When Is Chemo Used For Breast Cancer

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.

Related Institutes & Services

Cleveland Clinic Cancer CenterCleveland Clinic Cancer Center provides world-class care to patients with cancer and is at the forefront of new and emerging clinical, translational and basic cancer research.

Ob/Gyn & Women’s Health InstituteCleveland Clinics Ob/Gyn & Womens Health Institute is committed to providing world-class care for women of all ages. We offer women’s health services, obstetrics and gynecology throughout Northeast Ohio and beyond. Whether patients are referred to us or already have a Cleveland Clinic ob/gyn, we work closely with them to offer treatment recommendations and follow-up care to help you receive the best outcome.

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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Side Effects Of Breast Cancer Chemotherapy

Chemotherapy usually works by attacking rapidly dividing cells. This means that chemotherapy can harm not only cancer cells but also healthy cells that are dividing rapidly, like the ones that cause your hair to grow.

Whether you have side effects from breast cancer chemotherapy will depend on the details of your treatment plan. The care teams at MSK are committed to helping you feel your best during and after treatment. During treatment, well watch carefully for your reaction to the drugs and adjust the drugs or dose as necessary. Well also continue to monitor you for possible long-term effects after your treatment ends.

We offer a variety of other specialized services to support you during your treatment. Many MSK patients find that our Integrative Medicine Service can be a valuable part of their treatment plan. Programs include massage, acupuncture, hypnotherapy, meditation, visualization, music therapy, and nutritional counseling.

One side effect of chemotherapy can be hair loss. MSK offers scalp cooling to help minimize hair loss. Learn more about scalp cooling, or ask your care team for more information.

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:

• infertility
• 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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Why Are Chemotherapies Divided Into Different Classes

Chemotherapies are divided into different classes based on how they affect the DNA in our cells. Disruption or harming the DNA of cancer cells causes them to die and prevents them from growing.

In many cases, a combination of two or more chemotherapy medications or a chemotherapy regimen will be used. A combination of medications is usually recommended to treat breast cancer because they affect DNA differently. A combination can attack breast cancer in different ways, raising the chance for a successful treatment.

How You Have Chemotherapy

You usually have treatment into your bloodstream .

You might have treatment through a long plastic tube that goes into a large vein in your chest. The tube stays in place throughout the course of treatment. This can be a:

• central line
• PICC line
• portacath

If you don’t have a central line you might have treatment through a thin short tube . The cannula goes into a vein in your arm each time you have treatment.

• About chemotherapy into your vein

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How Long Will I Have Chemotherapy For

Chemotherapy is commonly given as a series of treatments with a break between each treatment to give your body time to recover from any short-term side effects. The treatment and period of time before the next one starts is called a cycle.

You may have treatment weekly or every two or three weeks.

You may have one drug or a combination of two or three drugs. The exact type and dose of chemotherapy will be tailored to your individual situation. The drugs used, the dose, how often theyre given and the number of cycles may be called your chemotherapy regime or regimen.

The length of time that you have chemotherapy will depend on your individual situation. Your treatment team will discuss this with you.

When Should I See My Healthcare Provider

• Fever above 100.4 degrees Fahrenheit .
• Chest pain or shortness of breath.
• Chills.
• Severe headache and neck stiffness.

A note from Cleveland Clinic

Chemotherapy is a common breast cancer treatment. You may have chemotherapy before or after surgery. Or you may have chemotherapy as your primary breast cancer treatment. Usually, you receive chemotherapy in two- to three-week cycles, with periods of rest between cycles. Throughout treatment, its normal to experience hair loss, nausea, vomiting or fatigue. These symptoms may take a few weeks or months to disappear. Your healthcare provider can talk with you about concerns and your specific treatment.Share Facebook Twitter LinkedIn Email Print

Last reviewed by a Cleveland Clinic medical professional on 08/18/2021.

References

• American Cancer Society. Chemotherapy for Breast Cancer. Accessed 8/18/2021.
• American Cancer Society. Coping With Hair Loss. Accessed 8/18/2021.
• Breastcancer.org. Hormonal Therapy. Accessed 8/18/2021.
• Cancer.net. Breast Cancer: Types of Treatment. Accessed 8/18/2021.
• Cancer Research UK. Chemotherapy for breast cancer. Accessed 8/18/2021.Get useful, helpful and relevant health + wellness information

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Is There A Breast Cancer Cure

There is currently no cure for metastatic breast cancer, or breast cancer that has spread to distant parts of the body. However, early stages of breast cancer that remain localized are highly treatable 99 percent of people who receive treatment in the earliest stages of breast cancer live for 5 years or longer after diagnosis, according to the American Cancer Society.

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What You Need To Know About Breast Cancer Chemotherapy Pills

People commonly associate chemotherapy with intravenous cancer drugs in a hospital or doctors office. This has been the traditional nonsurgical method of treating cancer.

Due to recent advances in cancer treatments, oral chemotherapy pills have become more widely used for many types of cancer. There are a few that are approved for breast cancer, including capecitabine , which is often used to treat metastatic breast cancer.

is approved in oral form for breast cancer.

Cyclophosphamide is another type of oral chemotherapy thats included as part of a combined treatment regimen called CMF .

Although most commonly administered intravenously for the treatment of breast cancer, methotrexate is another chemotherapy agent thats available in pill form.

Its important to know the difference between the various forms of oral medication prescribed to fight breast cancer, says Dr. Hannah Luu, California-based oncologist and CEO and founder of OncoGambit, an online service that creates personalized cancer treatment plans.

