Talk:Chemotherapy

From Wikipedia, the free encyclopedia

This is the talk page for discussing improvements to the Chemotherapy article.
Article policies
This article is within the scope of the following WikiProjects:

Contents

[edit] Definition

I was taught that chemotherapy is the use of synthetic agents to selectively injure particular organisms or cells within a patient. This includes anticancer, antibacterial, antiviral, anti-fungal and anti-protozoal chemotherapy. Natural and semi-synthetic antibiotics are not included in a strict definition because they are natural compounds. The sulfonamides are synthetic "antibiotics" are so are true chemotherapeutic agents. I don't know about the natural-source anticancer drugs (vinca alkaloids and all that). The lay public thinks CHEMO = CANCER; I think it would be worth changing the slant of this article. Anyone else? ben 13:12, 23 June 2006 (UTC)

Probably the more recent "questionable" usage is so widespread that it eclipses the "proper" usage. This problem occurs elsewhere; i.e. begging the question. I think that a note about the etymology (that "chemo" means chemical and "chemotherapy" originally meant therapies using synthetic chemicals) might be appropriate, but a citation of that usage would be nice (a la the OED), and it may be hard to find a text online with that usage. MartinGugino 00:38, 6 August 2006 (UTC)


The modern definition of chemotherapy (according to the OED) :

"The treatment of disease, esp. of parasitic infections or cancer, by means of chemical substances which act selectively on micro-organisms or malignant tissue."

The term was coined by Ehrlich, and it referred to the killing of (bacterial, protozoan, etc) cells by means of chemicals (as opposed to by serum (antibodies), etc.). Later, the term was also applied to cancer cells, and there are a lot of similarities between the two. I frequently hear antibiotics today referred to as chemotherapy, and I think this article should be moved to an article called "Cancer chemotherapy", and a new generic chemotherapy article should be implemented that discusses the similarities of the two, and points to both. This is analogous to the word "steroid"...the popular definition means "anabolic steroid", but properly it is a more generic term, and the Wikipedia article reflects this. Similarly, the popular definition of "chemotherapy" refers to "cancer chemotherapy", but Wikipedia doesn't yet reflect this. Mauvila (talk) 00:52, 13 December 2007 (UTC)

Considering that some of the most promising anti-cancer agents are antibody-driven, perhaps this article should follow the WHO convention and be renamed to "antineoplastic agents", with "chemotherapy" serving as a disambiguation. --Arcadian (talk) 13:49, 13 December 2007 (UTC)
Not sure if the Ab would be considered chemo or not...I think the distinction between chemo and bio becomes trivial at some point thanks to modern molecular engineering. "Anti-neoplastic agents" seems a little overkill...plus, the term agents will open the door to all sorts of herbal and junk remedies...chemotherapy still strongly implies the killing of cells, a quality which agents doesn't necessarily emphasize. Mauvila (talk) 18:13, 4 January 2008 (UTC)

[edit] Side-effects

Current chemotherapeutic techniques can have a range of side effects mainly affecting the fast-dividing cells of the body. These include the mouth, digestive system, skin, hair and bone marrow.
Most frequent and most important side-effects of chemotherapy :

  • hair loss
  • fatigue
  • vomiting
  • wight loss or gain
  • anaemia
  • depression of immunity hence infections
  • hemorrhage
  • secondary neoplasms
  • cardiotoxicity
  • hepatotoxicity
  • nephrotoxicity

[1] [2] [3] [4][5] [6] [7] [8]

[9]

[10]--86.29.247.206 (talk) 19:11, 2 June 2008 (UTC) [11] [12] [13]

--Chemo facts (talk) 13:51, 3 June 2008 (UTC)


The treatment can be exhausting physically for the patient.
Sometimes the complete myelosupression is the intended treatment that is in these cases followed by allogenic or autogenic stem cells transplant.

However some patients still develop diseases such as fungal tuberculosis because of this interference with bone marrow.

Isn't "fungal tuberculosis" a misnomer ?
I agree; tuberculosis isn't fungal. ben 13:06, 23 June 2006 (UTC)
agreed. Buzybeez 15:25, 12 July 2007 (UTC)

What about the physiological causes of the side effects, especially the depression of immune system? I heard vomiting is due to destruction of stomach lining Animation about side effects of chemo The animation is a commercial for a drug but has lots of useful info. Karl.langberg (talk) 17:46, 24 April 2008 (UTC)

That is not a typical reliable source. There are numerous causes to CINV, and mucositis is only one of them. JFW | T@lk 22:26, 24 April 2008 (UTC)

"Mutations of normal cells creates cancerous tumours which can grow out of control."

