December 13, 2013 – Chemo Drugs

Cancer is characterized by rapid cell division/growth.  The ability of chemotherapy to kill cancer cells depends on its ability to halt cell division.  Usually, the drugs work by damaging the RNA or DNA that tells the cell how to copy itself in division.  If the cells are unable to divide, they die.  Chemotherapy is most effective at killing cells that are rapidly dividing.  Unfortunately, chemotherapy does not know the difference between the cancerous cells and the normal cells.  The “normal” cells will grow back and be healthy, but in the meantime side effects occur.  The “normal” cells most commonly affected by chemotherapy are also cells that divide and copy quickly – blood cells, cells in the mouth, stomach and bowel, and the hair follicles; resulting in low blood counts, mouth sores, nausea, diarrhea, and/or hair loss.

                           

Jess and I attended Chemo class this past Wednesday.  This 2-hour class is conducted by an oncology RN for patients and caregivers.  We each got an individualized loose-leaf binder with info on our specific chemo drugs.  Here are mine:

Taxotere is an anti-cancer (“antineoplastic” or “cytotoxic”) chemotherapy drug.  Taxotere is classified as a “plant alkaloid,” a “taxane” and an “antimicrotuble” agent.  It’s given intravenously.  Premedication with a corticosteroid pill starting a day prior to Taxotere infusion for 3 days is given to reduce the severity of fluid retention and allergic reactions.  Common side effects:

·         Low white blood cell count (increased risk of infection)

·         Low red blood cell count (anemia)

·         Nadir: Meaning low point, nadir is the point in time between chemotherapy cycles in which you experience low blood counts.

o   Onset: 4-7 days

o   Nadir: 5-9 days

o   Recovery: 21 days

·         Fluid retention

·         Peripheral neuropathy (numbness in fingers and toes)

·         Nausea

·         Diarrhea

·         Mouth sores

·         Hair loss

·         Fatigue and weakness

·         Infection

·         Nail changes

The process of cell division, whether normal or cancerous cells, is through the cell cycle.  The cell cycle goes from the resting phase, through active growing phases, and then to mitosis (division).  Chemotherapy drugs that affect cells only when they are dividing are called cell-cycle specific.  Chemotherapy drugs that affect cells when they are at rest are called cell-cycle non-specific.  The scheduling of chemotherapy is set based on the type of cells, rate at which they divide, and the time at which a given drug is likely to be effective.  This is why chemotherapy is typically given in cycles.

Taxotere belongs to a class of chemotherapy drugs called plant alkaloids, and is cell-cycle specific.  This means it attacks the cells during various phases of division.  Antimicrotubule agents inhibit the microtubule structures within the cell.  Microtubules are part of the cell’s apparatus for dividing and replicating itself.  Inhibition of these structures ultimately results in cell death.

Cytoxan is an anti-cancer (“antineoplastic” or “cytotoxic”) chemotherapy drug.  Cytoxan is classified as an “alkylating agent.”  Usually given by intravenous, the following side effects are common:

·         Low blood counts (white and red blood cells and platelets) – increased risk for infection, anemia and/or bleeding.

·         Nadir:

o   Onset: 7 days

o   Nadir: 10-14 days

o   Recovery: 21 days

·         Hair loss

·         Nausea and vomiting

·         Poor appetite

·         Loss of fertility

Cytoxan is classified as an alkylating agent, most active in the resting phase of the cell.  This drug is cell-cycle non-specific.

Non-chemotherapy Drugs:

Neulasta is a biologic response modifier.  It is classified as a colony stimulating factor used to stimulate the growth of “healthy” white blood cells in the bone marrow, once chemotherapy is given. White blood cells help the body fight infection. This is not a chemotherapy drug.  It is usually given at least 24 hours after chemotherapy to stimulate the growth of new, healthy, white blood cells (WBC), and is given via injection.

Dexamethasone – corticosteroid used to mitigate fluid retention, allergies, arthritis, asthma and skin conditions.

Prochlorperazine – used to control severe nausea and vomiting.

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