When Is Chemotherapy Used For Breast Cancer

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.

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.

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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.

How Will I Know If The Chemotherapy Treatments Are Working

Some people may think that their chemotherapy treatment is not working if they do not experience side effects. However, this is a myth.

If you are receiving adjuvant chemotherapy , it is not possible for your doctor to directly determine whether the treatment is working because there are no tumor cells left to assess. However, adjuvant chemotherapy treatments have been proven helpful in studies in which some women were given chemotherapy, while others were not. If you are receiving chemotherapy for metastatic disease, the effects will be monitored, routinely, by blood tests, scans, and/or other imaging studies. These may include CT scans, bone scans, and/or X-rays).

After completing adjuvant chemotherapy, your doctor will evaluate your progress through periodic physical examinations, routine mammography, and appropriate testing if a new problem develops.

Last reviewed by a Cleveland Clinic medical professional on 09/05/2013.

References

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Where You Have Chemotherapy

You usually have treatment into your bloodstream at the cancer day clinic. You might sit in a chair for a few hours so its a good idea to take things in to do. For example, newspapers, books or electronic devices can all help to pass the time. You can usually bring a friend or family member with you.

You have some types of chemotherapy over several days. You might be able to have some drugs through a small portable pump that you take home.

For some types of chemotherapy you have to stay in a hospital ward. This could be overnight or for a couple of days.

Clare Disney : Hello, my name is Clare and this is a cancer day unit.

So when you arrive and youve reported into with the receptionist, one of the nurses will call you through when your treatment is ready, sit you down and go through all the treatment with you.

Morning, Iris. My name is Clare. I am the nurse who is going to be looking after you today. Were going to start by putting a cannula in the back of your hand and giving you some anti sickness medication. And then I am going to come back to you and talk through the chemotherapy with you and the possible side effects you may experience throughout your treatment. Is that okay?

Each chemotherapy is made up for each individual patient, depending on the type of cancer they have and where it is and depending their height, weight and blood results.

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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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.

Why Might Your Doctor Recommend Chemotherapy

Your doctor might recommend chemotherapy after surgery if:

• You are younger than 35. Women younger than 35 usually have a more aggressive type of breast cancer.
• Your breast cancer was bigger than a pea. Breast cancers that are at least 1 cm are more likely to come back later.
• Your breast cancer has spread to the lymph nodes under your arm. If that’s the case, there is a bigger chance that the cancer may also have spread to other places in your body.
• Your breast cancer is HER-2 positive or triple-negative. These types of cancer tend to grow faster and spread more quickly.

Your doctor may use a genetic test to find your risk for having your cancer come back. This information can help you and your doctor decide about chemotherapy.

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Genetics And Family History

Treatment for breast cancer may depend partly on having a close relative with a history of breast cancer or testing positive for a gene that increases the risk of developing breast cancer.

Patients with these factors may choose a preventive surgical option, such as a bilateral mastectomy.

Clinical trials are studies in which patients volunteer to try new drugs, combinations of drugs, and methods of treatment under the careful supervision of doctors and researchers. Clinical trials are a crucial step in discovering new breast cancer treatment methods.

Emerging treatments for breast cancer being studied in clinical trials include:

• PARP inhibitors that block protein used to repair DNA damage that occurs during cell division are being used and tested for TNBC.
• Drugs that block androgen receptors or prevent androgen production are being used and tested for TNBC.

If youre interested, ask your oncologist for information about available trials.

The Birth Of Chemotherapy

After the Second World War, the observation by Goodman and Gilman that nitrogen mustards had the potential for anticancer effects , and parallel work on antifolates by , led to the first successful drug treatments for cancer . Subsequently, observations of uracil uptake by normal rat mucosa and tumours led to the development of 5-fluorouracil , and then cyclophosphamide+methotrexate+5-fluorouracil the first effective chemotherapy regimen for breast cancer .

CMF was tested in the 1970s by

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How Often You Receive Chemotherapy

Treatment schedules for chemotherapy vary widely. How often and how long you get chemotherapy depends on:

• Your type of cancer and how advanced it is
• Whether chemotherapy is used to:
• Cure your cancer

You may receive chemotherapy in cycles. A cycle is a period of chemotherapy treatment followed by a period of rest. For instance, you might receive chemotherapy every day for 1 week followed by 3 weeks with no chemotherapy. These 4 weeks make up one cycle. The rest period gives your body a chance to recover and build new healthy cells.

Neoadjuvant Vs Adjuvant Chemotherapy

• after surgery, which is called .

So far, research has found both options to be just as effective at lowering the risk of cancer return and prolonging life.

Most chemotherapy for breast cancer is given as adjuvant therapy, after and in addition to surgery. usually begins about a month after , once you have had a chance to heal.

Your doctor also may offer you the option of neoadjuvant treatment, which means chemotherapy before surgery.

There are two possible benefits of neoadjuvant treatment:

• It may shrink the cancer so you have to have less extensive surgery.
• If the cancer is very big when you are diagnosed, you may need treatment to reduce it before it can be removed.
• Or you may have the option of having instead of

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How Chemotherapy Is Used With Other Cancer Treatments

When used with other treatments, chemotherapy can:

• Make a tumor smaller before surgery or radiation therapy. This is called neoadjuvant chemotherapy.
• Destroy cancer cells that may remain after treatment with surgery or radiation therapy. This is called adjuvant chemotherapy.
• Help other treatments work better.
• Kill cancer cells that have returned or spread to other parts of your body.

