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Chemotherapy Chemotherapy refers to the use of medication and drugs for treatment of cancer. The history of chemotherapy traces back to medical observations in World War I. Soldiers who were exposed to chemical warfare, Sulfur Mustard, suffered from lowering of their white blood cells, especially lymphocytes. Following that observation, Nitrogen Mustard, a similar and yet less toxic agent, was used in patients with high white blood cells ( lymphoid leukemia ) and then in lymphomas. Nitrogen Mustard indeed lowered the count of lymphocytes and assisted in the management of lymphoid cancers. Today, this drug still plays a major role in the treatment of Hodgkin's Disease. Subsequent to the discovery of Nitrogen Mustard, many more substances were discovered and studied in laboratory. This came with better understanding of illnesses and their nature, culminating in a newer approach, designing some chemotherapy drugs that would interfere with certain functions of the cells. This journey still continues. Most have heard of extraction of Taxol from yew trees, resulting in production of a very active cancer drug. There is a limit on how much of these drugs could be safely used. Since all the chemotherapy drugs interfere with growth of the cells, they all have some form of unwanted side effects. The maximum tolerated dose of a drug is determined by the profile of its side effects. Certain drugs can damage heart, lung, kidney, bladder, etc. These drugs can still be used safely, as long as damage is reversible and not life- threatening. Scientists took this concept to a different phase. How about if we use much higher doses of drugs? They allowed the side effects to occur, but somehow overcame the life-threatening side effects. Can we cure cancer more successfully? Can we cure more patients? This became the basis for bone marrow transplantation. Usage of lethal doses of chemotherapy, with or without radiation therapy. This treatment is followed by giving the patient a healthy bone marrow. And the answer became apparent -- YES, indeed we can cure some cancers by using higher doses of drugs. This was the birth of a new chapter in medicine. Today there are many drugs to counteract the side effects of chemotherapy drugs, including anti-nausea medicines. Up until a decade ago, most patients suffered from severe nausea and vomiting. This problem is now a thing of the past -- not a problem anymore. New vehicles have been designed to make chemotherapy treatments safer. Most chemotherapy drugs are given intravenously; some are administered orally. When Chemo is given intravenously, it can damage the veins. Leakage of certain drugs from the injection site can cause severe damage to the skin and surrounding tissue. With rare exception, every patient should have a Port-A-Cath to receive chemotherapy. Most chemotherapy regimens are given in an outpatient setting, in the oncologist's office or a in hospital. Single agent chemotherapy refers to usage of only one drug to treat the cancer. Combination chemotherapy refers to usage of more than one drug at the same time. Most cancers are treated with combination chemotherapy. Drugs that are used in conjunction with chemotherapy
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