Infusion O0 T51 $#,I, O' CO!$I0#TIO0 O' !12ICI01./ 1. C'7 Chemotherapy &. #$G2 Chemotherapy B. #C Chemotherapy @. $18 Chemotherapy C. Cisplatin Chemotherapy ). C!' Chemotherapy A. 2o il Chemotherapy *. 1poch Chemotherapy (. 'olfo Chemotherapy 10. IC1 Chemotherapy 11. Induction Chemotherapy 1&. 3ice Chemotherapy 1B. Ta otere chemotherapy 1@. !O88 chemotherapy OT513 C51!OT513#84 1. !etronomic Chemotherapy &. 8alliative Chemotherapy

T3O8IC#; C51!OT513#84

The therapy when the medicines are given by applying the chemical agents to the skin is known as Topical chemotherapy. Topical chemotherapy is basically used to treat skin cancer in a patient. The topical chemotherapy is one of the methods that have been trialed and tested and proved to be able to cure the skin cancer. The skin cancer that is found on the upper layer of the skin can be treated through topical chemotherapy. The diseases that affect the skin because of it being e posed to the sun for several years can also be treated through this chemotherapy. One of the reasons for the cause of skin cancer is the harshness of the sun on the skin. The medicine that is used to treat skin cancer is called 'luorouracil. This ointment needs to be applied directly on the skin twice a day for some time. $y doing this the progression of the disease can be controlled to a much significant level. The patients themselves can apply the medicine after being guided for the initial period. The cancer cells on the upper layer of the skin can be destroyed through Topical chemotherapy. The Topical chemotherapy is also not free from side effects. ,ome sort of irritation is e pected to occur due to the application of the ointment. The doctor advises the medicine to be discontinued for some time if the irritation persists. There are a lot of differences between the Topical chemotherapy and other types of chemotherapy. This is the therapy which can be done by the patients themselves. Only the cancer cells that are present on the surface of the skin can be treated through this chemotherapy and the cells that are deep down in the skin or on the other parts of the body cannot be treated. The side effects of the Topical Chemotherapy are easier to handle than the Conventional chemotherapy. This is because the medicines that are applied during the Topical chemotherapy are applied only on the upper portion of the skin. The skin can get sensitive as rashes may develop on the skin. #s the medicines that are used during the therapy make the skin very sensitive to the sun, the patient should avoid going on in the sun and getting sun/burnt even after the treatment is over. 2epending upon the type of chemotherapy, the side effects are also various in numbers. ,ome side effects are very intense while others are tolerable. The good thing about the Topical chemotherapy is that the upper layer of the skin is only affected as a side effect, which does not create much of a problem or inconvenience to the patient. Once the medicine are stopped the side effects also starts to lessen. There is high chance of skin cancer when the skin is e posed to the sun. ,ometimes diseases that are not malignant are also treated through the Topical therapy. The Topical Chemotherapy is the best way to treat skin cancers or skin diseases which may get fatal if not taken care of in time.

,4,T1!#TIC C51!OT513#84
The systemic chemotherapy uses anticancer drugs that are in-ected directly into a vein or a muscle, or they are taken orally through mouth. It works either by killing the cells or prevents them from dividing. These drugs enter the blood stream and reach all the areas of the human body, thus, it makes the treatment 6uite useful. Through this treatment, the pain of many different types of cancer can be reduced and if it is traced out at the initial stage, then it has an efficiency to destroy the cells completely. Though

systemic chemotherapy is the most successful treatment of cancer but to enhance the rate of recovery, it can be used along with radiation therapy. !ost chemotherapy treatments are given on an outpatient basis, which means either in a doctorHs chamber or a clinic or a hospital. $ut if the patient is in the advanced stage then he is re6uired to be hospitali?ed for some time. Thus, depending upon the stage of cancer, the treatment is prescribed by the doctor. The chemotherapeutic can fight against any type of cancer but in certain cases, if the patient is struggling against any particular type of cancer then he will be prescribed against that particular drug. 'or such cases, a combination of various types of drugs can be more effective in bringing about the better results. The main aim of systemic chemotherapy treatment is that it can remove out the cancer cells and it also slows down the growth rate of the cancer cells as well as helps to reduce the si?e of the tumor. It is due to these reasons which help to wipe out the cancer cells as fast as possible. Though the main aim of chemotherapy drugs is to kill the cancer cells but due to this treatment the normal cells also get damaged. This is one of the main reasons there are some side effects which occurs during the chemotherapy treatment. The chemotherapy treatment can hamper the health of a patient if proper care is not taken. To apply a high do?e of chemotherapeutic drugs to a patient, doctors and the scientist are trying their best to reduce this problem. The side effects also depend on the type of cancer and the dose of the drugs that are given to the patient. It also depends on the length of the time they are consumed. The drugs used in cancer chemotherapy specially attack the cells that are rapidly dividing. 5owever, there are some normal cell tissues like the lining of the mouth and intestine, bone marrow which also grow rapidly in order to replace cells that are worn out. These rapidly growing normal cells are likely to be affected by chemotherapy. #s a result, a patient may have hair loss, mouth sores, lowered resistance to infection due to low white blood cell counts, bleeding due to low platelet counts, loss of appetite, nausea, and vomiting but these side effects are temporary and they are generally disappeared after treatment is finished. There are often other ways to reduce the side effects. 2rugs can be given along with the chemotherapy treatment to prevent or reduce nausea and vomiting. . 8owerful antibiotics are used to fight against any kind of

infection. The treatment process of systemic chemotherapy is cyclic. #t an initial stage the chemotherapeutic drugs are applied and then there is a long gap in between. This gap is to see if the patient can cope up with the situation. 2uring this time the patient should be 6uiet particular and careful about washing hands and he should avoid uncooked fruit and other foods that might carry germs and infection.

