How Does Chemotherapy Actually Work?

Including why it often causes hair loss:

From death to life

Chemotherapy was discovery born from war: during World War I, mustard gas was found to severely damage bone marrow and stop blood-cell production. Because cancer cells, like bone marrow cells, divide rapidly, researchers wondered whether mustard-gas compounds could destroy cancer cells. By the end of World War II, this research had produced the first chemotherapy drugs.

More than a 100 years after that initial research began, more than 100 chemotherapy drugs now exist, using cytotoxic agents that damage or kill cells. They work in different ways, for example alkylating agents damage DNA, particularly affecting rapidly dividing cancer cells, while microtubule stabilizers interfere with the structures needed for cell division.

This explains why side effects occur: chemotherapy also harms healthy cells that divide rapidly, including your hair follicles, mouth, gastrointestinal lining, reproductive system, and bone marrow. Thus, we often see side effects such as hair loss, fatigue, infertility, nausea, and vomiting.

Unwanted side effects can at least be mitigated somewhat; for example, anti-nausea medications can help control nausea and vomiting, while cold caps can reduce blood flow around your hair follicles and potentially limit hair loss. The good news is, healthy tissues generally recover after treatment ends.

And yes, “after treatment ends” is more often a happy story than a sad one, because chemotherapy has transformed cancer survival, with (per the examples given in the video) up to 95% of people with testicular cancer surviving and an estimated 60% of people under 60 with acute myeloid leukemia entering remission after their initial treatment phase. Researchers are also developing increasingly precise treatments designed to target cancer cells while reducing harm to healthy tissue.

Cancer is one of the most well-funded medical research areas, so it’s little wonder that advances keep on coming.

For more on all of this, enjoy:

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Take care!