Chemotherapy for breast cancer

When is chemotherapy recommended?

Chemotherapy uses drugs to kill cancer cells or slow their growth. It may be used before or after surgery or after surgery. It is often used for breast cancers that are not sensitive to hormone therapy, are HER2+ or triple negative, or for inflammatory breast cancers. Chemotherapy is sometimes used for hormone receptor positive breast cancers.

Having chemotherapy

Different types of chemotherapy drugs are used. The choice of drugs will depend on the type of cancer, how far it has spread and what other treatments you are having. Usually, you will have a combination of drugs. Common drugs include carboplatin, cyclophosphamide, docetaxel, doxorubicin, epirubicin and paclitaxel. Your treatment team may also refer to the drugs by their brand names, or letters like AC or TC. Your medical oncologist will talk to you about the most suitable types of chemotherapy drugs, as well as their risks and side effects. For more information, visit the eviQ cancer treatments website.

Generally, chemotherapy is given through a vein (intravenously). You will usually be treated as an outpatient, but occasionally you may have to stay in hospital overnight. Chemotherapy is usually given once every 1–3 weeks for 3–6 months.

Side effects of chemotherapy

Chemotherapy damages cells as they divide. This makes the drugs effective against cancer cells, which divide rapidly. However, some normal cells – such as hair follicles, blood cells and cells inside the mouth or bowel – also divide rapidly. Side effects happen when chemotherapy damages these normal cells. Unlike cancer cells, normal cells can recover, so most side effects are temporary.

Nausea

You may feel sick for a few hours or days after each treatment. Not everyone feels sick, and you’ll be given medicine to help prevent it. Some medicines may cause constipation; talk to your doctor about this.

Diarrhoea

You may have loose, watery stools and feel like you urgently need to go to the toilet. You may be given medicine to manage diarrhoea.

Hair loss

You may lose the hair from your head and other areas of the body (e.g. eyebrows, underarms and pubic area). Cold caps may prevent hair loss on your head in some cases. Learn more about hair loss and cancer.

Swelling (oedema)

Some medicines used with chemotherapy drugs can cause excess fluid (fluid retention) to build up in the body. This can affect the arms and the trunk, but it usually gets better when treatment ends.

Changes to fertility

Chemotherapy can cause infertility in females and males. If you may want to have children in the future, it’s essential that you talk to your cancer specialists about your options and ask for a referral to a fertility specialist before treatment starts. Learn more about fertility and cancer.

Heart problems

The risk is small but chemotherapy can sometimes damage the heart muscle (cardiomyopathy). Your heart health will be checked before, during and after treatment. If you are at risk of heart damage, you may be offered other types of drugs.

Peripheral neuropathy

You might develop tingling in your hands or feet. This is called peripheral neuropathy.

Other side effects

These include an increased infection risk, fatigue, mouth ulcers, constipation, and memory changes.