Chemotherapy
This section describes chemotherapy and explains possible side
effects. We hope that it will help you to talk about any concerns
you might have with your cancer specialist or chemotherapy nurse
and enable you to take part in your treatment plan. You will also
be given relevant information about your particular treatment by
the team treating you at the hospital or unit.
Page Contents
Factsheets
What is Chemotherapy?
Side Effects of Treatment
Further Support
Help from Action Breast Cancer
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Factsheets
What is Chemotherapy?
Chemotherapy is a treatment using drugs that cure or control cancer.
These drugs can be used on their own or with each other. This treatment
may be given
before or after surgery.
The drugs used in chemotherapy
travel through the blood stream to almost every part of the body.
They are often given in cycles such as once every three weeks with
a rest period between treatments.
Chemotherapy may be given directly into a vein as an injection
or through an intravenous infusion. It may also be given in tablet
form. If your treatment is given by intravenous infusion you may
need to stay overnight in hospital. However, there are some treatments
that may be given in day-care.
Sometimes, two or three courses of chemotherapy are given before
surgery. This happens when the tumour is large. The chemotherapy
may shrink the tumour and make the operation easier and more effective.
Once you have recovered from surgery you may need further chemotherapy.
In some cases, there may be a risk that some cancer cells have
been left behind. The cancer may have released cells into the bloodstream
or the lymphatic system. These cells can sometimes cause secondary
cancers called metastases in other parts of the body.
If the cancer has spread and/or surgery is not possible for other
reasons chemotherapy is the main treatment used. Even if the cancer
comes back after surgery or a course of chemotherapy, it is important
to know that it can still be treated. Your doctor will consider
your general health and where the cancer has spread. He or she
will also take into account the kind of drugs you have had in the
past.
There are several chemotherapy drugs used to treat breast cancer.
Your doctor or breast care nurse will discuss your treatment with
you. A number of chemotherapy drugs are often used together and
are given every 3-4 weeks for about 6 months. The rest period between
treatments allows the body time to recover from the side effects
of treatment.
There are new drugs and different ways of treating breast cancer
being developed all the time. Herceptin is a new drug used to treat
breast cancer. It belongs to a new type of treatment using monoclonal
antibodies. In order to receive this treatment, your breast cancer
cells must contain a certain gene called Her2. There are two ways
of testing your cells- your doctor or breast care nurse can discuss
these with you. You will not need any further surgery as the tissue
that was removed during surgery can be tested. Your test results
will come back as positive or negative. If you are positive for
Her2, Herceptin may be used in your treatment. At this time, Herceptin
is only used as an adjuvant treatment in the setting of a clinical
trial. For more information on clinical trials see our booklet
Understanding Cancer of the Breast .
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Side effects of treatment
The side effects of chemotherapy vary from person to person and depend on the
drugs used. These unwanted side effects happen because while the chemotherapy
is working on the cancer cells it can have an effect on the normal cells
too. In most cases the side effects go away when the treatment ends or soon
after. Your doctor or nurse can give you something to stop most of them or
make them easier to cope with.
Side effects may include:
Infection
Chemotherapy can make you more likely to get infections. This happens
because most chemotherapy drugs affect the bone marrow, which
makes the white blood cells that fight infection. If you do not
have enough white blood cells, even minor infections such as
a cold or sore throat could make you quite ill.
During treatment cycles you will have blood tests to make sure
that you have enough white blood cells. If your white cell count
is low your doctor may ask you to watch out for signs of infection.
These signs could include feeling shivery and unwell or running
a high temperature of 38°C or higher. If this happens tell
your doctor straight away. He or she will tell you what to do.
Some hospitals prefer you to ring them directly. Check this out
with your doctor or nurse before you start treatment. If you have
a high temperature you will need to have a blood test. Some antibiotics
are required to treat the infection.
You will be more at risk of picking up infections while on treatment.
Try to avoid close contact (such as hugging or kissing) with people
who have colds or flu or other infections such as chicken pox,
shingles or measles.
Let your doctor know if you are in contact
with these or any other infections. Wash your hands often during
the day, especially before you eat and after going to the bathroom.
Try to avoid crowds. Infection can be a serious complication of
chemotherapy. It needs to be treated as soon as possible. Talk
to your doctor or nurse. He or she will give you more information.
