How Often Is Chemotherapy Given For Breast Cancer
Chemotherapy for breast cancer is given in cycles, usually 2 to 3 weeks long, with a short break in between. This gives the body time to recover after receiving chemotherapy. Some chemotherapy is only given on one day per cycle, while others are given on multiple days per cycle. For example, gemcitabine is often given on day 1, day 8, and day 15 of an overall 28-day treatment cycle .
A chemotherapy schedule depends on the type of chemotherapy medications given. Chemotherapy is usually given over 3 to 6 months, or longer in some cases, depending on the type and stage of breast cancer. If you experience bothersome side effects or the treatment is no longer working, you may need to switch treatment to a different chemotherapy or therapy option.
Which Cancer Has Highest Recurrence Rate
Some cancers are difficult to treat and have high rates of recurrence. Glioblastoma, for example, recurs in nearly all patients, despite treatment. The rate of recurrence among patients with ovarian cancer is also high at 85%.Related Articles. Cancer Type Recurrence Rate Glioblastoma 2 Nearly 100%.
How Will I Know If My Chemotherapy Is Working
You will see your doctor often. During these visits, she will ask you how you feel, do a physical exam, and order medical tests and scans. Tests might include blood tests. Scans might include MRI, CT, or PET scans.
You cannot tell if chemotherapy is working based on its side effects. Some people think that severe side effects mean that chemotherapy is working well, or that no side effects mean that chemotherapy is not working. The truth is that side effects have nothing to do with how well chemotherapy is fighting your cancer.
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Dont Plan Your Chemo Response Until Youve Gone Through Your First Infusion
My reaction to a cancer diagnosis was to dive into what my husband calls âbiblio-therapy.â As a journalist, I researched it to death. As I drove to my first infusion, I felt armed with information to vanquish chemo. Iâd planned out everything.
I was sure Iâd get sick immediately. Instead, I went home from chemo and had dinner with friends. The second day, I felt tired. The third day, I felt completely sick and immobilized. That lasted for 3 or 4 days. Then, gradually, I got better. When I felt almost normal again, it was time for the next infusion.
I expected to throw up all the time but hardly did. I didnât expect chemo brain, but my thinking got so fuzzy, I could barely read a book. I imagined that I would end up in the hospital at some point during treatment, but I didnât.
Everyoneâs pattern is a little different. Wait to see what yours is before you make a lot of plans.
Sex Contraception And Pregnancy
You can still have sex during treatment. Its thought that chemotherapy drugs cant pass into vaginal fluids or semen, but this cant be completely ruled out as chemotherapy drugs can pass into the blood and some other body fluids. Most treatment teams will advise using barrier methods of contraception, such as condoms during treatment, and for a few days after chemotherapy is given.
If you havent been through the menopause, its important to use contraception because chemotherapy drugs can harm a developing baby in the first three months of pregnancy. Its still possible to become pregnant even if your periods become irregular or stop completely.
Your specialist will usually recommend barrier methods of contraception, such as condoms. The contraceptive pill is not usually recommended because it contains hormones. Emergency contraception such as the morning after pill can still be used.
An interuterine device can be used as long as its not the type that releases hormones. If you have a coil in place that does release hormones, such as the Mirena or Jaydess, when youre diagnosed, you may be advised to have this removed.
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Common Chemotherapy Drugs For Breast Cancer
Chemotherapy drugs used to treat early breast cancer include:
How Is Chemotherapy Given
Chemotherapy may be given in several different ways, which are discussed below.
Intravenous chemotherapy. Many drugs require injection directly into a vein. This is called intravenous or IV chemotherapy. Treatment takes a few minutes to a few hours. Some IV drugs work better if you get them over a few days or weeks. You take them through a small pump you wear or carry. This is called continuous infusion chemotherapy.
Oral chemotherapy. You can take some drugs by mouth. They can be in a pill, capsule, or liquid. This means that you may be able to pick up your medication at the pharmacy and take it at home. Oral treatments for cancer are now more common. Some of these drugs are given daily, and others are given less often. For example, a drug may be given daily for 4 weeks followed by a 2-week break.
Injected chemotherapy. This is when you receive chemotherapy as a shot. The shot may be given in a muscle or injected under the skin. You may receive these shots in the arm, leg, or abdomen. Abdomen is the medical word for your belly.