She outlines three categories of oral medications cancer patients may take as part of their treatment plan:

• chemotherapy pills
• antihormonal pills
• targeted therapy pills

Each therapy works differently and serves a different purpose, and not every medication will be right for everyone. Which therapy is right for you will depend on various factors including the type and stage of cancer youre fighting, and other health considerations.

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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.

Chemotherapy For Triple Negative Breast Cancer

Chemotherapy is often recommended for treating triple negative breast cancer. Unlike most other types of breast cancer, triple negative breast cancer does not respond to the presence of certain hormones, such as estrogen and progesterone, nor does it have an abnormally high level of HER2 receptors. Therefore, hormone therapy is largely ineffective for treatment purposes. Nevertheless, triple negative breast cancer often responds very well to chemotherapy.

Depending on when chemo is administered, its goals can vary. For instance, chemotherapy may be recommended prior to surgery to attempt to destroy rapidly dividing cancer cells. In this way, it may be possible to shrink tumors and make them easier to remove, which can increase the likelihood of a successful surgical outcome. Additionally, because it is not always possible for a surgeon to completely remove a patients cancer, chemotherapy may be recommended after surgery to target any remaining cancer cells and help prevent spread and recurrence. Alternatively, chemo can be used as a primary form of treatment to control the growth and ease the symptoms of large tumors that cannot be surgically removed.

• Infused into a vein through an intravenous drip

• Injected by needle into a vein or muscle

• Taken by mouth in pill or capsule form

• Swallowed in liquid form

• BROWSE

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Goals Of Chemotherapy And Radiation

Both types of therapy share the same goals:

• Cure: Get rid of all cancer cells and stop the cancer from coming back
• Control: Shrink or slow cancer tumors or stop the spread of cancer cells to other parts of the body
• Relief: Shrink tumors to lessen pain and other difficult symptoms of cancer

When a cure isnât possible, both therapies can be powerful tools to slow the progress of your cancer and relieve pain and other uncomfortable symptoms.

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Six Ways To Prepare Yourself For Chemo

In 2015, Beth W. was diagnosed with stage 3 breast cancer. After receiving her initial treatment at another facility, she sought out a second opinion at Cancer Treatment Centers of America®, where she eventually underwent chemotherapy, radiation and surgerya nine-month treatment plan. For the past six years, Beths scans have shown no evidence of disease, and today, she serves in our Cancer Fighters program, helping other patients through their cancer journey with tips, advice and peer support. One aspect she gets the most questions about is how she dealt with chemotherapy. Here are the six ways she says she prepared for her treatments and the side effects they caused.

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Complementary And Alternative Medicine

CAM is the term for medical products and practices that are not part of standard medical care. This includes acupuncture, homeopathic medicine, dietary supplements, probiotic therapy, massage and reiki. And mind-body therapies such as relaxation, visualization, yoga, qigong and tai chi. CAM can also help minimize side effects, relieve pain and boost your immune system.

CAM can be used as a complementary medicine – along with conventional medicine. Or it can be used as an alternative medicine – in place of conventional medicine. Finally, Integrative medicine is the combination of conventional and evidence-based CAM treatments.

Find a CAM provider who has experience with cancer patients if you decide to use CAM therapies. You should also talk to your oncologist. Especially if you are considering taking supplements or following a special diet. Those may have interactions with your chemotherapy or other treatments.

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

Get our printable guide for your next doctors 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 youve 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, dont hesitate to call your clinic and ask for help. If youre 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.

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Combination Treatment Of Ceritinib And Paclitaxel Strongly Affects Ar Or Arlow Tnbc Growth In Vitro And In Vivo

Next we examined the effect using the TNBC PDX model that expressed AR and ACK1. Although ceritinib and PTX alone inhibited tumor growth, combination treatment with both drugs together much stronger inhibition of tumor growth . Importantly, there was no change in body weight suggesting minimal toxic effects of the combination treatment . Furthermore, ex vivo ceritinib and PTX combination treatment significantly increased apoptosis in PDX tumors as exhibited by increasing cleaved caspase 3 and reducing MCL1 . To show the therapeutic outcomes and confirm the cellular mechanistic data, we isolated the fresh 4QATb2 PDX tumor and cut it to 3×3 mm3 small pieces, and treatment them with DMSO , ceritinib , paclitaxel and Ceri + PTX for 48h, the treated samples were examined by western blot assays. We found that ceritinib and enzalutamide combination treatment significant suppressed the p-FAK and pYB-1 than single treatment . These data strongly suggest that the combination of ceritinib and PTX is more effective than single drug alone in AR and AR low TNBC cancers.

Fig. 7

Nod scid gamma

Hormone Therapy For Breast Cancer

Hormone therapy is sometimes used to treat breast cancer. It is a treatment that adds, blocks or removes hormones. Hormones are substances that control some body functions, including how cells act and grow. Changing the levels of hormones or blocking certain hormones can slow the growth and spread of breast cancer cells. Drugs, surgery or radiation therapy can be used to change hormone levels or block their effects.

Hormone therapy is only used for breast cancer that is hormone receptor positive. This means that the cancer cells have receptors for estrogen , progesterone or both. When cancer cells have these receptors, the hormones can attach to them and help them grow. Research has shown that giving hormone therapy after surgery and radiation therapy lowers the risk that the breast cancer will come back, and improves survival.

Breast cancer tissue is always tested to find out if it has hormone receptors or does not have hormone receptors . Find out more about .

You may be offered hormone therapy to:

• lower the risk that non-invasive breast cancer, or may lead to an invasive breast cancer
• lower the risk that invasive breast cancer can come back by destroying cancer cells left behind after surgery and radiation therapy
• shrink a large tumour before surgery
• treat locally advanced or recurrent breast cancer
• relieve pain or control the symptoms of advanced breast cancer

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