R-CHOP chemotherapy: Drugs, uses, and effects

R-CHOP consists of five separate drugs. These are:

  • (R) rituximab (Rituxan)
  • (C) cyclophosphamide
  • (H) doxorubicin hydrochloride
  • (O) vincristine (Oncovin, Vincasar PFS)
  • (P) prednisolone

R-CHOP is a systemic treatment, which means that it spreads through the body.

R-CHOP kills cancer cells, and it is a standard treatment for some types of non-Hodgkin lymphoma (NHL), which accounts for about 4 percent of all cancers in the United States.

Receiving a chemotherapy prescription can be unsettling and daunting. This article will explain what R-CHOP chemotherapy is, how it works, and how effective it is.

How does R-CHOP chemotherapy work?

Three of the drugs in R-CHOP attack cancerous cells. They work in different ways:

  • Cyclophosphamide converts to metabolites in the liver. These bind to cancerous cells and interfere with their DNA. This interference prevents the cancer cells from dividing, which stops the tumor from growing.
  • Doxorubicin hydrochloride is an enzyme blocker. Cancer cells rely on an enzyme called topoisomerase 2 to spread. Blocking this enzyme slows or stops the growth and division of cancerous cells.
  • Vincristine is part of a group of drugs called vinca alkaloids. These drugs prevent cells from dividing, which slows or stops the growth of tumors.

The other two R-CHOP drugs — rituximab and prednisolone — are not chemotherapy drugs.

Rituximab is a type of antibody drug. It belongs to a class of drugs called targeted therapies. Rituximab attaches itself to cancerous cells, which it can trigger the body’s immune system to attack.

Prednisolone is a corticosteroid. In the case of cancer, it helps with:

  • reducing swelling around the tumor
  • combating nausea that can occur during chemotherapy
  • protecting and boosting the immune system
  • treating allergic reactions

If any of the following symptoms appear during or after the chemotherapy, it is essential to make the nurse aware:

  • breathlessness
  • feeling itchy
  • feeling sick
  • flu-like symptoms
  • pain in the stomach, back, or chest
  • rashes

Low blood pressure

Some people experience a fall in blood pressure after chemotherapy. Anyone who is taking blood pressure medication must tell the nurse ahead of their treatment.

Drug leak around the line

A drug leak could lead to stinging or tingling around the cannula or tube. It is best to inform the nurse if this happens.

R-CHOP can reduce the number of platelets in the blood. Platelets help the blood clot, and reduced numbers of platelets can result in easy bruising and bleeding. Sometimes, nosebleeds and bleeding gums can occur.

There is also a risk of infection because R-CHOP can cause a reduction in the number of white blood cells.

Symptoms of an infection include:

  • temperature above 99.5°F
  • rapidly becoming unwell, with a normal temperature
  • frequent passing of urine
  • feeling shaky or light-headed
  • diarrhea

Anyone who experiences any of these symptoms should speak to someone at the chemotherapy unit.

Is R-CHOP right for me?

The drugs that a doctor prescribes will depend on certain factors. These include:

  • type of cancer
  • size of tumor
  • location of tumor
  • other medical conditions

R-CHOP is among the most effective treatments for NHL and is often successful. In an analysis of the effectiveness of various chemotherapies on NHL, the authors state that R-CHOP offers “significant advantages” over other chemotherapies for the treatment of this cancer.

The 5-year overall survival rate of NHL is 71 percent when R-CHOP is the treatment.

However, R-CHOP is not suitable for everyone for the following reasons:

  • Cancer and chemotherapy can increase the risk of clotting, so people who are prone to blood clots should not have R-CHOP treatment.
  • Anyone planning a baby should speak to their doctor before agreeing to the treatment. R-CHOP chemotherapy can affect fertility.
  • Women who are breastfeeding should stop doing so during treatment.
  • Chemotherapy can affect certain other medical conditions.
  • Some people may be taking other medications that are not compatible with the drugs in the R-CHOP combination. A doctor can provide advice on possible drug interactions.
  • Cancer medications could affect specific dental procedures, so people should make their dentist aware of their treatment.

Cancer and chemotherapy specialists will be able to discuss specific details with the individual and help them make the right decisions regarding their treatment.

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