Conventional chemotherapy drugs are given at high doses in order to kill tumor cells as quickly as possible. At these high doses, chemotherapy also kills normal cells, such as those in the gut and the hair follicles, which is why many cancer patients on chemotherapy experience severe nausea, diarrhea, hair loss, and fatigue. Some chemotherapy agents, however, when administered in low, regular doses have been shown to starve cancers by halting their blood vessel growth without causing debilitating side effects. This strategy is called ‘metronomic chemotherapy’ because the dosing schedule resembles the steady rhythmic pattern of a metronome.

Metronomic chemotherapy has been evaluated in advanced liver cancer. In one study, 22 patients received the chemotherapy drug capecitabine at the standard starting dose, followed by a lower metronomic dosing schedule.⁸ There were encouraging signs of activity: two patients had partial tumor shrinkage and three had their tumors stop growing, suggesting that metronomic therapy may be useful for advanced liver cancer. Further research of this treatment is ongoing.