Table of Contents

Chapter 7: The Role of Chemotherapy

a. Understanding Chemotherapy

The term "chemotherapy" refers to any type of therapy that uses chemicals to kill or halt the growth of cancer cells. The drugs work in a variety of ways, but are all based on the same simple principle: stop the cells from dividing and you stop the growth and spread of the tumor.

The first step in cancer cell growth is cell division. Each cell divides into two, each of those two divide into two, and so forth. As the cells continue to divide, they take up more and more space, and ultimately become a tumor mass. The goal of chemotherapy, therefore, is to somehow stop the cancer cells from dividing and the tumor mass from growing.

But stopping the tumor from growing is not enough, because oftentimes the tumor will take up enough space that it will press up against other organs and cause pain or other symptoms that negatively affect quality of life. So when we look at whether a drug is working, there are generally two levels of effectiveness—whether a drug is palliative, meaning whether it can alleviate symptoms, and whether it can affect the tumor’s growth significantly enough to prolong life.

As we touched on earlier, chemotherapy is a mainstay of treatment of a number of cancers. In breast and colorectal cancers, it’s often used in conjunction with surgery and/or radiation to improve the chances of killing all of the circulating cells, and to reduce the odds of the cancer coming back. Perhaps the best results with chemotherapy have been seen in testicular cancer, where the use of chemotherapy cures the disease in the majority of cases.

In prostate cancer, as we noted earlier, chemotherapy wasn’t seen as an essential part of the therapeutic regimen for many years, and was only seen as a treatment of last resort. Things have started to change, and more and more doctors are looking to chemotherapy to help alleviate symptoms and prolong the lives of men with advanced prostate cancer.