O3#; C51!OT513#84
In oral chemotherapy, a drug is taken orally =by mouth> for treating cancer. It is chemotherapy for oral cancer. There can be many variations in form of capsule, li6uid and tablets. 7nlike other forms, here in-ections need not be taken. "ith oral chemotherapy one gets good results, since it works well. ,ince it was earlier not possible to feed drugs through mouth since the digestive system could not support it, drugs had to be always inserted through the veins along the IG line. 5owever, now drugs can be taken orally following simple instructions given by the caretaker. The time duration of the treatment varies on the status and the type of cancer one has, and the oral chemotherapy medications prescribed. ,tarting with the oral chemotherapy the patient first needs to consult the nurse or the doctor regarding the matter. T!e c"n'iti"n( t" be ta)en care "* are+

3 If there is more than one drug, their names should not be the same 3 The time of the drug intake 3 The directions for taking the medication should preferably by easily understandable 3 1 tra precautions to be taken if the drug is consumed with other food, drugs, supplements, vitamins, herbs, etc. 3 The drug storage method 3 The side effects. The doctor must be consulted if there are such issues. 3 The duration of the oral chemo. 3 'actors to take care of and follow in case a dose is missed. 3 8ossibility of any friend or family support being there, if re6uired, during the treatment period. 3 If the doctor might call up and find out the details of the treatment process. 3 Consideration about other health conditions that might cause forgetting to take the dose. Te(t( t" )n", !", t!e treatment i( ,"r)ing There are various kinds of tests that help to know how the oral chemotherapy drug treatment is helping. ,ome of them are. ' -l""' te(t(+ 2one by e tracting blood from the arm, it helps to know the body condition and to know how it is working. ' ./ra$ "* t!e c!e(t+ $y taking a heart and lung picture one can know its working status, and to find out conditions of pneumonia and other infections. It can also help to know if there are any collapsed lungs, broken ribs, tumors or fluid around this area. ' CT (can+ #lso termed as C#T, here a special machine for /3ay helps show a clearer cancer picture. This is done by in-ecting a particular dye along the vein using an IG. 5owever, often people are allergic to it.

' -l""' tran(*0(i"n+ This is vital for those who have damaged their cells due to oral chemotherapy medication. 'riends or family members with the same blood group could be asked for help. 5owever tests must be first performed to avoid cases of blood infections and related diseases like "est 0ile Girus, #I2,, 5epatitis, etc. ' Vital (ign(+ $lood pressure, heart beats, temperature and pulse must be checked. $lood pressure can be checked by tying a tight cuff around the arm, connected to a blood pressure reading machine. ;ungs and heart can be checked using stethoscope to know the lung and heart working status.

C51!OT513#84 I0'7,IO0 Chemotherapy Infusion is when the chemotherapy medicines are given to the patients through drips that are given from time to time. 8atients suffering from breast cancer are the ones who are generally given the chemotherapy infusion. The Chemotherapy Infusion is in-ected into the bloodstream along with the medicines that are given through drips. #fter the medicines are induced into the blood it spreads throughout the body and fights the cancer cells. The Chemotherapy Infusion is only given to the patients after knowing the proper health condition of the patient and the level of the hormones. "hile a patient is being given Chemotherapy Infusion care should be taken to see to it that the patient does not suffer much from the side effects. #ll the schedules of the treatment of Chemotherapy infusion are dependant on the patient. If the infusion administered is of a high dose than a break of three weeks is given and if the dose is low then the therapy is given every week. The doctor takes the final decision after proper investigation and checkup on the patientHs health as to how the Chemotherapy Infusion shall be given. The body is e posed to various kinds of medicines before the each Chemotherapy Infusion is given to the patient. This is done so that the patient gets used to the chemotherapy. 'ew normal cells also get affected when the body gets e posed to the medicines that are used during the

chemotherapy treatment Thus in order to keep the blood count under control proper care needs to be taken. The treatment is stopped for sometime until the patient feels well again, if the tests and the reports show any sort of problem. The chemotherapy infusion is given in a hospital under proper medical supervision. The doctors as well as the nurses are all well versed as well as trained with the procedures of the Chemotherapy and so can handle it properly. The doctors and the nurses take e tra care to see to the comforts of the patients. The means of giving the medicine is either through drip or through in-ections which all depend upon the type of medicine that has been prescribed. It is with the help of the catheter that the medicines are given into the vein. The side effect that may occur during the treatment is made clear to the patient before hand so that they are prepared. The care that will be re6uired after the treatment is e plained very well to the family members and the patient. The medicines that are prescribed by the doctor should be taken regularly after the Chemotherapy infusion is over. If the medicines are not taken properly the whole treatment gets affected. The doctor needs to be contacted immediately if the medicines have not been taken regularly for some reason or the other. The level of the blood should also be monitored regularly. 0ausea and vomiting are the side effects that are generally associated with chemotherapy infusion. The weight of the body should be monitored carefully. The doctor can bring slight changes in the prescription if the side effects continue to be there. These days with the advancement of modern day science, the medical science too has development to such an e tent that it is now possible to treat cancer also which was earlier regarded as an untreatable disease. Chemotherapy infusion is the best treatment amongst al the chemotherapy treatments available.

1FU/CHEMOTHERAPY
The generic name of C'7 chemotherapy is fluorouracil. C'7 chemotherapy treatment is an anticancer chemotherapy drug that is given as a treatment to patients who have been suffering from some specific types of cancer. 8atient who suffer from breast, stomach, esophagus cancer, are treated by this particular type of chemotherapy. The C'u chemotherapy treatment is given through an in-ection. It can be directly in-ected in the patientHs body through the veins and or through drip. #t times the medicines are also given through the drip. The in-ection is given below the surface of the skin on the collar bone. In order to give the in-ection a cream is applied on the skin which changes the color of the skin. 1ach personHs reaction to C'7chemotherapy is different. The C'7 chemotherapy also has some side effects. 7lcers and mouth sores are some side/effects which a patient may undergo during the treatment period. In order to provide relief to the patient he is asked to suck some ice chips. This gives the patient a kind of relief from the treatment. The patient is e pected to drink plenty of fluid and water and cleaning the teeth gently with toothbrush is also highly recommended as this will help to keep away mouth infections. To prevent from any mouth infection special mouth wash and medicines are prescribed. 2ue to small ulcers formed in the mouth, the taste of the food changes completely. The normal taste will only get restored once the treatment is over.