Chemical: Cyclophosphamide / Brand: Cytoxan

How it works:Cytoxan is a type of alkylating agent that damages the DNA of cancer cells, making them unable to divide and causing cell death. It is typically administered after surgery and other treatments, but can be given before to reduce the size of advanced tumors before surgery. Most often it is used in combination with other chemo treatments, especially Adriamycin or Taxotere .

Types of breast cancer treated:-Early stage: cancer hasnt spread-Locally advanced: cancer has spread to lymph nodes and other tissues in the chest or neck-Metastatic: cancer has spread to other organs

Pill or IV:

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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.

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:

• Hair loss

• Easy bruising or bleeding

• Fatigue

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.

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Key Points To Remember

• Chemotherapy is sometimes used after surgery for early-stage breast cancer to help lower the chances that your breast cancer will come back.
• Some types of cancer have a very small chance of coming back. Women who have those types of cancer may not need chemo. There are gene tests that may show whether having chemo will help you reduce your chances that the cancer will return.
• Your age, type of cancer, tumor size, and hormone receptor status have an effect on how well chemo will work to keep your cancer from coming back.
• Different medicines used for chemo have different side effects. Your doctor can give you other medicines to help you deal with side effects like nausea and vomiting. Some women are bothered a lot by the side effects, but some aren’t.
• The drugs used for chemo can be very expensive. Insurance policies don’t always cover the whole cost. If you have no insurance, your doctor may be able to help you find drug companies or organizations that will help you pay for this treatment.

Which Chemo Is Best For You

In cases of early stage cancer, an oncologist can make an informed decision about which drugs are best to use. Your age, the stage of the cancer, and any other health problems will all be taken into consideration before deciding on a chemo regimen.

These drugs are usually injected into a vein, either at your doctors office or at a hospital. Locations that provide chemotherapy injections are often called infusion centers.

You may need a port implanted if you have weak veins or are being given a certain type of drug. A port is a device thats surgically placed in your chest that allows for easy needle access. The port can be removed when therapy is finished.

Typically, a person is given several drugs, often called a regimen. Regimens are designed to attack the cancer at different stages of growth and in different ways. Your chemo drugs will be given on a regular schedule in doses called rounds.

According to the American Cancer Society, the most common drugs and regimens used for breast cancer today are:

While chemotherapy treatments have greatly improved over time, there are often still noticeable side effects of treatment.

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Common Chemo Drugs And What They Do

By C. Dixon

The prospect of undergoing chemotherapy for cancer can be terrifying especially when the drugs themselves have daunting, hard-to-pronounce names, and the same drug has a brand name and a chemical name. There are more than 100 different types of chemo drugs and some are prescribed jointly while others are only given alone. Why are there so many kinds, and how do your doctors know which one is right for you and your specific type of cancer?

Were here to help clear that up. Chemotherapy works by targeting cells at specific points in the cell cycle. Since cancer cells form more quickly than normal cells, the cancerous ones will be more readily destroyed by chemo than normal cells, though some normal cells will be affected .

Usually, at least two or three chemo drugs are used in combination with each other when treating localized cancer, while only one is commonly used at a time for advanced stages. There is no drug or combination thats considered the best your doctors will discuss the most promising treatment plan for you based on your stage, potential side effects, how the drugs will interact with each other, and more.

Well list several of the most common types of chemo, and explain their effect on cancer cells and your body. Common side effects for any type of chemotherapy include low blood count and an increased risk of blood clots. In addition, women are advised not to get pregnant.

How Chemotherapy May Affect You

Chemotherapy affects people in different ways. How you feel depends on:

• The type of chemotherapy you are getting
• The dose of chemotherapy you are getting
• Your type of cancer
• How advanced your cancer is
• How healthy you are before treatment

Since everyone is different and people respond to chemotherapy in different ways, your doctor and nurses cannot know for sure how you will feel during chemotherapy.

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What Are Some Common Chemotherapy Combinations Used In Breast Cancer

Chemotherapy regimens usually have acronyms to help simplify what theyre called. They can also include other medications like HER2 target therapy, discussed below. A few examples of some common breast cancer chemotherapy regimens are:

• AC T: Doxorubicin and cyclophosphamide followed by paclitaxel

• AC T: Doxorubicin and cyclophosphamide followed by docetaxel

• AC THP: Doxorubicin and cyclophosphamide followed by paclitaxel, trastuzumab, and pertuzumab

• TC: Docetaxel and cyclophosphamide

• TAC: Docetaxel, doxorubicin, and cyclophosphamide

• CMF: Cyclophosphamide, methotrexate, and fluorouracil

• TCHP: Docetaxel, carboplatin, trastuzumab, and pertuzumab

These acronyms consist of the first letter of each medications name in the regimen, but it varies if the first letter refers to the medications brand or generic name. For example in the TC regimen the letter T refers to Taxotere, which is the brand name of docetaxel. The C refers to cyclophosphamide.

These medications are discussed individually below.