Chemotherapy is a cancer treatment method that uses chemical substances designed to destroy cells that divide rapidly. The prefix "chemo" refers to the chemical origin of these therapeutic agents; the treatment is based on the administration of one or several anticancer drugs in combination, according to precisely defined protocols. Chemotherapy agents are generally administered intravenously, but they can also be taken orally in tablet form, injected into a muscle, or applied directly to the tumour area. The duration of treatment can extend over several weeks or even months, depending on the diagnosis and the drug protocol used.
Contact Us
Chemotherapy can be used on its own or in combination with surgery, radiotherapy, or targeted therapies. In some cases, it is administered before the operation to reduce the size of the tumour known as neoadjuvant chemotherapy; in others, it is given after surgery to eliminate any remaining cancerous cells known as adjuvant chemotherapy. The objectives of the treatment vary according to the disease and its stage: complete cure, control of tumour progression, or improvement of quality of life through symptom management.
How Does Chemotherapy Act on Cancerous Cells?
Chemotherapy drugs work primarily by interfering with the cell division cycle, thereby preventing the proliferation of cancerous cells and bringing about their destruction. Cancerous cells divide far more rapidly and in an uncontrolled manner compared with healthy cells, which makes them more vulnerable to chemotherapy agents. These drugs exert their action through different mechanisms: by disrupting DNA synthesis, by blocking the proteins necessary for cell division, or by directly damaging the genetic material within the cell. They thus prevent the cancerous cell from reproducing and trigger its death.
However, chemotherapy does not affect only cancerous cells it also affects the rapidly dividing healthy cells present in the body. Hair follicles, the lining of the digestive system, and bone marrow cells are among the most vulnerable tissues. This is why adverse effects such as hair loss, nausea, fatigue, and a weakened immune system can occur. Once the treatment has ended, as healthy cells are capable of regenerating, most of these side effects disappear progressively; nevertheless, this process can vary considerably from one patient to another.
In Which Types of Cancer Can Chemotherapy Be Used?
Chemotherapy is used effectively in many types of cancer, including lung cancer, breast cancer, colon cancer, ovarian cancer, leukaemia, lymphoma, and pancreatic cancer. In blood cancers such as leukaemia and lymphoma, chemotherapy is often the first-line treatment, as the disease is not concentrated in a localised area that can be removed surgically. In the case of solid tumours, a combined approach incorporating surgery or radiotherapy is favoured; chemotherapy then plays a complementary role, either by reducing the tumour or by eliminating residual cells.
Not all types of cancer respond in the same way to chemotherapy agents. The drug protocol is established taking into account the biological characteristics of the cancerous cells, the molecular subtype of the tumour, and the treatments the patient has previously received. Certain types of cancer are highly sensitive to chemotherapy, whilst others may present resistance. This is why oncologists base their therapeutic decision not solely on the diagnosis but on all available data: histopathological reports, biopsy results, and, where applicable, genetic assessments.
Is Chemotherapy Necessary for All Patients?
Chemotherapy is not a treatment that is automatically essential for every patient with cancer. In certain cancers diagnosed at an early stage, when the tumour can be completely removed by surgery or controlled locally by radiotherapy, chemotherapy may prove unnecessary. In particular, for small, well-defined tumours with no lymph node involvement, the multidisciplinary oncology team assesses all therapeutic options before reaching a decision on the need for chemotherapy. When more recent approaches such as targeted therapies or immunotherapy are viable, it is also possible to forgo conventional chemotherapy.
Furthermore, the potential benefit of chemotherapy is always weighed against the patient's general health. Factors such as advanced age, chronic conditions, or kidney or liver insufficiency directly influence treatment tolerance. In these situations, the question of whether the expected benefit outweighs the side effects and risks is examined with the utmost rigour. The decision to use chemotherapy is in no way the mechanical application of a standardised protocol it is the result of a personalised medical assessment, adapted to the specific characteristics of each patient.
On What Basis Is the Decision to Use Chemotherapy Made?
The decision to use chemotherapy does not rest on the opinion of a single doctor but on a multidisciplinary consultation bringing together specialists in oncology, surgery, radiation oncology, and pathology. Within this process, the type of cancer, the stage of the disease, the histopathological subtype, and, where applicable, the results of molecular biomarkers constitute the main determining factors. Genetic characteristics such as hormone receptor status, HER2 expression, or the presence of a KRAS mutation play a decisive role in identifying the most effective drugs and in determining whether chemotherapy is indicated.
Beyond the medical criteria, the patient's overall performance status, age, comorbidities, and expected quality of life also form an integral part of the decision-making process. The objective of chemotherapy whether curative, aiming for a complete cure, or palliative, aiming to slow the progression of the disease and to prolong survival is also defined at this stage. Taking into account the patient's preferences and their expectations regarding potential side effects is of paramount importance in developing a treatment plan that is both ethically sound and genuinely sustainable over time.