CARBOPLATIN (Carboplatin)

Synonyms: Carboplatin-Teva, Cyclopatin, Para-platinum.

Pharmacological action. Antitumor agent. Belongs to the group of platinum derivatives. The mechanism of action is associated with the formation of “crosslinks” between adjacent pairs of guanine bases in DNA (deoxyribonucleic acid, an integral part of the cell nucleus responsible for the transfer of hereditary information), which leads to suppression of nucleic acid biosynthesis and cell death. Unlike the drug, cisplatin has less nephrotoxicity (damaging effects on the kidneys), ototoxicity (damaging effects on the hearing organs) and neurotoxicity (damaging effects on the nervous system).

Indications for use. Ovarian cancer, germ cell tumor (a malignant tumor formed from the germ cells of the embryo) of the testicle and ovaries, seminoma (a malignant tumor developing from the tissue of the testicles that produces male germ cells - sperm), melanoma (cancer developing from pigment-forming cells), tumors of the head and neck, lung cancer, cervical cancer, bladder cancer, osteogenic sarcoma (a malignant tumor arising from osteoblasts - bone cells).

Method of administration and dose. The drug is taken only intravenously. Adults - 400 mg/m2 body surface for 15-60 minutes. The next dose of the drug is administered no earlier than after 4 weeks. In the case of previous treatment with drugs that have a myelosuppressive (suppressing bone marrow activity) effect, the dose of carboplatin is reduced by 20-25%.

The contents of the bottle should be dissolved immediately before use in sterile water for injection, 5% glucose solution, isotonic sodium chloride solution to the final concentration (10 mg/ml). The prepared solution must be used within 8 hours. It is not recommended to prescribe simultaneously with other drugs that have myelosuppressive (suppressing bone marrow activity), nephrotoxic (damaging effect on the kidneys), neurotoxic (damaging effect on the central nervous system) effect.

The drug is used only under the supervision of a physician experienced in chemotherapy. Before starting treatment and during it, it is necessary to assess the functional characteristics of the kidneys, determine the content of blood cells, and carry out a neurological examination. IV needles or sets must not contain aluminum components.

Side effect. The expression inhibits hematopoiesis (blood formation). Thrombocytopenia (decreased number of platelets in the blood), leukopenia (decreased level of leukocytes in the blood), anemia (decreased hemoglobin content in the blood); increased levels of urea and creatine in the blood, decreased concentrations of magnesium, potassium, calcium; nausea, vomiting; allergic reactions in the form of skin rash; decreased hearing acuity; peripheral polyneuropathy (damage to peripheral nerves, accompanied by disturbances of movement, sensitivity, muscle weakness); liver dysfunction; change in taste; alopecia (complete or partial hair loss); hyperthermia (increased body temperature); chills.

Contraindications. Severe renal dysfunction, severe myelosuppression, hypersensitivity to drugs containing platinum.

The drug may have a carcinogenic (cancer-causing) effect, which requires caution for personnel working with the drug.

Release form. Sterile lyophilized (dried by freezing in a vacuum) powder for injection 0.05; 0.15; 0.2 and 0.45 g in bottles; solution for injection in ampoules of 5, 15 and 45 ml (1 ml contains 0.01 g of the drug).

Storage conditions. List A. In a cool, dark place.

PLATINUM

Pharmacological action. A cytostatic (inhibiting cell growth) drug containing platinum. The mechanism of action is similar to carboplatin.

Indications for use. Sycamore is used in adults for malignant testicular tumors: teratoblastoma (a testicular tumor that arises from cells that are incorrectly formed during fetal development), embryonal cancer (a cancerous tumor that develops from cells similar in structure to fetal cells), seminoma (a malignant tumor that develops from testicular tissues that produce male reproductive cells /spermatozoa/), etc.; ovarian cancer; tumors of the head and neck; melanoma (cancer that develops from pigment-forming cells).

Method of administration and dose. Sycamore is administered intravenously (40 drops per minute) at a dose of 80-100 mg per 1 m2 of body surface daily for 4-5 days. Repeated courses are carried out at intervals of 3-4 weeks. (in the absence of symptoms of intoxication/poisoning/).

Solutions are prepared immediately before use by dissolving 15 or 30 mg of the drug, respectively, in 5 or 10 ml of sterile water for injection, followed by adding 400 ml of isotonic sodium chloride solution.

Side effects and contraindications. Possible side effects, precautions and contraindications are the same as when using cisplatin.

Release form. Lyophilized (dehydrated by freezing in a vacuum) powder or porous mass (white with a slightly yellowish tint) in ampoules of 0.015 or 0.03 g (15 or 30 mg) in a package of 10 pieces.

Storage conditions.

CISPLATIN Synonyms: Platidiam, Platinol, DDP, DDR, Platilit, Sisplatin.

