‘Chemotherapy’ refers to treatment with drugs and can describe the treatment with drugs in any illness. It is however, mainly associated with the treatment of cancer where chemotherapy is short for ‘cytotoxic chemotherapy’. Cytotoxic (cell poison) chemotherapy constitutes a group of drugs used to treat cancer by interfering with the process of cell reproduction.

Chemotherapy is a systemic therapy affecting the entire body. It is particularly toxic to rapidly dividing cells, a primary feature of tumour development, and it works by disrupting cellular function. Unlike radiotherapy, which is mainly used to treat local disease (see ‘Radiotherapy’), the purpose of chemotherapy is to destroy cancer cells that may have spread from the primary site. It is therefore typically given to patients where there is evidence or suspicion of a regional disease spread (i.e. nodal involvement).

The goal of chemotherapy treatment may be (i) as a primary therapy with curative intent; (ii) as adjuvant therapy with curative or long term survival intent, i.e. by controlling the cancer, keeping it from spreading or by slowing its growth; (iii) as a neoadjuvant therapy with the aim of reducing tumour burden or to spare an organ; and (iv) as palliative therapy to relieve symptoms such as pain caused by advanced cancer, to help patients live more comfortably (Knobf et al., 1998).

Side effects and the role of psychological factors

Although chemotherapy works best on rapidly dividing tumour cells, it may also damage healthy cells, especially those that also have a tendency to divide quickly such as cells in the blood, mouth, intestinal tract, nose, nails, vagina and hair.