Chemotherapy

Anti-cancer drugs, known as chemotherapy, are often given after surgery through an IV, which allows them to enter the bloodstream and target cancer cells wherever they are in the body.

Depending on how it is used, your doctor may refer to chemotherapy as either adjuvant or neoadjuvant therapy.

Adjuvant therapy describes chemotherapy that is used after surgery to lower the risk of breast cancer recurrence (in the breast and throughout the body). Even when all of the cancer appears to be gone, doctors will sometimes recommend chemotherapy as an added measure of safety in case some cancer cells have escaped into the bloodstream. Over time, these cells could spread cancer to other places in the body. Chemotherapy helps to lower this risk.

Neoadjuvant therapy is used before surgery to shrink cancer. Shrinking the size of a cancer  gives some women with larger cancers the option of choosing breast-conserving surgery over mastectomy. Using chemotherapy before surgery also gives doctors and patients a chance to see how well a certain drug or combination of drugs is going to work in an individual woman’s case. In some instances, chemotherapy may be the main treatment (instead of surgery) for women diagnosed with advanced breast cancer.

Prior to initiating chemotherapy, patients will spend time with their oncologist or oncology nurse to review the potential risks, side effects and benefits of therapy. The side effects of chemotherapy vary depending on the drugs used, the dosages, the overall length of treatment and the individual woman, but the most side effects are nausea and hair loss. Mouth sores, diarrhea or constipation are other common side effects. Women planning to become pregnant (or able to become pregnant but not taking birth control) should talk with their doctors before starting treatment.

The good news is that most of these side effects go away when chemotherapy is completed. Additionally, major strides have been made in developing drugs that treat the cancer more effectively and have fewer side effects.

Questions you may want to ask your doctor about chemotherapy:

• Which type of chemotherapy do you recommend? Why?
• When do you recommend I have chemotherapy — before surgery or after?
• How long will I need to receive chemotherapy?
• How will the treatment be given? Do I need a port?
• How will we know if the treatment is working?
• How will chemotherapy affect my daily life? Will I be able to work, exercise and perform my usual activities?
• Can I stay alone after my treatments or do I need someone to stay with me?
• What are the potential short- and long-term side effects of each medication?
• Will I lose my hair?
• Where can I get more information about the medication(s) I will be taking?
• If I am worried about the cost of treatment, who can help me with this concern?