Types of Chemo Treatment

Chemotherapy is a cancer treatment that uses chemicals to kill the fast-growing cells in the body. Because cancer cells grow and multiply quickly, chemotherapy can target them. Chemotherapy is an effective treatment for many types of cancer. It can also have serious side effects. 

In addition to cancer cells, chemotherapy damages healthy cells as well. Normal cells most likely to be damaged by chemotherapy are in the hair follicles, mouth, digestive tract, and reproductive system. This cell damage causes common chemotherapy side effects like hair loss and vomiting. 

This article will describe the different types of chemotherapy and the possible side effects. 

A nurse tends to a person undergoing chemotherapy.

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Different Types of Chemo 

There are several different types of chemotherapy, and your medical team may recommend one or more for your treatment. The type of chemo you receive will depend on your type of cancer, how advanced it is, and your overall health. 

Alkylating Agents

Alkylating agents fight cancer cells by preventing them from making copies of themselves. This type of chemotherapy damages the cell’s DNA, which keeps it from reproducing. Alkylating agents are able to work in all phases of the cell cycle. 

Alkylating agents are used to treat several types of cancer, including brain, lung, breast, and ovary cancers. It may also be used to treat leukemia, lymphoma, Hodgkin disease, multiple myeloma, and sarcoma. Examples of commonly used alkylating agents include Myleran (busulfan), Cytoxan (cyclophosphamide), and Temodar (temozolomide). 

Nitrosoureas are a type of alkylating agent that is able to cross the blood-brain barrier and travel to the brain. This means they can treat certain types of brain cancer.

Side Effects

Alkylating agents damage the DNA in cells and can cause serious side effects. Alkylating agents affect the cells in the bone marrow, which work to make new cells. Because of this, a rare side effect of this type of chemotherapy is leukemia. However, the risk of developing leukemia is low with low doses of alkylating agents and goes up as the dosage increases. 

Other possible side effects include anemia, hair loss, absence of menstruation (amenorrhea), and damage to the mucosal lining of the digestive tract. 

Antimetabolites

Antimetabolites fight cancer by interfering with the DNA and in cells. These drugs can substitute for certain building blocks in the DNA and RNA of cells, preventing the cells from being able to replicate themselves. 

Antimetabolites are often used to treat cancers of the breast, ovary, intestinal tract, and leukemias. Examples of commonly used antimetabolites include 5-FU (5-fluorouracil), 6-MP (6-mercaptopurine), Xeloda (capecitabine), and Gemzar (gemcitabine). 

Side Effects

Antimetabolites have several possible side effects, including:

  • Dizziness
  • Fatigue
  • Headaches
  • Gum pain
  • Hair loss
  • Decreased appetite

More serious possible side effects include vision loss, seizures, confusion, weakness, and loss of consciousness. 

Antitumor Antibiotics

Antitumor antibiotics fight cancer by changing the DNA inside of cancer cells to prevent them from growing and replicating. These drugs do not behave the same as antibiotics that are used to fight infection. 

They can be used to treat several types of cancer. Examples of commonly used antitumor antibiotics include Cosmegen (dactinomycin), Bleo 15K (bleomycin), Cerubidine (daunorubicin), and Adriamycin (doxorubicin). 

Side Effects

High doses of antitumor antibiotics can damage the heart. For this reason, there are lifetime limits placed on these drugs 

Other possible side effects include:

  • Nausea and vomiting
  • Mouth sores
  • Weight loss
  • Weight gain
  • Fatigue
  • Weakness
  • Dizziness
  • Hair loss
  • Eye pain
  • Tingling in the hands and feet
  • Red-colored urine 

Corticosteroids

Corticosteroids, also called steroids, are drugs that act like the hormone cortisol in the body. Cortisol is a hormone produced by the adrenal gland. Corticosteroids are able to fight cancer by treating common side effects like nausea and vomiting. They may also be helpful in preventing allergic reactions to other chemotherapy drugs. When corticosteroids are used during cancer treatment, they are considered chemotherapy drugs. 

