Chemotherapy

Chemotherapy is applied to the cancer cells which tend to divide and spread fast. The chemotherapy drugs create toxicity on the cancer cells and they stop the cells from multiplying. When the drugs enter the cells they prevent them from division and from the formation of new cells. Chemotherapy usually is a single application of drugs or a combination of the various drugs orally or through intravenous injections.

Myeloma patients usually go through a number of chemotherapy regimens which is mainly conventional chemotherapy, salvage therapy and transplantation of stem cell or high dose chemotherapy. Conventional chemotherapy is also known as the chemotherapy involving standard doses. It includes regimens and chemo therapeutic agents which have been used for fifteen to forty years. Some cancer affected people would receive conventional therapy as the only treatment.

When before the transplantation of stem cells, conventional therapy is applied, it is known as induction therapy. The main aim of this therapy is to lessen the burden of tumor before the transplant takes place. There are a few drugs which are important for this therapy than the other drugs. This is due to the reason that some agents in the drugs have less toxicity in the bone marrow cells than the others. This results in more stem cells emerging from the bone marrow. The instances of chemotherapy drugs for the induction therapy are the myeloma drugs called dexamethasone, vincristine, Ortho-Biotech, doxorubicin, DVd, VAD, cyclophosphamide, dexamethasone, thalidomide and methasone.

The induction chemotherapy is given in cycles. There are rest periods and treatment periods alternating. During the treatment cycles more and more tumor cells are exposed to treatment. These treatments help the patients to recover from side effects of chemotherapy. This type of chemotherapy is mainly administered for six to twelve months until a patient achieves a stable state. When this treatment is an induction therapy generally three to four cycles are given before the stem cells are collected. After the cells are collected the patient may continue with the chemotherapy till they reach a plateau state. In some cases the transplant is reserved for the myeloma relapse.

For the treatment of myeloma, corticosteroids are sometimes used and the most common form of induction therapy is the treatment with Dexamethasone a very commonly used corticosteroid. The use of VAD is increasing. A recent research has show that Thal-dex has a higher response than VAD when the drug is used as an initial drug for therapy. New chemotherapy agents and regimen are also researched on for the myeloma treatment.

Chemotherapy is generally associated with a lot of side effects. This is because the chemotherapy drugs are not only toxic to the cancer cells but also to the other cells. This includes the cells in the intestines, the stomach, the hair follicles, and the bone marrow and so on. The counts in the blood cell decreases due to chemotherapy and there is hair loss, diarrhea, vomiting, nausea and other associated sickness. The side effects resulting from chemotherapy are varied and this depends on the stage of the disease, the physical condition of the patient and the chemotherapy regimen that is usually followed.