Be careful, because most mutations to genetic information in cells will actually kill it. It is only in the relative minority of cases where a mutation will actually cause a cancer.

Jedi Dan 16:29 Apr 23, 2003 (UTC)

[edit] Chemo is deadly

Both my mother and father were killed by chemo.--Mr-Natural-Health 21:42, 7 Dec 2003 (UTC) (on talk:Alternative medicine)

It is sad that you lost both of your parents Mr-NH. It is a private event that sensitive people would usually refrain from referring to, but your comment raises points that really need addressing. Do the death certificates state that chemotherapy caused the deaths of your parents? As you are such a strong advocate for alternative medicine, could you not convince them to try that? Had they been exclusively using alternative medicine and had still died would you have written here "by the way, both my mother and father were killed by alternative medicine?" Moriori 22:15, Dec 7, 2003 (UTC)
Mr-Natural-Health is nuts if he believes that doctors killed his parents by trying to save their lives with chemotherapy. Apparently (if we are to take his word), his parents were killed by cancer, but at that point his [personal attack removed], so he decided to blame doctors. RK
That is tantamount to saying that the Doctors who treated George Washington in 1799 with repeated bleedings and dosages of calomel did not kill this founding Father of the United States. Following RK's logic, our president died from old age. What I call Quackery, is the science community conveniently leaving out the little detail that Chemo comes with a minor side effect called death.--Mr-Natural-Health 13:48, 13 Dec 2003 (UTC)
You may be right, but I'd prefer to hear what Mr-NH has to say. Moriori 01:30, Dec 8, 2003 (UTC)
Ha, ...Hah, Ha! I finally found this article on Chemotherapy and just now have discovered that my comments have arrived before me! Yes, Chemo is truly the heroic medicine of the modern era.--Mr-Natural-Health 12:52, 13 Dec 2003 (UTC)

I'm pretty sure that chemotherapy can be lethal, and that this is undisputed, rather than a sign of someone being nuts. For example, it reduces the immune system, so the patient may contract a fatal disease in their weakened state, be unable to fight it off, and subsequently die. That's why people undergoing chemotherapy are carefully monitored. In a few cases, chemotherapy may kill someone before their cancer would have done, had it been untreated. Chemotherapy is used because it helps more often than it causes harm, but it is not without side effects, and those side effects are potentially lethal. Martin 00:11, 9 Dec 2003 (UTC)

Quite right. Chemo causes substantial damage to the vascular system and many people later get cardio-vascular disease. Many of Mr NH's points were not frivolous. -- Viajero 00:15, 9 Dec 2003 (UTC)

I think this issue is hardly worth discussing. It is so obvious that chemotherapy although not without downsides is an important treatment modality. Eventually it will (hopefully) be replaced by better methods of fighting and preventing cancer but for the time being that's a tool that definitely has a place in cancer management. Period.

BTW antibiotic therapy can rarely cause fatal side-effects and chemotherapy can prolong life and properly used can cause less damage that the disease itself. So is antibiotic therapy to be abolished ?

Kpjas 16:18, 13 Dec 2003 (UTC)

I have a friend who got 3 years of Chemotherapy in just 6 months, she was also told that her life was gonna be shorter (50 to be exact, she's 23 at the time) clearly this is caused by this "overdose" and may infact cause death.
And this is why i have added death/shorter life as a side effect and is pretty much correct. But yes everything in a overdose can cause death but this is a medecine. Slushq 08:34, 11 June 2006 (UTC)

Overdosing is deadly of course and so is inappropriate drug delivery. I find it very interesting that people have not found any alternative drug delivery methods that have better cytotoxicity regarding the tumor and not the patient, such as http://en.wikipedia.org/wiki/Electrochemotherapy

Owners of pharmaceutical companies probably know the answer.. :) —Preceding unsigned comment added by 212.93.227.10 (talk) 15:30, 31 March 2008 (UTC)

Source for your allegations? Or is it just that all evil in the world is being perpetuated by big pharma? JFW | T@lk 15:59, 1 April 2008 (UTC)
Everybody knows that already? Just kiddin. I am gaining a little experience in pharma business at the moment (operating as a CRO) and sadly I dont like what I see.. —Preceding unsigned comment added by Leskovsek (talk • contribs) 21:52, 2 April 2008 (UTC)
Neither anaemia nor obesity are typical causes of death. Rather than posting vague messages here, you might want to clarify with the doctor in question whether the chemo is to blame. Obesity is not a typical complication of chemo. JFW | T@lk 17:10, 5 May 2008 (UTC)