"hile under going the C'7 chemotherapy treatment the patient may suffer from diarrhea. #lthough this side effect can be easily controlled the doctor should be kept informed in case of any emergency. #nother side effect of this treatment is gritty eyes and blurred vision. It is 6uite important to inform a doctor if the patient faces this problem, so that he can prescribe a soothing eye drop to give relief from this problem. #part from these two side effects, another change that is seen in the patient is the change in the color of the skin. The skin may become dark due to pigmentation. #ll these side effects are temporary and they will all be gone once the treatment has finished. The patients who are treated with C'7 chemotherapy may also suffer from hair loss, but total hair loss is something that does not happen often. 2ue to this therapy the hair line gets thin. The change in the hair can only be noticed after three to four weeks of starting of the. 5air loss is a temporary phenomenon and the hair can be got back after the treatment is over. The nails also become very fragile due to the effect of chemotherapy. "hen the treatment is in progress the skin is very sensitive and thus may get sun/ burnt very easily, so in order to avoid this good sun/screen lotion needs to be applied while going out. They may also get rashes which may cause discomfort to the patients. The palms and the soles of the patients may get numb and they may also suffer from hand and foot syndrome. #ll these side effects are only seen if the treatment is carried out for a very long time.

#$G2 C51!OT513#84
The treatment that is used to treat people suffering from 5odgkin ;ymphoma is known as #$G2 chemotherapy. 5odgkin ;ymphoma is a cancer which affects the lymphatic system of the body. 2o orubicin, bleomycin , dacarba?ine and vinblastine are some of the medicine( t!at are 0(e' '0ring t!e A-VD c!em"t!era#$ treatment . The medicine that is given to a patients through saline water drip or through in-ections are 2o orubicin and vinblastine while the medicine that is given through infusion to the patients are dacaba?ine and bleomycin. $efore the treatment is started some blood tests are re6uired to be done. The treatment is started immediately once the reports of the tests show that itHs positive. # fle ible thin tube called cannula is inserted into the vein in the patientHs arm or hand by the nurse when the chemotherapy treatment starts. There are other patients also who prefer to use a thin tube which is made of plastic. This tube is inserted into the vein below the skin collar/ bone of the patient around the The medicines that are given to the patients in a #C chemotherapy treatment are usually given to the patients through in-ections or as infusion % The time period that is re6uired for this treatment is two hours. The cannula is removed by the doctors once the treatment is over. ,ome anti/sickness medicines are given to the patients by the doctor, which help to prevent the side/effects. 1ven if the patients do not face any type of side effects, the anti/sickness medicine that is given by the doctor should be taken. The number of times the #$G2 treatment needs to be given to a patient is decided by the doctor. "hen a patient decides to go for chemotherapy treatment the doctors prepare a proper regime of the #$G2 chemotherapy for him. On the first day of the treatment the doctors give the patients

prescribed 6uantity of medicines like do orubicin, bleomycin, vinblastine and dacarba?ine after which the patient is allowed to rest for about two weeks. #fter this two weeks period is over that is on the 1C th day the same medicines are given to the patients again. #fter the medicines are given again a period of two weeks rest is given to the patient. Thus this chemotherapy treatment is constituted in a cycle of four weeks period. The ne t session of the chemotherapy treatment is given on the &( th day. The time taken for the whole treatment is about &/* months as the treatment is given in cycles of &/*. The #$G2 chemotherapy also has a few side effects like the production of white blood cells get reduced. # person may also suffer from very high temperature as well as bleeding and getting bruised for no -ustified reason. Chemotherapy treatment also causes anemia in patients. #part from this many people also complain of nausea and vomiting along with fatigue, allergic reactions, hair loss, fever and chills, changes in the skin and nails, mouth ulcers and numbness.

#C C51!OT513#84
#C chemotherapy is the treatment used for treating breast cancer. The medicines that are used during the #C chemotherapy treatment are cyclophosphamide and do orubicin. $oth the medicines do orubicins as well as the cyclophosphamide are in-ections so they are usually given to the patients through drip. The #C chemotherapy treatment will only be done on the patient by the doctor only when the blood tests reports turn out to be normal. # fle ible and thin tube which is known as the canula is inserted into the hands or the arms of the patient by the nurse in order to start the treatment of the #C chemotherapy. # thin tube made of plastic is inserted either below the skin or into the vein around the collar bone by some patients going in for #C chemotherapy. The medicines of the #C chemotherapy treatment are given in the form of in-ection to the patients through saline water drip. $oth the medicines do orubicin and cyclophosphamide are given to the patients through drip which is in-ected into the cannula of the patient. It takes about an hourHs time for the entire process to be over. #fter the treatment is over the doctors suggests some anti/sickness medicines for the patient. These medicines that are given help to reduce the impact of the side effects that may take place due to the treatment. The anti/sickness medicines that is given by the doctor should be taken as prescribed by the doctor even if the patient does not feel any sort of side effect. # proper schedule for the #C chemotherapy treatment for the patient is fi ed by the doctor. The medicines that may be given to the patient on the fist day of the chemotherapy treatment are cyclophosphamide and do orubicin. #fter the first dose of medicine is given, there is some rest period that is given to the patient which is about three weeks. 2uring this period the patient is not given any medicines. #fter the first cycle of medicine and rest period, the same medicines are given to the patient after which the patient is rested again. This is regarded as the second cycle of treatment. The entire treatment is done within a period of three or four months during which a patient is generally given four to si cycles of chemotherapy treatment.

