Telling The Boss And Colleagues
Typically, sharing life news with those at work isn’t difficult, but when talking about a breast cancer diagnosis, the words can get caught in your mouth.
First, don’t rush it. There is no reason to talk to the boss or colleagues so soon after receiving the news. Wait until it feels as comfortable as possible.
There is no right or wrong way to divulge a cancer diagnosis. Some people might feel more comfortable talking to their boss or supervisor first, avoiding the miscommunication that can stem from the office gossip mill. Consider setting up a meeting or a lunch, so you can be sure to have her full attention. Also, remember that discussions about health between a boss and employee are protected.A supervisor has a legal obligation to keep the information private. However, co-workers do not have the same obligation.
Talking to colleagues about a cancer diagnosis isn’t a necessity however, co-workers can be an unexpected source of support. It’s not uncommon for colleagues to provide needed support for those with breast cancer. This support may include personal assistance on the job, donated vacation days, or even a fundraising campaign.
Chemotherapy For Breast Cancer
Chemotherapy uses anti-cancer drugs that may be given intravenously or by mouth. The drugs travel through the bloodstream to reach cancer cells in most parts of the body. Sometimes, if cancer spreads to the spinal fluid, which surrounds and cushions the brain and spinal cord, chemo may be given directly into in this area .
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After Breast Cancer Has Been Diagnosed Tests Are Done To Findout If Cancer Cells Have Spread Within The Breast Or To Other Parts Of Thebody
The process used to find out whether the has spread within the or to otherparts of the body is called .The information gathered from the staging process determines the of the disease. It isimportant to know the stage in order to plan treatment. The results of some of the tests used to are also used to stage the disease.
The following tests and procedures also may be used inthe staging process:
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After Each Chemo Treatment
If necessary, your blood will be drawn after chemo. If your red blood cells or neutrophils are low, you may be offered shots to boost those counts. Chemotherapy can greatly affect your blood counts because blood cells divide and multiply quickly and are therefore targeted by the drugs.
Staying on top of your blood counts is essential for recovering from chemo with a healthy immune system and avoiding anemia and neutropenia .
Breast Cancer Doctor Discussion Guide
Get our printable guide for your next doctor’s appointment to help you ask the right questions.
- Nerve damage
- “Chemo brain”
Your specific chemotherapy drug or regimen may cause other side effects, as well. These effects will subside after you’ve finished treatment.
Before each treatment, your medical oncologist may want you to take medications to protect against side effects. Be sure to take these on time and as prescribed.
Between chemotherapy appointments, if you have trouble dealing with side effects, don’t hesitate to call your clinic and ask for help. For example, if you’re dehydrated after a treatment, your healthcare providers may suggest an IV infusion of fluids. Other medications may be given along with the saline to help with nausea and vomiting.
Chemo Drugs For Breast Cancer That Has Spread
- Taxanes: Paclitaxel , docetaxel , and albumin-bound paclitaxel
- Ixabepilone
- Gemcitabine
- Antibody drug conjugates
Although drug combinations are often used to treat early breast cancer, advanced breast cancer often is treated with single chemo drugs. Still, some combinations, such as paclitaxel plus gemcitabine, are commonly used to treat metastatic breast cancer.
For cancers that are HER2-positive, one or more drugs that target HER2 may be used with chemo.
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Are There Ways To Prevent Hair Loss With Chemotherapy
Not everyone loses hair when receiving chemotherapy, but many people do. Some peoples hair only thins. Others lose the majority or all of their hair.
Using a cold cap can reduce hair loss. Cold caps cool your scalp before, during and after chemotherapy treatment. Cooling tightens the blood vessels in your scalp, potentially reducing how much chemotherapy goes to your hair follicles.
People may choose to wear a wig as a result of hair loss. Some private insurance companies may help cover wig costs if your doctor prescribes a cranial prosthesis or hair prosthesis. Medicare Parts A and B do not cover wigs, but the costs may be tax-deductible.
In Breast Cancer Stage Is Based On The Size And Location Of The Primary Tumor The Spread Of Cancer To Nearby Lymph Nodes Or Other Parts Of The Body Tumor Grade And Whether Certain Biomarkers Are Present
To plan the best treatment and understand your , it is important to know the breast cancer stage.
There are 3 types of breast cancer stage groups:
- Prognostic Stage is used first to assign a stage for all patients based on , , , and . The Clinical Prognostic Stage is described by the , , and status . In , or is used to check the lymph nodes for of cancer.
- Pathological Prognostic Stage is then used for patients who have surgery as their first treatment. The Pathological Prognostic Stage is based on all clinical information, biomarker status, and results from breast tissue and lymph nodes removed during surgery.
- Stage is based on the size and the spread of cancer as described by the TNM system. The Anatomic Stage is used in parts of the world where biomarker testing is not available. It is not used in the United States.
