Cancer Chemotherapy In Clinical Practice

Cancer Chemotherapy in Clinical Practice Cancer Chemotherapy in Clinical Practice Terry Priestman Terry Priestman, MD, FRCP, FRCR New Cross Hospital Wolverhampton UK British Library Cataloguing in Publication Data Priestman, Terry J. Cancer chemotherapy in clinical practice 1. Cancer - Chemotherapy I. Title 616.9’94061 Library of Congress Control Number: 2007936871 ISBN: 978-1-84628-989-7 e-ISBN: 978-1-84628-991-0 Printed on acid-free paper © Springer-Verlag London Limited 2008 Apart from any fair dealing for the purposes of research or private study, or criticism or review, as permitted under the Copyright, Designs and Patents Act 1988, this publication may only be reproduced, stored or transmitted, in any form or by any means, with the prior permission in writing of the publishers, or in the case of reprographic reproduction in accordance with the terms of licences issued by the Copyright Licensing Agency. Enquiries concerning reproduction outside those terms should be sent to the publishers. The use of registered names, trademarks, etc. in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant laws and regulations and therefore free for general use. Product liability: The publisher can give no guarantee for information about drug dosage and application thereof contained in this book. In every individual case the respective user must check its accuracy by consulting other pharmaceutical literature. 987654321 Springer Science+Business Media springer.com Preface This book is intended as a basic overview of the drug treatment of cancer for junior doctors and specialist nurses who come into contact with people having chemotherapy as part of their day-today work. The aim is to provide a context to those treatments, explaining what the drugs are, how they work, some of their more likely side effects, how they are used in the treatment of the commoner cancers and what therapeutic results might be expected. The first use of the word chemotherapy is credited to Paul Ehrlich (1854–1915), who used it to describe the arsenical compounds he developed to treat syphilis. Nowadays when people talk about ‘chemotherapy’, as part of cancer treatment, they are usually referring to the use of cytotoxic drugs. Cytotoxics have dominated systemic cancer therapy for the last 50 years, and their use has resulted in enormous improvements in outcome. But they are only one component of the drug treatment of malignancy. Hormonal therapies are another major contributor to increased cure rates and survival times, and the last decade has seen an explosion of entirely new types of drugs for cancer treatment. The latter are mainly drugs specifically targeted against cancer cells (whereas cytotoxics affect both normal and malignant cells). These newer compounds have sometimes been popularly termed ‘magic bullets’, which again takes us back to Ehrlich, as this was another phrase he used to describe his treatments. The aim of this text is to cover all these diffe