Chemotherapy is one of the leading directions in the field of treatment of oncological pathologies. Most often, patients are treated with polychemotherapy, which involves the administration of several antitumor drugs of various groups.
The chemotherapeutic effect can be used as the main treatment either as a supplement to the surgical and radiotherapy method.
Types of drugs for chemotherapy
All chemotherapeutic drugs are classified into several groups, according to the mechanism of their action:
- Alkylating agents;
- Anthracyclines;
- Platinum preparations;
- Anti-cancer antibiotics;
- Winkalkaloids;
- Cytotoxic;
- Taxa, etc.
Each group of drugs can affect different phases of cellular processes and life cycles.
Alkylating agents
The principle of action of the preparations of this group is based on the formation of covalent bonds with the DNA chain.
It has not yet been determined exactly how the cell structures die after the alkylating effect, but it is clear that these preparations cause an error in the processes of reading out the genetic information, which leads to inhibition of the formation of the corresponding proteins.
However, there is a glutathione system - a natural immunity against alkylating agents, therefore, with an increased glutathione content, the effectiveness of alkylating agents against a malignant tumor will be reduced.
But as a result of taking these medications, there is a possibility of the occurrence of secondary cancer, the most common form of which is leukemia, manifested several years after chemotherapy.
The main representatives of this group are preparations such as Cyclophosphamide, Embichin and Ifosfamide, Chlorambucil and Busulfan, Procarbazine and BCNU, nitrosourea drugs.
Antibiotic antibiotics
These drugs have nothing to do with commonly known antibiotic agents. The mechanism of their effect is to slow down the gene division of the oncocellular structures.
Anticancer antibiotics are capable of influencing different cell phases, so sometimes the mechanisms of their effects are somewhat different. Preparations of this group in terms of adverse reactions are most dangerous for lung structures, because because of the formation of free oxygen radicals they have a toxic effect on the lungs.
The most famous anti-cancer antibiotics are Adriamycin and Bleomycin. Most often it is used in polychemotherapy with Cytotoxin.
It is not necessary to confuse antibiotics with antimetabolites, the active substances of which are built into the genetic cell apparatus. As a result, when the cancer cell structure divides, its destruction occurs.
These drugs are Methotrexate, Gemzar, Gemcitabine, Fludarabine and Cladribine, 5-Fluorouracil, etc. The latter drug, as an adverse reaction, can suppress the bone marrow, cause severe intestinal intoxication of the digestive system, provokes the appearance of neurotoxins causing seizures and coma.
In order to exclude such consequences, thymidine is assigned to oncological agents as an antidote. The analogue of 5-fluorouracil taken orally is capecitabine, but it has identical side effects.
Anthracyclines
The medications of this group include Adryblastin and Rubomycin. They contain a specific anthracycline ring interacting with DNA cells.
In addition, the components of these drugs can suppress the chemical reactions that occur during the formation of the topoisomerase( II) enzyme and form radicals of the free group that damage the structural basis of the DNA of cancer cells.
Preparations Daunorubicin and Doxorubicin also belong to the anthracycline group and have a natural origin - their active component was isolated from soil fungi. They form free oxygen radicals that violate the integrity and inhibition of DNA synthesis.
Anthracyclines are very effective against cancer, but they have many dangerous side effects, such as cardiac toxicity. Free radicals formed by these drugs can damage the cellular structures of the myocardium. Therefore, the use of this group requires special control by the doctor.
Vinaalkaloids
These are antitumor drugs that have a plant origin( based on the extract of vinca leaves).
The components of these medications are able to bind tubulin( a specific protein) from which the cytoskeleton is formed.
It is necessary for cells in any phase, and its destruction disrupts chromosomal movements during division, which causes oncocells to be destroyed.
Winkalkaloids are distinguished by the fact that malignant-abnormal cellular structures are most sensitive to vincalcaloids, rather than normal cells.
For drugs of the vinca alkaloid group, neurotoxicity is most characteristic as a side effect. The most famous vinaalkalcoids are preparations like Vindezin and Vinorelbine, Vincristine and Vinblastine.
Platinum
Platinum preparations are classified as toxic heavy metals and act on the body in a manner analogous to the alkylating agents.
After penetration into the body, the components of platinum drugs begin to interact with DNA molecules, destroying their functions and structures, which causes the death of a malignant cell.
Among the most commonly used platinum drugs in chemotherapy are:
- Cisplatin( especially used in testicular and lung cancer), but it often causes kidney damage;
- Carboplatin is the second generation of platinum drugs, has a significantly lower toxic effect on renal structures;
- Oxaliplatin - a representative of the third generation, is most effective in colonic cancer, it is not toxic to the kidneys, but it can cause neuropathy.
Cytotoxic drugs
These drugs have a combined mechanism of action, similar to the already described medication. Some of them are similar to alkylating agents( for example, Dakarbazin and Procarbazin).
There are cytostatics, acting by analogy with antimetabolites( Hydroxyurea).Excellent cytotoxic properties are endowed with corticosteroid preparations, often used in anticancer therapy.
To frequently used cytostatics include drugs like Acecitabine, Taxol, etc.
