Chemotherapy is a type of cancer treatment.

Also called “chemo,” it’s

one of several cancer treatments that use drugs against various types of
cancer.

The goals of chemotherapy

Chemotherapy in the treatment of cancer can have different goals. Doctors differentiate between
the following types of chemotherapy:
Curative chemotherapy: Curative chemotherapy aims to eliminate all cancer cells from the body
and make the cancer go away completely.
Adjuvant chemotherapy: Adjuvant chemotherapy mainly aims to fight the cancer cells that might
be left in the body after surgery, but that can't be detected. The goal of this kind of supportive
therapy is to prevent recurrences.
Neoadjuvant chemotherapy: Some tumors are too big to be directly operated on. Neoadjuvant
chemotherapy can often shrink the tumor enough for it to be surgically removed at all, or for it to
be removed using less invasive surgery.
Palliative chemotherapy: Chemotherapy is called palliative when it is no longer possible to
remove all tumor cells. Chemotherapy can then help to relieve certain symptoms, to slow down
the progress of the disease or to stop it temporarily, and to avoid complications.

How chemotherapy is done

Types of applications
The medications used in chemotherapy are usually given using an infusion into a vein (IV drip),
but some medications can also be taken as tablets. There are many different cytostatics, which are
often given in combination with one another. Because these medications travel in the bloodstream,
they usually affect the whole body. So they can also reach cancer cells that aren't detected in
examinations, and that can therefore not be targeted with surgery or radiation. This kind of
treatment is known as systemic treatment.
In a few types of cancer it's also possible to use local chemotherapy. Then the medications aren't
given through the bloodstream, but are instead injected directly into the affected part of the body,
for example the spinal canal. In that way they only reach areas connected to the spinal canal, such
as the brain or the membranes lining the brain and spinal cord. Basal cell carcinoma (a type of skin
cancer) is sometimes treated with chemotherapy medications applied as a cream or an ointment,
which only act locally.
Chemotherapy: Infusion in a vein

Chemotherapy is often combined with radiotherapy – it is then called radiochemotherapy.

Radiotherapy can be done at the same time as or after chemotherapy. Some cytostatics only have
an effect in combination with radiotherapy. In that case, chemotherapy only acts locally – in the
places where radiation was applied.
People who receive cytostatics over a long period of time can sometimes get these drugs through
a device called a port. A port is a small container that is inserted under the skin in an outpatient
operation, and connects to a large vein with a thin tube. It can remain in the body for as long as
the course of treatment lasts. This has the advantage that infusions can be connected to the port
without having to look for a vein and puncture it for each treatment.
Chemotherapy: Infusion with a port

Chemotherapy cycles
In chemotherapy, cancer is treated with cytostatics at specific intervals. This is also referred to as
treatment cycles or treatment schedules. Various factors influence the number of cycles and the
intervals between the individual treatments, including
• how long the effect of the administered drug lasts,
• how much time the body needs to recover, and
• the overall length of treatment.
Treatment schedules are tested in studies, which allows them to be optimized over time. How
exactly a treatment is done not only depends on research results, though, but also on the
individual's personal wishes and general health. If chemotherapy is causing severe adverse effects,
for example, it can make sense to deviate from the commonly used treatment schedule.
Doctors can see whether a tumor is responding to the chemotherapy with the help of various
examinations, such as blood tests, tissue samples and imaging techniques (e.g. computed
tomography). If the treatment isn't working, other medications can be used instead, or the treatment
can be stopped.