Cancer Chemotherapy in Clinical Practice

This book is intended as a basic overview of the drug treatment of cancer for junior doctors and specialist nurses who come into contact with people having chemotherapy as part of their day-- day work. The aim is to provide a context to those treatments, explaining what the drugs are, how they work, some of their more likely side effects, how they are used in the treatment of the commoner cancers and what therapeutic results might be expected. The first use of the word chemotherapy is credited to Paul Ehrlich (1854–1915), who used it to describe the arsenical compounds he developed to treat syphilis. Nowadays when people talk about ‘chemotherapy’, as part of cancer treatment, they are usually referring to the use of cytotoxic drugs. Cytotoxics have dominated systemic cancer therapy for the last 50 years, and their use has resulted in enormous improvements in outcome. But they are only one component of the drug treatment of malignancy. Hormonal therapies are another major contributor toincreased cure rates and survival times, and the last decade has seen an explosion of entirely new types of drugs for cancer treatment. The latter are mainly drugs specifically targeted against cancer cells (whereas cytotoxics affect both normal and malignant cells). These newer compounds have sometimes been popularly termed ‘magic bullets’, which again takes us back to Ehrlich, as this was another phrase he used to describe his treatments.