Chemo question

Chemo is one of the most confusing things for me.  What I understand is that is why you get chemo every other week.  That way when your good cells are hit with chemo, they are 'repaired' the next week.  Another thing that is confusing to me is why can't you just 'up' the dose if you spot any new growth?  Dr told us if chemo stops working you cannot do this and have to go to the next chemo in line.  Also, you cannot go back to the chemo's you have had.  Hard to understand!

I don't understand Chemo off and on.  When I had it, they gave me a pump pushing FU5 24/7 during the five weeks I was getting radiation.  Then a six week rest, to let it work before the resection.

I had intra-peritoneal chemo for my appendix cancer.  By infusing it directly into my belly and not my bloodstream it 1) only was in the area where the cancer was localized and 2) could be done at a much, much higher strength (300x) than can be done with systemic chemo.  They also have a direct chemo system for some liver cancers - the HAI pump.

There also is directed radiation - either focused or brachytherapy.  It would be wonderful if chemo could be directed specifically at a tumor, and not have to be systemic.

Sorry to read about John, I know he had mentioned some issues cropping up towards the end of last year.  Had not seen him post since the beginning of the year I think.

Some of it depends on the type of cancer, the chemo and efficacy.  Some drugs for tumors have issues getting to the brain (a friend of mine was in a trial, cleared up everything but for the brain tumor because of blood/brain barrier).

"cytotoxic medicines delivery methods" is something I just looked for to see what I could find.  A lot of big words I don't understand  

Wiki (grain of salt) has some information that is fairly straight forward and is my general understanding of things.

https://en.wikipedia.org/wiki/Chemotherapy

Most chemotherapy is delivered intravenously, although a number of agents can be administered orally (e.g., melphalan, busulfan, capecitabine).

There are many intravenous methods of drug delivery, known as vascular access devices. These include the winged infusion device, peripheral cannula, midline catheter, peripherally inserted central catheter (PICC), central venous catheter and implantable port. The devices have different applications regarding duration of chemotherapy treatment, method of delivery and types of chemotherapeutic agent.^[54]

Depending on the patient, the cancer, the stage of cancer, the type of chemotherapy, and the dosage, intravenous chemotherapy may be given on either an inpatient or an outpatient basis. For continuous, frequent or prolonged intravenous chemotherapy administration, various systems may be surgically inserted into the vasculature to maintain access.^[55] Commonly used systems are the Hickman line, the Port-a-Cath, and the PICC line. These have a lower infection risk, are much less prone to phlebitis or extravasation, and eliminate the need for repeated insertion of peripheral cannulae.^{[citation needed]}

Isolated limb perfusion (often used in melanoma),^[56] or isolated infusion of chemotherapy into the liver^[57] or the lung have been used to treat some tumors. The main purpose of these approaches is to deliver a very high dose of chemotherapy to tumor sites without causing overwhelming systemic damage.^[58] These approaches can help control solitary or limited metastases, but they are by definition not systemic, and, therefore, do not treat distributed metastases or micrometastases.

Topical chemotherapies, such as 5-fluorouracil, are used to treat some cases of non-melanoma skin cancer.^[59]

If the cancer has central nervous system involvement, or with meningeal disease, intrathecal chemotherapy may be administered.^[1]

https://patient.info/health/chemotherapy-with-cytotoxic-medicines

Other methods

Medicines usually do not get into the brain or spinal cord very well from the bloodstream. So, to treat some cancers of the brain or spinal cord, medicines may be injected into the fluid which surrounds the brain and spinal cord. This is done by a lumbar puncture when a needle is inserted into the space next to the spinal cord in the lower back.

In certain situations cytotoxic medicines may be given:

• By injection into a muscle.
• As a cream which is rubbed on to skin.
• As an injection into the chest cavity.
• As an injection directly into a cancerous tumour.