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Chemotherapy is the use of drugs to kill cancer cells. If you need chemotherapy as part of your breast cancer treatment, you also may need other drugs to block cancer growth. For your chemotherapy treatments, you will work with a cancer specialist called a medical oncologist. Together, you and your doctors will need to work through your chemotherapy options. Knowing what to expect can help you get ready for this discussion.
Chemotherapy Basics
When a chemotherapy drug enters your body—whether you swallow it or get it by injection into your veins—it travels through your bloodstream to kill cancer cells. Here are some basics:
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You may have cycles of treatment. For instance, you may have treatment for 2 to 3 weeks and then have a rest period of 2 to 3 weeks. Your treatment may last a total of 3 to 6 months.
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You may get several types of chemotherapy drugs. Usually you take these drugs in combinations. Treatment works better when you take more than one drug at a time.
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You could have chemotherapy before or after breast cancer surgery. Your doctor will call this "neoadjuvant therapy" if you have chemotherapy before surgery and "adjuvant therapy" for chemotherapy after surgery. When done before surgery, chemotherapy can shrink the tumor. This improves the odds for a successful surgery. After surgery, chemotherapy can kill any cancer cells that remain behind.
- Chemotherapy may be your main treatment. This might be the case if your breast cancer has spread beyond your breast and lymph nodes.
Possible Side Effects from Chemotherapy
Breast cancer cells divide and multiply quickly. Chemotherapy attacks these types of cells. However, other healthy cells in your body also divide quickly. Chemotherapy can attack them, too. These cells include those in your hair follicles, digestive tract, and bone marrow. That's a big reason why chemotherapy comes with side effects.
The side effects you have will depend on the drugs you are taking. Ask your doctor what to expect from the specific drug(s) you are on. Here are some of the most common side effects:
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Nausea and vomiting
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Increased chance of bleeding
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Increased chance of infections
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Weakness and fatigue
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Mouth sores
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Hair loss
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Menstrual changes
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Tingling and numbness
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Brain fog, called "chemo brain"
It is important to tell your doctor about any type of abnormal feeling or symptom you have, even if it isn’t on your list of potential side effects. Sometimes other medication can reduce them. Also, remember that most side effects will go away once the treatment ends. If you still have your periods and are sexually active, be sure to talk to your doctor about birth control. It is not safe to become pregnant during chemotherapy.
Hormone Therapy
You may be on hormone therapy as well as chemotherapy. Hormones like estrogen can act like fuel for some cancers. If your breast cancer cells have what are called "hormone receptors" (places on the cells where hormones can attach), hormone therapy can help keep your cancer from growing.
Hormone therapy with the drug tamoxifen blocks the effects of estrogen. Tamoxifen is a pill that you take once or twice a day. You may need to take it for up to five years. Tamoxifen works on early or late stages of breast cancer.
The most common side effects of tamoxifen are fatigue and hot flashes. Because tamoxifen can increase your risk of uterine (endometrial) cancer, you will need to have a pelvic exam every year while on this drug. Always tell your doctor if you have unusual vaginal bleeding.
Targeted Therapy
Targeted therapy uses drugs that target breast cancer cells but leave your normal cells alone. Your cancer doctor may suggest these drugs if you have a type of breast cancer that gets growth signals from a protein called HER2. They can attach to HER2-positive breast cancer cells. The drugs kill these cells or block their growth.
You usually get targeted therapy through an IV along with chemotherapy. Side effects are milder than chemotherapy and can feel like a mild allergic reaction.
Dealing With Chemotherapy
The ups and downs of treatment cycles can take a toll on your everyday life. This is a time to surround yourself with loved ones and other people you can talk to freely. Keep an open line of communication with your doctor and the rest of your care team during your treatment. Talk to your loved ones and your doctor about quality of life issues, from fatigue and insomnia to maintaining a healthy weight and intimacy with your partner. Expressing what you’re going through can help you get through treatment and being cancer free.