Examples of commonly used corticosteroids in cancer treatment include Cortan (prednisone), Medrol (methylprednisolone), and Decadron (dexamethasone). 

Side Effects

Corticosteroids may cause mild or more serious side effects. Possible short-term side effects include increased appetite, weight gain, upset stomach, trouble sleeping, depression, and confusion. Possible long-term side effects include:

Plant Alkaloids 

Plant alkaloids are compounds made from plants and other natural products. They are able to fight cancer by interfering with the enzymes that cells need to grow and replicate. Enzymes are proteins in cells that cause chemical reactions. 

Topoisomerase Inhibitors

Topoisomerase inhibitors are plant alkaloids that interfere with topoisomerases, enzymes that help to separate parts of DNA so they can be replicated. By preventing the copying of DNA strands, topoisomerase inhibitors prevent cells from multiplying.

These types of drugs may be used to treat leukemia and cancers of the lung, ovaries, and gastrointestinal tract. Examples of commonly used topoisomerase inhibitors include Toposar (etoposide), Camptosar (irinotecan), and Hycamtin (topotecan). 

Mitotic Inhibitors

Another kind of plant alkaloid used in cancer treatment is mitotic inhibitors. Mitotic inhibitors keep cells from growing and dividing by preventing enzymes from making the proteins that are needed for replication. 

Mitotic inhibitors are used to treat cancers of the lung and breast, as well as leukemias, lymphomas, and myeloma. Examples of commonly used mitotic inhibitors include Taxotere (docetaxel), Halaven (eribulin), Ixempra (ixabepilone), Taxol (paclitaxel), and Velban (vinblastine). 

Side Effects

Plant alkaloids have several possible side effects. Topoisomerase inhibitors may lead to anemia, low neutrophils (neutropenia), low platelets (thrombocytopenia), diarrhea, and nausea. 

Certain topoisomerase inhibitors have been linked to an increased risk for a type of cancer called acute myeloid leukemia. This second cancer may develop about two to three years after treatment. Talk with your oncologist about your risk. 

Mitotic inhibitors are more likely than other types of chemotherapy to cause nerve damage. Nerve damage may feel like numbness and tingling or pain. 

If you or a loved one have recently been diagnosed with cancer, talk with your healthcare team about treatment options. Your team will be able to discuss the different types of chemotherapy and recommend the ones that are most likely to be effective for you. 

Summary

There are several types of chemotherapy, and each one treats cancer differently. Many types of chemotherapy interrupt the cancer cell cycle, preventing the cells from growing and multiplying. The most common types of chemotherapy include alkylating agents, antimetabolites, antitumor antibiotics, corticosteroids, and plant alkaloids. Chemotherapy drugs have serious side effects as well. 

A Word From Verywell 

Receiving a cancer diagnosis has likely been one of the most stressful times in your life. Cancer treatment plans often feel complicated and overwhelming. Talk with your healthcare team about the different types of chemotherapy, and ask about which ones will be most effective against your type of cancer. 

Frequently Asked Questions

  • What are the methods of chemotherapy?

    Chemotherapy can be administered to the body through injection, intravenous (IV) injection, oral medication, or topical treatment. 

  • What is the strongest form of chemo?

    The strength of a chemotherapy drug is dose-specific. This means that the higher the dose, the stronger the drug’s effects will be in the body.

9 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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  2. MedlinePlus. Types of chemotherapy.

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  5. LiverTox. Alkylating agents.

  6. MedlinePlus. Methotrexate

  7. MedlinePlus. Doxorubicin.

  8. Grennan D, Wang S. Steroid side effects. JAMA. 2019;322(3):282. doi:10.1001/jama.2019.8506

  9. LiverTox. Topoisomerase inhibitors.

By Carrie Madormo, RN, MPH
Carrie Madormo, RN, MPH, is a health writer with over a decade of experience working as a registered nurse. She has practiced in a variety of settings including pediatrics, oncology, chronic pain, and public health.