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Chemotherapy Overview

What is chemotherapy?

Chemotherapy is the use of anticancer drugs to treat cancerous cells. Chemotherapy has been used for many years and is one of the most common treatments for cancer. In most cases, chemotherapy works by interfering with the cancer cell's ability to grow or reproduce. Different groups of drugs work in different ways to fight cancer cells. Chemotherapy may be used alone for some types of cancer or in combination with other treatments such as radiation or surgery. Often, a combination of chemotherapy drugs is used to fight a specific cancer. Certain chemotherapy drugs may be given in a specific order depending on the type of cancer it is being used to treat.

While chemotherapy can be quite effective in treating certain cancers, chemotherapy drugs reach all parts of the body, not just the cancer cells. Because of this, there may be many side effects during treatment. Being able to anticipate these side effects can help you and your caregivers prepare and, in some cases, prevent these symptoms from occurring.

How is chemotherapy administered?

Chemotherapy can be given:

What are some of the chemotherapy drugs and their potential side effects?

The following table lists specific chemotherapy drugs and some of the side effects, however, each child may experience symptoms differently and at different times of the treatment. Some side effects may occur early on (days or weeks) and some side effects may occur later (months or years) after the chemotherapy has been given. The side effects listed are not all the possible problems that may occur. Always consult your child's physician if your child is feeling anything unusual.

Chemotherapy drug

Side effects (short-term and long-term)

L-asparaginase, Elspar - usually given IV

  • drowsiness can occur during and continue for several weeks after treatment
  • nausea, vomiting, and cramping
  • allergic reaction: rash or increased breathing effort
  • increased blood sugar that is reversible but may require intervention

busulfan, Myleran - usually given orally

  • fatigue, tiredness
  • dry mouth and lips
  • decreased appetite
  • hair loss (reversible)
  • nausea and vomiting
  • rash and itching
  • decrease in blood cell counts
  • darkened skin coloration
  • lung damage

carboplatin (Paraplatin) - usually given IV

  • decrease in blood cell counts
  • hair loss (reversible)
  • confusion
  • ringing in ears and hearing loss
  • kidney damage

cisplatin (cis-platinum, Platinol, Platinol AQ) - usually given IV

  • decrease in blood cell counts
  • allergic reaction: rash and increased breathing effort
  • nausea and vomiting that usually occurs for about 24 hours
  • ringing in ears and hearing loss
  • fluctuations in blood electrolytes
  • kidney damage

cyclophosphamide (Cytoxan, Neosar) - can be given IV or orally

  • nausea, vomiting, and abdominal pain
  • decreased appetite
  • hair loss (reversible)
  • bladder damage
  • fertility impairment
  • decrease in blood cell counts
  • allergic reaction
  • lung disease with high doses
  • secondary malignancies (rare)

cytarabine (ara-C, cytosine, arabinoside, Cytosar-U) - usually given IV and/or intrathecally (into the spinal column)

  • nausea, vomiting, and diarrhea
  • decreased appetite
  • abdominal pain
  • mouth ulcers several days after treatment
  • decrease in blood cell counts
  • allergic reaction
  • fever
  • inflammation of the eyes
  • reversible liver damage

daunorubicin (Cerubidine), idarubicin (Idamycin), doxorubicin (Adriamycin PFS, Adriamycin RDF, Rubex) - usually given IV

  • nausea and vomiting
  • hair loss (reversible)
  • fever and chills
  • mouth ulcers
  • red colored urine (not bleeding but a drug effect)
  • decrease in blood cell counts
  • headache
  • heart failure

etoposide (VePesid) - may be given orally or IV, teniposide (Vumon) - usually given IV

  • nausea and vomiting
  • hair loss (reversible)
  • decrease in blood cell counts
  • allergic reaction
  • mouth ulcers
  • low blood pressure
  • decreased appetite
  • diarrhea and abdominal pain

hydroxyurea (Hydrea) - usually given orally

  • decrease in blood cell counts
  • nausea and vomiting
  • decreased appetite
  • diarrhea
  • drowsiness
  • fever and chills
  • hair loss (reversible)
  • darkening of skin pigmentation

ifosfamide (Ifex) - usually given IV

  • confusion, irritability, and/or hallucinations
  • seizures
  • decrease in blood cell counts
  • hair loss (reversible)
  • kidney damage
  • darkening of skin pigmentation

mercaptopurine (6-MP, Purinethol) - usually given orally

  • nausea and vomiting
  • decreased appetite
  • mouth ulcers
  • diarrhea and digestive tract ulcers
  • decrease in blood cell counts
  • darkening of skin pigmentation
  • skin rash
  • liver damage (reversible)

methotrexate (Folex, Mexate, Rheumatrex Dose Pack) - may be given IV, intrathecally (into the spinal column), or orally

  • nausea and vomiting
  • decrease in blood cell counts
  • mouth ulcers
  • skin rashes
  • dizziness, headache, or drowsiness
  • kidney damage (with a high-dose therapy)
  • liver damage
  • seizures

thioguanine (6-TG, Lanvis) - usually given orally

  • nausea and vomiting
  • stomatitis
  • diarrhea
  • decreased appetite
  • decrease in blood cell counts (after several weeks)
  • rash
  • liver damage

thiotepa (Thioplex) - usually given IV, intrathecally (directly into the spinal column), may be instilled in bladder, or injected into the tumor

  • headache, dizziness, fatigue, or blurred vision
  • nausea and vomiting
  • hair loss (reversible)
  • decrease in blood cell counts
  • allergic reaction
  • fever

topotecan (Hycamtin) - given IV, irinotecan (Camptosar) - given IV

  • diarrhea
  • decrease in blood cell counts
  • hair loss (reversible)
  • nausea and vomiting

vincristine (Oncovin, Vincasar PFS) - usually given IV, vinblastine (Velban, Velbe) - usually given IV

  • seizures
  • weakness
  • loss of reflexes
  • jaw pain
  • nausea and vomiting
  • hair loss (reversible)
  • diarrhea or constipation, abdominal cramping
  • decrease in blood cell counts
  • difficulty breathing
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