Treating cancer with chemotherapy

Chemotherapy can work well to treat certain cancers, but it may also cause many side effects. Doctors use tumor marker tests to determine which patients are more or less likely to benefit from chemotherapy. These tests can also help doctors select which treatments are most likely to be effective. 

Despite the side effects, chemotherapy plays an important role in treating certain types of cancers. The use of chemotherapy for treatment and the choice of agent chosen vary by cancer type, stage and situation. Visit the sections for each of the cancers listed below for more information on treatment selection. 

• Breast cancer 
• Colorectal
• Endometrial
• Fallopian tube, ovarian and primary peritoneal
• Pancreatic cancer

For melanoma and prostate cancer, chemotherapy is mostly reserved for treating advanced, recurrent disease. 

Some hereditary cancers may respond better to certain types of treatment. For example, people with mutations in genes that repair DNA damage, including BRCA1, BRCA2, PALB2, ATM, CHEK2, BRIP1 and other mutations may benefit from platinum chemotherapy. Cancer cells that have one of these mutations already have problems repairing DNA, and platinum chemotherapy can make that worse. 

Goals of chemotherapy

• Neoadjuvant chemotherapy is given before surgery to try to shrink a tumor.
  • If a tumor is large, shrinking it may help the surgeon remove the entire tumor with wide margins of healthy tissue.
  • It may also allow the oncologist to learn how well the cancer responds to a particular chemotherapy. If the cancer doesn't shrink, the oncologist may recommend a different type of treatment after the tumor is removed. 
• Adjuvant chemotherapy is given to patients with early-stage disease after surgery to remove the tumor, when there is no longer evidence of disease. Adjuvant chemotherapy is used to treat any hidden cancer cells that may remain somewhere in the body after the cancer has been removed.
• Chemotherapy for advanced or metastatic cancers may be used to shrink tumors, reduce symptoms, decrease further spread and help people live longer.