What is chemotherapy?
Chemotherapy treatment, also called chemo, is a way of treatment in which a drug or a combination of drugs are given (either orally or through other ways such as intravenous, subcutaneous etc.) to kill cancer cells. With newer techniques and development in medical science, more targeted therapies or immunotherapy are given, which may have reduced side effects and better action on cancer cells.

Under what situations will chemotherapy be given?
Your medical care team may suggest chemotherapy under the following situations:
• Curative chemotherapy is given to cure the disease.
• It may be given alone, for instance to cure blood cancer
• It may be given before or after a surgery, for instance in case of breast cancer
• It may be given with radiation, for instance in the case of cervical cancer.
• Palliative chemotherapy is given for the prolonged duration of life.
• It is given to control the disease and, or, the symptoms that are caused due to the disease.
• In this case, chemotherapy does not cure the disease.

How will Chemotherapy treat cancer? How effective is it?
• Chemotherapy uses drugs that kill the cancer cells.
• It stops or slows down the growth of cancerous cells that have a tendency to grow fast.
• It also helps to shrink the tumours and may reduce the chances of a relapse.

Will I need other cancer treatments with chemotherapy?
The types of treatment will differ from patient to patient. It also depends on the type of cancer that is being treated, the parts where the cancer has spread, as well as the overall health of the patient.

Depending on the specific needs, chemotherapy treatment may also be combined with some other forms of cancer treatment, such as:
• Surgery, Radiation therapy, or a mix of both
• Immunotherapy also known as biologic therapy, which helps the body’s immune system to fight the cancer.
• Targeted therapy where the drugs work against the specific areas of the cancer cells and stop them growing further.
• Hormone therapy also known as hormonal therapy or hormone treatment, which is used to treat those types of cancers that require hormones to help them grow, such as breast cancer or prostate cancer.
• Stem cell transplant where you may be given radiation or chemotherapy to kill as many cancerous cells as possible and replace them with healthier stem cells from the blood or bone marrow in cases of blood cancers.
• Photodynamic therapy where a special drug may be injected directly in the bloodstream, followed by a specific type of light that helps to kill the cancerous cells.

What are the drugs given in chemotherapy treatment in Mumbai?
Various types of drugs are used during chemotherapy, either as stand-alone or in combination with other drugs. These drugs will differ in their chemical composition, dosage as well as their effectiveness in treating cancer. You can discuss with your doctor about the same when starting on chemotherapy.

What are the side effects of chemotherapy treatment?
Side effects will vary from person to person, and your doctor will be able to brief you better. Some of the most common side effects from chemotherapy are:

  • Fatigue
  • Weakness
  • Giddiness
  • Nausea and vomiting
  • Hair loss
  • Body ache
  • Heaviness in the limbs
  • Diarrhoea
  • Sores in the mouth
  • Body pain
  • Reduced appetite
  • Altered taste sensation
  • Low haemoglobin (Anemia)
  • Low Platelets (Thrombocytopenia)
  • Low While blood Cells (Neutropenia) and infections
  • In very few cases, chemotherapy may cause some long-term side effects such as:
    • Fertility problems
    • Damage to the nerves
    • Damage to heart
    • Damage to lungs

At Sunrise Oncology Centre, we counsel patients before starting on chemotherapy treatment about the side effects and discuss ways to reduce them wherever possible.

How can I prepare for chemotherapy treatment?
• In the initial visits, we recommend a family member to accompany you
• Communicating with your employer and letting them know that you would require leaves on certain days
• Unless advised not to do so, go for regular short walks to have some form of exercise.
• It is important to get proper rest and be relaxed on the day before and on the day of chemotherapy
• If you have members in your family who seek your care, arrange for someone to take care of their needs, especially in the case of young children or pets as they require constant care and attention
• Consult your doctor to have a better understanding of how to properly handle and dispose of bodily discharge
• Sores are often a common side effect of chemotherapy, so visit your dentist before the session to ensure your dental hygiene and ask for tips and suggestions to avoid sores
• Stock up on healthy food items in your kitchen before you begin chemotherapy sessions
• If you were trying to conceive, consult your doctor about the same before the chemotherapy sessions begin

How will I be given chemotherapy?
Chemotherapy treatment is usually given in different ways. Some of the most common ones are as follows:
• Orally, where you will be given tablets, capsules or liquids
• Injected through a shot in the muscle in your arm, thigh, hip, under the skin in the muscular part of the stomach, leg or arm
• IV (intravenous) that is given directly in your vein
• Intrathecal where you will get an injection between the tissue layers that are covering the spinal cord and the brain
• Intraperitoneal (IP) where chemotherapy will be directly given in that part of the body where you have major organs such as the intestine, liver and stomach
• Intra-arterial (IA) where chemotherapy will be directly injected in the artery that leads directly to the cancer
• Topical where you can rub on the chemotherapy in a cream form directly on the skin

For the injection, your nurse or caregiver will be using a thin needle, whereas for the IV, it may be given using ports, pumps or catheters.

