A course of chemotherapy

A course of chemotherapy is a tool for eliminating many types of malignant neoplasms. Its essence is reduced to the use, during the treatment process, of medical chemical preparations that can significantly slow down the growth of defective cells or damage their structure.

Based on many years of research, doctors have developed their own doses of cytostatic drugs and a schedule of use for each type of tumor. The drugs taken are strictly dosed and calculated depending on the patient's body weight. The chemotherapy course protocol is prepared individually, for each patient separately.

In modern oncology, it has not yet been possible to obtain a drug that would meet two main categories in relation to the human body and cancer cells: low level of toxicity for the body and effective action on all types of tumor cells.

[ 1 ], [ 2 ], [ 3 ]

How does chemotherapy work?

Quite often, patients and their relatives have a natural question: “How does the chemotherapy course go?”

Based on the characteristics of the patient's disease, the course of chemotherapy is carried out in a hospital or at home under the close supervision of an experienced oncologist with sufficient experience in such treatment.

If the attending physician allows therapy at home, then it is better to conduct the first session in a hospital setting, under the supervision of a doctor who will adjust further treatment if necessary. When treating at home, periodic visits to the doctor are mandatory.

Some ways to administer chemotherapy:

• Using a thin enough injection needle, the medicine is injected into a vein in the arm (peripheral vein).
• A catheter, which is a small tube in diameter, is inserted into the subclavian or central vein. It is not removed during the course and the medicine is administered through it. The course often lasts several days. A special pump is used to control the volume of the administered drug.
• If possible, they “connect” to the artery that passes directly through the tumor.
• The medications are taken orally in tablet form.
• Intramuscular injections directly into the tumor site or subcutaneously.
• Antitumor drugs, in the form of ointments or solutions, are applied directly to the skin at the site of tumor development.
• If necessary, medications can also be injected into the abdominal or pleural cavities, spinal fluid or urinary bladder.

Observations show that during the administration of anticancer drugs, the patient feels quite well. Side effects appear immediately after the procedure, after a few hours or days.

Duration of chemotherapy

Each patient's therapy depends largely on the classification of the cancer; the doctor's goal; the drugs administered and the patient's response to them. The treatment protocol and the duration of the chemotherapy course are determined individually for each patient by his doctor. The therapy schedule may include daily administration of the anti-cancer drug, or it may be spread out over a weekly intake, or the patient may be prescribed monthly administration of chemical drugs. The dosage is precisely calibrated and recalculated depending on the victim's body weight.

Patients receive chemotherapy in cycles (this is the time during which the patient receives anti-cancer drugs). The course of treatment usually lasts from one to five days. Then there is a break, which can last from one to four weeks (depending on the treatment protocol). The patient is given the opportunity to recover a little. After that, he undergoes another cycle, which, in a measured manner, continues to destroy or stop tumor cells. Most often, the number of cycles ranges from four to eight (as needed), and the total treatment time usually reaches six months.

There are cases when the attending physician prescribes a repeat course of chemotherapy to the patient to prevent relapses, in which case the treatment can last for a year and a half.

A very important element in the therapy process is strict adherence to dosages, timing of cycles, maintaining intervals between courses, even if it seems that there is no more strength. Otherwise, all efforts will not lead to the expected result. Only in exceptional cases, based on clinical tests, the doctor can temporarily suspend the intake of cancer drugs. If a failure in the schedule of administration occurred due to the patient's fault (forgot or for some reason could not take the necessary medicine), it is necessary to inform your doctor about this. Only he will be able to make the right decision.

With a long course of taking oncology drugs, partial or complete cell addiction may occur, so the oncologist conducts a sensitivity test to this drug both before starting the treatment and during the course of treatment.

[ 4 ], [ 5 ], [ 6 ]

Duration of chemotherapy

Medicine and pharmacology do not stand still, new innovative technologies and treatment regimens are constantly being developed, and more modern medicines are appearing. During treatment, oncologists prescribe oncological drugs or their most effective combinations. Moreover, depending on the patient's diagnosis and the stage of its progression, the duration of the chemotherapy course and its schedule are strictly regulated by international methods.

Cytostatic drugs and their complexes are quantitatively composed according to the principle of minimum necessity to obtain the most significant effect on cancer cells while causing the least harm to human health.

