Breast Cancer in women

Chemotherapy for breast cancer

Chemotherapy is the use of anti-cancer (cytotoxic) drugs to destroy cancer cells. The aim of chemotherapy is to do the maximum damage to cancer cells while causing the minimum damage to healthy tissue. Women with breast cancer may have chemotherapy:

  • Before surgery to shrink the cancer. This is known as neo-adjuvant (or primary) chemotherapy. If it shrinks the cancer successfully, only part of the breast may be removed, avoiding the need for a mastectomy.
  • After surgery if doctors think there is a risk of the cancer coming back. This is known as adjuvant chemotherapy. Decisions about adjuvant chemotherapy are made after considering the pathology report of the tissue removed during surgery. It is usually given after surgery when the cancer is: large, high-grade, has spread to the lymph nodes, triple negative (breast cancers that don’t have receptors for oestrogen, progesterone or HER2) or HER2 positive (human epidermal growth factor receptor 2). Sometimes an Oncotype DX test (also known as a gene expression profiling test, a gene expression analysis text or a gene assay) is performed on the removed tissue which helps the doctors decided if having chemotherapy will be beneficial and how likely it is for the cancer to return in the future. Chemotherapy is also often given with Herceptin (trastuzumab) if the patient is HER2 positive (as HER2 positive tumours have a worse prognosis and it improves the disease free survival of these women- for more information see ‘Herceptin’). 
  • As treatment for breast cancer that has spread or come back.

Chemotherapy drugs are usually given as an outpatient, either by injection into a vein (intravenously) or as tablets. Chemotherapy into the vein is given as a session of treatment, usually over a few hours. This is followed by a rest period of a few weeks, which allows the body to recover from any side effects of the treatment. A complete course of chemotherapy is likely to take 4–6 months. There are many different chemotherapy drugs used to treat breast cancer, and they’re often used in combinations (chemotherapy regimens) usually a combination of about 3 chemotherapy drugs (see Cancer Research UK for a list of chemotherapy drugs and the most common combinations for breast cancer).


Here women we interviewed discuss their experiences of chemotherapy and its side effects.

Having heard or read about chemotherapy and its side effects, many women were anxious or concerned about having it. Several described the procedure, and many commented on the comfortable clinic environment and supportive staff. One woman who had inflammatory breast cancer was given constant chemotherapy for several weeks and described her experience.

Tess was 33 when she was diagnosed, and pregnant. She had chemotherapy during her pregnancy and very few side effects.

Chemotherapy affects different people in different ways. A few women had no or minimal side effects and some of them continued working through the treatment.

For many women, however, chemotherapy was a difficult experience because of the side effects, and most were unable to work at this time. Common side effects include tiredness, weakness, nausea, vomiting, diarrhoea, hair loss, weight change, and altered taste. Women often experienced several of these side effects temporarily. Many said they felt low, tired, a lack of energy or weakness and several noted that, once they knew what to expect, accepting the treatment became much easier.

Nausea and vomiting were also common side effects for some women. Others discussed their experiences of weight gain or loss, and altered taste.

Some chemotherapies cause hair loss. A few women described the cold cap procedure that aims to reduce hair loss, though several also noted its failure in their case.

Several women who lost their hair decided to have their heads shaved. Others described wearing wigs and scarves at this time. Pricking pains, buzzing or burning sensations to the head were also reported by some women. Some women said they felt restless.

One woman described having oral thrush as a result of chemotherapy. Another woman said she had cystitis, as an unusual side effect of chemotherapy.

Menopausal symptoms were reported by some women and one woman, having experienced several severe side effects, refused further chemotherapy. Doctors prescribe chemotherapy if they believe that the additional chance of cure outweighs the side effects. The patient has a chance of weighing pros and cons, and many women stressed that the benefits of treatment outweigh the temporary side effects. Most women also felt encouraged by the support they received at this time from family, friends, hospital staff and other patients (see 'Sources of support').

Audio onlyText only
Read below

Janet was told she would need to have a mastectomy, chemotherapy and radiotherapy. She asked her doctor whether she could have chemotherapy before surgery rather than after it, in the hope that it might shrink the tumour and rule out the need for a mastectomy. Her doctor agreed that, in her case, having chemotherapy first would be possible.

A few women said they’d experienced complications during or after chemotherapy. Ingrid had a serious complication during chemotherapy and went to Accident and Emergency, where she was treated for a bi-lateral pulmonary embolism (blood clot in the lungs). Gillian had a viral infection shortly after the end of treatment and went into hospital for a week.

Healthtalk has a whole site on breast cancer in men, for more information see 'Chemotherapy for men with breast cancer'.


Last reviewed May 2015.
Last updated May 2015.

Feedback

Please use the form below to tell us what you think of the site. We’d love to hear about how we’ve helped you, how we could improve or if you have found something that’s broken on the site.

Make a Donation to healthtalk.org





Find out more about how you can help us.

Send to a friend

Simply fill out this form and we'll send them an email