Treatment Options: Chemotherapy

Research suggests that, even if a lump is small, cancer cells may have spread outside the breast. Doctors can use chemotherapy drugs to destroy cancer cells. Some chemotherapy drugs work better when combined with other chemotherapy drugs than when used alone.

The oncologist will recommend a treatment plan according to your individual case. The treatment will depend on your age, whether or not you still are having periods, the risk for spread or recurrence, and your general health. The drugs you take will depend on the type and stage of cancer, where it is located, how much or how fast it has grown, and how it is affecting you. Chemotherapy is used to:

* Decrease the chances that cancer will come back after breast cancer surgery.
* Shrink breast cancer before surgery, when the tumor is large or it is inflammatory cancer.
* Control the disease when breast cancer is found in the lungs, bones, liver, brain, or other parts of the body.

Chemotherapy drugs travel throughout the body to slow the growth of cancer cells or kill them. Often, the drugs are injected into the bloodstream through an intravenous (IV) needle that is inserted into a vein. Some drugs are given as pills. Treatment can be as short as a few months or as long as 2 years.

Chemotherapy is usually given in cycles during which you have treatment for a period of time, and then you have a few weeks to recover before your next treatment. Depending on the drugs you take, you may have your chemotherapy at home, in your doctor's office, in a clinic, in a hospital's outpatient department, or in a hospital. How often and how long you have chemotherapy will depend on the type and stage of breast cancer, the drugs that are used and how your body responds to them, and the goals of the treatment. You should follow the schedule prescribed by your doctor.

Throughout chemotherapy, your oncologist and nurse will watch how you respond to the therapy. You will have frequent physical exams and blood tests. You should check with your doctor before taking any other medications during your treatment.

Chemotherapy affects all fast-growing cells throughout the body. Therefore, in addition to killing cancer cells, it also kills fast-growing normal cells. This is what may cause side effects such as hair loss, mouth sores, and fatigue. Today, because of what has been learned in research studies, doctors are able to control, lessen, or avoid many side effects of chemotherapy.

POSSIBLE PROBLEMS: Chemotherapy can cause short-term and long-term side effects that are different for each patient, depending on the drugs used.

The most common short-term side effects that may appear during chemotherapy include: loss of appetite, nausea, vomiting, diarrhea, constipation, fatigue, infections, bleeding, weight change, mouth sores, and throat soreness. Some of these problems may continue for some time after chemotherapy ends.

Some drugs cause short-term hair loss. Hair will grow back either during treatment or after treatment is completed. Before you start chemotherapy, you may want to have your hair cut short, or buy a wig, hat, or scarves that you can wear while you are going through treatment.

Serious long-term side effects may include weakening of your heart, damage to your ovaries, infertility, early menopause, or second cancers such as leukemia (cancer of the blood). These side effects may not appear until later, some time after chemotherapy is completed.

Fighting Infections

You are more likely to get infections during chemotherapy, and your body is less able to fight infections during this time. You can help yourself stay healthy by following these steps:

* Finish dental work before starting chemotherapy. You cannot have dental work during chemotherapy.
* Eat a healthy diet and get plenty of rest.
* Stay away from large crowds and from anyone with a cold, infection, or contagious disease.
* Bathe daily, wash your hands often, and follow good mouth care.
* Wear work gloves to protect your hands against cuts and burns.
* If you cut yourself, keep the wound clean and covered. Talk with your doctor or nurse about applying antibiotics or medications.

Pregnancy

During chemotherapy, you may stop having monthly menstrual periods. You still can get pregnant, however, so talk with your doctor about birth control. The effect of chemotherapy on an unborn baby is unknown. After your treatment is over, your ability to get pregnant will depend on your age and the types of drugs you received. If you hope to become pregnant after treatment, talk with your doctor before starting chemotherapy.

MANAGING NAUSEA

Feeling nauseous, or as if you have to vomit, is a common side effect of chemotherapy. Your doctor can prescribe medication to help with this problem. Good nutrition is especially important during cancer treatment. The following suggestions may help:

* Eat small meals often; do not eat 3 to 4 hours before your treatment.
* Eat whatever you can tolerate; for example, popsicles, gelatin desserts, cream of wheat, oatmeal, baked potatoes, and fruit juices mixed with water.
* Chew your food thoroughly and try to relax during meals.
* Learn stress reduction exercises such as relaxation, meditation, and deep breathing.