[edit] Leah's death

[dubious – discuss] My sister, Leah, (41) took a 10 month's chemo due to Brest cancer, and suffered badly. She soon went bald after a week or so, then became constipated, became very smelly after 2 months and at about the same time her weight rapidly rose from 9st 2lb to 13st 6lb, after the 7th month due to water retention. She finally died of a heart attack the doctor was convinced was caused by here body weight problem. She also had trouble with anemia at this point. Her chemo would have only lasted for just over 3 more months and it would have been over. Chemo can kill with anemia and obesity in some cases! --86.29.255.225 01:19, 29 July 2007 (UTC) --86.29.251.5 (talk) 14:02, 5 June 2008 (UTC) [dubious – discuss]

[edit] Splitting types?

Anybody object if I split the sections in "Types and dosage" onto their own subpages? --Arcadian 03:18, 23 November 2005 (UTC)

I don't know; the chemotherapy article as it stands isn't overly long—in total it still is less than 32 KB. If you're planning on expanding those sections significantly, then it might be appropriate to split it into a sub-article. (I could also see a benefit to giving parts of the article a good copy-edit, but I haven't got the time right now....) TenOfAllTrades(talk) 04:03, 23 November 2005 (UTC)

We should minimally have alkylating agent and anthracycline, two major classes. I'm not convinced we need to have specific pages for the vinca alkaloids, the topoisomerase inhibitors etc. JFW | T@lk 08:47, 23 November 2005 (UTC)

Since we do already have pages for alkylating agent (and individual pages for a number of specific drugs) we could probably condense the section in this article a bit—describe the mechanism briefly and add a See main article: alkylating agent pointer. TenOfAllTrades(talk) 15:44, 23 November 2005 (UTC)
Okay, I chose the middle path -- I split out Alkylating agent, Antimetabolite, and Antineoplastic, because they already had existing pages, and some of the content on those pages had been gradually diverging from the content on this page. The other categories I left in. --Arcadian 18:58, 27 November 2005 (UTC)

[edit] Death, and Some other Notes.

Of course chemotherapy, can cause death. Why would chemicals not be able to kill you?

Shouldn't the story of Abraham Cherrix be added? Abraham is a 16 year old teen that has cancer and the court tried to force him into taking Chemotherapy.

Shouldn't there be something about criticism? There is a lot of criticism againsto chemo, and if it is a multi billion dollar industry there should be a lot of criticism against it.

Like is it being used just to make money?

I very strongly agree there should be a discussion of the negative issues associated with Chemo for instance this from USA Today should be added:

Study: Chemotherapy can alter brain by killing cells Posted 11/29/2006 9:07 PM ET http://www.usatoday.com/news/health/...py-brain_x.htm

[Copy of entire article removed JFW | T@lk 23:16, 21 October 2007 (UTC)]

[edit] Safety

The page needs a section on safe handling of chemotherapeutic agents. Handling applies to healthcare providers, the patient, and the patient's household members. See for example [Safe handling of hazardous drugs]. 66.167.45.138 15:31, 30 January 2007 (UTC)

And extravasation. JFW | T@lk 23:16, 21 October 2007 (UTC)

[edit] Delivery

The article does not mention localised methods of delivery, targeted at the cancer itself. Any news.

It does now. JFW | T@lk 23:16, 21 October 2007 (UTC)

[edit] Re : Delivery

I've added some brief sections on isolated infusion approaches, stem cell harvesting and autologous bone marrow transplant, and on minicells. I've also discussed the importance of these approaches since severe toxicity is the limiting constraint on dosage and effectiveness of traditional systemic chemotheraputic approaches.

I hope that this helps. (Naturally, please add to, modify and/or improve these changes.) Regards, G. Holt

Mr(?) Holt--please sign your posts using the tool on your wikipedia editor. Also, I edited your statement above. Also, I am continuing to redact your minicell section.

