Principles of Cancer Management and Chemotherapy

Even as it wipes out cancer cells, chemotherapy, like Noah piloting his ark, must strive to shelter those meant to be spared, protecting normal cells as cancer drugs flood the body.

Dilemma

• Richard A. Lehne, Ph.D., notes that in killing cancer cells, chemotherapy kills normal cells, too, especially those with a high growth rate.

Goal

• According to Joyce M. Black and her co-writers of "Medical Surgical Nursing," chemotherapy aims to destroy all cancer cells while minimizing damage to normal cells.

Strategy

• The writers indicate that combinations of chemotherapy drugs work far better than drugs administered separately. According to Lehne, oncologists assemble combinations based on three considerations: Each drug should be effective in itself; each should kill the cancer cells by a different means; regarding harm to normal cells, the drugs should act in different ways so as to minimize any single kind of toxicity.

Intermittent Therapy

• Physicians may administer the drugs with rest periods between rounds, giving normal cells a chance to recover. As Lehne notes, however, this makes sense only insofar as normal cells grow back faster than the cancer cells.

Protective Measures

• Health-care personnel must protect patients from the consequences of drug toxicities. These, according to Lehne, include heightened susceptibility to infection, bleeding and anemia due to destruction of white blood cells.