Womens Health

Chemotherapy for Breast Cancer

Chemotherapy is currently one of the most common types of breast cancer treatments. This cancer treatment has a variety of benefits for women undergoing breast cancer treatment. However, breast cancer chemotherapy is not for everyone and there are certain side effects of chemotherapy that can affect your everyday life.

What is Chemotherapy?

The term chemotherapy refers to cytotoxic chemotherapy; that is, the use of drug treatment in order to destroy cells. Chemotherapy employs cytotoxic drugs in order to destroy cells by minimizing their growth. Chemotherapy drugs are able to reach cancer cells throughout the body by circulating through the bloodstream.

However, these drugs do not distinguish between cancerous and non-cancerous cells and so target all cells that divide. Because cancerous cells divide at a higher rate than non-cancerous cells, and because they repair themselves at a slower rate, they are targeted more often, making chemotherapy an effective form of breast cancer treatment.

How is Chemotherapy Used for Breast Cancer Treatment?

Chemotherapy may be used as a part of breast cancer therapy in a variety of ways:

  • prior to surgery in order to shrink a tumor (known as neoadjuvant therapy). This is used to decrease the size of a tumor or to minimize the amount of surgery required, which in some cases can reduce the chances of having a mastectomy. In some cases, radiotherapy is also required.
  • following surgery in order to reduce the risk of the tumor spreading or returning (known as adjuvant therapy). This is used in cases when of large primary cancers, or when the lymph nodes under the arms have breast cancer cells. Adjuvant therapy is also performed when breast cancer cells are a high grade 3, and when hormone therapy is not a viable treatment option.
  • for the treatment of breast cancer that has spread or that has returned.

When is Chemotherapy Required for Breast Cancer Treatment?

A variety of factors are used to determine whether chemotherapy is the best form of breast cancer treatment:

  • key features of the cancer: for example, tumor grade, growth and size.
  • individual patient profile: age and health of the individual.
  • menopausal status: whether the individual has reached menopause or not. Chemotherapy is usually performed in women who are pre-menopausal.
  • stage of the disease: the stage of progression of the cancer
  • severity of the cancer: chemotherapy is generally not recommended for non-invasive (in situ) cancer, as this type of cancer has a low risk of metastasizing (spreading). On the other hand, chemotherapy is typically used for more aggressive forms of breast cancer, especially if cancer is found in the lymph nodes.

In addition, chemotherapy is a viable option when the benefits associated with this type of cancer treatment outweigh the side effects.

What Does Chemotherapy Treatment Involve?

Chemotherapy treatments are given in a period of cycles, with time for recovery in between each cycle.

Generally, chemotherapy treatment lasts from 3 to 6 months. When surgery is required, it chemotherapy will typically begin as soon after the surgery as possible.

Chemotherapy can be administered orally through a pill, capsule or liquid format; it can also be administered using an intravenous tube. In some cases, it is administered through a port (sometimes referred to as a "port-a-cath"), a small device that is inserted in the upper chest wall via minor same-day surgery. Medication is administered through the port to insure that drugs go directly to the bloodstream.

Chemotherapy Side Effects

Some common side effects of chemotherapy are:

  • hair thinning and hair loss, either partial or total (alopecia)
  • dry, discolored skin that is extra sensitive to the sun
  • changes in nail enamel, including the appearance of dark or white lines, as well as nails that grow more slowly
  • loss of appetite and change in taste of food
  • fatigue that can be chronic in nature and which can last from six months to one year
  • nausea

Side effects depend on dose, as well as the type and combination of drugs administered. Age and gender can also play a role in the nature of chemotherapy side effects.

Benefits of Chemotherapy

A recent review that looked at randomized trials of 30 000 women found that chemotherapy is beneficial in treating all types of breast cancer, even in cases where cancer was not found in the lymph nodes.

Studies have shown that chemotherapy reduced the likelihood of recurrence of breast cancer by 35% among women under the age of 50 and by 20% in women aged 50 to 69.

In addition, chemotherapy has long-term benefits. The percentage of women with node negative disease (breast cancer not found in lymph nodes) who survived 10 years after diagnosis increased from 71% to 78% with chemotherapy and from 67% to 69% among older women.

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