How often is chemotherapy given?
The schedule for chemotherapy therapy will vary from person to person and will depend on the following factors:
• The type of cancer
• The stage of the cancer
• The reason for which chemotherapy is being given, whether to cure the cancer, to control its growth or to ease the symptoms
• The type of the chemotherapy that is being given
• The way your body responds to the treatment

Usually, your doctor will describe the schedule of therapy in detail.
• In case of solid tumours, majority chemotherapy will usually be 4 to 6 times, given at 3 weeks’ interval.
• Chemotherapy for blood cancers is usually of a prolonged duration.
• Palliative chemotherapy can have variable schedule, depending upon the control of disease and any adverse effects.
These therapies are tailor-made for each and every patient on an individual basis, based on the intent of therapy and the nature of the cancer.

Should I take any precautions for chemotherapy? What tips should I follow?
If there are any of the following side effects, immediately go to the nearest hospital’s emergency department as advised by your treating doctor –
• Fever >1000F or chills or rigors.
• Extensive oral or throat ulcers which make it difficult or impossible to take either solid/liquid food orally.
• More than 3 episodes of vomiting in a day or persistent nausea and vomiting causing a decrease in food intake.
• More than 3 episodes of loose motions in a day.
• If the patient feels very lethargic or there is less activity than usual.
• Any skin rash or persistent cough or choking sensation – these could be due to an allergic reaction.
• Persistent coughing or breathlessness or haemoptysis (blood in cough).
• Bleeding from any site.
• Persistent headache that is not relieved by analgesics.
• Any new symptoms.

How should I maintain my hygiene during chemotherapy treatment?
• Personal hygiene is extremely important during chemotherapy.
• Take a bath daily, even if you have fever or other symptoms, unless your doctor has advised you otherwise.
• Wear clean and comfortable clothes.
• Use clean and frequently changed bed sheets and pillow covers.
• Maintain oral hygiene. Brush twice a day and use an antiseptic mouthwash to gargle after every meal.
• Have regular dental check-ups with your dentist, but DO NOT perform any dental procedure without consulting your chemotherapy doctor and medical team.
• Avoid crowded places such as markets or social gatherings.
• Avoid eating out.
• It is mandatory for all visitors and caretakers to wash their hands before touching the patient. Anyone coming in contact with the patient has to maintain complete cleanliness.
• Avoid coming in contact with anyone with contagious infections such as skin rash, cough, cold or fever.

How long will I need chemotherapy treatment?
Chemotherapy will usually be given at regular intervals as part of a schedule, which is also known as a cycle.
• This could be a dose of a single type of drug, or a combination of drugs on one or more days, with no further treatment for the next few days or weeks.
• In some cases, the treatment may be given for a number of days in a row, followed by a few days of rest.
• The dosage will be determined by your doctor and care team depending on the type of drug being used.
• Some drugs will work best with a few days of therapy followed by rest, while some work best with a longer duration of therapy.
• Your doctor may discuss about the schedule before beginning the treatment, based on the stage and type of the cancer.
• In some cases, the dosage may be reduced or increased depending on how it is affecting the cancer and the overall health of the person who is receiving it.

Is chemotherapy painful?
Certain drugs used during chemotherapy may cause some pain, especially headaches, pain in the muscles and joints, abdominal pain and so on. Speak to your oncologist about how to minimize the pain.

Is there a special diet or other diet instructions I need to follow during chemotherapy treatment?
At Sunrise Oncology Centre, you will be guided by a nutritionist to follow certain guidelines so that we support your therapy and the effects that they may have. A few basic guidelines are as follows:
• Eat a good balanced diet including lots of proteins, fruits and vegetables.
• Follow restrictions as suggested, such as low salt diet and less oily foods for high blood pressure, a diet low in sugars for diabetes mellitus etc.
• Consume freshly cooked food.
• Do not consume stale food, preserved food, raw food or outside food as it might cause infection.
• Clean hygienic food is the key to prevent infection.
• Preferably, have boiled and cooled water.
• Always carry your food and water while travelling or while coming to the hospital for treatment.
• During chemotherapy, due to decreased appetite, your food intake may be less than usual. Try to eat small food portions every 2-3 hours rather than attempting to consume large quantities at once.

