When doctors diagnose you or a loved one with breast cancer, the next word you hear, 'chemotherapy,' can be a nerve-wracking, scary thing. It's very common. We've heard things like, "Chemotherapy makes your hair fall out," "It's really hard," and so on. But don't worry. Chemotherapy is a very powerful and effective treatment for killing cancer cells. Let's talk about it all clearly, simply, and honestly.
Simply put, what is chemotherapy?
Chemotherapy, or "chemo" as we call it, is a very powerful class of drugs given to kill cancer cells. Think about it, cancer cells in our body are cells that divide very quickly and grow uncontrollably. Chemotherapy drugs mainly target and destroy these rapidly dividing cells. This treatment not only helps to kill the cancer cells in your breast, but also those cells that have spread to other parts of your body.
Your oncologist may give you this treatment using a single chemotherapy drug, a combination of drugs, or a combination of other treatments. This all depends on the type and stage of your cancer, and your overall health.
In what cases is chemotherapy given?
Chemotherapy is used in various stages of breast cancer treatment. Your medical team will decide exactly when. Let's look at the main stages.
| Treatment Stage | Explanation |
|---|---|
| Before surgery (Neoadjuvant Chemotherapy) | Chemotherapy is given before surgery to shrink the tumor. When the tumor is smaller, it is easier for the surgeon to remove only the tumor, leaving healthy breast tissue. It also allows doctors to know in advance how the cancer will respond to this treatment. |
| After surgery (Adjuvant Chemotherapy) | After surgery, there may be very small, microscopic cancer cells that are not visible to the naked eye or on tests. Chemotherapy is given after surgery to destroy these remaining cells and reduce the risk of the cancer coming back. |
| For cancer that has spread throughout the body (Metastatic Breast Cancer) | If the cancer has spread beyond the breast to other parts of the body (such as the liver, lungs, bones), chemotherapy is used as the main treatment. |
| For other specific types of cancer | There are some types of cancer, for example `(Inflammatory Breast Cancer - IBC)`. In these cases, there is no clear tumor that can be removed by surgery. Therefore, chemotherapy is given as the primary treatment. Also, `(Triple-Negative Breast Cancer - TNBC)` and `(HER2+)` cancers that have a high risk of recurrence are also treated with chemotherapy along with other treatments (e.g. `(immunotherapy)`, `(targeted therapy)`). |
What are these chemo drugs?
There are many types of chemotherapy drugs used for breast cancer. Your doctor will choose one or more of these depending on your condition. Some of the most commonly used classes of drugs are:
- Anthracyclines: Examples include drugs like `doxorubicin` and `epirubicin`.
- Taxanes: Examples include `paclitaxel` and `docetaxel`.
- Other drugs: Drugs such as `5-fluorouracil (5-FU)`, `cyclophosphamide`, and `carboplatin` are also commonly used.
In addition to this, other drugs such as `capecitabine`, `gemcitabine`, `vinorelbine` are also used for metastatic breast cancer. You do not need to memorize these drugs. Your doctor will explain the most suitable drug for you and the details about it.
Let's talk about the side effects that everyone fears.
Yes, chemotherapy does cause side effects. This is because these drugs affect not only cancer cells but also some healthy cells in our body that divide rapidly (e.g. hair cells, digestive tract cells, blood cells). But the important thing is that most side effects are temporary. They gradually disappear once the treatment is over. Moreover, there are now very good drugs and methods to control these side effects.
Remember, not everyone experiences the same side effects. It varies from person to person and depending on the type of medication given.
| Common side effects | Description |
|---|---|
| Fatigue | This is not normal fatigue. It is an extreme tiredness that you feel no matter how much sleep you get. It can last during treatment and for several months afterward. |
| Nausea and Vomiting | There are now very effective medications to control this. The doctor will give these medications before giving chemo. |
| Hair Loss | Not all chemo drugs cause hair loss. Some drugs do. This is temporary. Hair usually grows back a few months after treatment ends. The hair that does grow back may be a different color or texture than it was before. |
| Anorexia and mouth sores | The taste of food may change, and small sores may appear in the mouth. This can be controlled by eating soft foods, drinking fluids, and taking care of your oral hygiene. |
| Numbness in the limbs (Peripheral Neuropathy) | Some medications can cause numbness or tingling in the fingers and toes. It is important to inform your doctor about this. |
| Decreased blood cells | Chemotherapy can cause a decrease in white blood cells (which protect against infection), red blood cells (which carry blood), and platelets (which help blood clot). This can increase your risk of infection, fatigue, and bleeding. Doctors will monitor this regularly. |
How is chemotherapy given?
Chemotherapy is given mainly in two ways.
1. Intravenous (IV): This is the most commonly used method. Like saline, the medication is given directly into a vein through a cannula. Sometimes, for long-term treatment, special equipment is used to avoid the hassle of inserting a cannula each time.
- PICC line: A long, thin tube placed in a vein in the upper arm.
- Chemo Port: A small device placed under the skin of the chest. This allows for the administration of medications without the need for needles.
2. Oral: Some chemo drugs come in the form of pills or capsules. These can be taken at home.
Treatment is usually given in "cycles." For example, you may have treatment sessions once a week, once every two weeks, or once every three weeks. There is a "rest period" between sessions. This time is given to give your body's healthy cells a chance to recover. The total treatment period for breast cancer usually lasts between 3 and 6 months.
How do you prepare for chemo treatment?
This time can be a bit challenging, so it's worth it to have a little preparation in advance.
- Talk to your doctor carefully: find out everything about your treatment plan, possible side effects, and what can be done about them. Don't be afraid to ask questions.
- Someone to help: It's a great help if you have someone to take you to the day of treatment, stay with you, and drive you home. It's even better if you can find someone to help with household chores for a day or two after treatment.
- Comfortable clothing: Wear comfortable, loose-fitting clothing on the day of your treatment.
- Something to entertain yourself: The therapy session can last several hours, so bring something to do, such as a book or a headset to listen to music.
- Drink plenty of water: Chemo can dehydrate the body, so drink plenty of water starting the day before your treatment.
- Nutritious food: Even if you feel hungry, try to eat as many nutritious foods as possible. Eating protein-rich foods (eggs, meat, fish, milk, nuts) can help reduce fatigue.
Situations when you should seek urgent medical advice
Your body's immune system may be weakened during chemotherapy. Therefore, if you experience any of the following symptoms , call your doctor immediately or go to the hospital's Emergency Department (ETU).
- Fever over 100.4°F (38°C).
- Chills.
- Chest pain or difficulty breathing.
- Sudden severe confusion.
- Severe headache and neck stiffness.
These symptoms could be a sign of an infection or other serious condition, so don't delay.
Take-Home Message
- Chemotherapy is a very important and life-saving treatment for breast cancer. Don't be unnecessarily afraid of it.
- While side effects are common, most of them are temporary, and there are now very effective methods and medications to manage them.
- Talk openly with your medical team. Share your concerns, fears, and questions with them. They are always ready to help you.
- You don't have to go through this journey alone. Get support from family and friends. Your mental health is just as important as your physical health.
- You can make your treatment period more comfortable with good nutrition, adequate rest, and light exercise.
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