The duration of the cycle and the number of courses are selected depending on the specific type of tumor, the clinical picture of the disease, the drugs used in the treatment, and the patient’s body’s response to the treatment (the doctor observes whether any side effects occur).

The treatment complex of measures can last on average from six months to two years. At the same time, the attending physician does not let the patient out of his field of vision, regularly undergoing the necessary examinations (X-ray, blood test, MRI, ultrasound, etc.).

[ 7 ], [ 8 ], [ 9 ]

Number of chemotherapy courses

In the terminology of medical oncologists, there is such a concept as dose intensity. This name determines the concept of frequency and quantity of medicine administered to the patient over a certain period of time. The eighties of the twentieth century passed under the auspices of increasing dose intensity. The patient began to receive a larger number of drugs, while the attending physician tried to prevent significant toxicity. But the patient and his relatives must understand that with a decrease in dose intake, with some types of cancer cells, the chances of recovery also fall. In such patients, even with a positive treatment result, relapses occur quite often.

Moreover, studies conducted by German scientists have shown that with an intensive dosage and a reduction in the time between courses, the treatment results are more impressive - the number of cured patients is significantly higher.

The number of chemotherapy courses depends largely on the patient's tolerance of the drugs and the stage of the disease. In each specific case, the oncologist must take into account many different factors. One of the significant ones is the area of localization of the disease, its type, the number of metastases and their prevalence. An important factor is also the immediate condition of the patient. With good tolerance of the drugs, the tandem of the patient and the doctor undergoes all the cycles of the chemotherapy course provided by the scheme, but if the doctor notices obvious signs of toxicity in the patient (for example, a sharp drop in hemoglobin, leukocytes in the blood, exacerbation of systemic diseases, etc.), the number of cycles is reduced.

In each specific case, the treatment regimen and number of cycles are strictly individual, but there are also generally accepted schedules for administering drugs, on which the treatment of many patients is based.

Most often, treatment is carried out according to the Mayo scheme. The patient takes fluorouracil with leucovorin at a dosage of 425 mg intravenously for one to five days with a four-week break. But the number of chemotherapy courses is determined by the attending physician based on the stage of the disease. Most often, six courses - about six months.

Or the Roswell Park scheme. Injecting cancer drugs once a week, every six weeks for an eight-month course of treatment.

Long-term studies provide the following figures for five-year survival of patients (for a specific type of lung cancer and the same stage of its development): three courses of chemotherapy - 5%, with five cycles - 25%, if the patient has undergone seven courses - 80%. Conclusion: with a smaller number of cycles, the hope for survival tends to zero.

Is it possible to interrupt chemotherapy?

When faced with this problem, patients almost always ask their attending physician a legitimate question: is it possible to interrupt the chemotherapy course? The answer here can be unambiguous. Interruption of the course of treatment, especially in its later stages, is fraught with quite serious rollbacks to the primary form of the disease, up to and including death. Therefore, it is unacceptable to independently stop taking the prescribed anti-cancer drugs. It is also necessary to strictly adhere to the regimen of administration of drugs. The attending physician must immediately know about any violation of the regimen (due to forgetfulness or due to some objective circumstances). Only he can advise something.

Interruption of the chemotherapy course is possible only by reasoned decision of the oncologist. He can make such a decision based on clinical indications and visual observation of the patient. The reasons for such interruption may be:

• Exacerbation of chronic diseases.
• A sharp drop in the number of leukocytes in the blood.
• Decrease in hemoglobin to critical level.
• And others.

Break between chemotherapy courses

Most of the drugs taken during chemotherapy work to destroy rapidly dividing cancer cells. But the process of division is the same for both cancer and normal cells. Therefore, as sad as it may sound, the drugs taken have the same effect on both cells of the human body, causing side effects. That is, healthy cells are also damaged.

In order for the patient's body to have at least some time to rest, recover a little and "start fighting the disease" with new strength, oncologists necessarily introduce breaks between chemotherapy courses. Such a rest can last about one to two weeks, in exceptional cases - up to four weeks. But based on monitoring conducted by German oncologists, the density of chemotherapy courses should be as high as possible, and the rest time should be as short as possible, so that during this period the cancerous tumor cannot grow again.