Chemotherapy into an artery. An artery is a blood vessel that carries blood from your heart to another part of your body. Sometimes chemotherapy is injected into an artery that goes directly to the cancer. This is called intra-arterial or IA chemotherapy.
Topical chemotherapy. You can take some types of chemotherapy in a cream you put on your skin. You get your medication at the pharmacy and take it at home.
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How Long Does Chemo Prolong Life In Lung Cancer
Chemotherapy may prolong life in some lung cancer patients. According to a study reported in the Journal of the American Medical Association that looked at the role of chemotherapy at the end of life, chemo for some patients with a specific type of lung cancer prolonged their lives by two to three months.
What Are Some Common Chemotherapy Combinations Used In Breast Cancer
Chemotherapy regimens usually have acronyms to help simplify what theyre called. They can also include other medications like HER2 target therapy, discussed below. A few examples of some common breast cancer chemotherapy regimens are:
AC T: Doxorubicin and cyclophosphamide followed by paclitaxel
AC T: Doxorubicin and cyclophosphamide followed by docetaxel
AC THP: Doxorubicin and cyclophosphamide followed by paclitaxel, trastuzumab, and pertuzumab
TC: Docetaxel and cyclophosphamide
TAC: Docetaxel, doxorubicin, and cyclophosphamide
CMF: Cyclophosphamide, methotrexate, and fluorouracil
TCHP: Docetaxel, carboplatin, trastuzumab, and pertuzumab
These acronyms consist of the first letter of each medications name in the regimen, but it varies if the first letter refers to the medications brand or generic name. For example in the TC regimen the letter T refers to Taxotere, which is the brand name of docetaxel. The C refers to cyclophosphamide.
These medications are discussed individually below.
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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.
Why Isnt A Cure The Goal
It can be painful and shocking when you come to understand the differences between what chemotherapy may offer for early-stage breast cancer and what it may accomplish for metastatic breast cancer.
It is not that healthcare providers dont want to attempt to cure advanced breast cancer with chemotherapy. They do. Its just that with the drugs we currently have, and the resistance which develops over time, the odds of chemotherapy curing an advanced cancer are very low. This is true even if you are treated with extremely high doses of several powerful drugs.
According to studies, many people who have breast cancer are expecting that chemotherapy will cure their metastatic cancer. There are some cancers that respond and continue to respond to chemotherapy for a long time. Still, its important to understand what chemotherapy can and cant do with the drugs we currently have.
If you are still hoping for a cure, talk to your healthcare provider. At this time there are not any approved medications that can cure metastatic breast cancer, though new medications are always being evaluated in clinical trials. For a few people, some of these newer medications, such as immunotherapy drugs, may offer a greater chance for long-term survivalbut we dont know for sure, and that is why they’re being studied.
Breast Cancer Healthcare Provider Discussion Guide
Get our printable guide for your next healthcare provider’s appointment to help you ask the right questions.
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Changes In Bowel Habit
Chemotherapy drugs and the anti-nausea drugs used with them may cause diarrhoea or constipation. Constipation is an annoyance but can usually be easily managed with laxatives. Diarrhoea is sometimes an important warning sign that develops with particular chemotherapy drugs. If you get diarrhoea you should let your oncologist or nurse know. You will be given specific advice about how to manage it.
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.
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Which Chemotherapy To Use In Early Breast Cancer
The successful history of adjuvant chemotherapy in early breast cancer started almost 4 decades ago when Bonadonna et al. in 1976 published the first report on the efficacy of cyclophosphamide, methotrexate, and fluorouracil as adjuvant treatment for node-positive breast cancer.
Later trials showed that substitution of methotrexate with epirubicin was even more efficacious both in terms of DFS and OS in premenopausal women with axillary node-positive breast cancer . The advantage of anthracycline-containing 3-drug combinations over CMF was unequivocally confirmed in an individual-patient data meta-analysis of the Early Breast Cancer Trialists Collaborative Group . Altogether, 100,000 patients in 123 randomized trials were included. Anthracycline-based regimens with substantially higher cumulative dosage than standard 4 × AC or CEF) were superior to standard CMF 0.78 p = 0.0004).
What Happens During Chemotherapy For Breast Cancer
Most people receive chemotherapy for breast cancer through one of their veins . You may receive chemotherapy as one short injection or as an infusion. Infusions last longer and usually take place in a hospital or specialized infusion center.
