Types Of Targeted Therapies
There are several different types of targeted therapies available for the treatment of breast cancer.
Trastuzumab and pertuzumab are the two most common monoclonal antibodies used to treat HER2-positive breast cancer. These medications are typically administered through an IV infusion and are used in combination with chemotherapy.
After chemotherapy has finished, treatment with medications like Herceptin generally continues every 3 weeks over a total period of 1 year.
Neratinib is another type of targeted therapy, which is taken orally and is designed to help prevent the recurrence of HER2-positive breast cancer for patients whove completed 1 year of Herceptin.
Other drugs like lapatinib and tucatinib , both oral medications, and ado-trastuzumab emtansine , which is administered through an IV, are also available for the treatment of advanced HER2-positive breast cancer.
For Metastatic Breast Cancer
Chemo can be used as the main treatment for women whose cancer has spread outside the breast and underarm area to distant organs like the liver or lungs. Chemo can be given either when breast cancer is diagnosed or after initial treatments. The length of treatment depends on how well the chemo is working and how well you tolerate it.
How Breast Cancer Is Treated
In cancer care, doctors specializing in different areas of cancer treatmentsuch as surgery, radiation oncology, and medical oncologywork together with radiologists and pathologists to create a patients overall treatment plan that combines different types of treatments. This is called a multidisciplinary team. Cancer care teams include a variety of other health care professionals, such as physician assistants, nurse practitioners, oncology nurses, social workers, pharmacists, counselors, nutritionists, and others. For people older than 65, a geriatric oncologist or geriatrician may also be involved in their care. Ask the members of your treatment team who is the primary contact for questions about scheduling and treatment, who is in charge during different parts of treatment, how they communicate across teams, and whether there is 1 contact who can help with communication across specialties, such as a nurse navigator. This can change over time as your health care needs change.
A treatment plan is a summary of your cancer and the planned cancer treatment. It is meant to give basic information about your medical history to any doctors who will care for you during your lifetime. Before treatment begins, ask your doctor for a copy of your treatment plan. You can also provide your doctor with a copy of the ASCO Treatment Plan form to fill out.
Learn more about making treatment decisions.
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What To Expect During Chemotherapy Treatment
Some chemotherapy medicines for breast cancer can be taken orally as pills. But most chemotherapy medicines are given as an infusion into a vein through an IV, a port, or a catheter over a period of time.
Chemotherapy is given in cycles a period of treatment followed by a period of recovery. One cycle may include chemotherapy on the first day and then three weeks of recovery with no treatment.
A chemotherapy treatment regimen is made up of several cycles. The number of cycles in a regimen and the total time it takes to complete one regimen depends on the chemotherapy medicines you receive. But most regimens take three to six months to complete.
In some cases, if the cancer is considered aggressive, doctors may recommend a dose-dense chemotherapy regimen. Dose-dense chemotherapy means there is less time between cycles say every two weeks instead of every three weeks.
Ovarian Ablation Or Suppression
In women who have not yet experienced the menopause, oestrogen is produced by the ovaries.
Ovarian ablation or suppression stops the ovaries working and producing oestrogen.
Ablation can be done using surgery or radiotherapy. It permanently stops the ovaries from working and means youll experience the menopause early.
Ovarian suppression involves using a medicine called goserelin, which is a luteinising hormone-releasing hormone agonist .
Your periods will stop while youre taking it, although they should start again once your treatment is complete.
If youre approaching the menopause , your periods may not start again after you stop taking goserelin.
Goserelin comes as an injection you have once a month.
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Possible Side Effects Of Chemotherapy
Chemo drugs can cause side effects. These depend on the type and dose of drugs given, and the length of treatment. Some of the most common side effects of chemo include:
- Nausea and vomiting
Chemo can also affect the blood-forming cells of the bone marrow, which can lead to:
- Increased chance of infection
- Easy bleeding or bruising
Other side effects are also possible. Some of these are more common with certain chemo drugs. For example:
Most of these side effects tend to go away after treatment is finished. Some, such as hand and foot numbness, may last for a long time. There are often ways to lessen these side effects. For example, you can be given drugs to help prevent or reduce nausea and vomiting.
Be sure to discuss any questions about side effects with your cancer care team. Report any side effects or changes you notice while getting chemo right away so that they can be treated promptly. In some cases, the doses of the chemo drugs may need to be reduced or treatment may need to be delayed or stopped to prevent the effects from getting worse.