[ 10 ]

1 course of chemotherapy

During one course of chemotherapy, not all, but only a certain percentage of cancer cells are usually destroyed. Therefore, oncologists almost never stop at one treatment cycle. Based on the overall clinical picture, the oncologist can prescribe from two to twelve cycles of chemotherapy.

Taken together, the time the patient receives anti-cancer drugs and the time off are designated as a chemotherapy course. Within the framework of the first course of chemotherapy, the dosage of the drug or drugs that are administered intravenously or in the form of tablets and suspensions orally is clearly prescribed according to the scheme. Their intensity of administration; quantitative limits of rest; doctor's visits; passing the tests provided for by the schedule of this cycle; clinical studies - all this is scheduled within the framework of one cycle, almost to the second.

The number of cycles is determined by the attending physician based on the following factors: stage of cancer; type of lymphoma; name of the drugs administered to the patient; the goal the doctor wants to achieve:

• Or it is preoperative stopping chemotherapy to slow down or completely stop the division of malignant cells, which is carried out before surgery to remove the tumor.
• Or it is an “independent” course of treatment.
• Or a course of chemotherapy, which is carried out after the operation, to destroy the remaining cancer cells and prevent the formation of new tumor cells.
• Quite often it depends on the severity of the side effects and their nature.

Only through monitoring and clinical research, which adds experience, a doctor is able to more effectively select a drug or a combination of drugs for a patient, as well as introduce into the treatment regimen the intensity and quantitative indicator of cycles, with minimal toxicity to the body and maximum ability to destroy cancer cells.

[ 11 ], [ 12 ], [ 13 ], [ 14 ], [ 15 ], [ 16 ], [ 17 ]

Chemotherapy course for lung cancer

Cancer patients with lung damage are currently leading in quantitative manifestation. Moreover, this disease covers all countries of the globe, and the percentage of patients with such a diagnosis is growing every day. Statistics voice quite frightening figures: for every hundred of those diagnosed with lung cancer, 72 people do not live even a year after diagnosis. Most of the patients are elderly people (approximately 70% of patients are over 65 years old).

Treatment of this disease is carried out in a comprehensive manner and one of the methods of treatment is chemotherapy, which gives a particularly high positive result in the case of small cell lung tumor.

It is quite difficult to recognize the disease at its early stage, since at first it proceeds almost asymptomatically, and when painful sensations begin to manifest, it is often too late. But this does not mean that you should give up and do nothing. Despite this, modern oncology centers have diagnostic methods at their disposal that make it possible to detect this terrible disease at an embryonic level, giving the patient a chance to live.

Differentiation of cancer cells and their classification occurs according to certain characteristics:

• Size of the neoplasm cell.
• The volume of the tumor itself.
• The presence of metastases and the depth of their penetration into other adjacent organs.

The classification of a specific disease into an existing class is important, since for finely dispersed and coarsely dispersed tumors, and at different stages of their growth, the treatment methods are somewhat different. In addition, differentiation of the disease makes it possible to predict the further course of the disease, the effectiveness of a specific therapy, and the general life prognosis of the patient.

Chemotherapy for lung cancer is aimed at damaging tumor formations. In some cases, it is used as an individual treatment method, but more often it is part of a general treatment complex. Small cell cancer responds particularly well to chemical drugs.

The patient almost always receives cytostatics orally through a drip. Each patient receives the dosage and treatment regimen from their attending physician individually. After completing one course of chemotherapy, the patient gets two to three weeks of rest to at least partially restore strength and prepare their body for a new batch of drugs. The patient receives as many treatment cycles as stipulated by the protocol.

The list of cytostatics used for lung cancer is quite extensive. Here are some of them:

[ 18 ], [ 19 ], [ 20 ], [ 21 ], [ 22 ]

Carboplatin (Paraplatin)

This drug is administered intravenously over 15 minutes to one hour.

The solution is prepared immediately before the dropper by diluting one bottle of the drug with 0.9% sodium chloride solution or 5% glucose solution. The concentration of the resulting mixture should not exceed 0.5 mg / ml carboplatin. The total dose is calculated individually in the amount of 400 mg per one m ² of the patient's body surface. The rest period between doses is four weeks. A lower dosage is prescribed when the drug is used in combination with other drugs.