Uh, pot-kettle phenomenon on signing here. The new approaches are useful, but are the minicells being used in practice? If not, they should not be mentioned. JFW | T@lk 23:16, 21 October 2007 (UTC)

[edit] Minicells

Someone keeps expanding the minicell section; I will continue to shorten it. This is not a mainstream approach; this article is called "chemotherapy," not "chemotherapy research," so we should limit the experimental info on it.--Dr.michael.benjamin 05:19, 29 June 2007 (UTC)

I agree. There are many other delivery systems under development. JFW | T@lk 23:16, 21 October 2007 (UTC)

[edit] Does chemotherapy work?

This article and most online information starts from the assumption that chemotherapy works. There are also a number of pages saying that it doesn't work or that the medical profession has no evidence that it works. Some people even believe that big Pharma pushes these drugs to make money. I think its important to add a section summarizing the evidence that chemotherapy actually works. I can write it if someone has the references. Dr d12 03:31, 19 August 2007 (UTC)

Do antibiotics work? Depends which infection and which antibiotic. We cannot possibly enumerate all the trials that show the efficacy of chemotherapy in specific cancers. That should remain on individual disease pages, e.g. lung cancer should discuss the platinum/topoisomerase inhibitor combinations used commonly nowadays.
Beware that "big Pharma" is a "word to avoid" in these discussions. It suggests corporations are acting unethically, a subject of which we can not generalise. JFW | T@lk 23:16, 21 October 2007 (UTC)

[edit] chemotherapy cost

What are the costs of a chemotherapy for an hospital, and more generally, from a Welfare-State point of view ? 82.240.207.81 13:33, 23 September 2007 (UTC)

Some are cheap, and some are expensive (e.g. cyclophosphamide is 100x cheaper than paclitaxel according to a 2000 estimate - Bodurka-Bevers D, Sun CC, Gershenson DM (2000). "Pharmacoeconomic considerations in treating ovarian cancer". PharmacoEconomics 17 (2): 133–50. PMID 10947337. ). Modern targeted therapies are often very expensive. JFW | T@lk 23:16, 21 October 2007 (UTC)

[edit] inconsistency

The article initially states that the active compounds from the american mayapple work by an unknown mechanism, then under topoisomerase inhibitors it is claimed they are type II topoisomerase inhibitors... which is it? 207.108.208.213 03:18, 13 November 2007 (UTC)B. Simon


[edit] Exsperimental Radar teatment

It's a new treatment that is being pioneared in the U.S.A. and U.K. [[5]] —Preceding unsigned comment added by 86.29.244.128 (talk) 18:14, 28 November 2007 (UTC)

[edit] Electrochemotherapy paragraph in Chemotherapy page?

Hi everyone, I have written an article about electrochemotherapy here: http://en.wikipedia.org/wiki/Electrochemotherapy and I am trying to introduce links in articles on related topics (following the message at the beginning on article "This article is orphaned as few or no other articles link to it.Please help introduce links in articles on related topics. (January 2008)").

I believe it would be fairly appropriate to include the short paragraph in the 'cancer page', as I can not find any other article as related as this one. You can read more about ECT at the http://en.wikipedia.org/wiki/Electrochemotherapy and help me with providing some feedback about what to include in the paragraph.

Thank you, Matevz Leskovsek —Preceding unsigned comment added by Leskovsek (talk • contribs) 08:40, 6 March 2008 (UTC)

Would this paragraph ba appropriate as the following:

Electrochemotherapy is a therapeutic approach providing delivery into cell interior of nonpermeant drugs with intracellular targets. It is based on the local application of short and intense electric pulses that transiently permeabilize cell membrane, thus allowing transport of molecules otherwise not permitted by a cellular membrane. Presently, applications for cancer treatment have reached clinical use (antitumor electrochemotherapy using bleomycin or cisplatin). Electrochemotherapy with bleomycin has been used to treat the patient for the first time in 1990 at the Institute Gustave Roussy in France, while electrochemotherapy with cisplatin has been used to treat the patient for the first time in 1994 at the Institute of Oncology, Ljubljana, Slovenia. Since then more than 600 patients were treated with electrochemotherapy all over the world (Australia, Austria, Denmark, France, Hungary, Ireland, Italy, Japan, Mexico, Nicaragua, Portugal, Slovenia, Spain, Sweden, UK, USA).

Please, reply with some feedback (regarding the paragraph to include or regarding the whole ECT article).. I am not a doctor myself, I am a PHD student in the field of biomedical engineering working mainly on ECT.

