Issue

Overview of how things have changed in treatment

Background

In the late 1950's and early 1960's, there were very few drugs available to treat children with cancer. As more drugs were discovered, and used in combination, it soon began to increase cures for children with cancer. As children became survivors of their cancer, the medical care team began to realize that many of these drugs, although beneficial in curing the cancer, also could result in undesirable side effects. Knowledge of these problems have lead to designing clinical and pharmacological studies that better assist in selection of the drugs and amount of drug that will be effective against the cancer, and yet minimize these short and long-term complications. Also, the development of better supportive care agents used in conjunction with chemotherapy have decreased known side effects.

Information

Chemotherapy agents used in combination was one of the major breakthroughs in the success of treating childhood cancer. Drugs that attacked the cancer cell at various stages of cell division and had different side effects are effective treatment for many cancer types. Giving very high dosages of chemotherapy drugs is also useful in overcoming the resistance cancer cells can develop to standard dosage. The down side of chemotherapy becoming stronger and more aggressive was that the child with cancer suffered from more short and long-term side effects.

There are several methods to decrease the short and long term side effects associated with chemotherapy. Better supportive care drugs can eliminate or decrease initial side effects of therapy. Here are a few examples:

• Better antiemetics are now available to control nausea and vomiting.

• A drug to prevent hemorhagic cystitis (bleeding from bladder wall) called Mesna, has significantly decreased this side effect due to Cyclophosphamide and Ifosfamide.

• Better antibiotics are available to treat infections or to prevent infections from occurring.

• Colony-stimulating factors can be given that stimulate a faster return of blood cells.

• Organ protective drugs can be administered prior to certain chemotherapy drugs to decrease toxic side effects on normal tissues.

Note

It is important to inquire about all the potential short and long term side effects of any drug you or your child may have and to ask if the side effects are sure to occur or only potential. You should also ask what can be done to minimize or prevent the side effect from occurring if possible.

Resource

Adams D., Deveau E., Coping with Childhood Cancer. Kinbridge Publications, Hamilton, l989