Chemotherapy is a form of drug treatment for cancer. It may be used to treat breast cancer whether it is localized (limited to the breast), removed (post-operative or adjuvant treatment), or advanced (in other areas of the body outside the breast).

There are many different types of chemotherapy drugs. For breast cancer, the drugs most commonly used are: doxorubicin (Adriamycin), cyclophosphamide (Cytoxan), paclitaxel (Taxol), docetaxel (Taxotere), fluorouracil (5-FU) and capecitabine (Xeloda). These drugs are usually administered intravenously (IV), but cyclophosphamide and capecitabine are available as pills. Treatment regimens (duration of treatment, intervals between treatments) vary among the different regimens used. Intravenous treatments are usually administered in the doctor’s office, at an infusion center and, less often, in the hospital. The oral tablets will be obtained from the pharmacy with the physician’s prescription. Frequent laboratory testing is used to monitor for the major side effect of chemotherapy which is a drop in the blood counts. If the red cell count drops and the patient becomes anemic, he/she may feel tired and may benefit from injections of erythropoietin (Procrit or Epogen) on a weekly basis; sometimes blood transfusions are necessary. If the white blood cell(wbc) count drops, the patient is at risk for an infection and may require prophylactic antibiotics, a growth factor given subcutaneously to stimulate the body to make new white cells, or very close observation; if the patient develops a fever despite some or all of the above precautions, he/she may require an admission to the hospital for more intensive intravenous antibiotics. If the platelet count drops, the patient may be at risk for bleeding. Physical examinations and x-rays will be used to help to monitor the effectiveness of the chemotherapy treatment.

The benefits of such treatments can be significant and depend upon the stage of the cancer and other markers such as estrogen receptors (ER) and progesterone receptors (PR), presence or absence of the her-2/neu protein (also called c-erb-b-2 protein), and site(s) of the disease. Chemotherapy can reduce the risk of a recurrence in the same breast after breast conserving surgery, such as a lumpectomy. It can also prevent or delay the risk of recurrence elsewhere (development of metastatic disease) after any kind of breast surgery that completely removed the primary tumor. If breast cancer has spread to other parts of the body (metastatic breast cancer or advanced breast cancer), chemotherapy can slow the progression or result in shrinkage of established cancer sites. A medical oncologist can provide more information on a given individual’s chances of benefit and/or risk after a detailed review of the patient and of all the patient’s data.

Other side effects of chemotherapy include: nausea, vomiting, hair loss, diarrhea, allergic reactions, rash, potential damage to the heart muscle, nail changes, muscle and joint pains, and numbness and tingling of the fingers and toes. The specific side effects are determined by the particular chemotherapy drugs administered. However, there are supportive measures that may significantly reduce these side effects and these will be discussed by your medical oncologist and by the oncology nurses. Additionally, the Integrative Medicine Program at Hartford Hospital offers services such as acupuncture or reiki which may alleviate chemotherapy side effects. There are boutiques, such as the one opening in the Helen and Harry Gray Cancer Center, that provide products to address the side effects of chemotherapy and surgery such as wigs, head dressings, camisoles, and breast prostheses.

You should always consult with your physician for more information and to discuss any questions you may have.