Chemotherapy: which side effects could be avoided

BThere is hardly any other treatment that is as difficult to adhere to as the fundamental principle of medicine, “Do no harm first”. chemotherapy with classic cell toxins. Despite new treatment concepts such as immune and antibody therapy, it still forms the backbone of oncology – alone or in combination with other drugs. The cytotoxins of chemotherapy prevent cancer cells from growing and multiplying, but they also attack other fast-growing cells in the body – such as the stem cells of the bone marrow, which are necessary for blood formation, or the mucous membrane and hair root cells. Therefore, they harm the patient physically, and also emotionally and socially through their side effects, often with severe long-term consequences.

The side effects also determine the success of chemotherapy because they force a change in treatment depending on their severity. Then either the dose of cell toxins is reduced, the number of treatment cycles is up for grabs, or the therapy is even stopped. This increases the risk that the therapy will not work or will work less well, or that the risk of a relapse will increase. Oncologists are therefore always faced with a difficult decision: what side effects are acceptable when trying to cure or prolong life, and what price does the patient pay for this, even in the long term?

In the journal Nature Reviews Clinical Oncology is now a review paper about some of the most important side effects of classic cytostatic therapy. Gary Lyman from the Fred Hutchinson Cancer Research Center in Seattle and his colleagues make it clear that, despite many advances, it has still not been possible to predict with certainty who will develop which side effects and how the occurrence of these side effects can best be prevented with new concepts and drugs leaves. There are obviously still many unanswered questions about the origin of the individual side effects.

The number of white blood cells often falls

A critical side effect is neutropenia. The number of white blood cells, more precisely: the neutrophilic granulocytes, drops dangerously due to the toxic effect of the cell toxins on blood formation. This leads to a weakening of the immune system. Patients become more susceptible to infections. It becomes particularly critical when an infection actually occurs. Then the neutropenia becomes febrile neutropenia, which requires immediate intervention.

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