Precautionary measures for using the drug during chemotherapy:

• This medicine is used only under the close supervision of the treating oncologist.
• Therapy can only begin when there is complete confidence in the correctness of the diagnosis.
• When using the medicine, you must work only with gloves. If the medicine gets on your skin, it must be washed off with soap and water as quickly as possible, and the mucous membrane must be thoroughly rinsed with water.
• With significant doses of the drug, suppression of bone marrow function, severe bleeding and the development of an infectious disease are possible.
• The appearance of vomiting can be stopped by taking antiemetic drugs.
• There is a possibility of allergic reactions. In this case, it is necessary to take antihistamines.
• Contact of carboplatin with aluminum leads to a decrease in the activity of the drug. Therefore, when administering the drug, needles containing this chemical element cannot be used.

There is no data on the use of the drug in the treatment of children.

[ 23 ]

Cisplatin (Platinol)

The drug is administered intravenously via a drip. The dosage is determined by the doctor: - 30 mg per m2 ^once a week;

• - 60–150 mg per m2 ^of the patient’s body area every three to five weeks;
• - 20 mg/m2 daily for 5 days. Repeat every four weeks;
• - 50 mg/m2 on the first and eighth days every four weeks.

In combination with radiation, the drug is administered intravenously daily at a dose of up to 100 mg.

If the doctor has prescribed intraperitoneal and intrapleural administration of the drug, the dose is set from 40 to 100 mg.

When administering the drug directly into the cavity, the medicine is not diluted too much.

Contraindications include hypersensitivity to the components of the drug, as well as impaired renal and hearing function.

[ 24 ], [ 25 ], [ 26 ], [ 27 ], [ 28 ], [ 29 ]

Docetaxel

The drug is administered slowly, once, intravenously, over 1 hour. The dosage is 75–100 mg per m2 ^, the procedure is repeated every three weeks.

When taking the drug, it is necessary to observe all the precautions that are stipulated when working with other antitumor drugs.

Almost all chemotherapy drugs have many side effects, so in order to remove some of them, the attending physician prescribes additional medications to the patient that partially or completely relieve them. The most common side effects are:

• Hair loss.
• Peripheral neuropathy.
• Nausea leading to vomiting.
• The appearance of ulcerative formations in the mouth.
• Disorders of the digestive tract.
• Decreased vitality: rapid fatigue, loss of appetite, depression.
• Changes in taste preferences.
• A decrease in the number of red blood cells in the blood is called anemia.
• A decrease in the number of white blood cells in the blood is called neutropenia.
• Decreased platelet levels.
• Suppression of immunity.
• Changes in the structure and color of nails, skin color.

The recovery process after the treatment cycle, in most cases, lasts approximately six months.

[ 30 ], [ 31 ]

Chemotherapy course for lymphoma

Lymphoma is a tumor cell that has penetrated the human lymphatic system, as well as organs adjacent to the lymph nodes. One of the first symptoms of cancerous neoplasms in lymphoma is swelling of various groups of lymph nodes (inflammation can affect either a separate group of nodes - inguinal, axillary, cervical localizations - or all of them together). The use of a course of chemotherapy for lymphoma gives quite good results and an optimistic prognosis. Doctors distinguish between lymphoma of sclerotic-nodular or combined form. The stages of the disease, as with cancerous neoplasms of other organs, are distinguished: mild, moderate and severe. A more advanced form often leads to death.

The chemotherapy course scheme is prescribed based on the severity of the disease, as well as depending on the composition of the lymphatic fluid. Despite the different localization of the disease, the diagnostic methods and schedules for taking chemotherapy drugs are quite similar. What distinguishes them is the drugs received by the patient and their combinations. Lymphomas are not operated on, so a course of chemotherapy is one of the main ways to recovery. Traditionally, when treating lymph cancer, the patient undergoes three cycles, with more severe forms, the number of courses increases.

To confirm the diagnosis, in addition to computed tomography, MRI, positron emission tomography (PET) and other methods are used, since the unifying name "lymphoma" includes a fairly large number of different diseases. But, nevertheless, the regimens for taking antitumor drugs are similar, the same set of drugs is used. At the early stage of the disease, several protocol-approved regimens of combined chemotherapy drugs in combination with laser therapy are used.

The list of such drugs is quite wide. Here are some of them.

