Why does my child need chemotherapy?
Chemotherapy will help treat your child’s brain tumour. The treatment team is led by a doctor called a neuro-oncologist. They take the responsibility for your child’s care during chemotherapy and makes the decisions about your child’s treatment plan.
How is chemotherapy given?
There are many different types of chemotherapy medicines. Each drug acts in a different way. Some medicines are given by mouth while others are given by injection into a vein or other area.
Often, more than one medicine is given. Chemotherapy may also be given as a treatment in combination with surgery and/or radiation.
Chemotherapy treatment is delivered based on a set schedule or protocol that is based on your child’s specific condition. Usually each course of treatment involves a treatment period, and then a recovery period. This course is then repeated for a period of time determined by the tumour type and the response to treatment.
To find information about a specific type of chemotherapy drug, visit the AboutKidsHealth Drug A-Z section on this website by clicking "Drug A-Z" in the menu in the top left corner.
How do chemotherapy drugs work?
Chemotherapy medicines act in a variety of ways. Some chemotherapy medicines work by interfering with cell division and replication. As tumour cells may be more actively dividing, they are often more sensitive to the effects.
Some normal or healthy cells may also be damaged, which can lead to side effects. However, as normal or healthy cells can repair themselves, the side effects of chemotherapy usually improve or go away.
What is involved in intravenous chemotherapy?
Chemotherapy medicines may be injected into a vein. These medicines may be given multiple times over many months. This can be difficult for children, both physically and emotionally. One key problem is that children’s veins are small. Chemotherapy can damage veins after many injections. To avoid this problem, a thin tube may be inserted into a larger vein to give the drugs. This tube is called a central venous catheter or central line. Once it is inserted, it will safely stay in your child during the entire treatment period. Having a central line may make it easier and safer for your child to receive injections.
Using antibiotics
During chemotherapy, your child may need to take antibiotics to prevent a lung infection called Pneumocystis jirovecii pneumonia (PJP). The antibiotic is a combination of two medicines called trimethoprim and sulfamethoxazole. It may also be called cotrimoxazole.
Why does my child need to take antibiotics?
PJP is believed to be caused by bacteria that is probably present in most healthy children’s lungs. When your child’s immune system is weakened during chemotherapy, their body loses the ability to cope with infections. As a result, your child may be at higher risk of developing this type of pneumonia.
Taking antibiotics is effective at preventing PJP from developing. This is called preventive or prophylactic use of antibiotics.
The antibiotics are usually given by mouth in a tablet form. They are taken once or twice a day, three days a week throughout treatment, and for three to six months after treatment.
Mouth care before and during treatment
Radiation therapy and chemotherapy medicines can affect the teeth and mouth. Some of the side effects are a sore mouth or throat, and a dry mouth. There may be a higher risk of your child developing cavities. If possible, arrange a checkup with your child’s dentist before treatment begins. During treatment, regular brushing may not be possible. If this is the case, the treatment team will provide you with alternate options for mouth care.
Monitoring during chemotherapy
While your child is receiving chemotherapy, they will have regular checkups. It is important to tell the treatment team about all of the changes or symptoms your child has while at home. The treatment team will ask about their appetite, daily activities, pain, bowel movements, weakness in their fingers or toes, headaches, and vision problems. There will also be a physical exam. A complete blood count (CBC) will be done. If your child is receiving certain medicines, they will be sent for a hearing test.
How will chemotherapy lower my child’s blood counts?
Bone marrow is the part of the body that makes new blood cells. Bone marrow is sensitive to the effects of chemotherapy so the numbers of new blood cells, or "counts" often drop or are lower during chemotherapy.
How long does it take to lower my child’s blood counts?
It takes one to two weeks after your child starts chemotherapy to lower the blood counts. That is how long it takes for the older blood cells to die and the newer blood cells to be made.
Usually, your child's blood counts will return to normal three to four weeks after starting chemotherapy.
What is a complete blood count?
When your child is having chemotherapy, the treatment team will check each type of blood cell in your child to see how they are being affected. To do this, they will take blood from your child. Then they will do a complete blood count, also called a CBC, to look at these four blood counts:
- A white blood cell count
- A neutrophil count, also called a poly count
- A red blood cell count and a hemoglobin count
- A platelet count
What are the side effects of chemotherapy?
The side effects from chemotherapy drugs depend on the type of drugs, the dose of drug, and your child’s reaction. Some children may not have any side effects.
Within 30 minutes to a day
- nausea or vomiting
- allergic reaction
Within two or three weeks
- fatigue
- infection
- low blood counts (myelosuppression): There are three main types of blood cells. All three types can be affected.
- low number of white blood cells (neutropenia)
- low number of platelets (thrombocytopenia)
- low number of red blood cells (anemia)
- loss of appetite
- sore mouth or throat
- diarrhea
- constipation
- taste changes
- pain and damage to the ends of nerves in hands, feet, or jaw (neuropathy)
- hearing loss
- hair loss
- changes to mood or behaviour
What can be done to manage the side effects of chemotherapy?
Your child’s doctor may recommend several medicines to improve the side effects. Some of these medicines are used specially for chemotherapy. If you notice side effects or changes in mood or behaviour, let your treatment team know.
What is informed choice or informed consent?
Informed choice is the option a person has to allow or not allow something to happen, like diagnostic procedures or treatment, after they have been informed of the benefits and risks of the options involved. If the person agrees, they give informed consent. Informed consent is required before beginning chemotherapy.