Pharmacological action. The mechanism of the antitumor effect of the drug (and other platinum derivatives) is associated with the ability to bifunctional alkylation of DNA strands (the ability to cause chemical processes in the cell leading to disruption of the stability of DNA /deoxyribonucleic acid/ - a component of the cell nucleus responsible for the transfer of hereditary information), leading to long-term suppression of biosynthesis (the process of formation in the body) of nucleic acids and cell death. The ability of the drug to cause regression of primary tumors and metastases (reversal/reduction/ of cancer at the site of its origin and in places of its spread) is also associated with its effect on the body’s immune system. CisPlatin is ineffective when taken orally. When administered intravenously, it quickly and in significant quantities enters the kidneys, gastrointestinal tract, liver, and ovaries; found in skin, muscles, bone tissue. It does not penetrate the blood-brain barrier (the barrier between blood and brain tissue). In a significant amount (90%) binds to plasma proteins. Slowly excreted by the kidneys: in small quantities in the first hours and about 40% after a 5-day administration.

Indications for use. Cisplatin is used alone or in complex therapy (in combination with methotrexate, cyclophosphate, thioguanine, antitumor antibiotics and other antitumor drugs) for malignant tumors of the testicle and ovaries, cancer of the cervix, bladder, squamous cell carcinoma of the head and neck region, and osteogenic sarcoma ( malignant tumor arising from osteoblasts (bone cells). It is also used in the complex treatment of lymphogranulomatosis (cancer of the lymphatic system, in which dense formations consisting of rapidly growing cells are formed in the lymph nodes and internal organs) and lymphosarcoma (malignant tumors arising from immature lymphoid cells).

Method of administration and dose. Cisplatin solution is administered intravenously. For monochemotherapy (treatment with cisplatin alone), it is usually administered at the rate of 20 mg per 1 m2 of body surface daily for 5 days, or 30 mg per 1 m2 daily for 3 days, or 100-150 mg per 1 m2 1 time every 3 weeks The interval between courses is 3 weeks. The total number of courses is determined individually. For injection, the drug is dissolved at the rate of 10 mg of dry substance per 10 ml of sterile water for injection and this solution is diluted in 1 liter of isotonic sodium chloride solution or 5% glucose solution.

The solution is administered in a stream (slowly) or in the form of long infusions (over 6-48 hours).

To reduce nephrotoxicity (damaging effects on the kidneys), it is recommended to hydrate (provide fluid) the patient’s body before starting cisplatin administration) by administering 1-2 liters of isotonic sodium chloride solution or 5% glucose solution over 8-12 hours.

During treatment, it is necessary to systematically examine kidney function (determining protein, creatinine, urea, uric acid), conduct blood tests, and perform audiometry (measurement of hearing acuity).

Side effects. When using cisplatin, renal dysfunction, nausea, vomiting, loss of appetite, dizziness, tinnitus, hearing loss, anaphylactic (allergic) reactions, leukopenia (low levels of white blood cells in the blood), thrombocytopenia (decreased number of platelets in the blood), anemia ( decrease in hemoglobin content in the blood). Neuropathies (diseases of the nervous system with predominant damage to the nerves of the lower extremities, especially the nerves of the calf muscles) have been noted.

Pain may occur along the vein after intravenous administration of the drug.

Contraindications. The drug is contraindicated in cases of impaired renal and liver function, inhibition of bone marrow hematopoiesis, circulatory failure, gastric and duodenal ulcers, pregnancy and individual intolerance. The use of cisplatin should not be combined with drugs that have a nephrotoxic or ototoxic effect (damaging effects on the kidneys and hearing organs) - aminoglycoside antibiotics, streptomycin, etc.

Release form. Lyophilized cisplatin (dehydrated by freezing in a vacuum) for injection, 0.01 g in ampoules in a package of 10 pieces. It is a porous mass of light yellow color of heterogeneous color; easily disintegrates into powder.

Storage conditions. List A. In a dark place at a temperature not exceeding +10 °C.

18.02.2017

If a patient has cancer, chemotherapy is one of the most effective ways to treat the problem.

Today, there are a variety of chemotherapy drugs for cancer, which must be taken only as prescribed by doctors. Today we will find out what medications are recommended to be taken for cancer, as well as what measures are recommended to take to protect your body during chemotherapy.

Types of drugs for chemotherapy

When a patient has cancer, he is prescribed special medications, which are classified into several categories. All means differ from each other according to their method of action and can be as follows:

• taxanes;
• cytostatics;
• vinkalkaloids;
• anticancer antibiotics;
• platinum drugs;
• anthracyclines;
• alkylating agents.

Each of the categories of medications described above allows for a direct impact on different phases of cellular processes and life cycles. That is why it is extremely important to know which medications are recommended to be taken in a particular case. In this case, in no case should you prescribe chemotherapy yourself, since these drugs are characterized by a high degree of toxicity and only a doctor can select them, based on the available test data.

Alkylating agents

These chemotherapy drugs act on the principle of forming covalent bonds with the DNA chain. Until now, it has not been possible to determine exactly how the death of a cell structure occurs after it is exposed to an alkylating effect, but it has been precisely determined that these drugs can cause an error in the processes of reading genetic information. Ultimately, this effect causes the appearance of the corresponding type of proteins.

At the same time, there is a glutatin system - a unique immunity from alkylating agents. It is for this reason that in the case of an increased amount of glutatin, the effectiveness of alkylating agents in relation to oncological manifestations will be reduced.

However, as a result of taking such medications, there is a possibility of the formation of secondary cancer, the most popular form of which can be considered leukemia. Such an oncological process is often observed several years after the patient has undergone chemotherapy.