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How Do You Get Chemotherapy For Breast Cancer
You get chemotherapy as a pill or in a vein daily, weekly, or every 2-4 weeks. You may get one drug or a combination of them. Your treatment plan is designed for your particular situation.
If your veins are hard to find, you may get a catheter in a large vein. These devices are inserted by a surgeon or radiologist and have an opening to the skin or a port under the skin, allowing chemotherapy medications to be given. They can also be used to give fluids or take blood samples. Once chemotherapy is finished, your catheter will be removed.
If Cancer Is Found Tests Are Done To Study The Cancer Cells
- how quickly the cancer may grow.
- how likely it is that the cancer will spread through the body.
- how well certain treatments might work.
- how likely the cancer is to .
Tests include the following:
Based on these tests, breast cancer is described as one of the following types:
- HER2/neu positive or .
- .
This information helps the doctor decide which treatments will work best for your cancer.
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Breast Cancer Is A Disease In Which Malignant Cellsform In The Tissues Of The Breast
The is made up of and . Each breast has 15 to 20 sections calledlobes. Each lobe has many smaller sections called . Lobules end in dozens of tiny bulbs thatcan make milk. The lobes, lobules, and bulbs are linked by thin tubes calledducts.
Anatomy of the female breast. The nipple and areola are shown on the outside of the breast. The lymph nodes, lobes, lobules, ducts, and other parts of the inside of the breast are also shown.
Each breast also has and . The lymph vessels carry an almost colorless, watery called . Lymphvessels carry lymph between . Lymph nodes are small, bean-shaped structures found throughout the body. They lymph and store that help fight and disease. Groups of lymph nodes are found near the breast in the , above the, and in the chest.
The most common type of is , which begins in the of the ducts. that begins in thelobes or lobules is called and is more often found in bothbreasts than are other types of breast cancer. is an uncommon type ofbreast cancer in which the breast is warm, red, and swollen.
See the following summaries for more information about breast cancer:
How Does Chemotherapy Work
Chemotherapy works by attacking fast-growing cells in your body, including cancer cells. There are many different types of chemotherapy your medical oncologist will talk to you about whats most suitable for you. Sometimes more than one type of treatment may be effective for you, and you may be asked to decide which one to have. Your medical oncologist can tell you about the pros and cons of each.
Some questions you might like to ask include:
- What are the possible side effects of each treatment?
- How long is the course of each treatment?
- How will the treatment fit in with my lifestyle and personal circumstances?
Some chemotherapy drugs are given in tablet form, however, most are administered intravenously . As a result, it is useful to drink plenty of fluids, relax and keep your hands and arms warm, as this can help the nurse or doctor find your veins.
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The Tnm System Is Used To Describe The Size Of The Primary Tumor And The Spread Of Cancer To Nearby Lymph Nodes Or Other Parts Of The Body
For breast cancer, the TNM system describes the tumor as follows:
Tumor . The size and location of the tumor.
Tumor sizes are often measured in millimeters or centimeters. Common items that can be used to show tumor size in mm include: a sharp pencil point , a new crayon point , a pencil-top eraser , a pea , a peanut , and a lime .
- TX: Primary tumor cannot be assessed.
- T0: No sign of a primary tumor in the breast.
- Tis: . There are 2 types of breast carcinoma in situ:
- Tis : DCIS is a in which cells are found in the lining of a . The abnormal cells have not spread outside the duct to other tissues in the breast. In some cases, DCIS may become that is able to spread to other tissues. At this time, there is no way to know which can become invasive.
- Tis : Paget disease of the is a condition in which abnormal cells are found in the skin cells of the nipple and may spread to the . It is not staged according to the TNM system. If Paget disease AND an invasive breast cancer are present, the TNM system is used to stage the invasive breast cancer.
What Are The Risks Of Chemotherapy
Different chemotherapy medicines tend to cause different side effects. Many women do not have problems with these side effects, while other women are bothered a lot. There are other medicines you can take to treat the side effects of chemo.
Talk to your doctor about the type of chemotherapy medicine that he or she is planning to give you. Ask about any side effects that the chemo may cause.
Short-term side effects can include:
- Nausea and vomiting.
- Hair thinning or hair loss.
- Mouth sores.
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Why Might Your Doctor Recommend Chemotherapy
Your doctor might recommend chemotherapy after surgery if:
- You are younger than 35. Women younger than 35 usually have a more aggressive type of breast cancer.
- Your breast cancer was bigger than a pea. Breast cancers that are at least 1 cm are more likely to come back later.
- Your breast cancer has spread to the lymph nodes under your arm. If thats the case, there is a bigger chance that the cancer may also have spread to other places in your body.
- Your breast cancer is HER-2 positive or triple-negative. These types of cancer tend to grow faster and spread more quickly.
