Breast cancer: Chemotherapy treatment

In cancer treatment, chemotherapy refers to the use of medicines to kill or slow the growth of rapidly multiplying cells.

Chemotherapy usually includes a combination of medicines, since this is more effective than a single medicine given alone. There are many medicine combinations used to treat breast cancer. Ask your doctor or chemo nurse for specific information about the medicines and the side effects you can expect from your chemotherapy medicines.

How is chemotherapy given?

Chemotherapy medicines are given intravenously (directly into a vein) or orally (by mouth). Once the medicines enter the bloodstream, they travel to all parts of the body in order to reach cancer cells that may have spread beyond the breast - so chemotherapy is considered a "systemic" form of breast cancer treatment.

Chemotherapy is given in cycles of treatment followed by a recovery period. The entire chemotherapy treatment generally lasts several months to one year, depending on the type of medicines given.

When is chemotherapy given?

When breast cancer is limited 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.

Can I still work while receiving chemotherapy treatments?

Yes. Most people are able to continue working while they are being treated with chemotherapy. It may be possible to arrange your treatments later in the day or just before the weekend so they don't interfere as much with your working life. You may need some time off while receiving chemotherapy, especially if you have side effects.

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. This is just a myth.

If you are receiving adjuvant chemotherapy (after surgery that removed all of the known cancer), it is not possible for your doctor to directly determine whether the treatment is working because there are no tumours left to assess. However, in studies in which some women were given chemotherapy while others were not, adjuvant chemotherapy treatments have proved helpful.

After completing adjuvant therapy your doctor will evaluate your progress through periodic physical examinations, routine mammography and appropriate testing if a new problem develops. If you are receiving chemotherapy for metastatic disease, its progress will be monitored by blood tests, scans and/or X-rays.

What are the potential side effects of chemotherapy medicines?

The specific side effects you will experience depend on the type and amount of medications you are given and how long you will be taking them. The most common temporary side effects include:

• Nausea and vomiting
• Loss of appetite
• Hair loss
• Mouth sores
• Changes in menstrual cycle
• Higher risk of infection (due to decreased white blood cells)
• Bruising or bleeding
• Fatigue

Ask your doctor or chemo nurse about the specific side effects you can expect from your specific chemotherapy medicines. Also discuss any side effects that are troubling you, or that you feel unable to manage.