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NCCN Guidelines for Patients


Adolescents and Young Adults with Cancer, Version 1.2017

What are systemic treatments?

Systemic treatments are a big part of the cancer

therapy world. They are drugs used to treat

cancer. Some go after rapidly dividing cells in the

body (chemotherapy), some zero in on particular

characteristics of cancer cells (targeted therapy),

and some recruit your body’s natural defenses to

recognize and destroy cancer (immunotherapy).

Because systemic therapies go after cancer in many

different ways, doctors will often use combinations of

cancer drugs to get the biggest treatment effect. This

increases the chances of getting rid of the cancer,

but it also puts healthy cells at risk for damage. This

damage can lead to side effects that may make it

necessary to stop or delay treatment, or change the

treatment approach.


Chemotherapy, or chemo, is a main systemic

treatment. All chemotherapy drugs affect the genetic

make-up that cells use to grow and divide. Some

damage DNA directly; others get in the way of

processes that help cancer cells build DNA.

This kind of treatment can be given in many ways

depending on what the doctor prescribes. You can

get it in cream form (topical), pill form, or a needle

(injection). Most often chemotherapy drugs are given

as liquids through:



(intravenous) – thin device that goes right

into the vein.



– thin, long tube that is often placed

in the chest. This goes into a large vein and

stays there until treatment is done. Medical

staff can also take blood from a catheter.



– small, round disc that is usually placed

in the chest where a catheter delivers the

chemotherapy. Minor surgery is done to place

the port and it stays in the body for days or

weeks until treatment is complete.



– this is attached to a port or catheter

and allows chemotherapy to be given outside

of the hospital. The pump is set to give certain

amounts of the drug at a time.

Chemotherapy is often given in cycles of treatment

days followed by days of rest. These cycles vary

in length depending on which drugs are used.


Understanding your treatment options

What are systemic treatments?

Chart 3. Chemotherapy drugs

Drug Class

What They Do

Alkylating agents

Damage DNA so cancer cells can’t multiply


Kill cancer cells by getting in the way of the

“building blocks” of DNA

Anticancer antibiotics

Interfere with enzymes that help cancer cells build DNA

Plant alkaloids

Block mechanisms that help cancer cells to divide