When you or someone you know is diagnosed with breast cancer, it's normal to feel a lot of fear and anxiety when the doctor says, "I need to have chemotherapy." When we hear the word "chemo," we often picture a difficult, painful experience. But if we are actually well-informed about this treatment, that fear can be greatly reduced. So today, let's talk about what exactly chemotherapy is for breast cancer, why it's done, and how we should deal with it.
What is chemotherapy?
Simply put, chemotherapy is a powerful type of medicine that is given to kill cancer cells. These drugs kill cancer cells in your breast, or cancer cells that have spread from your breast to other parts of your body. Oncologists usually give this treatment before or after breast cancer surgery.
Sometimes only one type of chemotherapy drug is used, other times several drugs are given together. Chemotherapy may also be given with other treatments.
This treatment does cause side effects. But don't worry about them. Your doctor will give you the necessary medication and advice to manage those side effects. Some side effects may persist for some time after treatment ends, and your doctor will also inform you about them.
In what cases is chemotherapy used for breast cancer?
Chemotherapy is used in different situations and for different purposes. Let's take a look at what they are.
| The opportunity to provide treatment | The main goal of treatment |
|---|---|
| Before surgery (Neoadjuvant Chemotherapy) | Shrinking the tumor helps the surgeon remove it more easily. Minimizing the removal of healthy breast tissue. It also helps to know in advance how effective the drugs given are on the cancer. |
| After surgery (Adjuvant Chemotherapy) | Destroying microscopic cancer cells that may remain in the body after surgery, reducing the risk of cancer coming back. |
| For cancer that has spread to other parts of the body (Metastatic Breast Cancer) | If the cancer has spread beyond the breast to other organs in the body, chemotherapy may be used as the main treatment to control it. |
| For specific types of cancer |
|
What are the most commonly used chemotherapy drugs?
There are many types of chemotherapy drugs used for breast cancer. Your doctor will choose the most appropriate drug or combination of drugs based on the type and stage of your cancer, and your health condition.
Some of the most commonly used drug classes are:
- Anthracyclines: For example, drugs such as `doxorubicin (Adriamycin®)` and `epirubicin (Ellence®)`.
- Taxanes: Drugs such as `paclitaxel (Taxol®)` and `docetaxel (Taxotere®)`.
- Other medications: Drugs such as `5-fluorouracil (5-FU®)`, `capecitabine (Xeloda®)`, `cyclophosphamide (Cytoxan®)` and `carboplatin (Paraplatin®)`.
In addition, other drugs such as gemcitabine (Gemzar®) and vinorelbine (Navelbine®) are also used for metastatic breast cancer.
The most important thing is that the medicine you are given is determined by your oncologist. So don't jump to conclusions about your medicine based on what you read on the internet or what other people say. Ask your doctor all your questions.
What are the side effects of chemotherapy?
The side effects of chemotherapy vary depending on the type of drug you are given, the dose, and the duration of treatment. Most side effects go away after treatment ends, but some may last for weeks or months.
Most common side effects
- Chemo brain fog: Difficulty remembering and feeling like you can't concentrate. This can last for about 6 to 12 months after treatment ends.
- Fatigue: You may feel very tired throughout the treatment period and for 3-6 months afterward.
- Nausea and vomiting: This can start during treatment and last for 2-3 weeks after it ends. But now there are very good medications to control it.
Other side effects
- Digestive system problems: Constipation and diarrhea may occur.
- Hair changes: Hair loss may occur during treatment. Many people experience this, but remember that this is temporary. Hair will grow back after treatment is over. It may be a different color or texture than before.
- Appetite: Your appetite may decrease during treatment. This will return to normal once treatment is complete.
- Skin and nail changes: The skin may become dry and itchy. Nails may become brittle and break easily.
- Peripheral neuropathy: This can cause numbness and pain in the hands and feet. This often goes away after treatment is completed.
How is chemotherapy given?
Chemotherapy is given in several main ways.
1. Oral: Medicines that are taken by mouth in the form of tablets or capsules.
2. Intravenous (IV): Giving the medication directly into a vein through a saline tube.
To avoid repeatedly stabbing veins, doctors sometimes use special devices.
- Central Line: A long, thin plastic tube placed in a large vein in the neck, chest, or arm.
- PICC Line: A tube inserted through a vein in the arm and leading to a large vein near the heart.
- Chemo Port: A small device surgically placed under the skin of the chest. It can be used to easily administer medication by inserting a needle into it.
How long does the treatment take?
This will vary depending on your treatment plan. Typically, chemotherapy for breast cancer lasts three to six months . Sometimes it can be as long as a year.
Treatment is given in "cycles" .
- Usually you will need to receive several treatments.
- One session may include two or three days of treatment.
- These treatment sessions may be once a week, once every two weeks, or once every three to four weeks.
- After each session, your body is given time to rest and recover. This is called a "rest period."
How do you prepare before treatment?
Before starting treatment, your doctor will determine the dosage of medication you need, taking into account factors such as the type and stage of your cancer, your test results, and your body mass index (BMI).
This is the best time to ask your doctor all the questions you have. Ask them clearly about the treatment, the side effects, and what they will do for you.
There are several things you can do to prepare for your treatment days:
- Ask someone to help you with household chores for a day or two after your treatment.
- Arrange for someone to accompany you to and from treatment.
- Choose comfortable, loose clothing to wear during treatment.
- Bring something to distract you, like a book or a headset to listen to music.
- Drink extra water the day before treatment, as chemotherapy can dehydrate the body.
When to see your doctor immediately
You will see your doctor regularly during your treatment. However, if you experience any of the following symptoms, call your doctor immediately or go to the Emergency Department (ETU) of the nearest hospital.
| Symptoms that require urgent attention | |
|---|---|
| Fever | Body temperature above 100.4 Fahrenheit (38 Celsius). |
| Chest pain or difficulty breathing | Sudden chest pain or shortness of breath. |
| Feeling cold and shivering | Shivering and feeling cold for no apparent reason. |
| Sudden loss of consciousness | Sudden confusion or delirium. |
| Severe headache | A severe headache with neck stiffness. |
Take-Home Message
- Chemotherapy is a very effective and widely used treatment for breast cancer. Don't be unnecessarily afraid of it.
- This treatment is used in various situations, such as before, after surgery, or for cancer that has spread throughout the body.
- It's normal to have side effects, but your medical team will help you control and manage them.
- It is very important to maintain good nutrition , engage in light exercise as much as possible, and maintain good mental health throughout the treatment period.
- Talk openly with your doctor about any questions, fears, or concerns you may have. Getting the right information is the best way to overcome your fears.
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