Any drug has toxic side effects, and so do chemotherapy drugs. Therefore, before chemotherapy, your doctor will have you undergo tests to determine the size and location of the tumor, to further understand your condition and physical status, and to determine if you can tolerate chemotherapy.
Pre-chemotherapy tests
CT and pathology exams
Imaging tests such as CT and pathology biopsies can confirm whether it is esophageal cancer and determine the type of tumor cells, which in turn can help your doctor develop a drug regimen that is right for you.
To learn more about how these tests work, read the following articles
Cardiac, hematopoietic, liver and kidney function tests
These tests can clarify whether you have liver, kidney, and other diseases to determine if you are well enough to tolerate chemotherapy.
If there are abnormalities in the tests, you need to do liver and kidney protection first, and then start chemotherapy only after the relevant indicators meet the treatment criteria.
Regular checkups during chemotherapy
During chemotherapy, you may experience nausea and vomiting, as well as some unnoticeable side effects, such as lowered white blood cells and platelets. So you will need to have some of these items reviewed regularly.
1. Review blood work 1 to 2 times a week
If the test finds that your white blood cells are below 2.0 x 10 /L and your neutrophils are below 1.0 x 10 /L, you are at increased risk for infection.
At this point, your doctor may give “white boosting” (raising white blood cells) therapy such as granulocyte colony-stimulating factor and granulocyte macrophage colony-stimulating factor, and may choose to delay chemotherapy, reduce drug doses, or change chemotherapy drugs, depending on the circumstances.
If your platelets are below 50×10/L, you are at a relatively increased risk of bleeding. It is important that you rest quietly, do not engage in strenuous activity, and remain emotionally stable. You should also be aware of the following conditions and tell your doctor if they occur so that he or she can treat you accordingly.
- A small amount of bleeding from the gums or nose may be treated with medication as prescribed by your doctor.
- Purpura or petechiae of the skin, hemoptysis, vomiting blood, blood in the stool, and intracranial hemorrhage should be seen immediately at a nearby hospital to assess the severity of the condition and to provide timely measures to stop the bleeding.
- Patients without bleeding tendencies are given medications such as interleukin-11 or recombinant human thrombopoietin to promote the rise of platelets.
The review interval may be adjusted as appropriate depending on the chemotherapy regimen and your bone marrow condition, based on the orders given by your primary care physician.
2. Review liver and kidney function once a week.
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If there are any abnormalities, please adjust your medication under the guidance of your physician.
It is important to note that do not worry about “compromising the efficacy” of chemotherapy because your doctor has “delayed chemotherapy, reduced or changed your medication”.
Chemotherapy is designed to improve your discomfort and hopefully prolong your life as long as possible. If chemotherapy causes greater, intolerable adverse effects on your body, greatly increases your pain, and reduces your quality of life, then your doctor will weigh the benefits. Then, your doctor will weigh the pros and cons and determine whether to delay treatment, for how long, and whether to reduce your medication, depending on your specific situation. I hope you trust your primary care physician and actively cooperate with your treatment.
Co-written by:
Dr. Liu Chang, Department of Gastrointestinal Oncology, Peking University Cancer Hospital