If we talk about chemotherapy drugs that belong to this category, then they should include busulfan and chlorambucil, ifosfamide and embiquin, cyclophosphamide, BCNU, procarbazine, as well as all medications based on nitrosomyurea.

Anticancer antibiotics

These chemotherapy drugs are in no way related to the well-known antibacterial medications. The principle of their action lies in the suspension of gene division of the structure of the cancer cell.

Taking such antibiotics against oncology makes it possible to have a direct effect on different phases of cells, for this reason, in some cases, the mechanisms of action may have a number of differences. If we talk about the side effects of such medications, they are the most dangerous for the structure of the lungs, since as a result of the formation of oxygen free radicals they can have a toxic effect on the lungs.

Well-known chemotherapy drugs in this category are bleomycin and adriamycin. In most cases, such medications are used in polychemotherapy in combination with a cytotoxin. Antibiotics should not be confused with drugs such as antimetabolites; the latter contain active substances that can integrate into the cellular genetic apparatus. Ultimately, during the division of cancer cells, their structure is destroyed.

It is recommended to include such medications as 5-fluorouracil, cladribine, fludarabine, gemcitabine, gemzar, metatrexate. If we talk about side effects, then the first drug has the ability to suppress the bone marrow; while taking it, extremely severe intoxication of the gastrointestinal tract is observed, provokes the appearance of neurotoxins, as a result of which a person begins to have convulsions and falls into a coma.

In order to avoid such negative side effects, it is recommended that people with cancer take thymidine as an antidote. An analogue of 5-fluorouracil, which must be taken orally, is the drug capecitabine, but its side effects are similar.

Anthracyclines

Chemotherapeutic agents in this category are rubomycin and adriblastin. These agents are distinguished by the presence in their composition of specific anthracycline rings that interact with DNA cells. In addition, the components of such drugs have the ability to suppress chemical reactions that occur when the topoisomerase enzyme occurs (2), and create a free group of radicals that can damage the basis of the DNA structure of cancer cells.

Also included in the anthracycline category are the drugs doxorubicin and daunorubicin, and the drugs are distinguished by the presence of natural origin. The active components of such drugs were isolated from soil fungi. They form oxygen free radicals, the action of which can disrupt the inhibition of DNA synthesis and integrity.

If we talk about drugs that are effective in the presence of a cancer process, then without a doubt anthracyclines can be included in them, but they also have many side effects, such as, for example, cardiac toxicity. The free radicals that form such chemotherapy drugs have the ability to damage the cellular structures of the myocardium. Therefore, while taking such medications, it is necessary to be under the strictest supervision of a doctor.

Vinkaalkaloids

When chemotherapy in tablets is required, the patient can be prescribed vinca alkaloids, which are antitumor drugs of plant origin. These medications are based on periwinkle leaf extract.

The components of such drugs can bind tubulin (a specific protein), from which the cytoskeleton is formed. Cells need it regardless of their phase, and as a result of its destruction, a disruption of chromosomal movements during division is observed, as a result of which cancer cells begin to be destroyed on their own.

In addition, vinca alkaloids are also distinguished by the fact that it is cancer cells that are sensitive to them, but they have practically no negative effect on normal, healthy ones. If we talk about drugs in this category, then the side effects primarily include neurotoxicity. The most well-known drugs in this category include vinblastine, vincristine, vinorelbine, and vindesine.

Platinum

Platinum chemotherapy drugs are classified as heavy toxic metals and have similar effects on the body as alkylating agents.

After the components of platinum drugs have entered the body of an oncology patient, they begin to interact with DNA molecules, leading to the destruction of their structure and function. As a result, complete death of cancer cells is observed.

Among the platinum drugs that are common in the treatment of oncology, the following should be noted:

• cisplatin (recommended for use if the patient has lung and testicular cancer), but in some cases it can cause kidney damage;
• carboplatin is the second generation of platinum group drugs; they have much fewer side effects in relation to renal structures;
• Oxaliplatin is a third-generation drug that is highly effective in treating colon cancer without causing toxic effects on the kidneys. At the same time, it can cause neuropathy.

Cytostatics

Such chemotherapeutic drugs are distinguished by the presence of a combined mechanism of action, reminiscent of previously described medications. Some drugs in this group resemble alkylating agents in their action, for example, procarbazine and decarbarzine.

There are also cytostatics that have an effect similar to antimetabolites (hydroxyurea). Corticosteroid drugs are also endowed with excellent cytostatic properties, which is why they are often prescribed in the treatment of oncology.

Cytostatic drugs prescribed to patients with oncology include such popular and effective drugs as Texol and apecitabine. If you require chemotherapy, drugs should be prescribed only after a thorough examination; under no circumstances choose the drug yourself, as this can be extremely dangerous to your health.

Taxanes

These drugs affect microtubules, which are present in the structure of any cell. As a result, there is a disruption in the processes of cell division, as a result of which they simply die. This category of anticancer drugs includes paclitaxel and docetaxel.

Taxanes have a fairly wide range of applications; they are recommended for use in patients with breast and lung cancer, head and prostate cancer, gallbladder and esophagus cancer, as well as gastric and ovarian cancer. If we talk about side effects, these drugs also differ in their presence. A sharp decrease in the number of blood cells should be highlighted.

Latest generation drugs

Even today, research into the activity of various anticancer drugs in the treatment of oncology continues. Every year, more and more new drugs are produced, the action of which is aimed at eliminating cancer cells.

