Sunday, March 3, 2024

Breast Cancer Chemo Side Effects

How Long Do Side Effects Last After Radiation Treatment

TCHP Chemotherapy Side Effects with HER2+ Breast Cancer

Early side effects happen during or shortly after treatment. These side effects tend to be short-term, mild, and treatable. Theyre usually gone within a few weeks after treatment ends. The most common early side effects are fatigue and skin changes. Other early side effects usually are related to the area being treated, such as hair loss and mouth problems when radiation treatment is given to this area.

Early Menopause And Fertility

If youre hoping to have a child after breast cancer treatment, there are things you can do. Talk with a fertility specialist before starting treatment to discuss your options. Some options are described below.

Storing eggs

The most common way to preserve fertility is to store eggs before chemotherapy begins.

In both procedures, some of your eggs are collected, frozen and stored. The eggs may be fertilized by sperm from a spouse, partner or donor. Or you may store unfertilized eggs, which dont require a sperm donor.

After treatment, the eggs can be thawed and implanted into the uterus.

Insurance coverage for fertility services varies from state to state. Check with your insurance company to find out whats covered.

Protecting the ovaries

There are no known treatments guaranteed to protect the ovaries from chemotherapy.

However, drugs that shut down the ovaries during chemotherapy may help women return to regular menstrual periods after treatment ends. This may help preserve fertility.

Summary Of Treatment Options For Metastatic Breast Cancer

Hormone receptor-positive, HER2-negative breast cancer

Hormonal therapy is considered the standard initial treatment for HER2-negative metastatic breast cancer that is also hormone receptor-positive. It is often given in combination with targeted therapy. However, chemotherapy may also be given. A clinical trial may also be an option for treatment at any stage.

Hormone receptor-negative, HER2-negative breast cancer

In general, chemotherapy or targeted therapy is given for treatment of triple-negative breast cancer. A clinical trial may also be an option for treatment at any stage.

HER2-positive breast cancer that has spread to parts of the body other than the brain

In general, HER2-targeted therapy is regularly added to treatment for HER2-positive breast cancer that has spread. The drugs used depend on the treatments already given and whether the cancer is hormone receptor-positive. The treatment recommendations for first-line, second-line, and third-line or higher treatment are described below. A clinical trial may also be an option for treatment at any stage.

First-line treatment

Second-line treatment

  • For people with advanced breast cancer that has grown during or after first-line treatment with a HER2-targeted therapy, ASCO recommends trastuzumab deruxtecan as a second-line treatment.

Third-line or higher treatment

HER2-positive breast cancer that has spread to the brain

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Tips To Improve Cognitive Function

Although no studies show the tips below improve cognitive function, they may help some people with memory problems .

Tips to improve cognitive function

  • Plan your day to do the things that need the most thinking when you feel your best.
  • Get extra rest at night, but limit naps during the day to less than one hour.
  • Write down or record things you want to remember.
  • Use a calendar and write down important dates and information.
  • Use a pill box to keep track of medications.
  • Ask a friend or family member for help when you need it.
  • Ask your nurse, social worker or patient navigator for help keeping track of clinic visits.
  • Ask your health care provider about complementary therapies, such as meditation, that may help.
  • Do puzzles or play games for mental exercise.

Adapted from National Cancer Institute materials .

For Metastatic Breast Cancer

Side Effects Of Breast Cancer Chemotherapy

Chemo can be used as the main treatment for women whose cancer has spread outside the breast and underarm area to distant organs like the liver or lungs. Chemo can be given either when breast cancer is diagnosed or after initial treatments. The length of treatment depends on how well the chemo is working and how well you tolerate it.

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Managing Symptoms And Side Effects

Breast cancer and its treatment can cause a number of symptoms and side effects. The greatest influence on the type of symptoms and side effects that you experience will be the sites your cancer has spread to and the type of treatment you are having. Other factors such as your general health and wellbeing will also play a part in how your symptoms may affect you.