The side effects that a person undergoing #C chemotherapy may face are like high temperature. Other side effects that can happen are bruising and bleeding without any rhyme or reason. #nemia, mouth ulcers, changes in the skin, fatigues well as nausea and vomiting in many people are some of the side effect faced by people undergoing #C chemotherapy%

-EP/CHEMOTHERAPY
$18 chemotherapy treatment is the process through which the Ovarian cancer and testicular cancer is treated successfully. In order to get rid of the testicular cancer as well as the ovarian cancer, medicines like 1toposide, bleomycin and cisplatin are used 'or getting this chemotherapy done the cancer patient is not re6uired to stay in the hospital for a very long time. In the $18 chemotherapy the report of the blood tests plays a very important role. Only when the blood test shows that it is positive that the cancer patients are treated with this type of chemotherapy. #s the $18 chemotherapy treatment starts the medicines 1toposide, bleomycin and cisplatin are infused into the blood through an elastic tube which is very thin. Incase the patient is an ious or curious to know about the chemotherapy treatment, he can always get all the details from the concerned doctor or nurse. Chemotherapy treatment generally has lot of side effects and generates a lot of sickness for which the doctors always prescribe an anti/sickness medicine. These anti/sickness medicines can be taken in the form of pills or they can be in-ected into the body through syringes. # lot of fluid and water based food is given to the patient before and after the chemotherapy treatment in order to avoid the kidneys from getting damaged. The whole process of $18 chemotherapy is divided into a few phases. 1ach phase is re6uired to give the e pected result so that the patient can go to ne t phase without any interruption.On starting the $18 treatment the medicine that is given is cisplatin and etoposide.On the ne t day etoposide, bleomycin and cisplatin are given. On the third day 1toposide is given. The patients get rest for a week after the first phase of treatment is over. $18 chemotherapy is done in a way of a cycle which means that after every treatment period there is a rest period and vice versa. The medicines that are used during the chemotherapy destroy the cancerous cells in a patient, thus during the rest period the body gets a chance to make healthy cells that can compensate for the cells that are destroyed. The $18 chemotherapy is a brilliant treatment for cancer patients but it also has some side effects which are very dangerous. The side effects may differ depending upon the dose of the medicine that is being given and the type of chemotherapy treatment that the patient has been registered for. $y

opting for the $18 chemotherapy the white blood cells which are responsible for helping the body fight against immunity gets affected. Thus we can say that the body shall lose its immunity if the treatment continues for a long time. Though this is not a permanent disease, it can cause other disease by destroying the immunity of the body completely. # patient can get back the normal white blood cells in the blood -ust within a period of ten to fourteen days. There are other side effects also which can cause danger to the life of a cancer patient. $18 chemotherapy treatment also has side/effects like nausea, hair/loss, loss of appetite, and anemia to name a few. 7lcers in the mouth due to sores and change of taste can also occur during $18 chemotherapy. 2espite all the side/effects the $18 chemotherapy can be said to be the most effective treatment that is known to cure a patient from cancer%

CI,8;#TI0 C51!OT513#84
There are various types of chemotherapeutic treatment that are there to reduce cancer, but only particular drug can work efficiently to wipe out particular types of cancer. Cisplatin which is a powerful chemotherapy

medicine is used only for the treatment of the cancer of the bladder, stomach, ovaries, lungs and testicle% 2uring this chemotherapy a very fine and fle ible tube is vein of the patients. The medicines can also be infused into the vein through the 8ICC line. The amount of cisplatin dose given to the patient depends upon many factors that include a personHs weight, height, general health conditions and the type of cancer one is suffering from. In eliminating the cancer cells, cisplatin chemotherapy can be 6uite efficient but the ma-or drawback with this treatment is that it has numerous types of side effects % The cisplatin chemotherapy side effects and their severity depend upon the cisplatic dose that is given to the patient. The higher the dose will be, the more severe shall be the side effects. If a patient is given cisplatin chemotherapy along with any other drug, the side effect will be 6uite different from the patient who is treated with only cisplatin. $y undergoing the Cisplatin chemotherapy the kidneys of a patient are also affected by the side effects. Though the affect is not much the doctors still get blood tests done in order to check the condition of the kidney, before they start with the chemotherapy treatment. In order to make sure that the kidneys are functioning properly li6uids are passed into the vein. The doctor keeps a check on the urination of the patient. If a person faces problems that relate to urination medicines are provided which help him for this purpose. Intake of lots of li6uid and fluids are advised as they also prove as a great help in such situations. Other common side effects that are faced by the cisplatin patients are reduction in the production of white blood cells, low red blood cells, and kidney to icity.. The neural system of our body can also be affected by Cisplatin chemotherapy% This is the reason why some patients have a feeling of numbness or itchy feeling in the hands and feet. These side effects are short lived. The taste buds also change and this is also a temporary phenomenon. 2ue to the side effect of this therapy a patientHs fertility can also be damaged. # person may lose the capability to father or mother child. Thus before starting the chemotherapy the doctor should be consulted. #part from this hair loss, loss of appetite and anemia are other common side effects but with the help of a good dietician and an e perienced doctor all these problems can be taken care of. The patient should maintain good nutritious food and should take ample rest during and after the chemotherapy treatment.

CMF CHEMOTHERAPY
The treatment that is used to treat breast cancer is known as C!' Chemotherapy. 'or the patients to get best result for patients suffering from breast cancer the C!' chemotherapy is highly recommended. In order for the patients to recover from this deadly disease three medicines namely cyclophosphamide, fluoroucil and methotre ate are used. The blood of the patient is checked thoroughly before the treatment is started. In order to confirm that everything is normal, the health condition of the patient needs

to be checked by a doctor. The patient can receive the treatment after all the tests are done which take about B/@ hours. The patient undergoing the C!' chemotherapy gets the chemo #nti/sickness medicines which are given to the patients who are suffering from breast cancer to help her get back her strength. The anti/sickness medicines can be given to the patients both through pills and through in-ection. These medicines are of great benefit in order to prevent the sickness from emerging, for patients suffering from breast cancer The word Kregimen K is usually used by the doctor when talking about the C!' chemotherapy Treatment. In other words this means the whole treatment along with the chemotherapy which may help a patient to recover from the hands of the deadly disease. #fter four weeks of the first in-ection of !ethotre ate the second stage of the C!' treatment is started. The medicines that are used in the second stage are methotre ate+ C'7 and cyclophoshamide. These are the best medicines that very effective for dealing with patients who have breast cancer. #fter the C!' Chemotherapy treatment is complete the patient is given rest for two weeks period. The same medicines are administered once again when the ne t phase of treatment start. The patients get rest or freedom from all sorts of activity may it be physical or mental for another three weeks after the completion of the second phase. #fter the second phase is over the patient has to go through the third phase in order to complete the circle of the C!' chemotherapy. It can take a period of si months more or less for the treatment to be complete.1very chemotherapy treatment has some sort of side effect or the other which makes it a very unpleasant e perience. The C!' chemotherapy is also not completely free from the side effects. This treatment is also individualistic and the severeness of the side effects may differ fro one woman to another. The most common type of side/effect is anemia. The feeling of getting tired very soon is also there in the patient because of this disease. Two side effects of this treatment which fre6uently attack a patient is nausea and then he should consult a doctor. #nother side effect of the treatment is the reduction in the thickness of the hair. "hile the patient is undergoing treatment he may feel the effect on the taste buds. $ut these are all temporary and the patient gets back normal taste after the treatment is completed.

