Feeling Sick And Being Sick
You may feel sick or be sick after chemotherapy. This will depend on the type and dose of drugs youre having. But this can usually be controlled.
You may start feeling sick straight after chemotherapy, a few hours after or up to several days later. For some people it may last for a few hours and for others it can continue for several days.
People who are very anxious or prone to travel sickness or morning sickness in pregnancy may be more likely to actually be sick.
Youll be given anti-sickness medication, as tablets or into a vein, before each cycle of chemotherapy. Youll also be given anti-sickness tablets to take at home.
Several types of anti-sickness drugs are available. You may need to take a combination of drugs to relieve your symptoms. This may include taking a low dose of steroids for a short time. If you keep feeling sick or are being sick, let someone in your treatment team know.
Contact your hospital if you keep being sick and have difficulty keeping fluids down, even if it happens at the weekend or during the night.
Alternative Therapy Used As Primary Treatment For Breast Cancer Negatively Impacts Outcomes
This study from Han et al was published in the Annals of Surgical Oncology in 2011, and may include some of the patients in the Chang analysis. This was a retrospective chart review of breast cancer patients who refused or delayed conventional treatments. 61 patients were identified. On average patients had Stage 2 disease at diagnosis, which is highly treatable and potentially curable. In patients that omitted or delayed surgery 96.2% had disease progression with 50% dying of the disease. At the time of diagnosis, the median tumor size was 2.0cm. Upon follow-up, the median-size was 7.8cm.
In patients that accepted surgery but rejected adjuvant therapy , the initial 10-year relapse-free survival was estimated at 59.2%, which would have been 74.3% had the patients accepted these treatments. Actual outcomes were much worse than predicted. The actual observed relapse-free survival was only 13.8%. Some subsequently elected to take palliative chemotherapy and radiation to control their disease. From this study we can conclude that refusing or delaying conventional cancer care is associated with much worse outcomes.
Do I Need Genetic Counseling And Testing
Your doctor may recommend that you see a genetic counselor. Thats someone who talks to you about any history of cancer in your family to find out if you have a higher risk for getting breast cancer. For example, people of Ashkenazi Jewish heritage have a higher risk of inherited genetic changes that may cause breast cancers, including triple-negative breast cancer. The counselor may recommend that you get a genetic test.
If you have a higher risk of getting breast cancer, your doctor may talk about ways to manage your risk. You may also have a higher risk of getting other cancers such as ovarian cancer, and your family may have a higher risk. Thats something you would talk with the genetic counselor about.
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Combination Drug Therapy For Early
Combination drug therapy means that you receive more than one type of drug at a time.
Combining drug therapies allows your care team to increase the chances that your treatment will be effective against the breast cancer. If a tumor becomes resistant to one drug, your treatment may still be effective because the tumor responds to the second or third drug in the combination you receive.
Combination therapy can be given before or after breast surgery. Most women receive a combination of two or three drugs at the same time. Some of these drugs are breast cancer targeted therapies. These drugs work by targeting specific molecules involved in breast cancer development.
Here are some of the drug combinations that MSKs medical oncologists commonly prescribe:
- Doxorubicin and cyclophosphamide, followed by paclitaxel
- Used to treat early-stage breast cancer, particularly in younger women or women with aggressive disease
- Given intravenously before or after surgery
- Doxorubicin and cyclophosphamide, followed by paclitaxel and trastuzumab
- Used to treat early-stage HER2-positive breast cancer
- Given intravenously before or after surgery
- Doxorubicin and cyclophosphamide, followed by paclitaxel, trastuzumab, and pertuzumab
- Used to treat early-stage breast cancer
- Given intravenously before or after surgery
- Used to treat early-stage breast cancer
- Given intravenously or by pill after surgery, depending on what your doctor recommends
Reducing Your Risk Of Infection And Bleeding
You can help reduce the risk of infection and bleeding by:
- Regularly washing and drying your hands thoroughly
- Cleaning any cuts and grazes and cover with a dressing or plaster
- Avoiding people who are unwell or may be infectious
- Eating as healthily as possible, and following any advice about food and drink given to you by your hospital
- Drinking plenty of fluids
- Storing and cooking food correctly
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Prompt Surgery Is Better
Because Im a surgeon Ill take a look at Bleicher et al first. This study looks at two large cancer databases, the Surveillance, Epidemiology, and End Results -Medicarelinked database and the National Cancer Database . The SEER-Medicare cohort included Medicare patients older than 65 years, and the NCDB cohort included patients cared for at Commission on Canceraccredited facilities throughout the United States. Analyses performed assessed overall survival as a function of time between diagnosis and surgery and evaluated five intervals . It also looked at disease-specific survival at 60 day intervals. The patient cohort included women diagnosed with invasive breast cancer that had not metastasized beyond axillary lymph nodes who were treated with surgery first. Patients with inflammatory breast cancer were excluded, which makes sense because inflammatory cancer is generally treated first with chemotherapy. The SEER-Medicare cohort included 94,544 patients 66 years or older diagnosed between 1992 and 2009, while the NCDB cohort included 115,970 patients 18 years or older diagnosed between 2003 and 2005.
