Treatment Options: High Dose Chemotherapy

In breast cancer treatment clinical trials, researchers at NCI and other health institutions are testing high-dose chemotherapy to find out if it is better than standard chemotherapy. They are trying to learn if higher doses of drugs can prevent or delay the spread or return of breast cancer better than standard doses of drugs, and which type of treatment helps patients live longer.

Patients who receive high-dose chemotherapy are at great risk of suffering life-threatening side effects because the treatment damages their bone marrow and they no longer are able to produce needed blood cells. To help repair the damage done by high doses of drugs, the treatment includes peripheral blood stem cell transplantation and/or bone marrow transplantation.

Peripheral Blood Stem Cell Transplantation

Peripheral blood stem cell transplantation involves the removal of a certain type of blood cell (stem cell) from a patient's blood. Stem cells are immature cells from which all blood cells develop as they are needed. Stem cells are able to divide and form more stem cells (copies of themselves) or they can become fully mature red blood cells (erythrocytes), platelets, and white blood cells (leukocytes).

The removed stem cells are frozen and stored while the patient is treated with high-dose chemotherapy. After chemotherapy ends and the drugs are gone from the body, the stem cells are returned to the patient through a vein. The healthy stem cells can then begin to grow and produce all types of blood cells the patient needs to survive.

Bone Marrow Transplantation

Bone marrow is the sponge-like material found inside bones that produces blood cells. Autologous bone marrow transplantation is used in breast cancer treatment. In this procedure, some of a patient's own healthy bone marrow is removed with a needle before treatment begins. The bone marrow is then frozen and stored while the patient is treated with high-dose chemotherapy. Several days after the treatment ends and the drugs are gone from the body, the healthy bone marrow is given back to the patient through a vein. The healthy bone marrow can then begin to produce blood cells that the patient needs to survive. Peripheral blood stem cells and bone marrow transplantation may be used together as part of high-dose chemotherapy.

It hasn't been proven yet whether high-dose chemo-therapy is better than standard chemotherapy, or which breast cancer patients need this treatment. It is best to have high-dose chemotherapy at an established transplant center or medical institution conducting a clinical trial. Some health insurance plans pay for some of the costs of peripheral blood stem cell or bone marrow transplantation.

POSSIBLE PROBLEMS: There are major risks involved with high-dose chemotherapy. Talk with your doctor about possible complications and severe side effects, and whether this would be an appropriate treatment for your type and stage of breast cancer.