Types of Chemotherapy

Chemotherapy affects substances inside the cells called DNA and RNA. DNA or deoxyribonucleic acid is a chemical in the cell that contains and controls genetic information. RNA or ribonucleic acid is one of the two types of nucleic acids found in cells. RNA helps send information from the DNA to the proteins produced by each cell. This is how the DNA controls the function of the cell.

Your cancer treatment team will often combine drugs with the actions and side effects of each drug in mind, so that the drugs will work well together. Using more than one drug to treat cancer is called combination chemotherapy. The cancer treatment team will recommend either a single chemotherapy drug or combination chemotherapy taking into account the disease type, stage and multiple other factors.

Alkylating Agents—this group of medicines work directly on DNA to prevent the cell from reproducing itself. These drugs will kill cells in all phases of the cell cycle. Some examples of alkylating agents are Chlorambucil, Cyclophosphamide, cisplatin, and carboplatin.

Nitrosureas—a group of drugs that act similarly to that of alkylating agents. These drugs interfere with enzymes that help repair DNA. They do travel into the brain, though many chemotherapy medicines do not. Examples are Carmustine and Lomustine.

Anti-metabolites—are drugs that interfere with the cells' RNA and DNA. Antimetabolites work in the phase of the cell cycle when cells are dividing. Examples are Fluorauracil, Methotrexate and Fludarabine.

Plant alkaloids and natural products—medicines derived from natural products. This group of drugs can block a cell's ability to divide and become two cells and repair damage to cells. Examples are Vincristine, Paclitaxel, and Topotecan.

Anti-tumor Antibiotics—are anti-neoplastic drugs derived from micro-organisms. It does not act like antibiotics used to treat infections. They may work in all phases of the cell cycle. They either break up the DNA strands or inhibit DNA synthesis that cells need to grow. Examples are Bleomycin, Doxorubicin and Mitoxantrone.

Hormonal Agents—there are two types of hormonal agents used in the treatment of cancer: Corticosteroid hormones and sex hormones. Corticosteroids are used in treating some cancer (leukemia, multiple myeloma, lymphoma). Steroids are also used to reduce swelling around tumors of the brain and spinal cord. Steroids are used with other chemotherapy drugs in combination chemotherapy. Examples of corticosteroids are Prednisone and Dexamethasone.

The sex hormones change the action and production of female and male hormones. They are used to slow the growth of breast, uterine and prostate cancer, which grow in the presence of hormones. These drugs do not kill cells, as typical chemo drugs do, they cut off the "food supply" to destroy cancers. Examples of sex hormones are Tamoxifen and Leuprolide.

Biological Response Modifiers—are drugs that strengthen the bodies' immune system to fight the growth of cancer. Other agents might deter certain cancer's growth by disrupting processes that are needed to grow or spread. This is a growing group of anti-cancer medicines and is often considered separate from chemotherapy. Examples of biological response modifiers are Herceptin and Avastin, Erbitux and Rituxan.