Anti-cancer Drugs

1. Introduction

   Cancer drugs aim to kill cancer cells, limit cancer growth and relieve associated symptoms.

   There are many types of anti-cancer drugs. Doctors will choose drugs based on the type, stage, and genetic make-up of the cancer that may include one or more of the following type(s) of treatment:

   • Chemotherapy: directly kill cancer cells.
   • Targeted therapy: target steps in cellular processes to block cancer growth.
   • Immunotherapy: switch on parts of the immune system to fight cancer.
   • Hormonal therapy: stop hormone-dependent cancer cells from growing.

2. Preparation

   • Doctor will assess patients’ fitness for the treatment by ordering blood tests and other investigations. The treatment plan will be explained along with anticipated side effects and advice on how to cope with the treatment side effects.
   • Some of the drugs are Self-Financed Items in the Hospital Authority, which are not provided as part of Hospital Authority’s standard services nor covered by the standard fees and charges in public hospitals and clinics. Patients who choose to use these drugs must purchase them at their own expense. The drug price depends on the current market price. The doses of anti-cancer drugs are often based on body build and patient’s condition. Therefore, the dose may be different for each individual. There will be no refund for all drugs dispensed or reconstituted.

3. Procedure

   • Anti-cancer drugs can be administered orally or injected into blood vessels (intravenously), into the fat tissue under skin (subcutaneously), into the muscles (intramuscularly) or into the spinal canal (intrathecally). Some patients may require administration through catheters or ports that are surgically inserted into the body.
   • Treatments may be given during a hospital stay, at the hospital day care center, or at home. Medical staff will take care of the patients and help manage the side effects.
   • Since anti-cancer drugs can cause serious birth defects, both male and female patients should use appropriate contraceptive measures that should be continued for at least 6 months upon completion of treatment or as directed by the doctor. Patients can consult doctors or nurses about the details.
   • During the treatment, patients should avoid taking other anti-cancer drugs that are not prescribed by doctors including traditional Chinese medicine or other herbal products as they may decrease the efficacy or cause unpredictable side effects when taken together.
   • Always keep a written record of the names, doses and duration of other drugs taken for treatment.
   • Female patients should avoid breastfeeding during the treatment and 6 months thereafter because the drugs may pass into the breast milk and harm the baby.

4. After the treatment

   • The doctor will arrange follow-up appointment(s) to monitor patients’ condition and assess the effectiveness of the treatment and potential side effects.
   • Patients should attend follow up appointments as scheduled and return for blood tests or other relevant investigations as instructed.
   • Patients should be aware of symptoms of infections and seek medical advice if they develop a fever or feel unwell after treatment.

5. Risk and complications

   • All anti-cancer drugs can cause side effects. Many of the side effects can be treated, and most, if not all, will pass after treatment stops.
   • Since the side effects vary for each drug and patient, the specific drug information sheet(s) should be referred for details regarding the treatment. The following are the general common side effects of anti-cancer drugs.
     • Chemotherapy: kill growing cancer cells, and may also kill some healthy cells. Common side effects can include bone marrow suppression (with weakened immunity, anemia or bleeding tendency etc.), mouth sores, nausea, diarrhea, loss of appetite, skin pigmentation and hair loss. Chemotherapy may rarely cause the development of new but different cancers.
     • Immunotherapy: the most common side effect is skin rash. Other symptoms such as fatigue, fever, chills, nausea etc. may also be experienced. Immunotherapy can sometimes cause serious inflammatory reactions in lungs, bowels, liver, pancreas and skin. It can also disturb the body’s normal hormone production.
     • Hormonal therapy: the side effects are usually mild. Common side effects include hot flashes and irregular periods for females. Bowel upset, loss of interest in sex, fatigue, joint and muscle aches can occur in either male or female.
   • Patients should note that:
     • Anti-cancer drugs can cause infertility. Patients should discuss with doctors about fertility preservation if concerned.
     • Rarely, patients may die or develop life-threatening side effects.
     • Treatments cannot always achieve their goals. These drugs may control cancers in some patients, but not others. Some patients whose cancers are initially controlled by the drugs may later experience cancer recurrence or regrowth.
     • Despite all precautions, unpredictable and unpreventable adverse outcomes may occur during and after treatment. Patients should consult the medical team and fully understand the details before deciding on undergoing the treatment.

6. Remarks

   Should you have any queries, please consult doctor-in-charge.