Systemic chemotherapy uses anti-cancer drugs that are injected into a vein or given by mouth. These drugs travel through the bloodstream to all parts of the body. In contrast to topical chemotherapy, systemic chemotherapy can attack cancer cells that have spread to lymph nodes and other organs.
One or more chemotherapy drugs may be used to treat squamous cell carcinoma or Merkel cell carcinoma that has spread to other organs. Chemotherapy drugs such as cisplatin, doxorubicin, 5-fluorouracil (5-FU), topotecan, and etoposide are given intravenously (into a vein), usually once every few weeks. They can often delay the spread of these cancers and relieve some symptoms. In some cases, they may shrink tumors enough so that other treatments such as surgery or radiation therapy can be used.
Chemotherapy drugs attack cells that are dividing quickly, which is why they work against cancer cells. But other cells in the body, such as those in the bone marrow, the lining of the mouth and intestines, and the hair follicles, also divide quickly. These cells are also likely to be affected by chemotherapy, which can lead to side effects.
The side effects of chemotherapy depend on the type and dose of drugs given and the length of time they are taken. These side effects may include:
- Hair loss
- Mouth sores
- Loss of appetite
- Nausea and vomiting
- Diarrhea
- Increased risk of infection (due to low white blood cell counts)
- Easy bruising or bleeding (due to low blood platelets)
- Fatigue (due to low red blood cells)
These side effects are usually short-term and go away once treatment is finished. Some drugs may have specific effects that are not listed above, so be sure to talk with your cancer care team about what you might expect in terms of side effects.
There are often ways to lessen these side effects. For example, drugs can be given to help prevent or reduce nausea and vomiting. Do not hesitate to discuss any questions about side effects with the cancer care team.
You should tell your medical team about any side effects or changes you notice while getting chemotherapy so that they can be treated promptly.
For more general information about chemotherapy, please see our document called Understanding Chemotherapy: A Guide for Patients and Families.
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