Chemotherapy in Breast cancer

What is chemotherapy?

Chemotherapy is the use of anti-cancer drugs to treat cancer. It can stop the growth of a tumor in the breast and kill cancer cells that have spread to other parts of the body. Chemotherapy may also be used to reduce the risk of breast cancer returning (recurrence), and to shrink the size of a tumor to reduce cancer-related symptoms.

How chemotherapy is given?

Chemotherapy may be given after surgery (called adjuvant chemotherapy) or before surgery (known as neoadjuvant chemotherapy). A few anti-cancer drugs are taken by mouth or injected into the muscle or fat tissue below the skin, but most are injected into a vein. Treatments can be given at home, at the doctor’s office or in the hospital — depending on the type of chemotherapy.

When chemotherapy is given?

Chemotherapy usually starts within 4 to 12 weeks after surgery. It is commonly given on a 21 or 28-day cycle. Drugs are generally given weekly or once every third week, with a rest period to allow your body to recover. The length of the cycle will depend on the type of drugs used. The length of the treatment period will vary, but it often lasts from 3 to 6 months.

Common drugs given in chemotherapy

In most cases, chemotherapy is most effective when combinations of drugs are given. Using different drugs together increases their ability to kill cancer cells. The drugs used depends on factors such as your age, the cancer type and stage. Some drugs that are used together most often are listed below:

• Cyclophosphamide

• Doxorubicin (Adriamycin)

• 5-fluorouracil

• Methotrexate

• Paclitaxel (Taxol) or Docetaxel 

Common side effects in chemotherapy

Side effects from chemotherapy depend on the drug or combination of drugs used. Side effects vary from person to person. Some of the most common side effects are described below.

our blood cell count before each treatment to make sure it is high enough to safely give you chemotherapy.

If you have any sign of infection such as fever while on chemotherapy, you should contact your doctor right away.

Nausea and vomiting in chemotherapy

Drugs called antiemetics can help reduce or prevent nausea and vomiting that can occur during chemotherapy.Eating several small meals throughout the day may also help.

Hair loss (alopecia) in chemotherapy

During treatment, your hair may get thinner or may fall out entirely, depending on which chemotherapy drugs you are given. You may also have hair loss from your eyebrows, eyelashes and body. Your hair will grow back after treatment ends, but it may be a different color or texture. Using mild shampoos, soft hair brushes and low heat when drying your hair may help reduce hair loss. Some women may choose to cut their hair short beforehand to gain some control. If you would like to wear a wig, it is a good idea to get it before treatment begins so you can match your hair color and style.

Early menopause in chemotherapy

Some women may have menopausal symptoms such as their menstrual periods stopping, hot flashes and vaginal dryness during treatment. For women who are closer to the age of menopause (45 years or older), these symptoms may be permanent. For younger women, these symptoms may be temporary. Your doctor can help you manage these symptoms.

Fatigue in chemotherapy

This is a common side effect. Try to get plenty of rest and ask family and friends to help. Exercise and a well-balanced diet may also help. Your doctor may also use a medication that may reduce fatigue. 

our blood cell count before each treatment to make sure it is high enough to safely give you chemotherapy.

If you have any sign of infection such as fever while on chemotherapy, you should contact your doctor right away.

Infections in chemotherapy

Because chemotherapy reduces the white blood cell count, infections are more likely to occur. You can help prevent infections by washing your hands often and staying away from others who are ill. If you get a cut or nick, clean it right away. Your doctor should check your blood cell count before each treatment to make sure it is high enough to safely give you chemotherapy.

If you have any sign of infection such as fever while on chemotherapy, you should contact your doctor right away.

Mouth and throat sores in chemotherapy

Because the cells in the mouth and throat are fastgrowing, some chemotherapy drugs affect these areas causing sores or dryness. Get a dental check-up before starting chemotherapy. During treatment, brush your teeth and gums after each meal and at bedtime using a soft toothbrush. Using a tooth paste with baking soda and peroxide can also help. Avoid mouthwashes that contain large amounts of alcohol.

Weight gain in chemotherapy

Although the reasons are unclear, some women gain weight during chemotherapy. Eating nutritious food and exercising can help maintain your normal weight.

Nail weakness in chemotherapy

Some treatments can cause damage to the fingernails and toenails. The nails become brittle and sore, and may fall off. Like hair loss, nail problems are temporary.

Memory problems (chemo-brain) in chemotherapy

Chemotherapy may lead to a general sense of mental fuzziness and short term memory problems. Most women say that these symptoms improve with time.

Drug Combinations with Drug Names for Chemotherapy

Combinations

CMF: cyclophosphamide, methotrexate, and 5-fluorouracil

CAF (FAC): cyclophosphamide, doxorubicin (Adriamycin), and 5-fluorouracil

AC: doxorubicin (Adriamycin) and cyclophosphamide

TAC: docetaxel (Taxotere), doxorubicin (Adriamycin), and cyclophosphamide

AC --> T: doxorubicin (Adriamycin) and cyclophosphamide  followed by paclitaxel (Taxol) or docetaxel (Taxotere)

CT: docetaxel (Taxotere) and cyclophosphamide