When you get to the infusion center, your nurse administers your chemotherapy drugs and any additional medications you need. For example, you may also receive an anti-nausea medication before the chemotherapy drugs.
During the infusion:
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What Damage Does Chemotherapy Do To The Body
Chemotherapy can cause fatigue, loss of appetite, nausea, bowel issues such as constipation or diarrhoea, hair loss, mouth sores, skin and nail problems. You may have trouble concentrating or remembering things. There can also be nerve and muscle effects and hearing changes. You will be at increased risk of infections.
Increased Risk Of Leukemia
Very rarely, certain chemo drugs, such as doxorubicin , can cause diseases of the bone marrow, such as myelodysplastic syndromes or even acute myeloid leukemia, a cancer of white blood cells. If this happens, it is usually within 10 years after treatment. For most women, the benefits of chemo in helping prevent breast cancer from coming back or in extending life are far likely to exceed the risk of this rare but serious complication.
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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
How Chemotherapy Is Given
Many chemotherapy drugs for breast cancer are given in liquid form, as intravenous infusions or injections , but some are available as pills or tablets.
Some drugs may be given alone, and other drugs are combined to work together. When chemo drugs are given in combination, the treatment is called a regimen.
Some of the common regimens are:
- AC: Adriamycin and Cytoxan
- ACT: Adriamycin and Cytoxan followed by a Taxol or Taxotere
- ECT: Epirubicin and Cytoxan followed by a Taxol or Taxotere
- CAF: Cytoxan, Adriamycin, and 5-FU
- CEF: Cytoxan, Ellence, and 5-FU
- CMF: Cytoxan, Trexall , and 5-FU
- TC: Taxotere and Cytoxan
- TAC: Taxotere, Adriamycin, and Cytoxan
Several types of targeted therapies have been approved for many cancer types, including breast cancer. For example, a therapy that targets the HER2 receptor is an antibody treatment called trastuzumab.
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Will I Be Able To Work While I Am Having Treatment
Most women are able to continue working during chemotherapy if they wish to. If you plan to keep working, it helps to have a supportive work place that gives you flexible work hours. You may need to have a few days off after each cycle of chemotherapy and when you get back to work you may find it difficult to work long hours. Your doctor can provide a medical certificate for time off this can be just a few days or a few months depending on your individual situation.
Which Types Of Cancer Does Chemotherapy Treat
Chemotherapy is used to treat many types of cancer. For some people, chemotherapy may be the only treatment you receive. But most often, you will have chemotherapy and other cancer treatments. The types of treatment that you need depend on the type of cancer you have, if it has spread and where, and if you have other health problems.
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What Is The Success Rate Of Chemotherapy For Lung Cancer
There are two types of lung cancer: small-cell and non-small cell . Around 13% of lung cancers are small-cell. Most people with this type receive chemotherapy.Lung cancer. N-SC lung cancer stage Treatment choice Early stage Late stage Surgery plus chemo and/or radiotherapy 16% 7% Chemo alone 1% 18%.
Is Early Menopause A Risk Of Chemotherapy For Breast Cancer
Yes. If you have not gone through menopause, chemotherapy may stop your ovaries from producing estrogen. You may go into early menopause. If you want to have children in the future, discuss the risks of infertility with your healthcare provider.
Some womens ovaries begin working again after chemotherapy treatment. Women who want to bear children in the future may also choose fertility preservation before starting chemotherapy.
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Effects On Appetite And Sense Of Smell
Sometimes chemotherapy causes you to lose your appetite. Food may taste different to you and some chemicals interact badly with certain foods, though both loss of appetite and chemical interaction are less common with breast cancer drugs than with others. You may also experience sensitivity to peculiar odors. The National Cancer Institute publishes a helpful booklet for people whose eating is affected by their chemotherapy.
Treating Stage Iii Breast Cancer
In stage III breast cancer, the tumor is large or growing into nearby tissues , or the cancer has spread to many nearby lymph nodes.
If you have inflammatory breast cancer: Stage III cancers also include some inflammatory breast cancers that have not spread beyond nearby lymph nodes. These cancers are treated slightly different from other stage III breast cancers. You can find more details in Treatment of Inflammatory Breast Cancer.
There are two main approaches to treating stage III breast cancer:
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