[ 32 ], [ 33 ], [ 34 ]

Adriamycin

The medicine is administered intravenously - 60-75 mg/ ^m2, once every three to four weeks. Or for three days at 20-30 mg/m2 ^every three to four weeks. Or on the first, eighth and 15th days, once, at 30 mg/m2 ^. The intervals between cycles are 3-4 weeks.

If the medication is prescribed to be administered into the bladder, the drip is administered once at intervals of one week to one month.

Complex therapy involves an IV drip every 3-4 weeks at a dosage of 25-50 mg/ ^m2, but the total course dose should not exceed 500-550 mg/ ^m2.

The drug in question is contraindicated for people who are hypersensitive to hydroxybenzoates, suffer from anemia, liver and kidney dysfunction, acute hepatitis, ulcerative manifestations in the stomach and duodenum, and others (a full list of contraindications can be read in the instructions for this drug).

[ 35 ]

Bleomycin

The antitumor agent is administered both into the muscle and into the vein.

• for intravenous injections: the bottle of medicine is diluted with a solution (20 ml) of sodium chloride. The medicine is injected at a fairly measured rate.
• When injecting into a muscle, the drug is dissolved in an isotonic solution of sodium chloride (5-10 ml). To dull the pain, 1-2 ml of a 1-2% solution of novocaine is injected beforehand.

The usual regimen for adults is 15 mg every other day or 30 mg twice a week. The total course dose should not exceed 300 mg. When repeating the cycle, both the single and course doses are reduced, the interval between doses is maintained for up to one and a half to two months. For elderly patients, the dose is reduced and is 15 mg twice a week. This drug is administered to babies with caution. The dose is calculated depending on the baby's body weight. Only freshly prepared solution is used for injection.

Contraindications for this drug are significant: these include kidney and respiratory dysfunction, pregnancy, severe cardiovascular disease...

[ 36 ], [ 37 ], [ 38 ], [ 39 ], [ 40 ], [ 41 ], [ 42 ]

Vinblastine

This drug is administered through a drip and only intravenously. The dosage is strictly individual and directly depends on the patient's clinic.

For adults: single starting dose is 0.1 mg/kg of patient weight (3.7 mg/m2 ^of body surface), repeated after a week. For the next administration, the dose is increased by 0.05 mg/kg per week and brought to the maximum dose per week - 0.5 mg/kg (18.5 mg/m2 ⁾. An indicator of stopping the increase in the dose of the administered drug is a decrease in the number of leukocytes to 3000/ ^mm3.

The prophylactic dose is 0.05 mg/kg less than the initial dose and is taken every 7-14 days until all symptoms disappear.

For babies: the starting dose of the drug is 2.5 mg/ ^m2 once a week, the dose is gradually increased by 1.25 mg/ ^m2 every week until the number of leukocytes decreases to 3000/ ^mm3. The maximum total dose per week is 7.5 mg/ ^m2.

^{The maintenance dose is 1.25 mg/ m2} lower, which the child receives for 7–14 days. The vial of the drug is diluted with 5 ml of solvent. Subsequently, if necessary, it is diluted with 0.9% sodium chloride solution.

This medicine is not recommended for patients who suffer from hypersensitivity to the active substance or any component of the drug, as well as viral or bacterial infections.

The number of chemotherapy courses is prescribed by the attending physician based on the clinical presentation of the disease and the general condition of the patient.

Chemotherapy course for stomach cancer

Stomach cancer is a cancerous tumor that penetrates the mucous membrane of the stomach. It can metastasize to layers of organs adjacent to the lesion, most often this penetration occurs in the liver, lymphatic system, esophagus, bone tissue and other organs.

At the initial stage of the disease, the symptoms of this disease are almost invisible. And only as the disease progresses, apathy appears, appetite disappears, the patient begins to lose weight, taste intolerance to meat food appears, a blood test shows anemia. Later, some discomfort begins to be felt in the stomach area. If the cancerous tumor is located close enough to the esophagus, the patient feels early saturation of the stomach, its overflow. Internal bleeding, nausea, vomiting is activated, severe pain sensations appear.

A course of chemotherapy for stomach cancer is administered either intravenously or in tablet form. This treatment complex is administered either before surgery, to at least slightly reduce the size of the tumor itself, or after surgery - to remove any cancer cells that may remain after resection or to prevent relapses.

