Journal of Radiology
Open Access

The term chemotherapy has come to connote non-specific usage of intracellular poisons to inhibit mitosis (cell division) or induce DNA damage, which is why inhibition of DNA repair can augment chemotherapy. The connotation of the word chemotherapy excludes more selective agents that block extracellular signals (signal transduction). The development of therapies with specific molecular or genetic targets, which inhibit growth-promoting signals from classic endocrine hormones (primarily estrogens for breast cancer and androgens for prostate cancer) are now called hormonal therapies. By contrast, other inhibitions of growth-signals like those associated with receptor tyrosine kinases are referred to as targeted therapy.

Importantly, the use of drugs (whether chemotherapy, hormonal therapy or targeted therapy) constitutes systemic therapy for cancer in that they are introduced into the blood stream and are therefore in principle able to address cancer at any anatomic location in the body. Systemic therapy is often used in conjunction with other modalities that constitute local therapy (i.e. treatments whose efficacy is confined to the anatomic area where they are applied) for cancer such as radiation therapy, surgery or hyperthermia therapy.

Radiation might not be a choice of treatment if the tumour was diagnosed on the late stage or is located on vulnerable places. Moreover, radiation causes significant side effects if used in children aged 0–14. It was determined to be a beneficial treatment but it causes significant side effects that influence the lifestyle of the young patients. Radiotherapy is the use of high-energy rays, usually x-rays and similar rays (such as electrons) to treat disease. It works by destroying cancer cells in the area that’s treated. Although normal cells can also be damaged by radiotherapy, they can usually repair themselves, but cancer cells can’t. If the tumour was found on the late stage, it requires patients to have higher radiation exposure which might be harmful for the organs. Radiotherapy is determined to be an effective treatment in adults but it causes significant side effects that can influence patients` daily living. In children radiotherapy mostly causes long-term side effects such as hearing loss and blindness. Children who had received cranial radiotherapy are deemed at a high risk for academic failure and cognitive delay.

Immunosuppression and myelosuppression

Virtually all chemotherapeutic regimens can cause depression of the immune system, often by paralysing the bone marrow and leading to a decrease of white blood cells, red blood cells, and platelets. Anaemia and thrombocytopenia may require blood transfusion. Neutropenia (a decrease of the neutrophil granulocyte count below 0.5 x 10⁹/litre) can be improved with synthetic G-CSF

Neutropenic enterocolitis

Due to immune system suppression, Neutropenicenter colitis (typhlitis) is a “life-threatening gastrointestinal complication of chemotherapy. “Typhlitis is an intestinal infection which may manifest itself through symptoms including nausea, vomiting, diarrhoea, a distended abdomen, fever, chills, or abdominal pain and tenderness.

Typhlitis is a medical emergency. It has a very poor prognosis and is often fatal unless promptly recognized and aggressively treated. Successful treatment hinges on early diagnosis provided by a high index of suspicion and the use of CT scanning, nonoperative treatment for uncomplicated cases, and sometimes elective right hemi colectomy to prevent recurrence.

Nausea and vomiting

Further information: Chemotherapy-induced nausea and vomiting

Nausea and vomiting are two of the most feared cancer treatment-related side-effects for people with cancer and their families. In 1983, Coates et al. found that people receiving chemotherapy ranked nausea and vomiting as the first and second most severe side-effects, respectively. Up to 20% of people receiving highly emetogenic agents in this era postponed, or even refused, potentially curative treatments.