As anyone who has had chemotherapy knows, there is often a “break” between chemotherapy cycles, which is known professionally as the “chemotherapy interval. The common chemotherapy regimen for lung cancer is mostly three weeks, followed by four weeks, so the interval is usually 21-28 days. Some patients may not be able to stay in the hospital when they start the next chemotherapy cycle, so the interval may be extended to 30 days or more.
Why is there an “interval” in chemotherapy?
Why is there an “interval” in chemotherapy?
People who receive multiple “rounds” of chemotherapy often have to go back and forth between home and the hospital many times because of the “interval” and the inconvenience of repeated admissions and discharges. You may ask: Why is there an interval for chemotherapy? Is it possible to complete it continuously?
The answer is no.
The answer is no. The interval of chemotherapy is based on the characteristics of the drug and the tumor cells themselves, the killing effect of the drug on the tumor cells, and the damage to normal cells and organ functions. Its significance is mainly twofold:
1. Maximize the therapeutic effect
According to the cell cycle principle, the chemotherapy interval is beneficial for maximizing the killing of tumor cells at different stages.
Tumor growth is primarily the result of the ongoing division of cells in the proliferative cycle, in addition to quiescent cells that are not yet in the proliferative cycle (G0 phase). Chemotherapeutic agents can be divided into cell cycle specific and cell cycle non-specific, which act on cells at different stages. For example, when cycle non-specific drugs are used, they are often administered in one large dose to kill a large number of cancer cells and then induce G0 stage cells to enter the proliferative cycle and then be killed. In contrast, G0 stage cells are insensitive to chemotherapeutic agents but are the source of tumor recurrence.
2. Reducing toxicity
Chemotherapy can have many side effects in the blood, digestive, and nervous systems, and a period of “rest” after each chemotherapy treatment can help the damaged organs to “catch their breath” and recover. For example, most of the reduction in white blood cells and platelets after chemotherapy can be recovered in the interval.
How should I spend the interval between chemotherapy treatments?
Is rest all you need to do in the interval between chemotherapy treatments? No!
Along with rest and nutrition, you should read your discharge orders and remember your doctor’s instructions, which remind you of what to do after you leave the hospital, what you need to review, and when your next chemotherapy treatment is due.
There are a number of items that need to be reviewed between chemotherapy sessions that should not be overlooked, especially routine blood tests and biochemical tests. These abnormalities often do not lead to obvious symptoms, but can have serious consequences if not detected and intervened in time. For example, severe liver function impairment may affect the normal metabolic function of the liver, leukopenia may cause serious infections, thrombocytopenia may bleed, and so on.
Of course, there is no need to be overly nervous, and following the doctor’s orders for regular review can go a long way toward avoiding serious consequences from the side effects of chemotherapy. The most important thing to remember is to bring your most recent hospital discharge statement or outpatient medical records for your doctor’s reference.
Co-authors: Guangdong Provincial People’s Hospital Guangdong Lung Cancer Institute Dr. Yue-Li Sun Dr. Xiaoxiao Peng