Chemotherapy for Children

What is chemotherapy?

Chemotherapy is the use of anticancer drugs to treat cancer cells. Chemotherapy has been used for many years and is one of the most common treatments for cancer. In most cases, chemotherapy works by interfering with the cancer cell's ability to grow or reproduce. Different groups of drugs work in different ways to fight cancer cells. Chemotherapy may be used alone for some types of cancer or in combination with other treatments such as radiation or surgery. Often, a combination of chemotherapy drugs is used to fight a specific cancer. Certain chemotherapy drugs may be given in a specific order depending on the type of cancer it's being used to treat.

While chemotherapy can be quite effective in treating certain cancers, chemotherapy drugs reach all parts of the body, not just the cancer cells. Because of this, there may be many side effects during treatment. Being able to anticipate these side effects can help you and your child prepare and, in some cases, prevent these symptoms from occurring.

How is chemotherapy administered?

Chemotherapy can be given:

As a pill to swallow
As an injection into the muscle or fat tissue
Intravenously (directly to the bloodstream through a vein; also called IV)
Topically (applied to the skin)
Directly into a body cavity

What are some of the chemotherapy drugs and their potential side effects?

The following table lists some of the chemotherapy drugs commonly used in children and some of the side effects. However, each child may experience symptoms differently and at different times of the treatment. Some side effects may occur early on (days or weeks) and some side effects may occur later (months or years) after the chemotherapy has been given. The side effects listed aren't all the possible problems that may occur. Always consult your child's doctor if your child is feeling anything unusual.

Chemotherapy drug	Side effects (short-term and long-term)
L-asparaginase, Elspar - usually given IV; also can be given as an injection (a shot into muscle or skin)	Drowsiness can occur during and continue for several weeks after treatment Nausea, vomiting, and cramping Allergic reaction: rash or increased breathing effort
Busulfan, Myleran - usually given orally	Fatigue, tiredness Decreased appetite Hair loss (reversible) Nausea and vomiting Diarrhea Decrease in blood cell counts
Carboplatin (Paraplatin) - usually given IV	Decrease in blood cell counts Hair loss (reversible) Dizziness Darkened skin coloration Ringing in ears and hearing loss Kidney damage
Cisplatin (cisplatinum, Platinol, Platinol-AQ) - usually given IV	Decrease in blood cell counts Allergic reaction: rash and increased breathing effort Nausea and vomiting that usually occurs for about 24 hours Ringing in ears and hearing loss Fluctuations in blood electrolytes Kidney damage
Cyclophosphamide (Cytoxan, Neosar) - can be given IV or orally (by mouth)	Nausea, vomiting, and abdominal pain Decreased appetite Sore mouth and taste changes Diarrhea Hair loss (reversible) Bladder damage
Cytarabine (Ara-C, cytosine arabinoside, Cytosar-U) - usually given IV and/or intrathecally (into the spinal column)	Nausea, vomiting, and diarrhea Decreased appetite Decrease in blood cell counts Fever and flu-like symptoms
Daunorubicin (Cerubidine), doxorubicin (Adriamycin PFS, Adriamycin RDF, Rubex) - usually given IV	Nausea and vomiting Hair loss (reversible) Red colored urine (not bleeding but a drug effect) Decrease in blood cell counts
Etoposide (VePesid, VP-16) - may be given orally or IV, teniposide (Vumon) - usually given IV	Nausea and vomiting Hair loss (reversible) Decrease in blood cell counts Low blood pressure Decreased appetite Diarrhea
Hydroxyurea (Hydrea) - usually given orally	Decrease in blood cell counts Nausea and vomiting Diarrhea
Mercaptopurine (6-MP, Purinethol) - usually given orally	Nausea and vomiting Decreased appetite Tiredness and weakness Decrease in blood cell counts
Methotrexate (MTX) - may be given IV, intrathecally (into the spinal column), or orally (by mouth)	Nausea and vomiting Decrease in blood cell counts Diarrhea Skin rashes Dizziness, headache, or drowsiness
Thioguanine (6-TG) - usually given orally	Nausea and vomiting Diarrhea Decreased appetite Decrease in blood cell counts (after several weeks)
Thiotepa (Thioplex, Tepa) - usually given IV, intrathecally (directly into the spinal column), may be instilled in bladder, or injected into the tumor	Loss of appetite Nausea and vomiting Hair loss (reversible) Decrease in blood cell counts Temporary or permanent sterility (inability to have children)
Topotecan (Hycamtin) - given IV	Muscle achiness Nausea and vomiting
Vincristine (Oncovin) - usually given IV, vinblastine (Velban, Velbe) - usually given IV	Weakness Loss of reflexes Nausea and vomiting Hair loss (reversible) Diarrhea or constipation, abdominal cramping Decrease in blood cell counts