Taxi
These are medications that affect the microtubules found in each cell structure. As a result, there is a violation of the processes of cell division and further cell death.
To this group of antitumor drugs include: Docetaxe, Paclitaxel, etc.
Taxanes have a rather wide range of applications: for lung and breast cancer, prostate and head, esophagus and bladder, as well as for ovarian and gastric malignant oncopathologies. The most characteristic side reaction of taxanes is the decrease in the number of blood cells.
Drugs of the latest generation
The study of the anticancer activity of various substances continues.
Antitumor drugs of new generations are coming out, which have a great therapeutic effect and fewer side-effects of toxic reactions.
These include:
- Avastin;
- Carboplatin and Oxaliplatin;
- Thalidomide;
- of Zomer;
- Gleevec;
- Fehmara;
- Sandostatin.
Increasingly, specialists are trying to use targeted chemotherapy, which involves the use of drugs of the latest generation.
Xelox chemotherapy: scheme
Chemotherapy according to the Xelox scheme involves oral administration of Xeloda with oxaliplatin. This scheme of treatment is most effective against common colorectal cancer.
But recently a lot of discoveries have been made, which allowed a few to change the combination of Xelox. Usually it is used for the treatment of metastatic intestinal cancer, pronounced gastric and dairy ferment malignant oncology.
The updated chemotherapeutic treatment according to the XELOX scheme gives the patients new opportunities, after all, with the addition of Avastin to polychemotherapy with oxaliplatin and Xeloda, the survival rates are markedly increased, and the progression of oncology is absent.
Remedies for
Because chemotherapy is accompanied by a mass of side effects, and cancer processes severely undermine health, then after an anti-cancer treatment it is necessary to help the body in recovery.
To this end, traditional medicines and phytopreparations are prescribed to oncologists. For each patient, the regimen is selected individually.
Usually, rehabilitative therapy is prescribed already during chemotherapy or immediately after it, in order to reduce the severity of the side symptoms and to exclude the damage of intraorganic structures from the toxic effects of anticancer agents.
Leukocyte enhancement
Because of the oppression of hematopoietic functions against the background of chemotherapeutic treatment, the number of blood cells significantly decreases, including leukocytes.
All patients who undergo chemotherapeutic treatment develop leukopenia accompanied by critically low immune status indicators.
Therefore, it is extremely important for such patients to normalize the leukocyte level.
Normally, the level of leukocytes is about 4-9 x 109 / l, however, after anticancer therapy they are reduced fivefold.
Immunity is pathologically reduced, and in fact it is so necessary for further opposition to malignant tumor processes. To restore the old level of leukocytes, patients are prescribed drugs like Imunofal or Polyoxidonium.
If they are ineffective, more potent drugs are shown, for example, Batilol, Leucogen, Cefaransin, Metiluracil, etc. In addition, the increase in leukocytes is achieved by extracorporeal pharmacotherapy, which involves the introduction of drugs into the bloodstream together with the infusion of donor red blood cells.
Liver
The hepatic structures in the course of chemotherapeutic treatment put a serious load, because antitumor drugs destroy and healthy structures. The body accumulates toxins, the output of which is carried out by the liver.
To restore the liver, patients are prescribed hepatoprotective drugs like:
- Hepasteril;
- of hepatic;
- Sirepah;
- Erbisol;
- Karsila;
- Hepadiff;
- Essentiale Forte-N, etc.
To accumulate toxins in the liver, it is recommended to drink abundantly and often to drink various liquids: broth of wild rose, water, cranberry juice, etc.
Immunity
All patients develop infectious processes due to reduced immunity, and availablein the body, conditionally pathogenic microorganisms acquire a pathogenic status. Since the body is exposed to general toxic effects, fungal infections develop.
According to statistics, 100% of patients face candidiasis, they are often disturbed by staphylococcal infections, which lead to the formation of inflammatory and necrotic foci, thrombosis, bleeding and sepsis.
The absence of necessary restorative treatment in most cases ends lethal. Therefore, so important is the support of immunity with the help of drugs such as Polyoxidonium and Antiox. Also prescribed are bioactive immunomodulators Bisk, Nutrimaks, Ursul, etc.
Drugs from
pimples Chemotherapy is accompanied by a mass of adverse reactions like anemia and nausea, baldness and brittle nails, taste changes and appetite problems, gastrointestinal disorders and fluid retention, urinary disorders andAve
Therefore, to facilitate the patient's condition, additional medications are prescribed for relief of side symptoms.
Tablets from nausea
Usually, the cause of nausea is toxins, which are released during the decay of a cancerous tumor and enter the body with chemotherapeutic drugs. This is a normal reaction of the body.
For the relief of the nausea syndrome, special medications such as
- Domperidone are prescribed;
- Dexamethasone;
- Cerukala;
- Metoclopramide;
- of Raglan;
- Cisapride.
To reduce nausea, drugs such as Wistaril, Kompasin and Torekan will help.
It is best to stop the choice of rectal suppositories, as they are directly absorbed through the intestinal mucosa without causing additional stomach irritation. The most effective candles are Kompazin and Kitril.
