What Are the Effects of Chemotherapy on Bone Marrow?

Chemotherapy is an abbreviation of chemical drug treatment. It is a treatment method that uses chemical drugs to prevent cancer cell proliferation, invasion, and metastasis until it eventually kills cancer cells. It is a systemic treatment, and it is called 3 major treatments of cancer together with surgery and radiotherapy. ^[1]

Chemotherapy

Chemotherapy is an abbreviation of chemical drug treatment. It is a treatment method that uses chemical drugs to prevent cancer cell proliferation, invasion, and metastasis until it eventually kills the cancer cells. It is a systemic treatment, and surgery,

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There are four ways of clinical application of chemotherapy

1. Systemic chemotherapy for advanced or disseminated tumors

Because of the lack of other effective treatments for patients with this tumor, chemotherapy is often used from the beginning, and the immediate goal is to achieve remission. This type of chemotherapy is commonly referred to as induction chemotherapy. If the initial chemotherapy regimen fails, the other regimen is called salvage treatment.

2. Adjuvant Chemotherapy

It refers to chemotherapy that is performed after local treatment (surgery or radiotherapy) to prevent possible recurrence and metastasis of small metastatic lesions. For example, postoperative adjuvant chemotherapy for patients with osteosarcoma, testicular tumors, and high-risk breast cancer can significantly improve the efficacy and improve the survival rate or disease-free survival rate.

3 Neoadjuvant Chemotherapy

For clinically relatively limited tumors, but surgery or radiation therapy is difficult, chemotherapy can be used before surgery or radiation therapy. The purpose is to hope that the tumor shrinks after chemotherapy, thereby reducing the scope of resection and reducing the disability caused by surgery; secondly, chemotherapy can suppress or eliminate possible micrometastasis and improve the survival rate of patients. It has been shown that neoadjuvant chemotherapy can reduce the scope of surgery for bladder cancer, breast cancer, laryngeal cancer, osteosarcoma and soft tissue sarcoma, non-small cell lung cancer, esophageal cancer and head and neck cancer, or treat tumors that cannot be surgically removed after chemotherapy. Become a resectable tumor.

4 Special route chemotherapy

(1) Endovascular treatment includes cancerous intrathoracic, intraperitoneal, and pericardial effusions. Chemotherapy drugs (such as mitomycin, cisplatin, 5-fluorouracil, and bleomycin) are usually dissolved or diluted with an appropriate amount of fluid, and then injected into the body cavity of various lesions through a drainage catheter to control malignancy. Purpose of body cavity fluid.

(2) Chemotherapy in spinal canal Leukemia and many solid tumors can invade the central nervous system, especially the meninges. The treatment method is that lumbar puncture is usually administered intrathecally so that the cerebrospinal fluid has a higher drug concentration, thereby achieving the therapeutic purpose. Methotrexate and cytarabine are commonly used in spinal canal.

(3) Arterial intubation chemotherapy such as external carotid artery branch intubation for head and neck cancer, and hepatic artery intubation for primary liver cancer or liver metastatic cancer.

Although there are currently more than 40 commonly used anti-tumor drugs, and new drugs are constantly being developed, in order to achieve good results, there must be a reasonable treatment plan, including the timing of drug use, selection and compatibility of drugs, and the order of administration Only in order, dose, course of treatment, and interval time, can a comprehensive, reasonable, and effective choice of combined chemotherapy regimen be achieved. The following principles are generally considered in the composition of combined chemotherapy regimens:

1. Use drugs with different mechanisms of action in order to exert synergy;

2. The drug should not have similar toxicity, so as not to add toxicity, the patient cannot tolerate it;

3 A single medication must be effective.

(1) The diagnosis must be clear before starting treatment, and hematology and bone marrow cytology must be obtained for leukemia, multiple myeloma and malignant histiocytoma. Malignant lymphoma and various other solid tumors must be diagnosed by local tissue pathology. Chemotherapy drugs are generally not used for diagnostic treatment, and they cannot be used as placebo to avoid unnecessary loss to patients.

(2) Patients generally have better conditions, and their blood and liver and kidney functions are normal before they can tolerate chemotherapy. In any of the following cases, the type and dosage of the drug should be carefully considered: [1] frail and old; [2] previously undergoing multiple chemotherapy or concurrently with radiation therapy; [3] liver and kidney dysfunction; [4] Significant anemia; [5] Leukocytes or platelets below normal; [6] Malnutrition and significant decrease in plasma proteins; [7] Tumor and bone marrow metastases; [8] Adrenal insufficiency; [9] Fever, infection or other Complications; [10] Cardiomyopathy, etc .; [11] Chronic pulmonary insufficiency.

1. Patient side

Bone marrow and other important organs (liver, kidney, heart, lung, etc.) are insufficiency, and the general condition of the patient is too poor to tolerate chemotherapy.

2. Oncology

Primary or secondary drug resistance; low proliferation rate and more cells in quiescent phase; excessive tumor load, tumor cells above 1011.

3 Drug side

The selectivity is not strong, and there is little difference between the damage to tumor and normal tissue cells; it is not effective or too poor for G0 phase cells; tumor cells that cannot act in the "refuge" cannot enter the skull through the blood brain barrier; No effective use has been found.

Even if you feel unwell during the treatment, you can often recover quickly between the two sessions (during the pause) and resume your daily activities when you feel better. If you are taking chemotherapy medicine pills at home, chemotherapy has minimal interference with your daily life. During oral chemotherapy, you still depend on your own mental state, such as going to work and participating in various social activities.

Some chemotherapies that require intravenous injections can be performed in the outpatient department of the hospital, but some situations do require hospitalization for a period of time, which requires more changes to your daily routine. But as long as you explain to your employer why vacation is needed, I believe most employers will understand.

For most patients receiving chemotherapy, occasionally drinking alcoholic beverages will not affect the effect of treatment.