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Chemotherapy Contraindications

by
author image Dominique Brooks
Dominique Brooks has been a medical editor for over 10 years. She has worked in medical education for physicians, nurses and pharmacists as well as consumers. She started writing business articles for Work.com in 2008 and health articles online in 2009. She holds a Master of Business Administration from the University of Alabama and a Doctor of Medicine from Vanderbilt University.
Chemotherapy Contraindications
Close-up of a doctor adjusting an IV pole. Photo Credit ChaNaWiT/iStock/Getty Images

Overview

For many patients, chemotherapy is an important part of cancer treatment and has improved the survival rates of a significant numbers of cancers. Since chemotherapy drugs have some short- and long-term side effects, physicians have to make sure that there are not conditions present in the patient with cancer that would make chemotherapy more dangerous or even life-threatening. There are certain contraindications to chemotherapy; the presence of these conditions suggests that chemotherapy treatment should be delayed or perhaps not given at all.

First Trimester Pregnancy

Because of the high potential of birth defects and other adverse events, the first trimester of pregnancy is generally a contraindication to chemotherapy drugs, according to a study published in the March 1992 issue of the "Archives of Internal Medicine." However, some types of chemotherapy drugs are safe to administer during the second and third trimester of pregnancy, although there is still an increased risk of stillbirth and intrauterine growth restriction. If the patient does not want to terminate the pregnancy, the doctor will generally wait until the second trimester to begin chemotherapy.

Thrombocytopenia

The presence of thrombocytopenia, or low platelet counts, and other types of low blood counts means that a physician should not start chemotherapy until those conditions have been corrected. Medications or transfusions may help increase blood cell levels. Chemotherapy drugs themselves can cause low blood counts, as well, so any pre-existing blood count issues need to be managed before treatment initiation, as noted in the 2005 textbook "Juta's Manual of Nursing."

Liver or Kidney Impairment

Since most chemotherapy drugs are metabolized by either the liver or kidneys, liver or kidney impairment or failure can be a contraindication to chemotherapy, "Juta's Manual of Nursing" reports. Severe impairment of function of either of these organs prohibits the use of chemotherapy. However, some drugs can be given in patients with decreased liver or kidney function, but the dosage needs to be adjusted for the amount of function that is present. If the liver or kidney failure is due to a temporary condition, the physician could manage the immediate causes and then begin chemotherapy.

Recent Surgery

Chemotherapy can interfere with the healing of any wounds, so generally recent surgery is a contraindication to chemotherapy. Once the surgical wound has healed, the physician can start to treat with chemotherapy, according to "Juta's Manual of Nursing."

Infection

Any ongoing infection is a contraindication to chemotherapy, as noted in "Juta's Manual of Nursing." Chemotherapy lowers blood cell counts so that the body would have a difficult time fighting the infection. Overwhelming sepsis could occur, which would pose a more immediate risk to the patient than the cancer. Once the infection is treated, the chemotherapy treatment can be started.

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