DO.IL CHEMOTHERAPY
2o il Chemotherapy is the name given to the chemotherapy treatment that is done for patients suffering from Ovarian Cancer, $reast Cancer and tumors. The name 2o il has been got from the medicine 2o orubicin ;iposomal which is used during the treatment. This medicine if very effective for removing the cancer cells from its root. 2o orubicin ;iposomal is used during the treatment procedure and it has made a name for itself. The medicines that are given to the patients are in-ected into the body of patient through the vein. This medicine needs to be handled carefully as it can cause irritation which may cause swelling of the veins. 'or this reason an e perienced nurse or doctor is re6uired to give the 2o il Chemotherapy therapy.

The cancer patientHs health condition as well as his height determines the amount of medicine that will be used during the treatment. #nother factor on which the dose of the medicine depends is the type of cancer the patient is suffering from. #s all chemotherapy treatment, the 2o il chemotherapy treatment is also not completely free from side effects, so proper information as well as necessary details needs to be gathered before going in for the 2o il Chemotherapy treatment. There are several factors on which the severeness of the side effects depends. The health of the patient as well as the dose that is being administered is to some e tent responsible for the side effects. It is usually seen that the side effects are gone within a few weeks of completion of the Chemotherapy treatment. #s the days are going by new medical researches and medicines are also coming up. Thus it can be said that by the use of new types of medicines the side effects can be curtailed effectively and thus improve the 6uality of the treatment. The 2o il Chemotherapy has some side effect which is also known as infusion related side effects. ,ome of the infusion related side effects of 2o il Chemotherapy are feeling of tightness in the chest, swelling in the face and having problems in breathing. The side effects are not there when the patient is given very low do?e of the medicine. It is seen that the side effects are over within a few weeks after the medicine has been administered into the patients or the chemotherapy treatment is over. This kind of side effect is faced by very few cancer patients. The production of red blood cells and the white blood cells can be reduced at the same time by the 2o il chemotherapy treatment. The main cause of the infection is immunity which is caused by low level of white blood cells and anemia is caused by the reduction in the production of red blood cells %

18OC5 C51!OT513#84
The treatment that is used for people suffering from complicated types of cancer is known as 1poch Chemotherapy. This therapy is usually done when the state of the tumors and malignancies get worse and the condition gets complicated due to the other health conditions. The 1poch Chemotherapy is basically a mi ture as well as blend of different types of medicines that are to ic. "hen a person goes for this type of treatment the medicines are administered into he patient through a process known as Chemotherapy. 1toposide, cincristine, do orubicin, prednisone, and cycolophosphamide are the medicines that are given during the 1poch Chemotherapy treatment. These medicines are to ic in nature. The 1poch chemotherapy is very effective on large tumors as it helps to shrink the si?e of the tumors . #fter the si?e of the tumor is decreased it is easy to get it removed and this can be done through surgery. It has been seen that in some cases the medicines that are given during the 1poch chemotherapy are successful in killing the tumor cells completely. The medicine that will be given to the

patients is dependent on the type of cell of cancer. It also depends upon the place where the cells of the cancer are growing and reproducing at a higher rate. There are many types of cancer that can start growing in any part of the body and then gradually e tend themselves towards the nodes of the lymph. The large cell lymphoma is the cancer that falls under this category and this is a very serious type of cancer. This cancer is so bad that due to this the nodes of the lymph can also get damaged and destroyed. #s the infection of the cancer becomes so severe, the only way to tackle it is by removing it through surgery. $ut if the disease is diagnosed at a very early stage the patient can be treated with the help of 1poch chemotherapy. $ut there are many researchers who are of the opinion that apart from 1poch chemotherapy there are many other alternatives to deal with this type of cancer, than, if is diagnosed at an early stage. They do not support the idea of giving to ic elements where there are other alternative options available. 5owever it has been proved that 1poch chemotherapy has a significance of its own and it deals with this type of cancer effectively. 1poch Chemotherapy is also known to cure another type of cancer what is known as 0on/5odgkin lymphoma or commonly abbreviated as 05; The immunity system of the patient is most likely affected in the 05; cancer. In cases which are very severe the immune system of the body of a patient get affected to such heights that function of the natural defense and immunity system of the body completely stops on their own. "hen this happens the body becomes very weak and get prone to many different types of diseases and infections. In such a situation the natural alternative method provides nutrition to the body as well as helps to build up the immune system through natural ways. #ccording to the latest medical research it has been observed that 1poch Chemotherapy treatment is very effective in cases where the c!ance( "* a2"i'ing (0rger$ are 2er$ le((%

'O;'OD C51!OT513#84
'olfo Chemotherapy treatment is a combined chemotherapy treatment which is done for patients suffering from colon cancer. 2uring this treatment medicines that are given include 'luorouaracil ='> O alipalatin =OD> and 'olinic #cid. #long with the 'lurouracil a vitamin is given to the patients who aid the chemotherapy to work more against the cancer cells. This type of Chemotherapy does not have any side effects e cept that in very rare cases the person undergoing the treatment may get high fever. Chemotherapy treatment is usually given in form of cycles. The cycles last for about two weeks and there may be about twelve cycles in a session. The medicines are in-ected into the blood through the in-ections that are given in the veins. $efore each treatment begins a very short tube known as the cannula is inserted into the vien.The tube is made of plastic and is inserted either into the chest or the arm. On the first day of 'olfo Chemotherapy Treatment, the patient is given O aliplatin and folinic acid through drip at the same time for a period of two hours. #n in-ection known as C'7 is in-ected through the central line or cannula after which an infusion of C'7 is given through drips and pumps over a period of twenty two hours. On the second day the 'olinic #cid is given through drip to the patient over a period of two hours which is followed by C'7 in-ection which is given in the cannula and an infusion of C'7 for about &hours