The tale is told by this graph, from the SEER-Medicare cohort and the NCDB cohort :
You might wonder why there is less of an effect of treatment delay in stage III disease. So did the authors:
Is Chemotherapy The Only Treatment For Breast Cancer
No. Occasionally, chemotherapy is the only breast cancer treatment, but most often, healthcare providers use chemotherapy with other treatments, such as:
- Lumpectomy: Removing the tumor and a small amount of surrounding breast tissue.
- Mastectomy: Removing one or both breasts.
- Hormone therapy: Taking medicines that lower estrogen or block estrogens effects on cancer cells.
- Targeted therapy: Taking medicines that target the changes in cancer cells to destroy them or slow their growth.
- Radiation therapy: Using high-energy X-rays to destroy cancer cells.
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Study: More Breast Cancer Patients Can Safely Skip Chemotherapy
A federally funded study has found that many women with the most common type of early stage breast cancer likely do not need chemotherapy after surgery. The study was presented June 3, 2018 at the American Society of Clinical Oncology meeting in Chicago, and simultaneously published in the New England Journal of Medicine. It is likely to change the way many newly diagnosed breast cancer patients are treated.
“With results of this groundbreaking study, we now can safely avoid chemotherapy in about 70% of patients who are diagnosed with the most common form of breast cancer,” said Kathy Albain, MD, a co-author of the study. “For countless women and their doctors, the days of uncertainty are over.”
Insurance And Scheduling Problems
Some people find that the surgeon they’ve chosen under their insurance company isn’t available for longer than they would like to wait, or that it’s difficult to coordinate a surgeon and plastic surgeon on the same day in a reasonable amount of time. This can be more difficult some places than others. With the larger cancer centers, you may have a coordinator who will assist you in setting up appointments. In the community, you may need to do most of the legwork yourself.
Regardless, it’s important to be your own advocate. If you’re having difficulty, make sure to work with your insurance company. Sometimes they may cover a second or third tier provider if it’s the only option available for scheduling your surgery promptly . With some procedures, prior authorization is needed before scheduling can take place.
There are many breast cancer organizations that can assist you as well as help you make decisions. Support groups and online support communities are also an excellent option when it comes to questions and challenges along the way.
There are many options as well for those who are underinsured or uninsured, but again, it’s usually up to you to do the legwork. Programs such as the SAGE program are available, as well as many other assistance programs that can help with anything from transportation to childcare. Talking to a social worker at your cancer center can be invaluable in learning about your options.
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Chemotherapy Regimens For Early
At some point, your medical oncologist will recommend a chemotherapy plan for you. Also called a chemotherapy regimen, the plan will have important details about your treatment, including:
- which drugs youre receiving
- the order in which you receive them
- the amount of each drug
- how often and how long you will need chemotherapy
Most women with early-stage breast cancer receive chemotherapy for approximately three to six months. Theres time in between treatments to allow your body to recover. If you are receiving targeted therapy for early HER2-positive breast cancer, treatment could last up to a year.
For some people, doctors may recommend a dose-dense chemotherapy regimen. Dose-dense chemotherapy means there is less time between treatments. You will not need to have a larger dose of chemotherapy.
Research has shown that dose-dense chemotherapy can improve survival and lower the risk of the breast cancer coming back compared to a traditional chemotherapy schedule. Dose-dense chemotherapy does not result in more side effects.
How Can A Genomic Oncotype Dx Test Be Helpful
Patients who have a small, estrogen receptor positive, HER2 receptor negative tumor and no evidence of cancer in their lymph nodes may benefit from an Oncotype DX genomic assay. This cutting-edge test looks deeper into breast cancer cells to better identify people who may benefit from chemotherapy with ER+, HER2 breast cancers. The results of this test can also confirm that only hormonal therapy will be needed. Our video lesson on Genomic Assays provides much more detail about these advances in breast cancer care.
- You will find well-organized guides on breast cancer treatment by stage. Follow the prompts to breast cancer and then stage in the dropdown menus. The NCCN is a consortium of organizations and governmental agencies to promote quality breast cancer care.
- Their section on Chemotherapy is comprehensive and has great detail . The American Society of Clinical Oncologists is a leading organization of clinicians who care for people with cancer.