To destroy tumor cells, oncologists use cytotoxic drugs. Modern pharmacology offers a fairly impressive list of them.

The course of chemotherapy consists of the following drugs:

Cisplatin, which was already written about above.

Fluorocyl

It is often introduced into various treatment protocols. The patient takes it intravenously. They stop administering it when the leukocytes reach a critical level. After normalization, the treatment process is resumed. This medication is dripped continuously for 100-120 hours at a rate of 1 g / m ² per day. There is another course, where the patient receives the drug on the first and eighth days at a dosage of 600 mg / m ². It is also prescribed in combination with calcium, then the volumes are 500 mg / m ² daily for three to five days with an interval of four weeks.

Patients who suffer from individual intolerance to the components of this drug, who suffer from renal or hepatic insufficiency, acute infectious disease, tuberculosis, as well as during pregnancy or lactation are not recommended to take this drug.

[ 43 ], [ 44 ], [ 45 ]

Epirubicin

The medicine is administered to the patient by jet injection into the vein. It is necessary to ensure that the drug does not enter other tissues, as it can cause deep damage to them, up to necrosis.

Adults: As a single drug - intravenously. Dosage - 60-90 mg/m2 ^. Interval in administration of the oncologic drug - 21 days. If there is a history of bone marrow pathology, the administered dosage is reduced to 60-75 mg/ ^m2.

If an anticancer drug is taken in combination with other medications, its dosage is reduced accordingly.

[ 46 ], [ 47 ], [ 48 ], [ 49 ], [ 50 ], [ 51 ], [ 52 ]

Temperature after chemotherapy

After any course of chemotherapy, the patient's body is weakened, the immune system is severely suppressed, and against this background, viral infections often occur, which provoke an increase in the patient's body temperature. Therefore, general treatment of the patient is carried out fractionally, in separate cycles, in between which the patient's body is given the opportunity to recover and restore the spent protective forces. The fact that the temperature rises after a course of chemotherapy tells the attending physician that the patient's body is infected and can no longer cope with the disease. It is necessary to include antibiotics in the treatment protocol.

The disease develops rapidly, so to prevent complications, treatment must be started immediately. To determine the causative agent of inflammation, the patient takes a blood test. Having identified the cause, you can treat the effect.

Unfortunately, an increase in temperature against the background of a general weakening of the body is an inevitable consequence of a course of chemotherapy. During this period, the patient simply needs to narrow the circle of contacts. Taking antipyretics is prohibited.

What to do after a course of chemotherapy?

After spending a long time in the hospital, patients ask their oncologist: What to do after a course of chemotherapy?

The main thing that patients need to remember is:

• The patient must show up for a follow-up examination with an oncologist. The first appointment will be scheduled by the attending physician at the hospital, and the patient will receive a further schedule of visits from the doctor at the clinic.
• At the slightest manifestation of a symptom, you must immediately return to see a doctor:
  • Diarrhea and nausea.
  • Pain that persists for several days.
  • Unexplained weight loss.
  • The appearance of swelling and bruising (if there was no injury).
  • Dizziness.
• Cancer is not dangerous. Therefore, you should not limit the patient in communicating with relatives and friends. Positive emotions also heal.
• If the body has returned to normal after a course of chemotherapy, you should not avoid intimacy, it is an integral part of a full life. It is impossible to infect your partner with cancer, but it is quite possible to ruin the relationship.
• After all the chemotherapy courses are over, the rehabilitation process is over, and vitality is restored, there is no reason to give up professional activity. Former patients can very well return to work, especially if it is not associated with heavy physical labor. In a heavy case, you can find yourself a place where the work is easier.
• As the body's immune system and vitality are restored, the former patient can gradually return to his or her normal level of activity. Go out, go to work, walk in the park - this will give you the opportunity to distract yourself from problems, push them into the background.

Recovery after chemotherapy

A cancer patient feels quite bad after general treatment. The functions of all organs and systems are reduced. Recovery after a course of chemotherapy includes the need to help the patient bring his body to a normal working condition as quickly as possible. Support in the desire to return to a full social life.

In most cases, this process takes about six months. During the recovery period, the patient undergoes rehabilitation courses developed by specialists, which will help cleanse the body of the effects of chemotherapy, protect against the penetration of pathogenic flora (taking antibiotics), stimulate the body to activate, consolidate the results obtained, and prevent complications.