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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Long Term Side Effects Of Chemotherapy For Breast Cancer
Bone density loss is one of the side effects of chemotherapy for breast cancer patients due to premature menopause like state. There is increased risk of fractures and bone density loss should be measured periodically and treated to avoid any serious damage.
The nerve damage results in numbness or tingling sensation. Most of the times the nerves recover and the symptoms disappear after finishing chemotherapy but sometimes these can stay for a very long time.
4. Damage to the Heart
Some chemotherapy medicines can damage the heart muscles and this damage can be permanent. The most common drugs causing this side effect are epirubicin and trastuzumab , especially in high doses.
5. Effects on Cognitive Function
6. Higher Risk of Infections
Some infections require antibiotics and to increase the number of white blood cells rapidly, G-CSF or GM-CSF can be prescribed.
7. Other Side Effects
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What Are The Health Problems That Affect Chemo
Certain health problems, such as heart disease or diabetes, may affect which drugs are selected for your chemotherapy. Hormone receptor status. If your cancer cells have receptors for the hormones estrogen and progesterone, your doctor may recommend hormone therapy in addition to chemotherapy. HER2 status.
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What Is The Treatment For Breast Cancer
Chemotherapy may also be given as the main treatment for women whose cancer has spread to other parts of the body outside of the breast and lymph nodes. This spread is known as metastatic breast cancer and occurs in a small number of women at the time of diagnosis or when the cancer recurs some time after initial treatment for localized breast
How Long Do Side Effects Last
Many side effects go away fairly quickly, but some might take months or even years to go away completely. These are called late effects.
Sometimes the side effects can last a lifetime, such as when chemo causes long-term damage to the heart, lungs, kidneys, or reproductive organs. Certain types of chemo sometimes cause delayed effects, such as a second cancer that may show up many years later.
People often become discouraged about how long their treatment lasts or the side effects they have. If you feel this way, talk to your cancer care team. You may be able to change your medicine or treatment schedule. They also may be able to suggest ways to reduce any pain and discomfort you have.
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Are There Any Lasting Side Effects Of Chemotherapy
Sometimes people do experience problems that may not go away. For example, some of the drugs used for breast cancer may weaken the heart. Your doctor may check your heart before, during, and after treatment. A rare side effect of chemotherapy is that occasionally, years after treatment, a few women have developed leukemia .Some chemotherapy drugs can damage the ovaries. If you have not gone through menopause yet, you may have hot flashes and vaginal dryness. Your menstrual periods may no longer be regular or they may stop. You may become infertile .
Feeling Unwell Or Tired
Many women do not feel as healthy after chemo as they did before. There is often a residual feeling of body pain or achiness and a mild loss of physical functioning. These changes may be very subtle and happen slowly over time.
Fatigue is another common problem for women who have received chemo. This may last a few months up to several years. It can often be helped, so its important to let your doctor or nurse know about it. Exercise, naps, and conserving energy may be recommended. If you have sleep problems, they can be treated. Sometimes fatigue can be a sign of depression, which may be helped by counseling and/or medicines.
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Swelling In The Arms And Legs
Swelling or fluid retention may occur, particularly in the arms and/or legs. Swelling is most common in the feet and ankles due to the effects of gravity. This side effect is most common with the use of some taxane chemotherapy drugs.Arm and leg swelling caused by chemotherapy is not the same as lymphoedema and rarely requires any specific treatment. However, treatment may be prescribed if the swelling is severe.The risk of arm or leg swelling can be reduced by giving another medication before chemotherapy. Symptoms will slowly improve once treatment is over.
Some women feel vague or mildly confused or have memory problems while having chemotherapy. This is sometimes called chemo brain or chemo fog. Symptoms can last for some months after treatment is over.The causes of these feelings are being studied.
Is It Normal To Worry About Chemotherapy
Easing worries about chemotherapy. Its normal to worry about possible side effects of chemotherapy. Talk with your health care provider about your concerns. Your provider may be able to suggest a hospital social worker, patient navigator, psychologist or support group to help ease anxiety related to chemotherapy .
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Will My Menstrual Flow Be Different After Chemotherapy
Menstrual cycles vary from woman to woman. Some women may experience less frequent cycles than they had prior to chemotherapy. They may skip a period or increase the number of days between periods. Other women may have more frequent periods.