New drugs are distinguished by the presence of a high therapeutic effect and fewer side effects. If we talk about the latest, most effective drugs in this category, then these include drugs such as:

• sandostatin;
• femara;
• Gleevec;
• zomera;
• thalidomide;
• oxaliplatin and carboplatin;
• Avastin.

In most cases, experts give preference to the use of targeted chemotherapy, during which patients are given the latest generation of drugs.

Such medications are also called smart drugs because they are able to independently recognize exactly those cells that have been affected by cancer. During such treatment, the drugs destroy them exclusively, without affecting healthy, normal tissue.

It should also be noted that the latest generation of drugs are less toxic, and therefore may be acceptable when treatment is required for a patient depleted of cancer, when the use of traditional anticancer drugs is contraindicated.

Xelox chemotherapy regimen

If we talk about the chemotherapy regimen called Xelox, it involves taking the drug Xeloda orally with oxaliplatin. This type of treatment is highly effective against common colorectal cancer.

However, over the past few years, many discoveries have been made that have completely changed the Xelox combination. In most cases, this drug is recommended for use when it is necessary to treat intestinal cancer in the presence of metastases, pronounced oncology in the breast or stomach.

Chemotherapeutic updated treatment according to the XELOX regimen allows us to provide new opportunities for patients, because if Avastin is added to polychemotherapy with Xeloda and oxaliplatin, much higher survival rates are observed. In this case, there is a complete absence of progression of oncological pathologies.

Recovery drugs

Since as a result of using chemotherapy, the patient is faced with a large number of side effects, and cancer processes themselves can significantly worsen general well-being, after completing a course of oncology treatment, the patient is prescribed drugs to restore health.

For these purposes, people suffering from cancer can be prescribed conventional medications and herbal remedies. At the same time, you need to know that in each specific case it is recommended to select a recovery scheme on an individual basis.

In most cases, rehabilitation treatment must be completed during chemotherapy or immediately after it ends. This is necessary in order to reduce the occurrence of side effects, as well as to eliminate the possibility of damage to the structures of internal organs from the toxic effects of cancer drugs.

Rehabilitation at home

After the patient's treatment with chemotherapy has been completed, he is prescribed rehabilitation. During this period, the patient may experience a variety of complications, among which the most common are nausea and vomiting syndrome, enteroplastic lesions, a decrease in the immune system and alopecia.

The manifestation of enteropathy is observed against the background of the accumulation of toxic substances that enter the patient’s body along with chemotherapy drugs. The rehabilitation period will be much faster and easier if the patient begins to take drugs from the category of enterosorbents, which accelerate the removal of toxins from the body. If we talk about popular drugs that have a similar effect, then they include Polysorb and Enterosgel.

Polysorb

The drug is available in the form of white silicon dioxide powder. It must be taken orally in suspension form, having previously been dissolved in water. The active components of such a drug enter the gastrointestinal tract, where the largest accumulation of toxic substances is located.

Polysorb molecules bind toxic substances, after which they leave the body along with feces. Moreover, it should be noted that silicon dioxide itself does not accumulate in the body, so the patient does not experience disturbances in digestive and metabolic processes.

Enterosgel

This medicine is available in the form of a paste, which is completely ready for use. In most cases, the course of taking the medicine is 1-2 weeks. It is recommended to take it three times a day, about a few hours before taking medications or food.

A single dosage should not exceed 15 grams. If a patient experiences extremely severe consequences after chemotherapy treatment, then it is permissible to double the dosage of the drug, but this can only be done for the first three days of use; in the future, it is recommended to gradually reduce it.

Conclusion

You should not be upset if you have been prescribed chemotherapy, because many modern medications have minimal negative effects. Also, do not neglect the rehabilitation period, which is aimed at restoring the body and removing toxins from it. In any case, take care of your health and don’t get sick!

Content

One of the leading trends in cancer treatment is chemotherapy. More often, patients undergo polychemotherapy, in which several drugs are administered at once. Chemotherapy is used as the main treatment or as an adjunct to surgery and radiation.

What is chemotherapy

Modern cancer drugs destroy affected cells, stop their growth and prevent the formation of new ones. Chemotherapy is difficult to tolerate, and after each course the patient requires rehabilitation. Its side effects are vomiting, nausea, hair loss, weight loss, deterioration of immunity, fatigue, and impaired clotting.

Treatment is divided into cytostatic (slows down the proliferation of tumor cells) and cytotoxic (kills the affected cells, the tumor necrotizes).

Types of chemotherapy drugs

During the treatment of cancer, the following groups of drugs are used:

1. Alkylating agents - destroy proteins responsible for the formation of DNA in cancer cells. The composition often includes cyclophosphamide.
2. Platinum drugs are toxic and destroy tumor DNA.
3. Anthracyclines – form free radicals that damage diseased cells, contain daunorubicin.
4. Taxanes – disrupt the process of cancer cell division and contain paclitaxel.
5. Vinca alkaloids - destroy the cytoskeleton of cancer cells, leading to their death. This is a mild form of chemotherapy. The composition of the products includes vinblastine, vincristine.
6. Antimetabolites serve as an important group of chemotherapy. They are integrated into the genetic cellular apparatus and destroy the cancerous structure. The group includes Methotrexate, Gemcitabine, Gemzar, Fludarabine, Cladribine, 5-fluorouracil. Their side effects are bone marrow suppression, intoxication, coma convulsions. To prevent them, Thymidine is prescribed.