The recovery period consists of several stages or courses:

• Restorative drug therapy carried out in a hospital setting.
• Rehabilitation at home.
• Traditional medicine.
• Sanatorium and resort treatment.

The initial course of rehabilitation therapy is given to the patient while he is still in hospital. And since the liver is the first to take the brunt of chemotherapy, it needs to be supported during the treatment itself. It also needs support during rehabilitation. To improve liver function, the patient is prescribed supportive medications, often made from natural plant materials, such as "Karsil", which is based on milk thistle.

• Karsil

Adults take these pills three times a day, one to four pieces (as prescribed by a doctor, depending on the severity of the disease). The duration of administration is more than three months.

For children over five years old, the daily dose of the drug is prescribed at the rate of 5 mg per 1 kg of the child's body weight. The resulting figure is divided into three doses.

This medicine has a number of minor side effects. The main one is dyspepsia, disruption of normal stomach function, problematic digestion, accompanied by painful sensations. Less common are vestibular disorders and alopecia (pathological hair loss), but they usually go away on their own. There is only one contraindication for use - hypersensitivity to any of the components of the drug.

Good helpers in cleansing the body are adsorbents, which, like a sponge, absorb, bind and remove toxins. These modern enterosorbents have an extensive adsorbing surface. This makes them highly effective.

• Enterosgel

This medicine is available in the form of a paste, completely ready for use. The duration of the course is strictly individual and is prescribed by the attending physician, leading the patient, but on average from one to two weeks. The intake is carried out one and a half to two hours before or after meals or medications, three times a day. A single dose for adults or adolescents over 14 years old is 15 g (respectively, the daily dose is 45 g).

Toddlers from zero to five years old are prescribed a teaspoon (5 g) - a single dose or 15 g - daily. For children from five to 14 years old, respectively: daily dose - 30 g, single - 10 g.

In case of severe manifestations of the consequences of chemotherapy, the dosage can be doubled in the first three days, and then return to the recommended dose. Side effects of this drug are also observed - constipation (if the patient was prone to their manifestation before). The drug is contraindicated for patients who have a history of acute intestinal obstruction, an allergic reaction to the component composition of the drug.

• Polysorb

This sorbent is drunk in the form of an aqueous mixture, which is prepared immediately before use: the powder of the preparation is introduced into one glass of not hot boiling water or mineral water (without gas) of neutral alkalinity: for adults - 1.2 g (one tablespoon), for children - 0.6 g (one teaspoon). The solution is thoroughly mixed. The resulting suspension is taken one hour before taking medications or food. In this case, the daily dosage of the preparation for adults and children who have reached the age of seven is 12 g (if there is a medical need, the dose can be increased to 24 g per day).

For children aged one to seven years, the daily dosage is determined at the rate of 150-200 mg per 1 kg of the child's weight and divided into three to four doses. A single dose should not be more than half of the daily dosage. In cases where it is difficult for a patient to take the medicine on his own, it is administered through a tube.

The course of treatment is strictly individual and is, on average, from 3 to 15 days. There are few contraindications for this drug. These include acute periods of ulcerative diseases of the duodenum and stomach, damage to the mucous membrane of the small and large intestine (erosions, ulcers), intestinal obstruction. Polysorb should not be given to children under one year of age.

After discharge from the hospital, the patient must radically change his previous lifestyle and diet. To prevent pathogenic flora from entering the body, it is necessary to take care of the oral cavity (mouth cavity, brush teeth...). At first, refuse solid food or wash it down well with liquid so that it passes through the esophagus more easily, without causing injury.

The effect of chemicals on the body leads to disturbances in the blood supply system, and the blood formula itself changes. To raise hemoglobin, the doctor prescribes the patient to drink red wine in small doses (although drinking alcohol itself after such a complex procedure as chemotherapy is not recommended). During this period, the patient also takes venotonics.

For example, venarus is an angioprotector that increases vascular tone, prevents venous blood stagnation in the vessels, and improves its microcirculation. Take one or two tablets twice a day (during lunch and dinner). This drug is not recommended for patients who have increased sensitivity to the components of the drug (complete intolerance is rare).

To increase platelets in the blood, the attending physician prescribes the patient vitamins of group B, as well as Sodecor and Derinat, and some others.

