How To Recognize A Cancer Emergency
Your doctor and the chemotherapy nurse will let you know what situations would be considered an emergency. But if you have any of the following warning signs, tell your doctor immediately:
- A temperature greater than 100.4 F.
- Any fever and chills. If you can’t reach your doctor, go to the emergency room.
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:
Before You Start Chemotherapy
You need to have blood tests to make sure its safe to start treatment. You have these either a few days before or on the day you start treatment. You have blood tests before each round or cycle of treatment.
The pharmacists make chemotherapy for each person individually. They do this once your blood test results have come through. Its worked out based on your weight, height and general health.
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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.
What Happens After Chemotherapy For Breast Cancer
Immediately after chemotherapy, you may feel sleepy or nauseated. Typically, the side effects of chemotherapy go away after you complete all prescribed cycles.
After all of your cycles of chemotherapy are completed, your healthcare provider may order imaging tests, such as CT scans or MRIs, to show whether the cancer is gone or the tumor has shrunk.
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What Are Some Common Side Effects Of Chemotherapy Used In Breast Cancer
Chemotherapy attacks cancer cells, but it can also attack healthy cells in your hair and gut. Chemotherapy side effects depend on the individual, the type of chemotherapy, the dosage and schedule, and the chemotherapy regimen being used.
In addition to some of the side effects mentioned above, chemotherapy used in breast cancer can cause the following more common side effects:
Easy bruising or bleeding
Chemotherapy effects can be bothersome, but sometimes necessary to receive effective treatment. Thankfully, however, there are other medications and strategies that can be used to help manage certain side effects. If youre receiving chemotherapy and you experience a bothersome side effect, make sure to mention it to your cancer specialist so they can help manage it.
If side effects are too bothersome or cannot be tolerated, your chemotherapy regimen may be altered, paused, or completely stopped.
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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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.
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.
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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.
Warnings For Other Groups
For pregnant women: Cyclophosphamide is a category D pregnancy drug. That means two things:
This drug can harm a pregnancy. Women shouldnt become pregnant while taking this drug. If youre a woman, be sure to use effective birth control during treatment and for up to one year after you stop taking this drug. If youre a man and your partner could become pregnant, be sure to use a condom during your treatment and for at least four months after your treatment ends.
Tell your doctor if youre pregnant or planning to become pregnant. Cyclophosphamide should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.
For women who are breastfeeding: Cyclophosphamide passes into breast milk and can cause serious effects in a child who is breastfed. You and your doctor may need to decide if youll take cyclophosphamide or breastfeed.
For seniors: As you age, your organs may not work as well as they did when you were younger. More of this drug may stay in your body and put you at risk for severe side effects.
For children: Children who receive cyclophosphamide have a higher risk for:
- ovarian fibrosis in girls who havent reached puberty yet
- low sperm counts, immobile sperm, or smaller testes in boys who havent gone through puberty yet
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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.
Chemical: Methotrexate / Brand: Maxtrex
How it works: Maxtrex is a type of antimetabolite, which gets absorbed into cancer cells because it can mimic other components of the cell. Once its in, it prevents the cell from dividing and causes cell death. It is often used in combination with other chemotherapies.
Types of breast cancer treated: -Early stage: cancer hasnt spread-Metastatic: cancer has spread to other organs
Pill or IV:Taken intravenously.
Most common side effects:Diarrhea nausea and vomiting sore mouth joint pain skin changes at infusion site swelling in feet & legs loss of appetite hair loss irregular menstruation.
Common combinations using Maxtrex:
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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.
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 you’ll 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 you’re taking it, although they should start again once your treatment is complete.
If you’re 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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Chemotherapy For Metastatic Breast Cancer
Advances in treatment are making it possible for women with metastatic breast cancer to live for many years. New drug therapies can not only slow down or stop a tumors growth but also keep symptoms at bay.
