After Each Chemo Treatment
If necessary, your blood will be drawn after chemo. If your red counts 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
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- 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. If you’re dehydrated after a treatment, you can ask for an infusion of saline fluid. Other medications may be given along with the saline to help with nausea and vomiting.
Practical Hints For Nausea
- Eat a small, light meal before your chemotherapy appointment. Most people do better if they have something in their stomach.
- Eat what sounds good to you. In general, starches such as rice, bread, potatoes, hot cereals and puddings are well tolerated.
- Try not to skip meals. An empty stomach will worsen all symptoms. If you don’t feel like sitting down to a meal, try nibbling on something that appeals to you.
- Drink plenty of fluids. Herbal teas, water, sports drinks and diluted juices are recommended more than soda.
- Avoid unappealing smells.
- Freeze meals so you don’t have to cook. Ask your family and friends to help with meals, especially following chemotherapy when you are most likely to feel nauseated.
For more practical tips on dealing with nausea, schedule a free appointment with the dietitian by contacting the Patient and Family Cancer Support Center.
Questions To Ask The Doctor
- Do you know the stage of the cancer?
- If not, how and when will you find out the stage of the cancer?
- Would you explain to me what the stage means in my case?
- Based on the stage of the cancer, how long do you think Ill live?
- Do you know if my cancer has any of these proteins: estrogen receptor, progesterone receptor, or the HER2 protein?
- What does it mean if my cancer has any of these proteins?
- What will happen next?
There are many ways to treat breast cancer.
Surgery and radiation are used to treat cancer in a specific part of the body . They do not affect the rest of the body.
Chemotherapy, hormone treatment, targeted therapy, and immunotherapy drugs go through the whole body. They can reach cancer cells almost anywhere in the body.
Doctors often use more than one treatment for breast cancer. The treatment plan thats best for you will depend on:
- The cancer’s stage and grade
- If the cancer has specific proteins, like the HER2 protein or hormone receptors
- The chance that a type of treatment will cure the cancer or help in some way
- Your age
- Other health problems you have
- Your feelings about the treatment and the side effects that come with it
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What To Expect On Your First Day Of Chemotherapy
Chemotherapy. It’s not a word people want to hear and certainly not something they want to go through. But, for those of us with cancer, we often don’t have a choice. I remember how terrified I was of getting my first chemotherapy treatment. Would I be sick? Would I have a reaction to the medication? Would I be in a room by myself or with other chemo patients?I really didn’t know what to expect the first day. However, almost 4 years later, I feel like a pro.
Testing For Proteins And Genes
The breast cancer cells will be tested for certain proteins called estrogen and progesterone receptors. If the cancer has these proteins, it’s called a hormone receptor positive breast cancer. The cells are also tested to see if the cancer makes too much of the HER2 protein. If it does, it’s called a HER2-positive cancer. These cancers are sometimes easier to treat. If the cancer doesn’t test positive for any of these proteins, it’s called a triple-negative breast cancer.
The cells might also be tested for certain genes, which can help decide if chemo might be helpful and how likely it is that the cancer will come back. Ask your doctor to explain the tests they plan to do, and what the results might mean.
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Breast Cancer: Types Of Treatment
Have questions about breast cancer? Ask here.
ON THIS PAGE: You will learn about the different types of treatments doctors use for people with breast cancer. Use the menu to see other pages.
This section explains the types of treatments that are the standard of care for early-stage and locally advanced breast cancer. Standard of care means the best treatments known. When making treatment plan decisions, you are strongly encouraged to consider clinical trials as an option. A clinical trial is a research study that tests a new approach to treatment. Doctors want to learn whether the new treatment is safe, effective, and possibly better than the standard treatment. Clinical trials can test a new drug and how often it should be given, a new combination of standard treatments, or new doses of standard drugs or other treatments. Some clinical trials also test giving less treatment than what is usually done as the standard of care. Clinical trials are an option to consider for treatment and care for all stages of cancer. Your doctor can help you consider all your treatment options. Learn more about clinical trials in the About Clinical Trials and Latest Research sections of this guide.
Ask Questions About Each Drug
Every chemotherapy infusion includes a mix of drugs. Some are actually cancer-killing drugs, others are medications which help alleviate side effects. Ask questions about all of the drugs you receive, including:
- What is this medication?
- What side effects may it have?
- What will I feel like with this drug?
- How do I cope with this?
- Who do I call if I have problems with this?
- How does this help kill the cancer cells?
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What To Expect At Each Chemotherapy Visit
Each chemotherapy visit lasts 1-6 hours. This includes time with your medical and nursing teams.
At each visit, your blood counts will be checked.
You may be given anti-nausea medications and other treatments to reduce some side effects.
A friend or family member may be able to stay with you during the visit. You may also choose to read, listen to music, watch TV or sleep.
Before you begin chemotherapy, talk with your health care provider about possible side effects and whether you need to have someone drive you home after each visit.
Learn about long-term side effects of chemotherapy.
When Is Chemotherapy Given For Breast Cancer
Chemotherapy is sometimes given before surgery in order to shrink the tumor so it can be removed more easily or so that a lumpectomy can be performed instead of a mastectomy. When breast cancer is localized only to the breast or lymph nodes, chemotherapy may be given after a lumpectomy or mastectomy. This is known as adjuvant treatment and may help reduce the chance of breast cancer recurrence.
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 cancer.
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Increased Risk Of Leukemia
Very rarely, certain chemo drugs 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.
Chemotherapy Is An Individual Experience
Every person experiences chemotherapy differently, both physically and emotionally. Each person experiences side effects from chemotherapy differently, and different chemotherapy drugs cause different side effects. Fortunately, as the science of cancer treatment has advanced, so has the science of managing treatment side effects.
