The answer will mostly depend on how much the chemotherapy is expected to help: The higher the risk of recurrence, the greater the potential benefit of chemotherapy. If the risk of recurrence is low, the side effects of chemotherapy are more likely to outweigh the potential benefits.
The decision over if or when to stop chemotherapy is a heart-wrenching one many cancer patients and their families eventually face. Now a new study, published online today in JAMA Oncology, suggests that for those near the end of their lives, the treatment may do more harm than good.
Because of chemotherapy's possible risks and side effects, it is not always recommended. Your oncologist may recommend avoiding chemotherapy if your body is not healthy enough to withstand chemotherapy or if there is a more effective treatment available.
Common side effects
Chemotherapy can cause fatigue, loss of appetite, nausea, bowel issues such as constipation or diarrhoea, hair loss, mouth sores, skin and nail problems. You may have trouble concentrating or remembering things. There can also be nerve and muscle effects and hearing changes.
Based on the overall cohort, that included 905 chemotherapy-exposed vs 3390 chemotherapy-naïve patients, overall survival rates at 18 and 30 months were 76.3 vs 69.3% and 61.6 vs 54.3%, favoring chemotherapy-exposed patients ( Figure 1A ).
86% of patients alive at 3 months completed the Decision Regret Scale. Results combined the 2 top categories indicating the greatest extent of regret. By this criterion, 13% of patients (95% CI: 7.4% - 19.2%) expressed regret at the 3-month timepoint after starting chemotherapy.
Concerns About Chemo and Your Natural Defenses
Chemotherapy does not kill your immune system as claimed, but it can harm it temporarily. 3 The potential for this side effect is well known and the oncologist will prepare for it and monitor your immune system closely throughout treatment.
Short, planned delays in chemotherapy for good-risk GCT patients (less than or equal to 7 days per cycle) appear to be acceptable since they may prevent serious toxicity in this curable patient population. Delays of longer than 7 days are strongly discouraged except in extraordinary life-threatening circumstances.
The Median Duration of Response tells you how long your cancer can be expected to respond to the chemotherapy, before the cancer starts growing again. For most cancers where palliative chemotherapy is used, this number ranges from 3-12 months. The longer the response, the longer you can expect to live.
Some people find they can lead an almost normal life during chemotherapy. But others find everyday life more difficult. You may feel unwell during and shortly after each treatment but recover quickly between treatments. You may be able to get back to your usual activities as you begin to feel better.
Immunotherapy, a relatively newer type of cancer treatment, uses medications to rev up the patient's own immune system to fight cancer. Immunotherapy treatments can work across different cancer types and may be effective in treating even the most advanced and hard-to-treat cancers.
Most chemotherapy side effects go away in time, but some can linger and require monitoring or treatment. Possible long-term side effects of chemo include damage to your heart and peripheral neuropathy, in which damaged nerves can cause pain, weakness or numbness in the extremities – arms, hands, legs and feet.
It was also confirmed that, for most people, quality of life was better in the absence of chemotherapy. It can be very difficult to tease apart physical symptoms and ailments that are side effects of chemo from problems being caused by cancer.
Studies have reported rates of less than 1% for patients who refused all conventional treatment [4] and 3%–19% for patients who refused chemotherapy partially or completely [5–9]. We tend to think that refusing therapy leads to a poorer quality of life as the disease progresses without treatment.
The chance of the chemotherapy curing your cancer depends on the type of cancer you have. Examples of cancers where chemotherapy works very well are testicular cancer and Hodgkin lymphoma. With some cancers, chemotherapy can't cure the cancer on its own. But it can help in combination with other types of treatment.
When a patient skips the chemotherapy cycle, the disease may progress to the next stage, and the oncologists may have to change the complete course of treatment, and eventually, the patient may have to take medicine from the beginning. The patient may also require adjuvant therapy.
During a course of treatment, you usually have around 4 to 8 cycles of treatment.
The effects of chemo are cumulative. They get worse with each cycle. My doctors warned me: Each infusion will get harder. Each cycle, expect to feel weaker.
It generally takes about 48 to 72 hours for your body to break down and/or get rid of most chemo drugs. But it's important to know that each chemo drug is excreted or passed through the body a bit differently.
Which Type of Cancer Spreads the Fastest? The fastest-moving cancers are pancreatic, brain, esophageal, liver, and skin. Pancreatic cancer is one of the most dangerous types of cancer because it's fast-moving and there's no method of early detection.
Chemotherapy alone had an 11-year shorter life expectancy versus a 6-year shorter one when diagnosed in the 1990s. Radiotherapy alone had a 21-year shorter conditional life expectancy versus an 18-year one when diagnosed in the 1990s.
When treatment ends, you may expect life to return to the way it was before you were diagnosed with cancer. But it can take time to recover. You may have permanent scars on your body, or you may not be able to do some things you once did easily. Or you may even have emotional scars from going through so much.