• Derinat

The injection of this medicine is administered intramuscularly (less often subcutaneously). Adults receive a single dose of 5 ml. The patient receives the injection as prescribed by the doctor every 24-72 hours. The course of treatment involves about three to ten injections.

The schedule for administering the drug to children is similar. But the single dose is different:

• for children under two years of age - 0.5 ml of the drug.
• from two to ten years - 0.5 ml of medicine, calculated for each year of life.
• over ten years old - 5 ml of Derinat.

This medicine is contraindicated for patients who suffer from individual intolerance to sodium deoxyribonucleate or diabetes mellitus.

• Sodecor

The daily dosage of the drug is from 15 to 30 ml (diluted in 200 ml of water or warm tea) divided into one to three doses. The duration of treatment is from three weeks to a month. The solution must be shaken well before use.

The drug Sodecor is contraindicated in case of hypersensitivity to its components, arterial hypertension.

During the recovery period, one should not neglect a course of treatment with folk remedies.

To overcome such a consequence of chemotherapy as baldness, you can use the experience of our ancestors:

• Rub burdock oil, which is sold in any pharmacy, into the roots of your head.
• In this case, an infusion of rowan and rose hips works well. You need to drink three glasses daily.
• Decoctions for washing hair, made from burdock or hops root.
• Berry fruit drinks have a wonderful effect.
• And others.

To increase the number of leukocytes, hemoglobin, platelets, erythrocytes in the blood (normalize its formula), the patient will be helped by:

• Decoctions prepared from herbs such as chicory, sweet clover, and angelica root.
• Tincture or decoction of golden root.
• Nettle decoction.
• Eleutherococcus tincture.
• A decoction based on yarrow herb.
• And other herbs.

For hematomas in the vein area, vodka compresses, covered with plantain or cabbage leaves on top, are very effective.

And as the final chord of the rehabilitation period - this is sanatorium-resort treatment, as well as climatotherapy, as an integral part of complex sanatorium treatment.

Due to the ever-increasing number of cancer cases, specialized sanatoriums have become an essential stage of the rehabilitation period. Special programs are being developed that include:

• Taking mineral water.
• Use of herbal medicine (herbal treatment).
• Selection of an individual balanced diet.

Physiotherapy procedures during the recovery period after chemotherapy:

• Iodine baths.
• Yoga class.
• Water treatments with sea salt.
• Aromatherapy is treatment with smells.
• Health-improving physical education.
• Therapeutic swimming.
• Working with a psychologist. Getting positive emotions, stress relief.
• Climatotherapy: walks in the fresh air (sanatoriums are often located in picturesque places, remote from industrial zones).

Nutrition after chemotherapy

Food during treatment has an important function of recovery. Nutrition after a course of chemotherapy is a real weapon to return to a normal, full life. Food during this period should be balanced. Especially on the table of the former patient there should be products that will help to put a barrier on the path of malignant neoplasms, working both for treatment and for prevention.

Products that are essential in the diet:

• Broccoli cabbage. It contains isothiocyanate. It is able to destroy cancer cells.
• Porridges and cereal flakes.
• Brown rice and nuts.
• Vegetables and fruits. It is advisable to eat vegetables raw or stewed.
• Legumes must be included in the diet.
• Fish.
• It is better to limit the consumption of flour products. Only coarsely ground bread.
• Honey, lemon, dried apricots and raisins – these products can significantly increase hemoglobin.
• Freshly squeezed juices, especially beetroot and apple juices. They will provide the body with vitamins C, P, B group and microelements.
• Herbal teas: with blackcurrant, rose hips, oregano...

It is necessary to exclude:

• Black tea and coffee.
• Alcohol.
• Fast food.
• Toxic products.
• Products that contain dyes, stabilizers, preservatives...

Many people perceive the word cancer as a death sentence. Do not despair. And if trouble has come to your home - fight. Work in the field of oncology is being carried out "on all fronts": innovative treatment methods, improving the quality of anti-cancer drugs themselves, developing rehabilitation complexes after all treatment procedures. Thanks to the achievements of recent years, the course of chemotherapy has become less painful, and the percentage of victories in the joint work of the doctor and the patient is pleasantly growing, which means another step has been taken in the fight against this terrible disease. Live and fight! After all, life is beautiful!!!