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Chemotherapy| is the use of anti-cancer drugs to destroy cancer cells. The drugs are carried in the blood and can reach cancer cells anywhere in the body.
Chemotherapy may be used as a first treatment if secondary breast cancer is growing quickly or is affecting the liver| or lungs|. It’s also given if the type of cancer you have doesn’t respond to hormonal therapy| (ER negative|). If you’ve already had a chemotherapy drug before, a different drug or drugs will be used.
Research trials| are looking at different combinations of chemotherapy drugs and chemotherapy in combination with treatments such as biological therapies|.
Chemotherapy drugs commonly used to treat secondary breast cancer are:
You may have a drug on its own or a combination of drugs. Capecitabine (a chemotherapy tablet) can be given on its own or with docetaxel, and paclitaxel can be given with gemcitabine. A drug called paclitaxel albumin (Abraxane®)| may be used in certain circumstances, but may not be widely available.
Your cancer specialist will explain which type of chemotherapy is appropriate for you and will discuss the benefits and side effects with you.
Our section on chemotherapy| has more detailed information about the treatment. It als has information on the individual drugs|, and drug combinations|.
Chemotherapy drugs can be given into a vein (intravenously), as injections or drips (infusions), or as tablets or capsules to take at home. Intravenous chemotherapy can be given through a small tube (cannula) in your arm or occasionally through a soft plastic tube called a central| or PICC line|. A central line is put into a vein in your chest under a general or local anaesthetic. If a tube is put into a vein in the bend of your arm it’s known as a PICC line.
You’ll usually have your treatment in the chemotherapy day unit. Some chemotherapy drugs can be taken as tablets or capsules at home.
Your chemotherapy will be given to you as a series of treatments known as cycles. You may have drugs weekly or every three weeks and the complete treatment may take several months. Your doctor or nurse will explain how many cycles of treatment are planned for you and how you’ll be given your chemotherapy.
Chemotherapy drugs can cause side effects, but many of these can be well controlled with medicines and will usually go away when your treatment is finished. Chemotherapy can also help you feel better because it can reduce the symptoms of secondary breast cancer.
Your doctor or specialist nurse will tell you more about what to expect. Always let them know about any side effects you’re having as there are usually ways in which they can be controlled. The main side effects are described below, along with some ways to control or reduce them.
While the drugs are acting on the cancer cells in your body, they also temporarily reduce the number of white cells in your blood. When these cells are reduced, you’re more likely to get an infection| and you may get tired easily.
Contact your doctor or the hospital straight away if:
If necessary you’ll be given antibiotics to treat any infection.
You may also be given injections of growth factors|, which stimulate your body to make more white blood cells. Your blood will be tested before each cycle of chemotherapy to make sure your cells have recovered.
Chemotherapy can reduce the number of platelets in your blood. Platelets are cells that help the blood to clot. If you develop any unexplained bruising or bleeding, such as nosebleeds, blood spots or rashes on the skin, or bleeding gums, contact your doctor or the hospital straight away.
If the level of red blood cells in your blood is low this is called anaemia. It can make you feel very tired| and lethargic, and you may also become breathless|. Anaemia can be treated by blood transfusions. These should help you feel more energetic and ease breathlessness.
Some of the chemotherapy drugs can make you feel sick| or be sick. But there are very effective anti-sickness drugs (anti-emetics) to prevent this. If the sickness is not controlled or continues, even with anti-sickness treatment, let your doctor know as they can prescribe other drugs for you to try.
You’re likely to become tired| and have to take things more slowly. Try to pace yourself and save your energy for things that you want to do or that need doing. Balance rest with taking a little exercise, such as short walks, which will help to increase your energy levels.
Try to eat frequent, small meals and ask others for help in preparing meals. If you have a poor appetite,| there are many ready-to-drink supplements that add energy and protein to your diet, some of which are available on prescription.
Some chemotherapy drugs can make your mouth sore| and may cause ulcers. Keeping your mouth and teeth clean, and using mouthwashes, is important. Your nurse will show you how to use these properly.
This is a common side effect of some, but not all, chemotherapy drugs. Your doctor or nurse will be able to tell you if you’re likely to experience this. Hair loss| can be a distressing side effect, but there are many ways of covering up hair loss, including wigs, hats or scarves. You may be entitled to a free wig from the NHS. If your hair does fall out, it should start to grow back 3-6 months after finishing treatment.
Cancer can increase your risk of developing a blood clot (thrombosis), and having chemotherapy may increase this risk further. A blood clot may cause symptoms such as pain, redness and swelling in a leg, or breathlessness and chest pain. Blood clots can be very serious so it’s important to tell your doctor straight away if you have any of these symptoms, as most clots can usually be successfully treated with drugs that thin the blood. Your doctor or nurse can give you more information.
It’s not advisable to become pregnant while having chemotherapy, as the drugs may harm the unborn baby. It’s important to use effective contraception during your treatment.
Condoms should be used if you have sex within the first 48 hours after chemotherapy. This is to protect your partner from any of the drug that may be present in vaginal fluid.
Younger women may find that chemotherapy brings on an early menopause|, which can be difficult to deal with.
Content last reviewed: 1 September 2010
Next planned review: 2013
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© Macmillan Cancer Support 2013
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