What Happens When Chemotherapy Doesn’t Work?

Chemotherapy is one of the most common ways cancer is treated. Chemotherapy 

How Does Chemotherapy Work? 

Depending on the type of cancer diagnosed, chemotherapy may be the only treatment needed. However, in most cases, chemotherapy treatment is combined with other treatments like surgery, radiation therapy or targeted immunotherapies. 

Chemotherapy itself is the use of specific drugs to stop cancer cells from growing. Cancer is a disease in which cells grow abnormally, in which, chemotherapy can be used to target such cells from diving and spreading further. Most commonly, chemotherapy is given as an infusion via the veins. It can also be taken in pill form.

Sometimes chemotherapy is used before surgery in order to help shrink the tumour and make it easier to remove. Additionally, it may be used post-surgery to essentially "mop up" remaining cancer cells that may have survived during the surgery. This is called adjuvant chemotherapy.

What Are the Signs that Chemotherapy Isn't Working?

There are several factors that may indicate chemotherapy is no longer working:

• The tumour is continuing to grow
• Tumours are appearing elsewhere in the body
• Old symptoms have returned
• New symptoms appear

While chemotherapy is a strong form of treatment that can kill cancer cells, it can take several months before it can be certain it is working or not. In addition, some cancers respond better to chemotherapy while others may become resistant to it over time.

A doctor will then conduct several tests to see whether or not the chemotherapy treatment is working or not. For example, blood tests, MRIs (Magnetic Resonance Imaging), CT scans (Computed Tomographies) and/or tumour market tests (which check the blood to see if cancer is still present). It is important to remember that you cannot tell by yourself if the chemotherapy is working or not.

What Are Alternative Treatment Options?

Usually, a doctor will choose a “first line treatment” of chemotherapy, which is the type they have determined has the best possible chance of success. But, if the first line form of chemotherapy is not working, the team may move onto a “second line treatment” with a different kind of chemotherapy.  

If after doing more tests it displays that the chemotherapy is not working, there may be other viable treatment options available. The type of treatment chosen will depend on the type of cancer being treated, where it is situated in the body and what cancer staging it has been assigned. 

Other possible cancer treatments include:  

• Surgery 
• Radiation therapy 
• Bone marrow transplant
• Immunotherapy
• Stem cell transplant therapy
• Hormone therapy
• Targeted drug therapy
• Cryoablation
• Radiofrequency ablation (RFA)

Can I Stop Chemotherapy Treatment?

At a certain stage in some people's cancer journeys they decide to stop taking treatment. At such a stage, the only option may be to get palliative care, which does not cure cancer but rather helps minimise or eradicate symptoms so people can live more comfortably.

Stopping treatment, without undergoing alternative routes if they aren't available, does mean that the cancer may continue to grow. This is evidently not a light decision to take, yet it is still a viable one for many. It is important to make this decision with your healthcare team and/or family or friends.

Hospice care is sometimes considered for end of life care, which can be at a hospital or specialised hospice facility. Some people even have support at home. The aim of hospice care is to support those with cancer, and to ensure they are comfortable and have the best psychological support and medication. Additional support may be provided to close family members or friends, who are also coming to terms with this difficult stage.