Which treatment your doctor recommends will vary based on your medical history, age, and breast cancer type, among other factors. Combinations of drugs are commonly prescribed for women with early-stage disease. Most women with advanced breast cancer generally receive only one drug at a time.
Chemotherapy drugs that MSK doctors commonly prescribe for advanced breast cancer include:
Women with advanced disease can also benefit from genomic testing. This is also called tumor sequencing or molecular profiling. It is offered to all MSK patients with metastatic breast cancer. Genomic testing involves looking at the cancer cells to see if there are any genetic mutations that could be linked to the specific type of breast cancer you have.
Our experts use a highly sophisticated testing approach developed by MSK researchers called MSK-IMPACT. The information gained from MSK-IMPACT can help us personalize your care. We can rule out drug therapies that may not work for you or sometimes recommend cutting-edge clinical trials designed to target the specific mutations in your tumor.
The Types Of Radiotherapy
The type of radiotherapy you have will depend on the type of breast cancer and the type of surgery you have. Some women may not need to have radiotherapy at all.
Types of radiotherapy include:
- breast radiotherapy after breast-conserving surgery, radiation is applied to the whole of the remaining breast tissue
- chest-wall radiotherapy after a mastectomy, radiotherapy is applied to the chest wall
- breast boost some women may be offered a boost of high-dose radiotherapy in the area where the cancer was removed however, this may affect the appearance of your breast, particularly if you have large breasts, and can sometimes have other side effects, including hardening of breast tissue
- radiotherapy to the lymph nodes where radiotherapy is aimed at the armpit and the surrounding area to kill any cancer that may be in the lymph nodes
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Who Needs Breast Cancer Chemotherapy
Chemotherapy is offered to most patients based on several factors including:
- Type of receptors and status
- Number of lymph nodes involved and degree of involvement
- The risk for cancer to spread elsewhere in the body
Your medical team will work to select the right blend of chemotherapy drugs to suppress each stage of the cancer cells growth.
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 .
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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:
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.
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Side Effects Of Chemotherapy
Chemotherapy damages cells as they divide. This makes the drugs effective against cancer cells, which divide rapidly. However, some normal cells such as hair follicles, blood cells and cells inside the mouth or bowel also divide rapidly. Side effects happen when chemotherapy damages these normal cells. Unlike cancer cells, normal cells can recover, so most side effects are temporary.
What Is Cyclophosphamide
Cyclophosphamide is a prescription drug. It comes as an injectable solution. It also comes as a capsule you take by mouth.
A healthcare provider will give you cyclophosphamide injectable solution through an intravenous infusion into your vein. Youll receive your infusion at your doctors office or hospital. You wont take this drug at home.
Cyclophosphamide injectable solution is only available as a generic drug. Theres no brand-name version.
This drug may be used as part of a combination therapy. This means you need to take it with other drugs.
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More Common Side Effects
The more common side effects that can occur with cyclophosphamide include:
- Infection, with symptoms such as:
Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this information includes all possible side effects. This information is not a substitute for medical advice. Always discuss possible side effects with a healthcare provider who knows your medical history.
How To Take Cyclophosphamide
Your doctor will determine a dosage thats right for you based on your individual needs. Your general health may affect your dosage. Tell your doctor about all health conditions you have before your doctor or nurse administers the drug to you.
Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this list includes all possible dosages. This information is not a substitute for medical advice. Always speak with your doctor or pharmacist about dosages that are right for you.
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Cyclophosphamide May Interact With Other Medications
Cyclophosphamide injectable solution can interact with other medications, herbs, or vitamins you might be taking. Your healthcare provider will look out for interactions with your current medications. Always be sure to tell your doctor about all medications, herbs, or vitamins youre taking.
Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs interact differently in each person, we cannot guarantee that this information includes all possible interactions. This information is not a substitute for medical advice. Always speak with your healthcare provider about possible interactions with all prescription drugs, vitamins, herbs and supplements, and over-the-counter drugs that youre taking.
This drug comes with several warnings.