Cytotoxic chemotherapy work by causing cell death or preventing cell growth, generally via inhibition of microtubule function, protein function, or DNA synthesis.
Chemo damage cells during division and replication.
Therefore, rapidly dividing cells (haematological, skin, mucosa, bowel) bare the brunt of toxicity
- Chemo agents may work at different stages of cell cycle – none work on quiescent stage
Goals/intent of chemo:
Curative vs palliative
Adjuvant (after other treatment) ; neoadjuvant (before other treatment) ; concurrent (with radiation as radiosensitiser)
(Diagram from “Chemotherapy basics for family physicians” – Wilkinson & Sumar)
Common side effects:
- Myelosuppression (neutropenia, anaemia, thrombocytopenia)
- Hair loss
- Nausea and vomiting
- Fatigue
- Mucositis
- Tumour lysis syndrome
