| Chapter 2: | Background |
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Childhood cancers are typically treated with chemotherapy, radiation therapy, surgery, or a combination of two or more of these therapies (American Cancer Society, 2007). Chemotherapy involves the use of chemical agents (i.e., drugs) to eradicate cancer cells; the chemical agents work by interfering with the ability of the cancer cells to divide and reproduce (Brown, 2006). Although there are exceptions, childhood cancers tend to respond well to chemotherapy because they are cancers that grow fast (American Cancer Society, 2007). As such, chemotherapy drugs are given for several reasons: (a) to decrease the size of tumors for easier and safer removal by surgery; (b) to enhance the cancer-killing effectiveness of other treatments, such as radiation therapy; (c) to overcome (when used in higher dosages) the resistance of cancer cells; and (d) to control the cancer and enhance the patient’s quality of life (Brown, 2006). Chemotherapy is typically administered to children intravenously (through a vein) or orally (by mouth), although it may also be administered into the spinal canal, into muscle, into the abdominal cavity, into a body cavity, or subcutaneously (through the skin) (Brown, 2006). The duration of chemotherapy treatment and type of chemotherapy drugs used depends on the type of cancer being treated and how the child responds to the drugs. Notably, many of the chemotherapy drugs utilized in childhood cancer treatment carry significant short- and long-term problems. Short-term side effects may include hair loss, mouth and throat sores, nausea and vomiting, diarrhea, fatigue, anemia, abnormal bleeding, and increased risk of infection. Long-term side effects may include liver damage and heart and skin problems (Brown, 2006).