There is no treatment from the third day till the fourteenth day after which the cycle is restarted again.The infusion of C'7 can be taken at the comfort of home provided the patient has cannula or central line. The infusion can also be taken through pumps but the patient needs to go to the hospital on the second day to change the infusion. #ll this can be done by a nurse who speciali?es in this treatment.The cannula can be taken out and drip discontinued after the Infusion of C'7 has been given for the second time. The side effects of this combined drug can be changed and they can be either increased or decreased. The most common side effect that a person undergoes after a 'olfo chemotherapy is fatigue which carries on even after the treatment is over and some people feel the hit of fatigue very hard. In order to recover it may sometimes take about si months or more. #nother side effect is the feeling of tingling or numbness that is felt on the toes and fingers by everyone who has been given o iplatin. This feeling is felt within a few days after the treatment is started. "hen a person feels sick due to the medicines anti sickness medicines are given to control their problem. The people feel sick because of the functions of the bone marrow getting dropped temporarily. If the count of the white blood cells suddenly drop then there is risk of getting infections like cold and cough which may lead to breathlessness. $reathlessness occurs when there is a decrease in the number of red blood cells which in turn causes anemia. 'or treating such a type of anemia transfusion of blood is necessary

ICE CHEMOTHERAPY
IC1 chemotherapy is the treatment for one of the four ma-or types of

malignant cancer known as 0on/5odgkinElymphoma. In order to cater to other types of cancer treatment can also be done by other methods. It has got its name IC1 because of the three types of drugs namely ifosfamide, carboplatin and etoposide which are used for this type of Chemotherapy. The first letters of the medicines has given this treatment an abbreviated name IC1. This type of chemotherapy is given in the hospitals and for a very short time. # blood test needs to be done before the treatment is started. The blood test can be done on the same day or a few days before the treatment. The doctor, a pharmacist or the professional nurse gives permission to the pharmacy to make the medicine that is re6uired during chemotherapy once the blood test reports show that itHs normal. It takes a little bit of time for this process. 2uring the treatment a thin plastic tube is inserted into the vein beneath the skin, near the collarbone. This is called central line. ,imilarly a thin plastic tube can also be inserted through the vein of the arm. This is known as the 8ICC/line. In case the two lines are absent, a thin elastic tube is put in the vein of the hand or the arm by the nurse. Though the process of treatment is very painful and uncomfortable it does not take long. #s the administration of drug may make a person sick, some medicines which are used as anti/sickness is given to the patients through in-ections along the cannula, central line or the 8ICC/line. The in-ections are in-ected into the drip which is hooked up. #nti/sickness medicines can also be in the form of tablets. In the present way chemotherapy medicines are not given alltogether. They are given in the form of combinations into the cannula.

The medicine Ifosfamide can cause bleeding as the bladder lines gets irritated. # person can go home once the treatment is over. In cases where the treatment is given through the cannula, the tube is removed and a few medicines which act as ant/sickness is given to the patients to take back home. The medicines are re6uired to be taken according to the directives given in the anti/sickness regime during the treatment if the doctor suggests the IC1 regimen it means the whole schedule of the chemotherapy treatment. Chemotherapy is an individualistic way of treatment and the way a person may respond may differ from individual to individual. The side effects of the treatment may also vary according to person as some may e perience fewer side effects while some may e perience more. The side effects related to chemotherapy are nausea, poor resistance towards any sort of infections, vomiting, anemia, bleeding or bruising, getting tired very soon, loss of appetite as well as irritation of the bladder. Other general side effects may be like diarrhea, effects that take place in the kidney, short term distress of the liver, changes in the skin, change in taste due to mouth sore, feeling of sleepiness and confusion and loss of balance. It has been noticed that when etoposide is given to the patients there is tremendous pain in the area where it has been in-ected or along the vein. If this happens then the concerned doctor should be informed and precautionary measures need to be taken immediately

INDUCTION CHEMOTHRAPY
Induction chemotherapy is the process when conventional therapy is used before the transplantation of the stem cells. The main aim of this therapy is to make the burden of the tumor less before the transplantation of the stem cells takes place. Out of the many medicines that are given to the patients there are a few medicines which are very important for this therapy. This is one of the reasons why some agents in the medicine have less to icity in the bone marrow then others. The chemotherapy drugs for the induction chemotherapy are the myeloma drugs which are called de amethasone, Ortho/$iotech, do orubicin, vincristine, 2Gd, cyclophosphamide G#2, de amethasone, methasone and thalidomide. The Induction chemotherapy is usually given in cycles. Treatment period as well as rest period is there alternately. !a imum of the tumor cells are e posed to the treatment during the treatment cycle period. The patients can recover from the side effects of chemotherapy through these treatments. The patients are given the Induction chemotherapy for si months or a year till the patient gets stable. Often three to four cycles are administered before the stem cells are collected 1ven after the cells are collected the patients can still continue with the chemotherapy till they reach a stable state. In some cases when the myeoma relapses then only is the transplantation done. Corticosteroids are sometimes used for the treatment of !yeloma or the cancer of the bone marrow and treating a patient with 2e amethasone is the most common form of Induction chemotherapy, as the most commonly used corticosteroid is 2e amethasone. There is an increase in the use of G#2. It has been observed through recent research that the medicine Thal/ de which is used for chemotherapy has a greater response in comparison to G#2 when it is used for the first time when the therapy starts. 'or the

treatment of bone marrow cancer new regimens as well as chemotherapy agents are also being researched.