Whatever you experience, remember there is no relationship between how the chemotherapy makes you feel and whether you derive benefit from it.
Many people feel fine for the first few hours following chemotherapy. Usually, some reaction occurs about four to six hours later. However, some people don’t 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.
We have many treatments to help you deal with side effects. Please let us know how you are feeling so we can address your concerns and help make you more comfortable.
Your well-being is very important to us. There is a delicate balance between the benefits of chemotherapy and the harm of possible side effects. Please tell your doctor if you feel that the harm outweighs the benefit.
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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.
Increased Risk For Leukemia
Although rare, receiving chemotherapy can put you at higher risk for developing leukemia down the line. If this is the case, it usually appears within 10 years of receiving chemotherapy.
For most people, the benefits of receiving chemotherapy to help treat breast cancer outweigh the slight risk for developing leukemia.
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Physical Emotional And Social Effects Of 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.
Palliative 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 palliative 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.
Palliative treatments vary widely and often include medication, nutritional changes, relaxation techniques, emotional and spiritual support, and other therapies. You may also receive palliative treatments similar to those meant to get rid of the cancer, such as chemotherapy, surgery, or radiation therapy.
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.
Preparing For Lasting Side Effects
As chemotherapy destroys cancer cells, it also harms healthy cells. This includes cells in your digestive system and hair, along with cells that produce blood.
In turn, chemo can cause various side effects. Some side effects go away quickly, while other side effects can last longer than the actual treatment. These effects can last months or years.
This means that chemotherapy can technically take much longer beyond the treatment itself. Heres what you can do to prepare for these side effects in the long term:
If you need financial assistance with these forms of care, organizations like Cancer Financial Assistance Coalition and CancerCare may help.
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Longer Term Side Effects
Tiredness is commonly reported during treatment. This may be a direct effect of the drugs or may be due to other factors such as disrupted sleep patterns.
- Try to get adequate rest but also try to exercise regularly. Go for a walk outside each day as this can actually give you more energy.
- Find something that you actually enjoy doing and also try to incorporate exercise into your usual day, e.g. walk upstairs rather than taking the lift, park further away from where you want to go and walk the extra distance. Build this up gradually.
- Your GP, practice nurse or a physiotherapist can work with you to devise a specific exercise plan for you.
- Let others help when your energy levels are low.
If your fatigue doesn’t allow you to exercise, discuss this with your GP.
Usually energy levels recover after treatment finishes but this commonly takes time. In some cases full recovery may take 12 months or more.
Some people notice they are having concentration and short-term memory problems following their chemotherapy. This is often referred to as chemo brain. The severity and duration of symptoms differ from person to person. For some people the symptoms are very mild and resolve soon after treatment stops, but others may find their daily life is noticeably affected for a much longer period, restricting their ability to return to work in their pre-treatment capacity.
How Is Chemotherapy Used In Cancer Treatment Today
How chemotherapy is used in treatment depends on the type and stage of the cancer and how aggressive it is. Some cancers, such as an indolent lymphoma or prostate cancer, may not need immediate treatment, but chemotherapy may eventually be recommended if the cancer progresses. Other cancers require immediate treatment.
Chemotherapy may be used alone as the primary treatment for a cancer, or it may be used in combination with other treatments, such as surgery, radiation therapy, targeted therapy or immunotherapy.
An oncologist may recommend chemotherapy before and/or after another treatment. For example, in a patient with breast cancer, chemotherapy may be used before surgery, to try to shrink the tumor. The same patient may benefit from chemotherapy after surgery to try to destroy remaining cancer cells.
Chemotherapy may also be used to relieve symptoms caused by advanced cancer, which improves a patients quality of life. Some of these patients may be able to take occasional breaks from treatment.
The types of cancers where chemotherapy is very commonly used as primary treatment include:
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Average Length Of Chemotherapy
One course of chemo treatment may last between 3 to 6 months. Typically, one course consists of several on-and-off cycles. One cycle usually lasts 2 to 6 weeks.
Within each cycle, there are multiple treatment sessions. The sessions might take place once a day, week, or month. The duration of each session depends on its form.
Heres how long different types of intravenous chemo take:
- Injection. A syringe is used to deliver the drug in a few minutes.
- IV infusion. The drug flows into your body over a period lasting several minutes to several hours.
- Continuous infusion. A continuous infusion takes a day to several days.
Oral and topical chemotherapy are less time-consuming. Thats because they can be done at home on your own.
In oral chemo, you take the drug by mouth. The drug might be in the form of a:
Chemotherapy infusions can last several hours or days. Your healthcare provider can let you know how long each session will likely take.
Heres what you can do to feel more comfortable during each session:
Keep in mind that every treatment center is different. To prepare, ask your healthcare professional what amenities and services will be available.
Questions To Ask The Health Care Team
Who is creating my chemotherapy treatment plan? How often will the plan be reviewed?
Which health care professionals will I see at every treatment session?
How will I receive chemotherapy treatments? Will I need a port?
Will I need any tests or scans before this treatment begins?
Can you describe what my first treatment will be like?
How long will each treatment session take?
Will I need someone to drive me home after each session?
How often will I have chemotherapy? For how long?
What are the common side effects of the chemotherapy I will receive?
Who should I talk with about any side effects I experience?
Should I track the side effects I experience at home?
Are there side effects I should let you know about right away?
Who can I talk with if I’m feeling anxious about having this treatment?
What type of caregiving could I need at home?
How will we know if the chemotherapy is working?
What follow-up care will I need after chemotherapy?
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