Drug treatment for advanced cancer
This section gives general information about the types of drugs that can be used to treat advanced cancer. For information about specific drugs used to treat your type of cancer, see our document about that type of cancer.
Several types of medicines can be used to treat advanced cancer.
Chemotherapy (chemo) uses drugs to kill cancer cells. Usually the drugs are given into a vein or taken by mouth. Once the drugs enter the bloodstream, they go throughout the body. This treatment is often useful for cancer that is widespread. By shrinking the cancer, it can relieve symptoms. It can even prolong life for some patients with advanced cancer.
Chemo kills cancer cells. But these drugs can also harm some of the normal, healthy cells. This can cause side effects, such as:
- Nausea and vomiting
- Loss of appetite
- Hair loss (the hair grows back after treatment ends)
- Mouth sores
- Increased chance of infection (from low numbers of white blood cells)
- Bleeding or bruising after small cuts or injuries (from low numbers of platelets)
- Feeling tired (from low numbers of red blood cells)
- Feeling weak
Your cancer care team can suggest many things to ease side effects. For example, there are drugs to help prevent or reduce nausea and vomiting. Sometimes it helps if the doctor changes the dose or the time of day you take your medicines. It’s always important to balance any side effects you have against the symptoms you are trying to relieve.
To learn more about chemo and dealing with side effects, please see A Guide to Chemotherapy.
Targeted therapy is a newer type of cancer treatment that uses drugs that attack specific parts of cancer cells or other cells or proteins that help cancer cells grow. These drugs work differently from standard chemo drugs. They can be used alone or along with other treatments.
Most targeted drugs do not affect normal cells as much as chemo drugs do, so they may not cause as many side effects. But even though they mainly target the cancer cells, these drugs are not perfect – they can still cause side effects and sometimes serious reactions.
To see what targeted drugs can be used to treat your cancer, see our information on that kind of cancer. To learn more about this treatment in general, see Targeted Therapy.
Hormone therapy uses drugs to block the actions of certain hormones or reduce how much is made. This is most often used to treat breast and prostate cancer, but it can be used for some other cancers as well. For example, estrogen is a hormone that causes many breast cancers to grow. Drugs can lower estrogen levels or block the effect of estrogen on breast cancer cells, which may stop growth and even cause tumors to shrink. Likewise, male sex hormones, called androgens, make most prostate cancers grow. Drugs that lower androgen levels or block their effect can help stop or slow growth of these cancers.
Side effects depend on the type of hormone therapy used but can include hot flashes, blood clots, and loss of sex drive.
Immunotherapy is a treatment that boosts the body’s immune system or uses man-made versions of immune system proteins to kill cancer cells. Several types of immunotherapy are used to treat patients with advanced cancer, including cytokines, monoclonal antibodies, and tumor vaccines. Immunotherapy can be a part of treatment for a number of cancers, including melanoma, non-Hodgkin lymphoma, multiple myeloma, and prostate cancer.
To see if immunotherapy is used to treat the cancer you have, see our document about that kind of cancer. General information about this kind of treatment can be found in Immunotherapy.
Drugs to treat cancer that has spread to the bones
Some types of drugs can be especially helpful if cancer has spread to the bones. A few examples are listed here, but for more information, see Bone Metastasis.
Bisphosphonates (bis-FAHS-fun-ates) are a group of drugs that work by slowing down the action of bone cells called osteoclasts. These cells normally dissolve small bits of bones to help remodel them and keep them strong. But osteoclasts are often overactive when cancer spreads to the bones, which can cause problems.
Bisphosphonates used to treat cancer in the bones, such as zoledronic acid (Zometa®) and pamidronate (Aredia®) are injected into a vein (IV), about once a month. They can often slow bone damage, lower the risk of broken bones, and reduce bone pain.
Still, these drugs can cause problems, too. The most common side effects are tiredness, fever, nausea, vomiting, and bone or joint pain. Some patients develop damage to their jawbone, known as osteonecrosis (os-tee-o-nuh-CROW-sis) of the jaw (ONJ), which can be serious. Because this is more common after a tooth extraction, many doctors have their patients get a thorough dental check-up before they start treatment to help prevent this. These drugs can cause kidney damage, so they should not be given to people with severe kidney problems.
Denosumab (Xgeva®) is another drug that can help when cancer spreads to bone. Like the bisphosphonates, this drug keeps slows down the action of osteoclasts, but it does so in a different way, by blocking a substance called RANKL.
This drug is injected under the skin every 4 weeks.
Common side effects include nausea, diarrhea, and feeling weak or tired. Denosumab also can cause ONJ, so doctors recommend taking the same precautions (such as having tooth and jaw problems treated before starting the drug). Unlike bisphosphonates, this drug is safe to give to patients with kidney problems.
Radiopharmaceuticals were discussed in the section on radiation.
- Advanced Cancer
- What is advanced cancer?
- What is metastatic cancer?
- Can advanced or metastatic cancer be prevented?
- How is advanced cancer found?
- How is advanced cancer treated?
- Surgery for advanced cancer
- Ablative techniques for advanced cancer
- Radiation therapy for advanced cancer
- Drug treatment for advanced cancer
- Clinical trials
- Complementary and alternative therapies for advanced cancer
- Managing symptoms of advanced cancer, by location
- Managing general symptoms of advanced cancer
- What should you ask your doctor about advanced cancer?
- Coping with advanced cancer
- Sources of support
- Choices for palliative care
- Advance directives
- Additional resources for advanced cancer
- References: Advanced cancer