Can I exercise while being on chemotherapy?
At Sunrise Oncology Centre, we want to maintain your quality of life as far as possible. We have physiotherapy and pain management services in order to ensure you are physically active.
• Carry on regular exercise in consultation with the doctor and physiotherapist to improve the effects of chemotherapy.
• Except in rare circumstances, avoid taking strict bed rest.
• Walking is most often the best exercise, especially early morning walks.
• Make sure that a family member or friend is around with you when you walk or exercise.

How do I maintain my mental health during chemotherapy?
As a result of the duration of the therapy and the nature of the disease, it is natural for many patients to develop depression. At Sunrise Oncology Centre, we believe in psychological counselling for both the patient and the family members/caregivers to maintain a positive mindset and belief.
• Try to continue with your hobbies and carry them out as you can.
• Reading, painting, writing, watching something you like, listening to music can help boost your mood.
• Support from family and friends are extremely helpful in ensuring better mental health during chemotherapy.
• Those who are in good physical and mental health will be able to tolerate the treatment better and have better outcomes.
• Avoid reading up excessively about chemotherapy as it can lead to many misconceptions and confusion.
• Let your doctor take care of your therapy planning. If you have any problems or misconceptions, discuss with your doctor.

What about the medicines I take regularly for my other health conditions?
• Inform your oncologist about any other health issues that you have and any other medicines or treatment that you are on. Your cancer care team will suggest whether or not you can continue these treatments or medication and suggest any alternate therapies if needed.
• Disclose about all medications before starting chemotherapy as some of these drugs may have interactions and cause side effects.
• Be regular in your medication and follow the schedule as per your doctor’s advice.
• Have regular follow-ups to check on dose modifications if required.
• Do not delay treatment on your own due to fear of side effects, as it will affect outcome of treatment.
• Do not take any alternative therapies (Ayurvedic or homeopathic) as these can be clashing forms of treatment. It can lead to adverse effects or reduce the positive effects of the treatment.
• Do not self- medicate.

What are the dos and don’ts during chemotherapy treatment?
• Speak to your doctor about taking the flu vaccine before you begin chemotherapy.
• Speak to your doctor if you have been trying to get pregnant or know that you are pregnant.
• Eat as per the nutritional guidelines shared by us.
• Sleep for 7 to 8 hours to boost your immunity and overall health.
• Exercise as advised by your doctor.
• Try and meditate to reduce stress, ease anxiety and fear about the treatment.
• Be regular in your treatment and follow the schedule as per your doctor’s advice.
• Do not delay or stop treatment on your own due to fear of side effects, as it will affect the outcome of the treatment.
• In case of any side effects, your doctors will take care of the same by either modifying the chemotherapy schedule, or changing the drugs or dosages.
• If you notice any side effects, even minor, immediately inform your caretaker.
• Avoid being near people who are sick or have any form of infection
• While receiving chemotherapy, do not take any injections for other health issues without consulting your oncologist
• Do not try to get pregnant
• Avoid handling babies
• Avoid substance abuse, alcohol and tobacco
• Do not expose yourself too much to the sun

How much does chemotherapy cost in Mumbai?

The cost of chemotherapy will depend on a number of factors such as:
• The type of chemotherapy that you require
• The number of doses that you need
• The duration for which the chemotherapy is needed
• The regularity at which chemotherapy is given
• The place where you receive the treatment, such as at home, at a clinic, as an outpatient or as an admitted patient at the hospital

Can I continue working during chemotherapy?
Whether or not you can continue to work during chemotherapy is a very personal subject, which will depend on a number of factors, such as the type of work you are in, the stage of the cancer, the type of treatment being given, the amount of travel one needs to do for work, how stressful or physically exhausting the work is, and so on.

Your doctor and medical team will be able to guide you about the same. Also, while some people are able to continue working during chemotherapy, some may need to rest more, and all this will depend on individual health and how the treatment is working.

Is chemotherapy covered by my insurance policy?
Chemotherapy comes under some special cases in the critical illness section in insurance, and it is advisable that you speak to your specific insurance provider about the same.

Does chemotherapy work for all types of cancer?
The results of chemotherapy will usually depend on the type of cancer and the stage at which it has been diagnosed. In some cases, chemotherapy may not be the best treatment modality on its own, and your oncologist may combine some other treatment options like surgery, radiotherapy, immunotherapy, etc. to give you the best results.

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