Some women may not experience a change in the length of their menstrual cycles but the flow pattern may be different than it was before treatment . Mixed patterns are also common: some women may have shorter menstrual cycles with heavier bleeding, or infrequent cycles with many days of a very high flow.
Even though periods tend to be irregular around the time of menopause, it is important to be aware of bleeding that is not normal for you. It is very important to call your physician if you ever have very heavy bleeding that is associated with weakness or dizziness.
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How Is Breast Cancer Chemotherapy Administered
Chemotherapy is commonly prescribed along with other treatment methods such as hormonal and targeted therapies. It can also be used to shrink a tumor before surgery for easier and safer removal, referred to as neoadjuvant chemotherapy.If you receive chemotherapy, your doctor will administer it in short courses with several weeks in between to allow your normal cells to recover. This treatment period can be a challenging time emotionally and physically. It is important for you to develop a support team of family or friends that can help comfort and encourage you in this time.
Tips To Improve Cognitive Function
Although no studies show the tips below improve cognitive function, they may help some people with memory problems .
Tips to improve cognitive function
Adapted from National Cancer Institute materials .
The Impact Of Breast Cancer Treatment On Your Long
The late effects associated with breast cancer treatments. Antonio Wolff, M.D., medical oncologist at the Johns Hopkins Sydney Kimmel Comprehensive Cancer Center, encourages a relationship with a primary care doctor who is knowledgeable about these effects on breast cancer survivors and their long-term health care.
These long-term and late side effects may include:
- Pain and numbness
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How Many Days After Chemo Do You Feel Better
Many people feel fine for the first few hours following chemotherapy. Usually, some reaction occurs about four to six hours later. However, some people dont react until 12 or even 24 to 48 hours after treatment. Some people experience almost all of the side effects described below, while others experience almost none.
Possible Serious Side Effects With Herceptin Hylecta
Not all people have serious side effects, but side effects with HERCEPTIN HYLECTA therapy are common.
Although some people may have a life-threatening side effect, most do not.
Your doctor will stop treatment if any serious side effects occur.
HERCEPTIN HYLECTA is not for everyone. Be sure to contact your doctor if you are experiencing any of the following:
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Chemo Drugs For Breast Cancer That Has Spread
- Taxanes: Paclitaxel , docetaxel , and albumin-bound paclitaxel
- 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.
Early Menopause And Fertility
If youre hoping to have a child after breast cancer treatment, there are things you can do. Talk with a fertility specialist before starting treatment to discuss your options. Some options are described below.
The most common way to preserve fertility is to store eggs before chemotherapy begins.
In both procedures, some of your eggs are collected, frozen and stored. The eggs may be fertilized by sperm from a spouse, partner or donor. Or you may store unfertilized eggs, which dont require a sperm donor.
After treatment, the eggs can be thawed and implanted into the uterus.
Insurance coverage for fertility services varies from state to state. Check with your insurance company to find out whats covered.
Protecting the ovaries
There are no known treatments guaranteed to protect the ovaries from chemotherapy.
However, drugs that shut down the ovaries during chemotherapy may help women return to regular menstrual periods after treatment ends. This may help preserve fertility.
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What Is The Difference Between Neoadjuvant And Adjuvant
Adjuvant therapy: Adjuvant therapy refers to chemotherapy treatment after surgery to remove any remaining cancer cells and reduce the likelihood of the cancer regrowing . Neoadjuvant therapy: Neoadjuvant refers to treatment with chemotherapy before surgery to shrink the tumor and increase the odds of surgical success.
How Do We Know That Less Or No Chemotherapy Really Is Enough For Her2
Early in the 2000s, trastuzumab , a monoclonal antibody, was introduced to treat women with relatively advanced cases of HER2-positive breast cancer, and it was successful, Dr. Winer explains.
Suddenly, women with relatively advanced forms of breast cancerwith lymph node involvementwere doing exceptionally well, he says. So, then we asked ourselves: If you have a very small HER2-positive breast cancer and no lymph node involvement, do you still need such complex chemotherapy treatments? In a study published in the New England Journal of Medicine almost a decade ago, we demonstrated that one could give a limited course of chemotherapy along with trastuzumab and achieve outstanding results.
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