Anti-inflammatory steroids used to control vasogenic edema around brain and spinal cord tumors (dexamethasone before brain RT), spinal cord compression, and SVC syndrome; they also serve as antiemetics and taxane premedication.
Supportive pharmacology
Pharmacology
The non-chemotherapy medicines of cancer care — steroids, antiemetics, antibiotics, growth factors, pain control, bone and protective agents, plus immunotherapy, targeted and hormonal therapy. Each class covers its description, side effects, contraindications, route of absorption, and use in the body. Tap a class card to expand the full detail.
11 medicine classes
Prevent and treat nausea and vomiting from treatment: 5-HT3 blockers target the gut and brainstem vomiting center, NK1 blockers raise the threshold for emesis, and benzodiazepines add anticipatory-nausea control.
Prevent and treat infection during immunosuppression: prophylaxis against PJP pneumonia and herpes during prolonged lymphopenia or high-dose steroids, and empiric broad-spectrum coverage for febrile neutropenia — a treatment-emergency protocol.
Stimulate the bone marrow to restore blood counts devastated by treatment: G-CSF raises neutrophils to prevent febrile neutropenia, and erythropoietin-stimulating agents correct treatment-related anemia and its fatigue.
Strengthen bone in metastatic disease: bisphosphonates and denosumab reduce skeletal events (fracture, cord compression, hypercalcemia) from bone metastases in breast, prostate, lung cancer and myeloma.
Manage cancer-related and treatment-related pain using the WHO ladder: non-opioids, then weak and strong opioids for bone metastases and tumor pain, plus adjuvants such as gabapentin for neuropathic pain and single-fraction RT for bone pain.
Monoclonal antibodies that block PD-1/PD-L1 or CTLA-4 "brakes" on T cells, releasing the immune system against tumor cells — not chemotherapy, but a systemic cancer treatment increasingly combined with radiation.
Agents designed against specific molecular drivers: HER2 (trastuzumab), VEGF (bevacizumab), EGFR (erlotinib), and BCR-ABL (imatinib) — select patients by biomarker testing before use. Precision medicines, not chemotherapy.
Block or suppress hormone signaling that drives hormone-receptor-positive breast cancer (tamoxifen, aromatase inhibitors) and prostate cancer (androgen deprivation therapy, commonly combined with radiation).
Agents that protect normal tissue from treatment toxicity: mesna shields the bladder from cyclophosphamide metabolites, leucovorin rescues cells from methotrexate, amifostine reduces radiation mucositis and cisplatin nephrotoxicity, dexrazoxane protects the heart from anthracyclines.
Manage the digestive side effects of treatment: opioids and vincristine cause constipation, chemo and irinotecan cause diarrhea, and radiation mucositis and reflux need protective and acid-suppressing support.