Specialists choose targeted chemotherapy for patients, which recognizes mutated cellular structures and destroys them specifically, without damaging healthy tissue. The latest generation of drugs have low toxicity and are therefore approved for cancer cachexia.

A popular regimen is using the chemotherapy drugs Xelod and Oxaliplatin. The combination has been successfully used to treat colorectal, metastatic intestinal, gastric and breast cancer. When Avastin is added to the regimen, survival rates increase and cancer pathology stops progressing.

Mechanism of action of chemotherapy drugs

Each group of drugs affects different phases of cellular processes and tumor life cycles, which is why there are so many of them.

All drugs are effective only against actively dividing cells and do not affect structures at rest.

The resistance of a malignant tumor to the effects of chemotherapy drugs depends on the number of cellular structures that are in the dormant phase.

Antibiotics for cancer

This group of drugs is not related to commonly known antibiotics. The mechanism of their work is to slow down the gene division of cancer cells. Antibiotics affect different cellular phases, but have many side effects. The most dangerous is the toxic effect on the lungs due to the formation of free radicals. The most famous chemotherapy drugs:

• Adriamycin – 30,000 rubles for 25 ml.
• Bleomycin – 2500 rubles per bottle of 15 units.

Alkylating agents

The principle of action of the drugs in this group is based on the formation of covalent bonds with the DNA chain. The drugs cause an error in the processes of reading genetic information, which suppresses the formation of proteins. The body has a glutathione system - natural immunity from agents, so their effectiveness with increased glutathione content will be low.

Due to the use of alkylating agents, the likelihood of secondary cancer and leukemia increases. Chemotherapy drugs contain nitrosourea:

• Cyclophosphamide – 3000 rub. per bottle;
• Ifosfamide – 3500 rub. per bottle;
• Embikhin – 7200 rub. per bottle;
• Chlorambucil – 4000 rub. for 25 tablets;
• Busulfan – 15,000 rub. for 25 tablets;
• Procarbazine – 6500 rub. for 50 capsules.

Anthracyclines

The group's products contain a specific ring that interacts with the DNA of cancer cells. The components of the drugs suppress chemical reactions and form free radicals that damage the structural basis of the tumor. The effectiveness of the drugs is high, but they often lead to side effects and toxicity to the heart muscle. Group representatives:

• Adriblastin – 1500 rubles per bottle;
• Rubomycin – 1,700 rubles per bottle;
• Doxorubicin – 1000 rubles per 25 ml.

Vinkaalkaloids

These antitumor drugs are of plant origin and contain periwinkle leaf extract. The components of the composition bind the specific protein tubulin, from which the cytoskeleton is formed. The latter is needed by cells at any growth phase. Therefore, its destruction leads to disruption of chromosomal movement during division and destruction.

Malignant abnormal structures are more sensitive to vinca alkaloids than normal cells. Neurotoxicity is reported as a side effect of the drugs. Known remedies:

• Vindesine – 22,500 rubles per bottle;
• Vinorelbine – 4000 rubles for 5 ml;
• Vincristine – 500 rubles for 2 ml;
• Vinblastine – 13,000 rubles for 10 ampoules.

Platinum drugs

The toxic heavy metal platinum acts similarly to alkylating agents. After entering the body, drugs based on it interact with the DNA of malignant cells, destroy them, and lead to death. The drugs are effective, but extremely toxic and can cause kidney damage and neuropathy. Popular medicines:

• Cisplatin – 1000 rub. for 100 ml;
• Carboplatin – 600 rub. for 5 ml;
• Oxaliplatin – 1500 rub. for 10 ml.

Taxanes

These medications act on the microtubules of the cell, which disrupts the processes of cell division, and the tumor dies. Taxanes have a wide range of applications; they are used for cancer of the lungs, mammary glands, prostate, esophagus, gall bladder, ovaries, and stomach. A side effect of the drugs is a decrease in the number of blood cells, leukemia. Group drugs:

• Docetaxel – 750 rubles per 1 ml;
• Paclitaxel – 500 rubles for 5 ml.

Cytostatics

Chemotherapeutic agents from the group of cytostatics have a combined effect. These include corticosteroids, which are used to treat cancer. The downside of the drugs is pronounced side effects, inhibition of bone marrow hematopoiesis. Group representatives:

• Dacarbazine – 300 rub. per bottle;
• Procarbazine – 6500 rub. for 50 capsules;
• Hydroxyurea – 4500 rub. for 100 capsules;
• Capecitabine – 9000 rub. for 120 capsules;
• Taxol – 4500 rub. per bottle.

New generation chemotherapy drugs

New generation anticancer drugs have a pronounced therapeutic effect and fewer toxic reactions. These include:

• Avastin – 20,000 rubles for 4 ml;
• Thalidomide – 15,000 rubles for 30 tablets;
• Zometa – 9000 rubles for 5 ml;
• Gleevec – 25,000 rubles for 30 tablets;
• Femara – 2500 rubles for 30 tablets;
• Sandostatin – 2500 rubles for 5 ml.

