Chemotherapy uses drugs to kill cancer cells or slow their growth. It is usually given before radiotherapy and may be used if:
- the cancer needs to be shrunk or controlled before surgery (neoadjuvant chemotherapy)
- the cancer is not sensitive to hormone therapy
- the risk of the cancer returning is high
- the cancer returns after surgery or radiotherapy (to gain control of the cancer and relieve symptoms).
Many different types of chemotherapy drugs are used to treat early breast cancer. The drug combination you are given will depend on the type of cancer, how far it has spread and what other treatments you are having. Common drugs include doxorubicin, cyclophosphamide, fluorouracil, docetaxel and paclitaxel. Your medical team may also refer to the drugs by their brand names.
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. The number of chemotherapy sessions varies depending on the combination of drugs prescribed by your oncologist.
Most people will have chemotherapy for 3–6 months. Some drugs are given once every three weeks, some are given each week (e.g. once a week for 12 weeks), and some are given on an accelerated schedule (e.g. once every two weeks instead of once every three weeks). Not every person with early breast cancer will have the same chemotherapy treatment on the same schedule.
Side effects of chemotherapy
Chemotherapy kills healthy cells as well as cancer cells, which can cause side effects. The side effects caused by chemotherapy depend on the drugs used. Most side effects are temporary, and they can often be prevented or managed by your treatment team.
Side effects may include tiredness, mouth ulcers, taste changes, nausea and vomiting, and constipation. Chemotherapy can also lower your immune system, increasing the risk of infection.
Hair loss − Most people who have chemotherapy for breast cancer lose their head and facial hair. Some treatment centres provide cold caps, which may prevent total head hair loss, but this depends on the drugs used.
Infertility − For some women, periods can become irregular or stop during chemotherapy. Periods may return to normal after treatment, or they may stop permanently (menopause), causing infertility. For men, chemotherapy can lower the number of sperm that are produced, which can cause temporary or permanent infertility. If you would like to have children in the future, ask your doctor for a referral to a fertility specialist before your treatment starts.
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