Your doctor may use a genetic test to find your risk for having your cancer come back. This information can help you and your doctor decide about chemotherapy.
What Is The Prognosis For Triple
A good treatment result depends on several factors. Chemotherapy is what can really make a difference in the outcome. The size of the invasive part of the tumor, and the number of involved lymph nodes can also greatly influence your prognosis, Sun says, but adds that if the cancer has spread , the prognosis is less certain.
There is hope, even with this serious diagnosis, and staying optimistic is essential. It can be stressful and scary to go through chemo, but positive thinking can make a difference. You have to believe that its doing you good, and for most people, it does.
Breast Cancer Treatment at Johns Hopkins
The breast cancer program at Johns Hopkins is made up of a diverse group of nationally-recognized specialists in breast cancer research and treatment.
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Success For Certain Cancer Types
Certain factors are considered in the choice to give neoadjuvant chemotherapy. These include the size of the tumor, evidence of lymph node involvement as well as the type of breast cancer.
Some specific types of breast cancer are more likely to respond to neoadjuvant chemotherapy, Dr. Moore says.
Unless the tumor is very small and shows no lymph node involvement most patients with either triple-negative breast cancer or HER2-positive breast cancer will be candidates for chemotherapy either pre-operatively or post-operatively.
In the best cases, this therapy can completely eradicate all visible tumor from the breast, producing what is called a pathologic complete response. This means a pathologist finds no trace of the invasive tumor in the breast or lymph nodes after treatment.
Thats good news not only in the short term, but also over a patients lifetime as the presence of a complete response is generally associated with an excellent prognosis.
For patients who do not have a complete response to neoadjuvant chemotherapy, additional treatments can also be administered in the post-operative or adjuvant setting to improve long-term outcomes. In this way, treatments can be individualized. Often this means applying more intensive treatments to those at higher risk.
How Do Anthracyclines Work
Youâll usually get anthracyclines through injections or through an intravenous infusion. The stage of your breast cancer will affect the dose of the medication and how long youâll need to be on it.
After you have surgery to remove early-stage breast cancer, your doctor may give you chemotherapy to get rid of any breast cancer cells that may be left in your body. This can help lower the risk of the cancer coming back. Experts refer to post-surgery chemotherapy as âadjuvantâ chemotherapy.
Anthracyclines are a specific class of medications for adjuvant chemotherapy. They disrupt the enzymes that copy DNA during a cellâs life. These antibiotics bind with DNA so that it canât make copies of itself. That stops cells from reproducing. Your doctor might have you take them alone or in combination with other chemotherapy drugs.
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What To Expect After Chemo
Once youâre home, you need to take care of yourself and take steps to manage chemo side effects. These include:
- Take medications the doctor prescribed for side effects.
- Stay away from anyone with a cold or infection — chemo makes it harder for your body to fight germs.
- Drink lots of fluids for the first 8 hours to move the medicine through your body.
- Manage bodily fluids and waste that may have traces of chemo. Usually, this means flushing the toilet twice.
Youâll see your doctor every 4 to 6 months for the next 5 years after treatment ends.
Choosing A Chemo Combination
Your doctor will probably talk to you about combining different chemo drugs. They may refer to them by abbreviations for their names. Some of the most common include:
- AC: Adriamycin and Cytoxan
- CMF: Cytoxan, methotrexate, and fluorouracil
- FAC: Fluorouracil, Adriamycin, and Cytoxan
- CAF: Cytoxan, Adriamycin, and fluorouracil
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Plan On Having A Support Buddy
Some people plan on driving themselves to chemo if their first infusion goes well. Yet there are many reasons why it’s beneficial to have a chemo buddy who can drive you, take notes and help ask questions, and keep you company through your infusion.
There is a lot of information to digest at each visit, and having a friend with you doubles your chance that you won’t miss anything. Sometimes a chemo buddy is better able to detect if you have a reaction to the chemo drugs and can point this out to you early on.
The emotional support of having a friend can’t be understated. Even if you and your friend each read a book, watch a movie, and don’t talk, the presence of another person can lift your spirits. In our fast-paced world, we seldom have time to simply sit and talk with a friend for a few hours. Chemotherapy offers this opportunity.
When Is Chemotherapy Used To Treat Early
The first treatment for early-stage breast cancer usually includes surgery and sometimes radiation. Your doctor may also talk to you about added treatment, such as chemotherapy and hormone therapy, that may help keep cancer from coming back.
It isnt possible for all women to know for sure who will benefit from added treatment. But if you have early-stage, estrogen receptor positive breast cancer with no cancer in the lymph nodes, you may have a gene test. Gene tests, such as the Oncotype DX, may be done on the cancerous tissue that was removed to look for tumor markers. These tests can give your doctor important information about whether chemotherapy will help you.
The type of added treatment you have depends on the stage and classification of your breast cancer:
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