An outline of Chemotherapy for Breast Cancer is provided . The American Cancer Society is an organization that supports patients with cancer and funds research for cancer of all types.
Teaching everyone to be an expert in their own breast cancer care.
All information is designed to help patients engage their physicians in discussions about treatment options. No professional services or specific care recommendations are intended or offered.
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Ten Tips For Getting Through Chemo
Laura tells us about her experience of chemotherapy and shares her top tips for getting through treatment.
In December 2012 I had just finished the last of six rounds of chemotherapy and was preparing for my first post-chemo Christmas. I found it hard to believe a whole year had gone by, particularly as I still remember the day I was ‘sentenced‘ to eight months of treatment as if it were yesterday.
Since then Ive met a lot of people going through chemo and Ive been surprised at the varying advice given to them by different hospitals, for example the woman whose nails went black and started falling off after chemo because she had never been given a simple tip to help protect them.
So below Ive listed a few tips from my own chemo experience that I hope will be beneficial to all. My particular regime was called FEC-T and there are many different types but hopefully some of the advice will still apply.
When Do Chemo Side Effects Kick In
I have breast cancer and am on an 8 cycle course of chemo It is now the day after my first dose and apart from feeling tired and a bit nauseous I don’t feel so bad. When do the really bad side effects kick in?? Do I really have to take all the steroids and other drugs if I don’t feel so bad? Interested to hear other experiences…
Welcome to Cancer Chat.
I am afraid that I have never had chemotherapy, so know little about the side-effects. From what I’ve read on this site, they seem to vary widely. In respect of whether or not you have to take all your drugs, why not ask your care team? I expect that this is a common question and the staff in chemo department should be able to answer this for you.
Why don’t you use the search engine on the blue band at the top of this page? Pop in ‘Chemotherapy side-effects’ in the search box then click search. This should bring up previous posts on the topic. There are 4,000+ posts, so you should find some useful information here.
Please let us know how you get on. There is always someone here for you whenever you feel like talking.
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What Is Breast Cancer
Breast cancer is the most common cancer in women in Australia and the second most common cancer to cause death in women, after lung cancer.
Breast cancer is the abnormal growth of the cells lining the breast lobules or ducts. These cells grow uncontrollably and have the potential to spread to other parts of the body. Both men and women can develop breast cancer, although it is uncommon in men. Transwomen, non-binary people can also get breast cancer.
Transgender and gender-diverse people can also get breast cancer. A transgender woman taking medication to lower male hormones and boost female hormones may have an increased risk of developing breast cancer.
It is estimated that 19,866 women and 164 men in Australia will be diagnosed with breast cancer in 2021.
In Australia, the overall five year survival rate for breast cancer in females is 91%. If the cancer is limited to the breast, 96% of patients will be alive five years after diagnosis this figure excludes those who die from other diseases. If the cancer has spread to the regional lymph nodes, five year relative survival drops to 80%.
Treatment depends on the extent of the cancer.
Ask Your Doctor For A Survivorship Care Plan
Talk with your doctor about developing a survivorship care plan for you. This plan might include:
- A suggested schedule for follow-up exams and tests
- A schedule for other tests you might need in the future, such as early detection tests for other types of cancer, or tests to look for long-term health effects from your cancer or its treatment
- A list of possible late- or long-term side effects from your treatment, including what to watch for and when you should contact your doctor
- Diet, physical activity, and other lifestyle modification suggestions
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What Receptor Patterns Suggest Chemotherapy
Your receptor pattern is a key piece of information that comes early in your breast cancer journey. In about 30% of patients with an invasive breast cancer, the receptor pattern alone can strongly suggest that chemotherapy will be needed regardless of what is found at surgery. If your receptor results suggest you will benefit from chemotherapy, you should inquire about the possible benefits of neoadjuvant chemotherapy, meaning chemotherapy given before surgery, not afterwards. The key points regarding receptors are outlined below.
Estrogen Receptor Negative tumors do not respond to anti-estrogen oral medications that are essential in treating estrogen receptor positive tumors. Quite simply, patients with ER negative tumors will benefit from chemotherapy if they are healthy enough to tolerate it. ER negative tumors are more aggressive cancers, but respond more favorably to chemotherapy than ER positive breast cancers.
Progesterone Receptors play a much smaller role than ER or HER2 receptors and are not addressed here.
Triple Negative tumors are fast growing tumors that are usually treated with a specific chemotherapy regimen. These tumors are not responsive to hormonal therapy at all, but may be sensitive to chemotherapy. View our video lesson on Triple Negative Breast Cancer to learn more.
Common Chemotherapy Drugs For Breast Cancer
Chemotherapy drugs used to treat early breast cancer include:
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