Bruising
The blood is made up of three types of different cells. Platelets
help to make your blood clot to stop the bleeding if you hurt
yourself. If there are ,
you may bleed or bruise more easily than usual, even from a minor
injury. Let your doctor or nurse know straight away if you are
bruising easily or notice tiny red spots under the skin, which
can . He or she will tell you what
to do.
Feeling sick or getting sick
Not everyone feels sick or gets sick with chemotherapy. It depends
on the drugs being given, but it can happen before, during or
after treatment. It may last several hours. Your doctor or nurse
will give you medication to stop you feeling sick. This may be
in injection or tablet form. While on treatment take all medication
as directed by your doctor or nurse.
Hair loss (alopecia)
The amount of hair loss depends on the drugs you are given. It
can vary from person to person. You may notice that your hair
just thins out a little bit. If you do lose your hair, it will
happen quite quickly. You may also find that you lose all your
body hair, including eyebrows, eyelashes and pubic hair, which
can be a shock, especially if you are not prepared for it. Try
not to worry, as your hair will grow again when treatment stops.
You may feel upset at the thought of losing your hair. Talk to
your nurse about your feelings. He or she will help you to find
ways to cope with hair loss. You can get a wig or hairpiece when
this happens or you may prefer to wear a hat, turban or scarf.
If you would like a hairpiece try to organize this before your
hair falls out. Your medical social worker or nurse may be able
to organize this for you. If your hospital does not have a social
worker ask if they have the name of a wig fitter you could go to
see. Your local hairdresser may also be able to help. In some cases
it is possible to get financial assistance towards the cost of
a wig. Ask your medical social worker or nurse for more information.
For some patients the amount of hair loss is small and a wig may
not be needed.
Sore Mouth
Some drugs used to treat breast cancer may cause a sore mouth.
They can also cause little ulcers to appear on the tongue, gums
and inside the cheeks of your mouth. Try to keep your teeth,
gums and mouth very clean, as this will reduce the risk of getting
a mouth infection. Clean your teeth after every meal. Use a soft
toothbrush. If you have dentures remove them if your gums are
sore. There are special mouthwashes that you can use. Your nurse
will show you how to use them properly.
Numbness or pins and needles in the hands and feet
Some chemotherapy drugs used to treat cancer can cause tingling or burning
sensations in your hands and feet. You may also have trouble in picking up
small objects or buttoning up a shirt or cardigan. This side effect is almost
always temporary and goes away after treatment stops. However, do tell your
doctor or nurse if this happens, as some changes may need to be made to your
treatment.
Feeling very tired
You may feel very tired. This tiredness can last for some weeks
after treatment has ended. If this happens take things easier.
Do less than you would normally do. Rest more if you can. Ask
your family or friends to help you at work or at home. Before
you start your treatment ask your doctor about any possible side
effects that may occur. Do tell your doctor about the way you
are feeling during your treatment as most side effects can be
eased with medication.
Not wanting to eat
It is best to eat as much as you can while on chemotherapy. Eat
smaller amounts more often. If you do not feel like eating during
treatment, you could try replacing some meals with special high-calorie
drinks. Talk to a dietician. He or she will give you advice on
what to eat.
If you have a different side effect or symptom from those listed
that concerns you, tell your doctor or nurse straight away. He
or she will tell you what to do.
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Further Support
You might find it easier to share your feelings with someone who
has had a similar experience to you. Reach to Recovery is a programme
set up to help and support women who have recently had a breast
cancer diagnosis. The programme works on the principle of personal
contact between the patient and a Reach to Recovery volunteer – a
woman who has treatment for breast cancer. Carefully selected
and fully trained volunteers are available to provide advice
and reassurance at a time when a woman is most in need of both.
For more information on individual support or support groups
in your area, call the National Cancer Freefone Helpline
on 1800 200 700.
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Help from Action Breast Cancer
Action Breast Cancer is a national project established by the Irish
Cancer Society to provide breast cancer information and support
and to fund breast cancer research. Its services are free, confidential
and accessible.
For more information call the National Cancer Freefone Helpline
on 1800 200 700.
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ABC would like to thank CancerBACUP in the UK for their permission
to adapt the text in their booklet, Understanding Cancer of the
Breast
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