Breast Cancer and Chemotherapy

Chemotherapy is a form of therapy that employs drugs to kill cancer cells. The drugs enter the bloodstream and travel through the body in order to kill cancer cells. The side effects from the chemotherapy come from the fact that it destroys normal cells as well as the cancer cells.

The type of chemotherapy you receive will depend on the type and stage of your cancer. New combinations of chemotherapy are constantly being designed as new information is discovered. The most common chemotherapeutic drug combinations are:

• Cyclophosphamide (Cytoxan), methotrexate (Amethopterin, Mexate, Folex), and 5-fluorouracil (l, 5-FU, Adrucil)—abbreviated CMF
• Cyclophosphamide, doxorubicin (Adriamycin), and fluorouracil—abbreviated CAF
• Doxorubicin (Adriamycin) and cyclophosphamide—abbreviated AC
• Doxorubicin (Adriamycin) and cyclophosphamide followed by paclitaxel (Taxol), docetaxel concurrent with AC, or docetaxel (Taxotere)—abbreviated TAC
• Doxorubicin (Adriamycin), followed by CMF
• Docetaxel (Taxotere) and cyclophosphamide—abbreviated TC
• Cyclophosphamide, epirubicin (Ellence), and fluorouracil with or without docetaxel

In addition to drugs that kill cancer cells (cytotoxic therapy), you may be given estrogen-blocking drugs, such as tamoxifen or the newer class of drugs called aromatase inhibitors (AIs). These drugs will produce symptoms of menopause (eg, hot flashes, night sweats) in many women. They may also produce a condition called “tumor flare” in patients with advanced cancer metastatic to bone, resulting in increased blood calcium. This may be a serious health threat that requires hospitalization.

Read more details about Chemotherapy.

Chemotherapy is usually given by vein, but some forms can be given by mouth as well. Your oncologist will tell you how many cycles or courses of chemotherapy are best for you. Usually there are between 4-8 cycles when the chemotherapy is delivered on its own.

Side Effects

Many types of chemotherapy drugs not only damage the cancer cells but can also damage some of your normal cells. This can create side effects. Side effects will vary between chemotherapy treatments. Your doctor will review a list of possible complications for your treatment type. Some side effects of chemotherapy include:

• Nausea and/or vomiting

• Diarrhea or constipation

• Appetite loss

• Hair loss

• Low red blood cell count ( Anemia )

• Weakened immune system and increased susceptibility to infection

• Fatigue

• Easy bruising and/or bleeding

• Mouth sores

• Persistent numbness and tingling sensation in the hands and/or feet, or weakness due to nerve damage

• Kidney damage

• Damage to the heart muscle

• Infertility

• Cessation of the menstrual period

You and your doctor will talk about options to help relieve some of these effects.

Call Your Doctor

After you leave the hospital, contact your doctor if any of the following occurs:

• Signs of infection, including fever and chills

• Sores in your mouth, throat, or lips

• White patches in your mouth

• Difficulty/pain with swallowing

• Diarrhea or constipation

• Vomiting that prevents you from holding down fluids

• Blood in your vomit

• Easy bruising

• Nosebleeds, bleeding gums, new vaginal bleeding

• Blood in your urine or stool

• Burning or frequency of urination

• Cough, trouble breathing, or chest pain

• Severe weakness

• Shortness of breath or cough

• Calf pain, swelling, or redness in the legs or feet (which could signify a blood clot)

• Abnormal vaginal discharge, itching, or odor

• New or uncontrollable pain

• Numbness, tingling, or pain in your extremities

• Joint pain, stiffness, rash, or other new symptoms

• Redness, swelling, increasing pain, excessive bleeding, or a "pimple" at the site of your IV

• Headache, stiff neck

• Hearing or vision changes

• Ringing in your ears

• Exposure to someone with an infectious illness, including chickenpox

• Weight gain or loss of 10 pounds or more

In case of an emergency, call 911.

American Lung Association website. Available at: http://www.lungusa.org . Accessed January 27, 2006.

Breast cancer. National Cancer Institute website. Available at: http://www.cancer.gov . Accessed January 27, 2006.

Detailed guide: breast cancer. American Cancer Society website. Available at: http://www.cancer.org . Accessed January 27, 2006.