How to reduce side effects

Chemotherapy is always accompanied by side effects. The most famous, according to reviews, are anemia, nausea, baldness, brittle nails, impaired taste, appetite, gastrointestinal disorders, fluid retention, urinary incontinence, fungus. Special medications will help you cope with them:

	Preparation	Price, rubles
Remedies for nausea caused by the accumulation of toxins during tumor decay	Domperidone	200 - 30 tablets
		125 - 50 tablets
	Dexamethasone	20 - 10 tablets
	Metoclopramide	40 - 56 tablets
	suppositories Kytril
Antiemetics, eliminate the effects of taking Cisplatin	Tropisetron
	Haloperidol
Antiulcer drugs, protect the stomach from the side effects of toxic medications		330 - 30 capsules
Hepatoprotectors – protect the liver, normalize metabolism, stimulate the restoration of hepatocytes		2000 - 20 tablets

Vitamins are needed to improve well-being and normalize the functioning of the body. During chemotherapy, taking dietary supplements is prohibited, so you need to get vitamins from food or enrich food products with them. Vitamins E, C, A, D are useful. They help speed up the recovery of liver cells and other affected organs, stimulate the immune system, and protect the body from viruses and bacterial infections.

Recovery after chemotherapy

During cancer treatment, all organs and systems are affected, but especially the liver, gastrointestinal tract, kidneys, and bone marrow. Rehabilitation is required to restore normal functioning of the body. It is carried out with special preparations:

1. Enterosorbents - accelerate the removal of toxins, eliminate intoxication, which always develops during the decay of tumor cells. Polysorb and Enterosgel are used.
2. Means for increasing leukocytes - eliminate the effects of inhibition of hematopoiesis, increase the number of blood cells, improve hematopoiesis. Imunofal, Polyoxidonium, Batilol, Leukogen, Cefaransin, Methyluracil are prescribed. If they are ineffective, blood transfusion is indicated.
3. Hepatoprotectors - restore the structure of liver tissue, help accelerate the elimination of toxins and poisons that are formed during the breakdown of liver tissue. These are Hepamin, Hepasteril, Sirepar, Erbisol, Gepadif, Essentiale Forte.
4. Bioactive immunomodulators - restore the immune system, prevent bacterial, fungal, inflammatory processes, necrotic lesions, thrombosis, sepsis, bleeding. Group drugs: Antiox, Bisk, Nutrimax, Ursul.

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Most often, patients are treated with polychemotherapy, which involves the administration of several antitumor drugs of different groups.

Chemotherapy can be used as the main treatment or as an adjunct to surgery and radiation therapy.

Types of chemotherapy drugs

All chemotherapy drugs are classified into several groups, according to their mechanism of action:

• Alkylating agents;
• Anthracyclines;
• Platinum drugs;
• Anticancer antibiotics;
• Vinkalkaloids;
• Cytostatics;
• Taxanes, etc.

Each group of drugs is capable of affecting different phases of cellular processes and life cycles.

All drugs are active only against working cells and cannot affect cellular structures that are in the resting phase (G0). Therefore, the resistance of the malignant process to the effects of chemotherapy drugs depends on the number of cellular structures that are in the dormant phase.

Alkylating agents

The principle of action of drugs in this group is based on the formation of covalent bonds with the DNA chain.

It has not yet been determined exactly how the death of cellular structures occurs after an alkylating effect, but it is clear that these drugs cause an error in the processes of reading genetic information, which leads to the suppression of the formation of the corresponding proteins.

However, there is a glutathione system - natural immunity from alkylating agents, therefore, with an increased glutathione content, the effectiveness of alkylating agents against a malignant tumor will be reduced.

But as a result of taking these drugs, there is a possibility of secondary cancer, the most common form of which is cancer, which appears several years after chemotherapy.

The main representatives of this group are drugs like Cyclophosphamide, Embiquin and Ifosfamide, Chlorambucil and Busulfan, Procarbazine and BCNU, nitrosourea-based products.

Anticancer antibiotics

These drugs are in no way related to commonly known antibiotics. The mechanism of their effect is to slow down the gene division of cancer cell structures.

Anticancer antibiotics can affect different cellular phases, so sometimes their mechanisms of action are slightly different. In terms of adverse reactions, drugs in this group are the most dangerous for the pulmonary structures, because due to the formation of free oxygen radicals they have a toxic effect on the lungs.

The most famous anti-cancer antibiotics are Adriamycin and Bleomycin. Most often it is used in polychemotherapy together with Cytotoxin.

Antibiotics should not be confused with antimetabolites, the active substances of which are integrated into the genetic cellular apparatus. As a result, when the cancerous cell structure divides, it is destroyed.

These are the drugs Methotrexate, Gemzar, Gemcitabine, Fludarabine and Cladribine, 5-Fluorouracil, etc. The latter drug, as adverse reactions, can suppress the bone marrow, causes severe intoxication of the gastrointestinal tract, provokes the appearance of neurotoxins that cause seizures and coma.

To exclude such consequences, Thymidine is prescribed to cancer patients as an antidote. An analogue of 5-Fluorouracil taken orally is capecitabine, but it has identical side effects.

Anthracyclines

Medicines in this group include Adriblastin and Rubomycin. They contain a specific anthracycline ring that interacts with DNA cells.