RICE CHEMOTHRAPY
# particular type of chemotherapy where particular types of medicines are given to the patients to help get rid of lymphoma is known as 3ice chemotherapy. 3ice chemotherapy is a little different from the other types of chemotherapy as the medicines that are given during the treatment are very effective in reducing the pain of the cancer patient and at the same time helps the patient to fight against cancer. The three main medicines that are used during the 3ice chemotherapy treatment are Isosfamide, Carboplatin and 1toposide. In order to increase the effectiveness of this chemotherapy on the cancer patients anti/body medicines like the ritu imab are also included in the treatment schedule. The medicine 3itu imab has the efficiency of destroying the cancer cells most effectively as well as accurately, and while doing so it sees to it that the normal cells are not affected. They have been made in such a way that they can differentiate between the cancer cells and the normal cells by -ust analy?ing certain types of proteins that can only be seen on the surface of the cancer cells. The antibody locks these cells and then begins to stimulate the immunity system of the body in order to destroy the cancerous cells. This method of chemotherapy is effective as well s uni6ue at the same time. It does not take a very long time to take the 3ice chemotherapy treatment and can be taken in a hospital. In order to determine the condition of the kidney and other health related conditions the blood test is essential for this particular situation. On the report depends the entire treatment, so it needs to be accurate otherwise if wrong treatment is given on the basis of the report it can cause dangerous side effects. 'or this reason a cancer patient is re6uired to consult a doctor who is e perienced. In order to avoid any sort of comple ities after the treatment starts the patients are given some anti/sickness medicines before the starting of the 3ice Chemotherapy treatment .

3ice chemotherapy is also preferred as if the patient faces any sort of reaction during the treatment period+ this can be changed by bringing down the level of the medicines. #t times itHs seen that the patient feels swelling in the veins or starts bleeding. The severeness of these kinds of side effects can be reduced by the application of a medicine menssa along with the other medicines. The medicine mensa is also available in tablet form. # patient is allowed to go back home for the rest period after a day or two of the completion of the chemotherapy treatment. #s all other chemotherapy 3ice chemotherapy is also not completely free from side effects. In order to avoid any sort of dreadful or horrible conse6uences, the side effects have to be handled with much care and caution. 0ausea and vomiting are the two common side effects that are complained by every person who undergoes chemotherapy. This is also complained by the patients taking the 3ice chemotherapy treatment. In order to destroy the side effects completely anti/sickness medicines are given by the doctor. The immunity system of the patient is hit indirectly as the chemotherapy leads to the reduction in the production of the white blood cells. $ut within a period fifteen days the level of the white blood cells becomes normal automatically. Other kind of side effects of this type of chemotherapy treatment is anemia, loss of appetite, bleeding and irritation.

TO.OTERE CHEMOTHERAPY
Ta otere is the chemotherapy treatment that is given to the patients suffering from stomach cancer, breast cancer and prostrate cancer. #t times the patients suffering from bladder cancer and ovarian cancer are also treated through this therapy. #s the medicine used for this treatment does not come in the form of pills the Ta otere chemotherapy has to be in-ected into the veins of the patient. The time re6uired for taking the treatment is an hour and the therapy is given after every three weeks. #fter seeing the patient sometimes the doctor decides when the dose needs to be given to the patient. The dose of the medicine depends upon the structure of the body as well as the condition of a patient. The dose that will be given to the patient is also fi ed by the doctor. $efore the starting of the treatment a dose of de amethsone is prescribed by the doctor as this medicine helps to reduce the side effects of the treatment. !any patients do not e perience many side effects of the Ta otere Chemotherapy treatment though there are plenty of them. #s the duration of the side effects is known before hand it is very helpful. #fter the completion of the treatment the side effects are said to disappear. If proper care is taken the side effects can be made less or stopped completely. #ll this depends upon the dose of the medicine that is given to the patient.. Control of the cancerous cells is not possible. They multiply much faster than the normal cells. The growth of the normal cells stop the very moment they come in contact with the cancerous cells. The growth of the healthy cells is encouraged and the cancerous cells are killed with the help of Ta otere Chemotherapy Treatment. This is possible as when the cells cannot divide they die. Garious precautions need to be taken before the dose of Ta otere Chemotherapy is given to the patients. #ll the medicines that the patient is taking should be informed to the doctor. "ithout the permission of the doctor #spirin also should not be taken nor should any sort of vaccination be given to the patient. #s the medicines may harm the unborn child Ta otere chemotherapy treatment is not given to a pregnant women. #

patient should also not get pregnant while she is undergoing the treatment. Contraceptive means to avoid getting conceived is recommended very strongly. The chances of getting infections become greater in patients who have undergone Ta otere Chemotherapy treatment. If they feel any sort of uneasiness the doctor should be consulted immediately and they should also stay way from crowded places. "ashing of hands should be done as many times as possible. #s there is chances of getting mouth ulcers care should be taken to avoid this. "hen going out in the sun sun/screen lotion should be applied as the skin also becomes very sensitive and lastly the patients should try to avoid getting in-ured as far as possible.

MOPP CHEMOTHERAPY
In 1()@, researchers at the 0ational Cancer Institute developed the first combination chemotherapy that cured a number of patients who had relapsed following a standard radiation therapy regimen. This drug combination was called !O88 and was, for a long time, the standard treatment for 5odgkin9s disease.

!ustargen =mechlorethamine, nitrogen mustard> Oncovin =Gincristine, GC3> 8rocarba?ine =!atulane> 8rednisone =2eltasone, Orasone>

5owever, !O88 may be used if there are lung or heart conditions present or allergies to any of the medications in the #$G2 combination. #dditionally, B0N to @0N of people will relapse after treatment with #$G2, which will re6uire MsalvageH treatment with !O88J The amount of each medication, the duration of chemotherapy, and the addition of radiation therapy is determined by a number of prognostic markers, which includes body si?e, your overall health status, the presence of any other medical conditions, and response to treatment. The usually !O88 chemotherapy regimen is once a week in @/) week cycles. "hile radiation therapy is not always used as a treatment, if used, Kintensive fieldL radiation closely targets the cancer area while avoiding damage to healthy tissues.

