Anti-cancer drugs destroy or kill cancer cells or modify their growth. These drugs are also known as chemotherapy or cytotoxic drugs. The drugs affect cancer cells as well as normal cells and produce different kinds of actions in the body.
Anticancer drugs have the ability to act on rapidly multiplying cells. However, most cancer cells have a lower cell fraction than normal bone marrow, epithelial lining, the reticuloendothelial system, and gonads. The action of these cytotoxic drugs is dose-dependent.
Cytotoxic drugs affect bone marrow and result in depression of bone marrow, which leads to granulocytopenia, agranulocytosis, and aplastic anemia. Complications include infection and bleeding.
Cytotoxic drugs negatively affect oral microbial flora. Most of these drugs produce stomatitis. Minor trauma to the gums and oral mucosa can result in bleeding gums and an increased progression of dental caries.
Cytotoxic drugs decrease gastrointestinal mucosa and result in diarrhea, shedding of the mucosal layer, and hemorrhages. Nausea and vomiting are most common in chemotherapy due to stimulation in the CTZ. Commonly used highly emetogenic drugs include Cisplatin, Cyclophosphamide, and Lomustine. Mildly emetogenic drugs include Bleomycin, Chlorambucil, Busulfan, Fluorouracil, Hydroxyurea, Methotrexate, Etoposide, and L-Asparaginase.
Anti-cancer drugs can damage the cells in hair follicles and skin, leading to dermatitis. These drugs can also damage gonadal cells and induce impotence or infertility in males, while in females, they can inhibit ovulation and cause menstrual irregularities.
Pregnant individuals who undergo chemotherapy may experience adverse effects on the fetus, leading to abortion, fetal death, and teratogenicity.
Targeted chemotherapy and immunotherapy help reduce side effects and are more specific compared to traditional chemotherapy. Patients undergoing chemotherapy should discuss their treatment with healthcare providers to address any doubts. Patients should also consider the benefits and risks of treatment to improve compliance and adherence.