In addition, the components of these drugs can suppress the chemical reactions that occur during the formation of the enzyme topoisomerase (II) and produce free group radicals that damage the structural basis of the DNA of cancer cells.

The drugs Daunorubicin and Doxorubicin also belong to the anthracycline group and are of natural origin - their active component was isolated from soil fungi. They form free oxygen radicals that disrupt the integrity and inhibit DNA synthesis.

Anthracyclines are very effective against cancer processes, however, they have many dangerous side effects such as cardiac toxicity. Free radicals generated by these drugs can damage the cellular structures of the myocardium. Therefore, the use of this group of drugs requires special monitoring by a doctor.

Vinkaalkaloids

These are antitumor drugs of plant origin (based on periwinkle leaf extract).

The components of these medications are capable of binding tubulin (a specific protein), from which the cytoskeleton is formed.

It is necessary for cells at any phase, and its destruction disrupts chromosomal movements during division, which leads to cancer cells destruction.

Vinkaalkaloids are also distinguished by the fact that malignant-abnormal cellular structures are more sensitive to vinkalkaloids than normal cells.

For drugs of the vinca alkaloid group, neurotoxicity is the most common side effect. The most famous vinca alkaloids are drugs like Vindesine and Vinorelbine, Vincristine and Vinblastine.

Platinum

Platinum preparations are classified as toxic heavy metals and act on the body by a mechanism similar to alkylating agents.

After penetration into the body, the components of platinum drugs begin to interact with DNA molecules, destroying their functions and structures, which causes the death of the malignant cell.

Among the most commonly used platinum drugs in chemotherapy are:

• Cisplatin (especially used for testicular and lung cancer), but it often causes kidney damage;
• Carboplatin is the second generation of platinum drugs and has a significantly less toxic effect on renal structures;
• Oxaliplatin is a representative of the third generation, most effective against colon cancer; it is not toxic to the kidneys, but can cause neuropathies.

Cytostatics

These drugs have a combined mechanism of action similar to the medications already described. Some of them are similar to alkylating agents (for example, Dacarbazine and Procarbazine).

There are cytostatics that act by analogy with antimetabolites (Hydroxyurea). Corticosteroid drugs, often used in anticancer therapy, also have excellent cytostatic properties.

Frequently used cytostatics include drugs like Apetitabine, Taxol, etc.

Taxanes

These are medications that act on microtubules found in every cellular structure. As a result, cell division processes are disrupted and further cell death occurs.

This group of antitumor drugs includes: Docetaxe, Paclitaxel, etc.

Taxanes have a fairly wide range of applications: for and, and, and, as well as for and. The most common side effect of taxanes is a decrease in the number of blood cells.

Latest generation drugs

Research into the anticancer activity of various substances continues.

New generations of antitumor drugs are being released that have a greater therapeutic effect and fewer adverse toxic reactions.

Such means include:

1. Avastin;
2. Carboplatin and Oxaliplatin;
3. Thalidomide;
4. Zomera;
5. Gleevec;
6. Femara;
7. Sandostatin.

Increasingly, specialists are trying to use targeted chemotherapy, which involves the use of the latest generation drugs.

These drugs are also called “smart” drugs, since they are able to recognize specifically mutated cellular structures and destroy only them, without affecting normal, healthy tissues. In addition, the latest generation of drugs are less toxic, and therefore are allowed in the treatment of a patient depleted of cancer, when traditional anti-cancer drugs are contraindicated.

Xelox chemotherapy: scheme

Chemotherapy according to the Xelox regimen involves oral administration of the drug Xeloda with Oxaliplatin. This treatment regimen is most effective against common.

But recently, many discoveries have been made that have made it possible to slightly change the Xelox combination. It is usually used for the treatment of metastatic, pronounced gastric and mammary glandular malignant oncology.

The updated chemotherapy treatment according to the XELOX regimen gives patients new opportunities, because when Avastin is added to polychemotherapy with Oxaliplatin and Xeloda, survival rates significantly increase, and there is no progression of oncopathology.

Recovery Tools

Since chemotherapy is accompanied by a lot of side effects, and cancer processes greatly undermine health, after anti-cancer treatment it is necessary to help the body recover.

For this purpose, cancer patients are prescribed traditional medicines and herbal remedies. A rehabilitation treatment regimen is selected individually for each patient.

Typically, restorative therapy is prescribed during chemotherapy or immediately after it in order to reduce the severity of side symptoms and eliminate damage to intraorganic structures from the toxic effects of anticancer drugs.

Increased leukocytes

Since hematopoietic functions are inhibited during chemotherapy treatment, the number of blood cells is significantly reduced, including leukocytes.

All patients who have undergone chemotherapy treatment develop leukopenia, accompanied by critically low levels of immune status.

Therefore, it is extremely important for such patients to normalize the leukocyte level.

Normally, the level of leukocytes is about 4-9 x 10 9 /l, however, after anti-cancer therapy they are reduced by five.

Immunity is pathologically reduced, but it is so necessary for further resistance to malignant tumor processes. To restore the previous level of leukocytes, patients are prescribed drugs like Imunofal or Polyoxidonium.

