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How Many Rounds Of Chemo Is Normal For Breast Cancer

Physical Emotional And Social Effects Of Cancer

My First Week of Chemotherapy (breast cancer)

In general, cancer and its treatment cause physical symptoms and side effects, as well as emotional, social, and financial effects. Managing all of these effects is called palliative care or supportive care. It is an important part of your care that is included along with treatments intended to slow, stop, or eliminate the cancer.

Supportive care focuses on improving how you feel during treatment by managing symptoms and supporting patients and their families with other, non-medical needs. Any person, regardless of age or type and stage of cancer, may receive this type of care. And it often works best when it is started right after a cancer diagnosis. People who receive supportive care along with treatment for the cancer often have less severe symptoms, better quality of life, and report that they are more satisfied with treatment.

Supportive care treatments vary widely and often include medication, nutritional changes, relaxation techniques, emotional and spiritual support, and other therapies.

  • Music therapy, meditation, stress management, and yoga for reducing anxiety and stress.

  • Meditation, relaxation, yoga, massage, and music therapy for depression and to improve other mood problems.

  • Meditation and yoga to improve general quality of life.

  • Acupressure and acupuncture to help with nausea and vomiting from chemotherapy.

Treatment Of Breast Cancer Stages I

The stage of your breast cancer is an important factor in making decisions about your treatment.

Most women with breast cancer in stages I, II, or III are treated with surgery, often followed by radiation therapy. Many women also get some kind of systemic drug therapy . In general, the more the breast cancer has spread, the more treatment you will likely need. But your treatment options are affected by your personal preferences and other information about your breast cancer, such as:

  • If the cancer cells have hormone receptors. That is, if the cancer is estrogen receptor -positive or progesterone receptor -positive.
  • If the cancer cells have large amounts of the HER2 protein
  • How fast the cancer is growing
  • Your overall health
  • If you have gone through menopause or not

Talk with your doctor about how these factors can affect your treatment options.

Chemo Drugs For Breast Cancer That Has Spread

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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What Are The Side Effects Of Chemotherapy For Breast Cancer

Chemotherapy side effects vary based on what kind of drugs you take and for how long. Common chemotherapy side effects include:

During chemotherapy treatment, many people still work, exercise and care for their families. For others, the treatment can be exhausting and time-consuming. It may be difficult to keep up with usual activities.

Speak with your healthcare provider about the risks and benefits of chemotherapy. You may manage side effects with supportive medications, such as anti-nausea drugs. Chemotherapy side effects generally go away after you finish treatment.

Lymphocyte Subtypes Show Differential Depletion And Recovery After Chemotherapy

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In order to understand better the effects of chemotherapy on the adaptive immune system, we conducted a longitudinal investigation of lymphocyte levels and phenotypes before and at time-points from 2 weeks to 9 months after the end of chemotherapy. 88 patients treated with chemotherapy for primary breast cancer were included and extensive clinico-pathological data concerning the patients were collected . Levels of peripheral blood B cells, CD4+ T cells, CD8+ T cells, and NK cells were determined and are presented as absolute levels , and as levels relative to the matched pre-chemotherapy level for each patient .

Fig 1

Lymphocyte subtypes show differential depletion and recovery after chemotherapy. Absolute numbers of the lymphocyte subgroups shown were determined by multi-parameter flow cytometry on peripheral blood samples taken from 88 breast cancer patients either before chemotherapy or at various time-points after the end of chemotherapy . Data are shown as absolute counts or relative to the matched pre-chemotherapy level . Boxes represent 50 % of the data, with medians , interquartile ranges and individual outliers . * p< 0.001 ns not significant

Fig 2

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Factors Influencing How Quickly Breast Cancer Tumors Grow

Several factors may influence how quickly breast cancer tumors grow. These factors include:

  • Your age. People under 40 are likely to have more aggressive breast cancer.
  • Menopause status. If you havent completed menopause, the hormones of menstruation may impact cancer growth.
  • History of breast cancer. A family or personal history of this cancer may increase the risk of an aggressive type.
  • The type of breast cancer. Some types are more aggressive than others.
  • Hormone treatment. If you had hormone replacement therapy with menopause, the chances of an aggressive form of cancer are higher.