A''iti"nal Me'icati"n( 2octors also prescribe additional medications to help prevent nausea during and after the chemotherapy. Oofran =ondansetron 5C;>, <ytril =granisetron>, Oantac =ranitidine 5C;> are taken both before treatment and after treatment. A''iti"nal Si'e E**ect( 8atient may become dehydrated from nausea, vomiting and diarrhea. patient will e perience temporary hair loss from the chemotherapy+ your hair will regrow once treatments are completed.#nother possible side effect of chemotherapy is low white blood cells =neutropenia>, which can affect how well patients are able to fight off common infections. "hite blood cell counts can be increased with the use of growth factors called %ranulocyte Colony/,timulating 'actor =%/C,' or C!/C,'> or 0eupogen =3>. #ntibiotics may also be prescribed as a preventative measure, but are usually only given when patients present with signs of infection. If radiation therapy is also used, red blood cell counts may also be reduced. In this event, patient may be prescribed erythropoietin =18O> to stimulate body to manufacture more red blood cells. L"ng/term E**ect( !O88 is no longer the first choice for 5odgkinHs disease treatment because of the large number of adverse effects and the possible long/term risk for the development of another cancer. In the first &0 years after treatment, the risk of a second cancer is more than &0N. The risk of developing another cancer after 5odgkinHs disease treatment is also related to the patient9s age when they were treated. The risk is higher for people who were over @0 years old when they were initially treated. # loss of fertility is another long/term effect of chemotherapy and radiation therapy.

!en treated with !ustargen lose their ability to produce sperm. "omen may stop ovulating and menstruating, resulting in premature menopause.

METRONOMIC CHEMOTHERAPY
# new treatment known as metronomic Chemotherapy which is a new variation in the field of chemotherapy has been found out. This treatment is basically of a low do?e chemotherapy and used for advanced stage of cancer. !etronomic Chemotherapy is one of the biggest steps forward in the history of cancer treatment. This is a new way of treating cancer patient and the most interesting feature of this treatment is that it has less side effects. 8rimarily, during the treatment the doctors give low dose of tablets to the patients. The research shows that this treatment gives e6ually good result as an ordinary chemotherapy. The best part of this treatment is that here the lowest possible amounts of doses are given to the patients and it has 6uite less number of side effects. In addition, the smaller amounts of doses help in making the chemotherapy tolerable for some patients. This approach may help to reduce some of the unpleasant side effects of cancer chemotherapy such as nausea and vomiting. On the other hand , the traditional chemotherapy drugs work on guideline of giving the highest amount of dose so as to kill the cancer affected cells. $ut due to the doses being given in high 6uantity , the main disadvantage of traditional chemotherapy is that it has e6ually many side effects which are 6uiet harmful to human body. This is one of the reasons why !etronomic Chemotherapy was discovered. This treatment has been proved successful and has reached a new height. The main aim of this chemotherapy is to reduce the harmful side effects that are produced by other ordinary drugs. ,ignificantly lower doses given more fre6uently on a prolonged basis prove to be far more effective than the traditional chemotherapy. The amount of dose given to the patient is generally one tenth of the usual dose. This form of chemotherapy can be possibly taken every day which is not possible in the traditional method. !etronomic chemotherapy is also known as anti/angiogenic chemotherapy. The low dose drug delivered to the patient is to give to minimi?e to icity

and the main target is endothelium cells. The endothelium cells provide blood and the nutrients to the swelling tumor. Thus, it permits the tumor to grow. $ut when the endothelial cells are destroyed, there is no supply of blood. In that case, the tumor collapses or the cancer cells get killed.,everal research groups and studies concluded that if metronomic chemotherapy and anti/angiogenesis agents are combined then it works more effectively than metronomic chemotherapy being used alone. # lot of research is going on in medical trial for treating a diverse range of cancer.

PALLIATIVE CHEMOTHERAPY

The 8alliative Chemotherapy is a treatment which is given to the cancer patients to relive them of the great pain that they undergo as well as to increase the number of years they may survive. There is hardly any change in the longevity of the patient though the treatment is given to increase the survival period. ItHs seen that the longevity of a patient is at the most increased by a year The 8alliative Chemotherapy is very popular among the chemotherapy treatments even though there are some people who believe that there are no visible signs that indicate that the personHs condition has improved after undergoing the chemotherapy. There is mi ed review regarding this therapy as some have really suffered due to the side effects while some have benefited from the treatment. "hile giving this chemotherapy proper care should be taken to see to it that patients do not face side effects of the medicines. The 8alliative chemotherapy should be immediately stopped if the patient complains of any sort of discomfort during the time when the medicines are being given as a means of treatment .The family members as well as the patient should be well informed about the 8alliative Chemotherapy by the doctor before he starts with the treatment. 'alse hopes should not be given to the patient by the doctor. This therapy is mainly given to people suffering from ;eukemia. 8eople have not been cured by this therapy but have got some sort of positive results. 8alliative Chemotherapy is also given to patients who are suffering from breast cancer, and sarcoma of the tissues .Things that should be kept in mind by the doctor before suggesting the chemotherapy treatment is if the patient is in a condition health wise to be able to take the treatment and will the patient benefit in any way from the treatment. The health of the patient should be the top most priority of the doctor and the doctor should also make everything clear before the treatment starts and not allow the patient to form any sort of false hopes on the treatment In order to control the symptoms of the disease the doctors at times suggest the patients to go for 8alliative chemotherapy treatment. The 8alliative chemotherapy is helpful in improving the 6uality of life of the patient and has very little effect on increasing the numbers of years of the patient. 8eople are of the opinion that by going in for the 8alliative chemotherapy treatment the physical condition of the patient may improve

which in turn may help to lead a better life. The 8alliative chemotherapy treatment has also shown positive results in many patients. The role of the 8alliative chemotherapy is still under controversy though it is administered to the patients. There is still doubt about this therapy in the minds of some people though there are some others who vote for it. In the recent studies as well as researchHs it has been found out that after taking the 8alliative Chemotherapy the 6uality of life of a patient improves. Pust with the hope of getting a new 6uality of life patients go for the 8alliative Chemotherapy treatment. The patients have been given a new ray of light even though it is not possible for the 8alliative chemotherapy treatment to cure the cancer from the root.