Best regards, Matevz —Preceding unsigned comment added by Leskovsek (talk • contribs) 09:57, 10 March 2008 (UTC)

I have added the above paragraph, please post any comments for discussion —Preceding unsigned comment added by Leskovsek (talk • contribs) 17:45, 17 March 2008 (UTC)

I completely disagree. 600 patients is child's play considering there are millions of people having cancer treatment worldwide at any given time. It is not standard treatment for anything, and I strongly oppose mention of this modality until there is data that this works and works well, and becomes part of the arsenal of oncologists worldwide. Who says intense electric pulses make cell membranes permeable? Surely that would give interesting pictures on MRI scans? JFW | T@lk 20:02, 17 March 2008 (UTC)

IMO, it belongs on Unproven cancer therapy. WhatamIdoing (talk) 22:08, 17 March 2008 (UTC)
Dear doctors! If you happen to disagree with the article: http://en.wikipedia.org/wiki/Electrochemotherapy - I'll have to ask you to repair/edit it yourself or adress your issues on its dedicated talk page. I will also have to ask you NOT to express your feelings by not allowing to introduce links from other relevant articles, such as Wiki:Cancer.

I am currently reading the wiki guidelines and see no excuses for your behaviour. I understand the responsibility that you feel towards the "Cancer" article but I will have to ask you to reconsider the above inclusion.

For Gods sake, please read the article first: http://en.wikipedia.org/wiki/Electrochemotherapy —Preceding unsigned comment added by Leskovsek (talk • contribs) 16:02, 18 March 2008 (UTC)

[edit] immunosuppression and stem cell transplants

hi all,

i added a little bit of information about allogeneic and autologous transplants below the paragraph that had lots of wrong information. i dont really care to make a pretty paragraph with in depth information but below it i typed up some general sloppy information...at least all of it is correct. the paragraph above shows that the writer has no idea what transplants are actually used for..well the effort that i put into fixing that section was erased...that's lovely, just know that the information in the article regarding transplants is completely wrong

If you contest something, use the {{fact}} or {{dubious}} tags, but we can't have un-cited, grammatically unprofessional sentences (starting a sentence with lowercase, etc., as you did above — it's fine here, not in the article). Thx in advance. El_C 05:33, 8 March 2008 (UTC)
eh, i dont care enough to go through all that trouble, just know that the guy who wrote that paragraph has no idea of the purpose behind a transplant. its spelled allogeneic, not allogenic... —Preceding unsigned comment added by 69.138.161.23 (talk) 05:45, 8 March 2008 (UTC)
Okay, I don't know what that is. El_C 05:56, 8 March 2008 (UTC)

Stem cell transplants are only of any use in myelo- and lymphoproliferative diseases, and then only as an adjuvant after high-dose chemotherapy (although some graft-versus-disease effect is also expected). Most actual cancers are not treated with HSCT, and in breast cancer we have reasonably good data that it is of proven uselessness. JFW | T@lk 19:58, 17 March 2008 (UTC)

[edit] Usefull links

  1. ^ http://www.cancerhelp.org.uk/help/default.asp?page=165
  2. ^ [1]
  3. ^ [2]
  4. ^ http://www.breastcancer.org/dictionary/c/chemotherapy_t.jsp?gclid=CLLHhJe71pMCFR4sagod50vIhg
  5. ^ http://hcd2.bupa.co.uk/fact_sheets/html/chemotherapy.html
  6. ^ http://news.bbc.co.uk/1/hi/health/medical_notes/3243613.stm
  7. ^ [3]
  8. ^ http://www.healingcancernaturally.com/alternative-cancer-treatment-2.html
  9. ^ http://www.library.nhs.uk/cancer/Page.aspx?prv=y&pagename=BCKW
  10. ^ [4]
  11. ^ http://www.ajcn.org/cgi/content/abstract/57/5/679
  12. ^ http://jcem.endojournals.org/cgi/content/full/84/12/4591
  13. ^ http://images.google.co.uk/imgres?imgurl=http://www.biojewellery.com/images/diary-virology2.jpg&imgrefurl=http://www.revolutionhealth.com/blogs/valjonesmd/posts_by_month/January-2008&h=347&w=420&sz=68&hl=en&start=36&um=1&tbnid=03rs2BR37KzGeM:&tbnh=103&tbnw=125&prev=/images%3Fq%3DChemotherapy%2Bfatness%2Bobesity%26start%3D18%26ndsp%3D18%26um%3D1%26hl%3Den%26rlz%3D1T4GGLJ_enGB226GB226%26sa%3DN

--86.29.246.126 (talk) 11:07, 2 June 2008 (UTC)