The Global Challenge of Chemotherapy Toxicity: Rethinking Supportive Care in Modern Oncology

Chemotherapy, while essential for cancer treatment, often leads to significant systemic toxicities that affect patient quality of life, including nausea, vomiting, anorexia, mucositis, diarrhea, fatigue, and alopecia. These side effects are caused by complex mechanisms such as inflammatory cytokine cascades, oxidative stress, neurotransmitter imbalances, mitochondrial dysfunction, and epithelial barrier disruption. For example, chemotherapy-induced emesis is linked to serotonin release and 5-HT3 receptor activation, while alopecia is due to p53 mediated apoptosis in hair follicle keratinocytes. Understanding these mechanisms is crucial for developing targeted adjunct therapies, particularly using biocompatible natural agents, to prevent and manage these toxicities.