Overview of Chemotherapy

There are many chemotherapy drugs available, as well as medications such as interferon and interleukin (called biological therapies) and monoclonal antibodies (such as Herceptin and Rituxan) that are used to treat cancer.

Chemotherapy can cause short term (acute), long term (chronic), and permanent side effects, some of which may be severe. In many cases, side effects of chemotherapy can be prevented or controlled.

Chemotherapy drugs may cause an allergic or hypersensitivity reaction. These reactions, which are triggered by an immune system response, can occur immediately (e.g., type I or type II reaction), or within hours or days of chemotherapy (e.g., type III or type IV reaction). Anaphylaxis is a severe reaction that requires immediate treatment. It can result in shock, low blood pressure, and death.

Symptoms of an allergic reaction include the following:

  • Breathing difficulty
  • Flushing (redness of the face and neck)
  • Hives (urticaria; raised, itchy blotches)
  • Rash
  • Swelling (e.g., of the lips, tongue, eyelids)
  • Systemic reactions (e.g., liver and kidney disorders)

In December 2015, the U.S. Food and Drug Administration (FDA) approved the first emergency treatment for overdose of or severe toxic reaction to certain types of chemotherapy drugs (e.g., fluorouracil, capecitabine). Uridine triacetate (Vistogard) is approved for use in adults and children who experience an overdose or toxicity within 4 days of treatment with fluorouracil or capecitabine (which are used to treat several types of cancer).

Vistogard is an oral medication that blocks cell damage and cell death caused by chemotherapy. It should be taken as soon as possible after overdose (even if symptoms are not present) or toxic reaction that occurs within 4 days (early-onset), according to the FDA. It is not used to treat non-emergency reactions to fluorouracil or capecitabine because it can reduce the effectiveness of these chemotherapy drugs. Side effects include nausea, vomiting, and diarrhea.

Biological Therapy

Interferon and interleukin-2 are commonly used biological agents. Interferon has been shown to improve survival in non-Hodgkins lymphoma patients, as well as in melanoma patients, renal cell cancer patients, and others. It is also used in patients who have hepatitis C. During treatment these agents—which are naturally made by the body—are delivered in higher doses than the body is capable of producing.

The major side effects associated with biological agents are constitutional—particularly fever and flu-like symptoms with associated body and muscle aches (arthralgias and myalgias). Other side effects include water retention and water leakage (often seen with interleukin), shortness of breath, cardiac arrhythmias (irregular heart rates), and skin rashes. In some cases, neurological changes (e.g., memory loss, depression, suicidal ideation ) may occur. As with most side effects of chemotherapy, these effects are temporary and reverse with discontinuation of the medication.

Monoclonal Antibodies

Most side effects of this treatment are constitutional, such as fever, chills, muscle aches, and lack of energy.

Updated by Remedy Health Media

Publication Review By: Stanley J. Swierzewski, III, M.D.

Published: 14 Aug 1999

Last Modified: 15 Dec 2015