Antiemetic
Because onco-patients after chemotherapy suffer not only nausea, but also vomiting, they are prescribed and antiemetics.
Especially severe vomiting is observed after preparations of a cytostatic group like Cisplatin. With the introduction of this drug, vomiting was observed in all patients up to 20 times per day.
To suppress the acute vomiting that occurs the first day after chemotherapy, shows the reception of Tropisetron, Granisetron or Emetron, Dolasetron or Ondasetron. Also prescribed antiemetics: Lorazepam, Marinol, Haloperidol, etc.
Vitamins in Oncology
After chemotherapy, the body needs vitamins. It is best to receive them from natural sources, since in the process of recovery after chemotherapeutic treatment it is forbidden to take multivitamin complexes, usually containing B vitamins, namely B6, B2 and B1, which promote the growth of malignant cancer cells.
But with vitamins like tocopherol( E), ascorbic acid, retinol( A) and vitamin D, the body needs to be enriched after chemotherapy treatment. They can be taken in the form of drugs or eat rich foods.
Omez
Oily drug is often prescribed to patients after chemotherapy.
The purpose of this function is to protect the gastric structures from the side effects of toxic anti-cancer drugs.
The drug is usually given 3 days before chemotherapy, its reception continues for a week after treatment.
Heptral
Heptral is a strong hepatoprotective drug designed to protect the liver. It is often prescribed to patients after chemotherapy as part of a rehabilitative treatment.
Heptral normalizes metabolic processes in the hepatic tissues and stimulates the restoration of hepatocytes.
The drug is taken in tableted form between food intakes. The daily dosage is 2-4 capsules or 0.8-1.6 g. If after a chemotherapy the patient experiences severe forms of cholestasis, then Heptral is administered in an injectable form.
Rehabilitation after chemotherapy at home
The rehabilitation period after chemotherapy is accompanied by a rather wide range of complications, the most common among which are enteropathic lesions and a sickening and vomiting syndrome, alopecia and a decrease in immunity.
Enteropathy occurs against the background of accumulation of toxic substances that enter the body together with chemotherapeutic drugs.
Polysorb
The preparation is prepared in the form of a white powder of silicon dioxide. It is taken internally in a suspension form, previously dissolving the powder in water. The active substance penetrates the digestive tract, where the largest toxic accumulations are located.
Polysorb molecules bind toxins and excrete them with feces. And the silicon dioxide itself does not accumulate in the body and does not disturb the metabolic and digestive processes.
Enterosgel
The preparation is made in the form of a paste, which is ready for use. Usually the drug is prescribed for 1-2 weeks. Take it three times a day, about a couple of hours before a meal or taking medication.
A single dose is 15 g. If the consequences after chemotherapy are severe, then the dosage can be doubled, but only for the first 3 days of admission, then it is gradually reduced to normal.
Reviews
Elena:
Who faced this treatment, for sure, wincing at a single word chemotherapy. I was given the first red chemotherapy, the most deadly. After it, I completely lost my hair, and all over the body and face. In addition, constantly vomited and vomited, impaired motor coordination, there were gastrointestinal problems and many other things. In my case, the goal of chemotherapy, unfortunately, is the maximum possible prolongation of life, since I can not be cured anymore. At me too weak organism, therefore now I pass or take place chemotherapeutic courses preparations in tablets( Capecitabine, Xeloda, Tutabin + a hormonotherapy).The procedure is very difficult, but without it you can not survive.
Hope:
When I was diagnosed with cervical cancer, it was literally a shock to me. I did not expect that at my age, I'm 39, I can face such a disease. The oncologist offered chemotherapy platinum. After listening to the stories about this terrible treatment, I prepared for the worst, but after the injection there was absolutely no discomfort, there was a former appetite, and nausea and vomiting, strangely enough, was not at all. She had already completed two courses with a one-month break. The hair began to fall out, the blood became absolutely nothing, as well as immunity, but the promised problems with the stomach and intestines, fortunately, never happened. There are still 2 courses left. I hope for the best, but wait and see.
Price of medicines
Prices for chemotherapy drugs are quite different and depend on the group and the generation of the medication.
Alkylating agents:
- Vinblastine - from 145 rubles;
- Vincristine - from 100 rubles;
- Vinorelbine - from 6914 rubles.
Antimicrobial antibiotics:
- Mitomycin - from 4250 rubles;
- Epirubicin - from 280 rubles.
Anthracyclines:
- Adryblastin - from 230 rubles;
- Zavedos - from 2800 rubles;
- Cyclophosphamide - from 20 rubles;
- Doxorubicin - from 100 rubles.
Antimetabolites:
- Methotrexate - from 99 rubles;
- Fluorouracil - from 260 rubles;
- Xeloda - from 2380 rubles;
- Mercaptopurine - from 860 rubles;
- Citarabin - from 720 rubles;
- Ftorafur - from 10,000 rubles.
Platinum preparations:
- Cisplatin - from 140 rubles;
- Carboplatin - from 430 rubles;
- Oxaliplatin - from 1210 rubles.
The price of chemotherapeutic drugs may vary depending on the manufacturer, the pharmacy in which it is sold, on the volume and form of release of the medication. Above are only approximate prices.