When To Use Chemotherapy In Early Breast Cancer

It is evident that the magnitude of chemotherapy benefit depends on the level of risk of the individual patient . In order to avoid both over- and undertreatment, it is advisable to select the appropriate treatment strategy on the basis of a careful risk assessment for each individual patient. According to the most recent St. Gallen consensus recommendations, conventional clinicopathological factors arguing for the indication of chemotherapy were histological grade 3 carcinomas, high Ki-67 levels, low hormone receptor status, human epidermal growth factor receptor 2 positivity or triple-negative status, and the involvement of more than 3 lymph nodes . In addition to these time-honored clinicopathological factors, a plethora of novel prognostic and predictive factors has emerged over the last decades. To improve the quality of research on biomarkers, a refined system for biomarker study design and evaluation was introduced that incorporates a revised level of evidence scale for tumor marker studies, including those using archived specimens 1) . Although fully prospective randomized clinical trials to evaluate the medical utility of a prognostic or predictive biomarker are still considered the gold standard, such trials are costly so, more efficient indirect prospective-retrospective designs using archived specimens might reach LoE I if validated with consistent results.

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How Long Is A Cycle Of Chemo

Chemotherapy often involves several sessions or cyles of treatment. A cycle of chemotherapy is the amount of time that elapses between the start of one round of chemotherapy to the start of the next.

Cancer Research UK states that it is very important for a person to receive their chemotherapy treatment in cycles. While chemotherapy drugs kill cancer cells, they also kill fast-growing healthy cells within the body. Receiving chemotherapy in cycles helps to effectively kill off the cancerous cells, while allowing the persons body time to replenish its healthy cells.

A single course of chemotherapy will typically involve four to eight chemotherapy cycles. For instance, a 4-week cycle could involve someone taking medications on the first, second and third days, then no further medication until the 29th day.

A doctor will decide the length and structure of a persons chemotherapy cycles.

Chemotherapy treatment typically lasts between 36 months. However, some people will receive chemotherapy for shorter or longer periods of time.

Sex Contraception And Pregnancy

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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.

Find out more about how breast cancer and its treatment can affect sex and intimacy and read our tips on how to manage these changes.

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Possible Side Effects Of Chemo For Breast Cancer

Chemo drugs can cause side effects, depending on the type and dose of drugs given, and the length of treatment. Some of the most common possible side effects include:

  • Hot flashes and/or vaginal dryness from menopause caused by chemo

Chemo can also affect the blood-forming cells of the bone marrow, which can lead to:

  • Increased chance of infections
  • Easy bruising or bleeding

These side effects usually go away after treatment is finished. There are often ways to lessen these side effects. For example, drugs can be given to help prevent or reduce nausea and vomiting.

Other side effects are also possible. Some of these are more common with certain chemo drugs. Ask your cancer care team about the possible side effects of the specific drugs you are getting.

Nausea Vomiting And Taste Changes

You may experience nausea and vomiting after your last chemotherapy treatment. It should go away in 2 to 3 weeks.

Your appetite may continue to be affected due to taste changes you may have experienced during your treatment. Your taste should go back to normal 1 to 2 months after chemotherapy. In the meantime, there are things you can do to help with these changes. Talk with your nurse if youd like more information.

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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.

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.

How Many Chemo Treatments Are Required For Breast Cancer

What Breast Cancer Taught Me

The cycle for chemotherapy can vary from once a week to once every three weeks. Each treatment session is followed by a period of recovery. Typically, if you have early-stage breast cancer, youll undergo chemotherapy treatments for three to six months, but your doctor will adjust the timing to your circumstances.

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How Many Chemo Treatments For Breast Cancer

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Youve Been Diagnosed With Breast Cancer How Soon Do You Need Treatment

Timely surgery for breast cancer is obviously better than delaying surgery, but how long can a patient safely wait for surgery once diagnosed. Because a randomized controlled clinical trial to answer this question would be unethical, this has been a difficult question to answer. Fortunately, a new study provides an estimate of how much of a delay it takes before outcomes start to suffer.