The following section also provides information on managing a wide range of symptoms and side effects. Remember, everyone is different and you are unlikely to experience all of these symptoms or side effects. Some people experience very few or have only mild side effects or symptoms

What Tests Are Used To Determine If A Patient Can Benefit From Chemo

Genomic profiling tests can help determine if a cancer is likely to return and whether or not some patients with small, early cancers will or will not benefit from chemotherapy.

There are many of these tests, and the two most common ones are Oncotype DX and MammaPrint, Dr. Lustberg says, adding that both are FDA-approved. The tests analyze a sample of a cancer tumortaken from a biopsy or a surgical specimenlooking for the activity of certain genes that can affect the likelihood that a patients cancer will grow or spread.

The following patients may be eligible for the Oncotype DX test:

  • Youve recently been diagnosed with Stage I, Stage II, or Stage IIIa invasive breast cancer
  • The cancer is estrogen-receptor-positive

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Cancer Chemo Side Effects And How To Limit Them

Despite a slew of new targeted treatments and immunotherapies, chemotherapy remains a mainstay of cancer treatment. Unfortunately, so do the adverse side effects that go with systemic â or system-wide â therapies like chemo, which simply target all the fast-growing cells in your body.

Primarily, chemotherapy is meant to kill fast-dividing cancer cells, but blunt tool that it is, it also impacts normal healthy cells that also happen to divide quickly. Those include hair follicles, skin and the cells lining the gastrointestinal tract, as well as cells in the bone marrow, including immune cells. This is why cancer patients often lose their hair, experience rashes, have diarrhea and are susceptible to infections during this type of therapy.

Improvements in antiemetics over the last two decades have reduced the risk of nausea and vomiting, one of the most debilitating side effects of chemotherapy, but patients undergoing chemo can experience many others, some of which â think blood clots or severe neutropenia â can be life threatening.

Physician-scientist Dr. Gary Lyman of Fred Hutchinson Cancer Center, a longtime thought leader within the American Society of Clinical Oncology , along with three colleagues recently in Nature Reviews Clinical Oncology offering a broad overview of common, acute chemotherapy-associated adverse events and how to manage â or better yet, prevent them.

Before You Start Chemotherapy

What Are the Side Effects of Chemotherapy?

You need to have blood tests to make sure its safe to start treatment. You usually have these the day before or on the day you start treatment. You have blood tests before each round or cycle of treatment.

The pharmacists make chemotherapy for each person individually. They do this once your blood test results have come through. Its worked out based on your weight, height and general health.

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Can Receiving Less Chemotherapy Result Ultimately In Better Outcomes

Chemotherapy can shrink cancer and slow its growth, which is why it has been used to treat breast cancer in conjunction with surgery for so many years. But the side effects can be difficult.

In the short term, these side effects can include such problems as nausea, fatigue, and hair loss, which can sometimes last far beyond treatment. We know that, after a course of chemotherapy, a number of women, up to several years out, don’t regain their full vitality, Dr. Winer says.

But even more concerning are the long-term effects, which can include rare, but difficult, complications such as heart problems, neuropathy, and leukemia, which can ultimatelyand indirectlyaffect outcomes.

These potentially debilitating side effects are why personalizing chemotherapy treatment has become so important. If a patient can do just as well with fewer medical treatments, it’s almost always a better thing, says Dr. Winer. Less chemotherapy can mean fewer side effects, less anxiety, improved quality of life, and possibly even a longer life, he adds.

Also, when side effects are truly debilitating, treatment delivery may be impaired, Dr. Lustberg says. If we can enhance how patients are feeling during treatment, they may actually tolerate treatment better, stay on it longer, not need dose reductions or modifications, and have better disease outcomes. It’s all interrelated.

Longer Term Side Effects

Fatigue

Tiredness is commonly reported during treatment. This may be a direct effect of the drugs or may be due to other factors such as disrupted sleep patterns.

  • Try to get adequate rest but also try to exercise regularly. Go for a walk outside each day as this can actually give you more energy.
  • Find something that you actually enjoy doing and also try to incorporate exercise into your usual day, e.g. walk upstairs rather than taking the lift, park further away from where you want to go and walk the extra distance. Build this up gradually.
  • Your GP, practice nurse or a physiotherapist can work with you to devise a specific exercise plan for you.
  • Let others help when your energy levels are low.