If they are ineffective, more powerful drugs are indicated, for example, Batilol, Leukogen, Cefaransin, Methyluracil, etc. In addition, an increase in leukocytes is achieved through extracorporeal pharmacotherapy, which involves the introduction of drugs into the bloodstream together with the infusion of donor red blood cells.

Liver

During chemotherapy treatment, a serious burden is placed on the liver structures, because antitumor drugs also destroy healthy structures. Toxins accumulate in the body and are removed by the liver.

To restore the liver, patients are prescribed hepatoprotective drugs such as:

• Hepasteril;
• Hepamine;
• Sirepara;
• Erbisola;
• Karsila;
• Hepaditha;
• Essentiale Forte-N, etc.

In order for the toxins accumulated in the liver to be eliminated more quickly, it is recommended to drink various liquids abundantly and often: rosehip decoction, water, cranberry juice, etc.

Immunity

In all patients, due to reduced immunity, infectious processes develop, and the opportunistic microorganisms present in the body acquire pathogenic status. Since the body is exposed to general toxic effects, fungal infections develop.

According to statistics, 100% of patients experience candidiasis; they are often bothered by staphylococcal infections, which lead to the formation of inflammatory and necrotic foci, thrombosis, bleeding and sepsis.

Lack of necessary restorative treatment in most cases ends in death. Therefore, supporting the immune system with drugs such as Polyoxidonium and Antiox is so important. Bioactive immunomodulators Bisk, Nutrimax, Ursul, etc. are also prescribed.

Medications for side effects

Chemotherapy is accompanied by a host of side effects such as anemia and nausea, baldness and brittle nails, taste changes and appetite problems, gastrointestinal disorders and fluid retention, urinary disorders, etc.

Therefore, to alleviate the condition, patients are prescribed additional drugs to relieve side symptoms.

Anti-nausea pills

Nausea is usually caused by toxins that are released during the breakdown of a cancerous tumor and enter the body with chemotherapy drugs. This is a normal reaction of the body.

To relieve nausea, special medications are prescribed such as:

1. Domperidone;
2. Dexamethasone;
3. Tserukala;
4. Metoclopramide;
5. Raglan;
6. Cisapride.

Medicines like Vistaril, Compazin and Torekan will also help reduce nausea.

It is better to opt for rectal suppositories, since they are directly absorbed through the intestinal mucosa without causing additional stomach irritation. The most effective candles are Compazin and Kytril.

Antiemetic

Since cancer patients suffer from not only nausea but also vomiting after chemotherapy, they are also prescribed antiemetic drugs.

Particularly severe vomiting is observed after drugs of the cytostatic group like Cisplatin. When this drug was administered, all patients vomited up to 20 times per day.

To suppress acute vomiting that occurs on the first day after chemotherapy, taking Tropisetron, Granisetron or Emetron, Dolasetron or Ondasetron is indicated. Antiemetics are also prescribed: Lorazepam, Marinol, Haloperidol, etc.

Vitamins for oncology

After chemotherapy, the body needs vitamins. It is best to obtain them from natural sources, since during the recovery process after chemotherapy treatment it is forbidden to take multivitamin complexes, usually containing B vitamins, namely B 6, B 2 and B 1, which promote the growth of malignant cancer cells.

But the body needs to be enriched with vitamins like tocopherol (E), ascorbic acid, retinol (A) and vitamin D after chemotherapy treatment. You can take them in the form of medications or eat foods rich in them.

Omez

The antiulcer drug Omez is often prescribed to patients after chemotherapy.

The purpose of this prescription is to protect the gastric structures from adverse reactions of toxic anticancer drugs.

The drug is usually prescribed 3 days before chemotherapy and continued for a week after treatment.

Heptral

Heptral is a strong hepatoprotective drug designed to protect the liver. It is often prescribed to patients after chemotherapy as part of rehabilitation treatment.

Heptral normalizes metabolic processes in liver tissues and stimulates the restoration of hepatocytes.

The drug is taken in tablet form between meals. The daily dosage is 2-4 capsules or 0.8-1.6 g. If after chemotherapy the patient experiences severe forms of cholestasis, then Heptral is prescribed in injection form.

Rehabilitation after chemotherapy at home

The rehabilitation period after chemotherapy is accompanied by a fairly wide range of complications, the most common of which are enteropathic lesions and nausea and vomiting syndrome, alopecia and decreased immunity.

Enteropathy occurs against the background of an accumulation of toxic substances that enter the body along with chemotherapy drugs.

Rehabilitation is much easier and goes faster if the patient takes drugs from the group of enterosorbents, which help to quickly get rid of intoxication. The most commonly used drugs of this type are Enterosgel and Polysorb.

Polysorb

The drug is produced in the form of white silicon dioxide powder. It is taken orally in suspension form, after dissolving the powder in water. The active substance penetrates the gastrointestinal tract, where the largest toxic accumulations are located.

Polysorb molecules bind toxins and remove them with feces. Moreover, silicon dioxide itself does not accumulate in the body and does not disrupt metabolic and digestive processes.

Enterosgel

The drug is produced in the form of a paste, which is ready for use. Usually the drug is prescribed for a period of 1-2 weeks. You need to take it three times a day, about a couple of hours before eating or taking medications.

A single dose is 15 g. If the consequences after chemotherapy treatment are severe, then the dosage can be doubled, but only for the first 3 days of administration, then it is gradually reduced to normal.