A new year is upon us yet again, and Science-Based Medicine has been in existence for eight years now. It seems only yesterday that Steve Novella approached me to ask me to be a contributor. Our part-serious, part-facetious predictions for 2016 notwithstanding, one thing about 2016 is certain: I will almost certainly encounter some form of cancer quackery or other and deconstruct it, probably multiple forms. In any case, a topic Ive been meaning to write about is based on a couple of studies that came out three weeks ago that illustrate why, even if a patient ultimately comes around to science-based treatment of his cancer, the delay due to seeking out unscientific treatments can have real consequences.

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Stage Iv Breast Cancer Treatment

Once the cancer has moved to this stage, its considered incurable. However, there are treatments that can shrink tumors, slow the growth of cancerous cells, improve symptoms and help prolong life. The main treatment for metastatic cancer is usually a combination of systematic or drug therapies such as hormone, chemo and targeted. Surgery and/or radiation may also be recommended to prevent, treat and/or address complications caused by the cancer. Many choose to continue treatment until the cancer stops responding to treatment, they dont feel the treatment-related side effects are worth it or various other personal reasons.

Side Effects And Complications

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All treatments have some side effects that range from mild to severe. Most clear up when treatment ends, but there can be some lasting complications.

Its important to tell your oncologist about all symptoms, even if they seem minor. Your healthcare team will work with you to ease side effects and deal with complications.

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Common Side Effects Of Ac Chemotherapy

Like any treatment, AC chemotherapy can cause side effects. Everyone reacts differently to drugs and some people have more side effects than others. These side effects can usually be managed and those described here will not affect everyone.

If youre concerned about any side effects, regardless of whether they are listed here, talk to your chemotherapy nurse or cancer specialist as soon as possible.

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.

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Take Advantage Of Patient Navigators

Though intuition would tell us that people who are insured would experience shorter delays before surgery, that doesnt appear to be true. A large 2019 study in PLoS One looked at over 1.3 million people to see how time to initial treatment affected survival. In this study, they found that with early stage breast cancer, waiting more than 35 days between diagnosis and surgery reduced survival rates. Surprisingly, uninsured people had faster times to initiation of treatment.

While the reasons werent certain, it was thought that perhaps those who were insured lost precious time going through prior authorization procedures for diagnostic tests and treatment. Difficulty navigating the maze of large treatment centers may also be at play, and the authors made mention of recent clinical trials showing patient navigation could have a beneficial effect on assuring timely cancer care.

Possible Cause Breast Tissue Changes

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Breast tissue has natural lumps and bumps that you may feel, and you might just be more likely than others to develop lumps in your breasts.

If you feel the same lumpiness in both breasts, or there isnt one lump thats firmer than the others, its most likely your normal breast tissue. That said, if you find a lump that feels harder, in only one breast, or one that just feels different than what you usually feel, address it with your doctor.

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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

Menstrual Changes And Fertility Issues

For younger women, changes in menstrual periods are a common side effect of chemo. Premature menopause and infertility may occur and could be permanent. If this happens, there is an increased risk of heart disease, bone loss, and osteoporosis. There are medicines that can treat or help prevent bone loss.

Even if your periods stop while you are on chemo, you may still be able to get pregnant. Getting pregnant while on chemo could lead to birth defects and interfere with treatment. If you have not gone through menopause before treatment and are sexually active, its important to discuss using birth control with your doctor. It is not a good idea for women with hormone receptor-positive breast cancer to take hormonal birth control , so its important to talk with both your oncologist and your gynecologist about what options would be best for you. When women have finished treatment , they can safely go on to have children, but it’s not safe to get pregnant while being treated.

If you think you might want to have children after being treated for breast cancer, talk with your doctor soon after being diagnosed and before you start treatment. For some women, adding medicines, like monthly injections with a luteinizing hormone-releasing hormone analog, along with chemo, can help them have a successful pregnancy after cancer treatment. To learn more, see Female Fertility and Cancer.

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