Chemotherapy

Chemotherapy occurs in the infusion room, located on the third floor of Adventist Medical Center. The infusion room treatments include, but are not limited to chemotherapy, blood products, antibiotics, other infusions and injections. This allows patients to maintain independent lifestyles and avoid unnecessary hospitalizations. The infusion room location at the hospital allows for convenient access to pharmacy, laboratory, X-ray, and other support services.

A physician's referral is necessary to begin receiving services. Services are available Monday thru Friday by appointment. For emergent needs other arrangements can be made. A physician, typically a medical oncologist works with the nurse, the patient and his/her family to identify infusion needs. For information please call Infusion Services at 503-261-6631.

Chemotherapy infusions may also be available thru your medical oncologist. Medical Oncology practices associated with Adventist Medical Center include:

  • Northwest Cancer Specialists
  • Pacific Oncology

What is chemotherapy?

Chemotherapy drugs are potent chemicals, which can control cancer. Since cancer cells have several ways to survive and multiply, different drugs have been discovered to kill or at least slow the growth of cancer cells.

Each drug has a different mechanism of action so combinations of drugs are often used to fight cancer. There are many standard combinations used in treatment and many more are being tested in clinical trials in hopes of improving the ability to treat disease. Additionally, treatments such as chemotherapy and radiation or chemotherapy and surgery are used in combination to improve treatment results.

What are the side effects of chemotherapy?

Historically the side effects of chemotherapy drugs were very difficult to manage and compromised quality of life or worsened the outcomes. Now with more advanced supportive care medications to counteract the side effects of chemotherapy, cancer treatments are more effective and less toxic. Different cancer types may require different drug combinations and not all chemotherapy regimens will have the same side effects. Although each chemotherapy drug has specific side effects, common side effects include:

  • Fatigue
  • Weakness
  • Anemia (low blood counts)
  • Nausea
  • Hair loss (temporary)
  • Numbness
  • Infections

How are chemotherapy drugs administered?

Depending on your type of cancer, chemotherapy drugs are delivered by different routes:

  • By mouth
  • By injection
    - Under skin
    - Into the muscle
    - Into spinal fluid

The intravenous route is the most common method and it allows the distribution of the anticancer drug to most locations in the body. Therefore these drugs can be effective both at the primary site of the tumor, and in places where cancer cells may have spread.

Intravenous treatment may be delivered over a few minutes to a few hours. Technological advances now allow the administration of some intravenous drugs at home through a small device that delivers the drugs automatically and precisely. This type of treatment is generally administered over several weeks.

For patients who require ongoing intravenous treatment, a catheter may be implanted under the skin and connected to a large vein. The catheter has a metal or plastic “port” and spares the patient from multiple needle sticks for both blood draws and drug infusions. The catheter does not interfere with activities such as bathing or swimming and may be used to maximize patient comfort. The port may have significant benefits to the patient in sparing veins in the arms and hands, which can become very difficult to access and chemotherapy treatment progresses.

In order to empower patients with knowledge to help them more effectively fight cancer, there is more specific information about diseases and treatments available at the National Cancer Institute site http://www.cancer.gov/.

What is biotherapy or biological therapy?

Biological therapy is a type of treatment that works with the immune system. It can help fight cancer or help control side effects from other cancer treatments. Examples of this are antibody medications, which allow the immune system to better, recognize and fight cancer cells and hormone-like drugs to assist in the recovery of low blood counts.

Biotherapy is one of the newest methods to treat cancer and to help the body recover from the side effects of treatment. Ongoing research in this area holds a great deal of promise for improving cancer treatment. Drugs that fall within this category are interferon, interleukin, and colony stimulating factors like Neulasta (G-CSF, a granulocyte colony stimulating factor that increases the white blood cell count) and Aranesp or Epo (erythropoietin, which increases the red blood cell count).

What is the difference between biological therapy and chemotherapy?

Biological therapy and chemotherapy are both treatments that fight cancer. While they may seem alike, they work in different ways. Biological therapy helps your immune system fight cancer. Chemotherapy attacks the cancer cells more directly to stop their growth.

How is/are biotherapy drugs administered?

Biotherapy drugs may be given into the vein or by an injection that goes under the surface of the skin. Depending on the type of medication and the dose, it may be administered in the hospital or in the physician office. Some people may be able to self-administer their “shots” at home.

What are the types/names of some common biological therapies?

Different kinds of drugs may be used for biological therapy--some to fight cancer and some to treat the side effects of other cancer treatments. Many of the substances used for biological therapy are similar to substances that naturally occur in the body. Examples of the types of drugs used for treatment are interferons, interleukins, colony-stimulating factors, monoclonal antibodies, and nonspecific immunomodulating agents. Gene therapy is yet another type of biological therapy.

  • Interferons enhance the efficacy of the immune system, and help it to recognize and attack cancer cells. Interferons may also act directly on cancer cells by slowing their growth or causing them to behave more like normal cells. There are three main classes of interferons: interferon alpha, interferon beta, and interferon gamma.
  • Interleukins, such as interleukin-2 (also called IL-2 or aldesleukin), stimulate the growth and activity of immune cells. The activated immune cells are then better able to destroy cancer cells.
  • Colony-stimulating factors (CSFs) usually do not directly affect tumor cells. Instead, they encourage your body to make more white blood cells, platelets, or red blood cells. This helps counteract the side effects of other cancer treatments. Examples of CSFs are erythropoietin (also called epoetin, Procrit, Epogen, or Aranesp) and G-CSF (also called Neupogen or Neulasta).
  • Monoclonal antibodies (MOABs or MoABs), such as Rituxan (rituximab) and Herceptin (trastuzumab), are antibodies created in the lab. The antibodies can attach themselves to cancer cells. They may be used to:
    - Enhance your immune response to the cancer (Herceptin)
    - Help stop the growth of cancer cells (Rituxan)
    - Deliver chemotherapy drugs directly to the cancer. (Mylotarg)
  • Gene therapy is an experimental treatment that involves putting specially-engineered genetic material within the tumor. For example, a gene may be inserted into a tumor to make it more recognizable to the immune system. Antisense oncogenes can be used to silence a cancer-related gene.

What are the side effects?

Just like other forms of cancer treatment, biological therapy sometimes causes side effects. The side effects can vary a lot, depending on the drug and the person receiving it. The most common side effects of biological therapies are:

  • rashes or swelling where the medicine is injected
  • flu-like symptoms such as fever, chills, nausea, vomiting, loss of appetite, tiredness, bone pain, and muscle aches
  • low blood pressure.
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