Chemotherapy is the use of anti-cancer drugs to treat cancerous cells. Chemotherapy reaches all parts of the body, not just the cancer cells. Your oncologist will recommend a treatment plan for you, which will be based on:
- Your overall health and medical history
- Your age and whether you are menstruating
- The type and stage of the cancer
- Your tolerance for specific medications and procedures
- Expectations for the course of the disease
- Your opinion or preference
Your oncologist will also determine how long and how often you will have chemotherapy treatments.
Chemotherapy can be administered intravenously (in the vein) or by pill, and it is usually a combination of drugs. Treatments are often given in cycles — a treatment for a period of time, followed by a recovery period, then another treatment. Chemotherapy may be given in a variety of settings, including your home, a hospital outpatient facility, a physician's office or clinic, or in a hospital. Some women will need to stay in the hospital during treatment.
Side effects depend mainly on the specific drugs and the dose. The drugs affect cancer cells and other cells that divide rapidly:
Blood cells — These cells fight infection, help your blood to clot and carry oxygen to all parts of your body. When drugs affect your blood cells, you are more likely to get infections, bruise or bleed easily, and feel very weak and tired. Years after chemotherapy, some women can develop leukemia (cancer of the blood cells).
Cells in hair roots — Chemotherapy can cause hair loss. Your hair will grow back, but it may be somewhat different in color and texture.
Cells that line the digestive tract — Chemotherapy can cause poor appetite, nausea and vomiting, diarrhea or mouth and lip sores.
Your doctor can suggest ways to control many of these side effects.
Some drugs used for breast cancer can cause tingling or numbness in your hands or feet. This problem usually goes away after treatment is over.
Menopause and Fertility
Some anticancer drugs can damage your ovaries, causing them to stop making hormones. You may have symptoms of menopause, including hot flashes and vaginal dryness. Your menstrual periods may no longer be regular or may stop. Some women become infertile (unable to become pregnant), and for women over the age of 35, infertility is likely to be permanent. You may wish to talk with a fertility specialist prior to chemotherapy.
On the other hand, you may remain fertile during chemotherapy and be able to become pregnant. The effects of chemotherapy on an unborn child are not known. You should talk to your doctor about birth control before treatment begins.
Timing of Treatment
Chemotherapy can be administered before and after women undergo breast surgery. Following surgery to remove all of the cancer that can be seen, chemotherapy is used to kill any cancer cells that may have been left behind but can’t be seen. Chemotherapy after breast-conservation surgery or mastectomy reduces the risk of breast cancer returning.
Some women have chemotherapy before surgery in order to shrink a large tumor so that breast-conserving surgery is possible. Women with large Stage II or IIIA breast tumors often choose this treatment.