If your fatigue doesn’t allow you to exercise, discuss this with your GP.

Usually energy levels recover after treatment finishes but this commonly takes time. In some cases full recovery may take 12 months or more.

Cognitive changes

Some people notice they are having concentration and short-term memory problems following their chemotherapy. This is often referred to as chemo brain. The severity and duration of symptoms differ from person to person. For some people the symptoms are very mild and resolve soon after treatment stops, but others may find their daily life is noticeably affected for a much longer period, restricting their ability to return to work in their pre-treatment capacity.

Menopause/fertility

Heart conditions

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Possible Side Effects Of Chemotherapy

Chemo drugs can cause side effects. These depend on the type and dose of drugs given, and the length of treatment. Some of the most common side effects of chemo include:

  • Nausea and vomiting

Chemo can also affect the blood-forming cells of the bone marrow, which can lead to:

  • Increased chance of infection
  • Easy bleeding or bruising

Other side effects are also possible. Some of these are more common with certain chemo drugs. For example:

Most of these side effects tend to go away after treatment is finished. Some, such as hand and foot numbness, may last for a long time. There are often ways to lessen these side effects. For example, you can be given drugs to help prevent or reduce nausea and vomiting.

Be sure to discuss any questions about side effects with your cancer care team. Report any side effects or changes you notice while getting chemo right away so that they can be treated promptly. In some cases, the doses of the chemo drugs may need to be reduced or treatment may need to be delayed or stopped to prevent the effects from getting worse.

Side Effects Of Cancer Treatment

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Cancer treatments may have many side effects. A side effect occurs when treatment damages healthy cells. Side effects can be different for each person, and for different medicines and kinds of treatment.

If you think youre experiencing any side effects, talk to your medical team. They may be able to help you manage them in a variety of ways.

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Chemo Drugs For Breast Cancer That Has Spread

Although drug combinations are often used to treat early breast cancer, advanced breast cancer often is treated with single chemo drugs. Still, some combinations, such as paclitaxel plus gemcitabine, are commonly used to treat metastatic breast cancer.

For cancers that are HER2-positive, one or more drugs that target HER2 may be used with chemo.

How Long Does Chemotherapy Take For Breast Cancer

Typically, you receive chemotherapy in cycles. You may receive chemo every week or every two, three or even four weeks. Cycles are usually two to three treatments long. Each cycle includes a rest period to allow your body to recover. For example, you may have the same treatment every Monday for three weeks. Then you have an extra week to recover before repeating the cycle. Many people have multiple treatment cycles in a row. Treatment may last three to six months.

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Fear Of Cancer Coming Back

After treatment, many people might be afraid that their cancer will come back . You may become concerned about new symptoms youre having and wonder if theyre related to breast cancer.

Its important to talk with your healthcare provider about any new symptoms you notice. Many of these issues are normal parts of healing and your body returning to a new normal after breast cancer treatment. Your healthcare team is always available to discuss your concerns or fears with you.

You can call or send messages to your doctor or nurse through MyMSK . It may also be helpful to talk with a social worker, therapist, or chaplain. You can also join a support group. For more information, read MSK Support Services.

How Long After Radiation Does Hair Fall Out

Long Term Side Effects of Chemotherapy During Breast Cancer Treatment

You might start to lose your hair about 2 or 3 weeks after you begin treatment. It usually starts to grow back once you finish your course of radiotherapy. But it might not be quite as thick as before and in some people can be patchy. The more radiotherapy you have had, the longer your hair will take to grow back.

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Early Menopause And Menopausal Symptoms

As with natural menopause, you may have symptoms such as hot flashes, including night sweats, and vaginal dryness. Because the onset of menopause is sudden, these symptoms may be worse than with natural menopause.

Early menopause can also affect bone health. Menopause can cause a loss of bone density .

You may also have muscle or joint aches.

What If I Have Side Effects

You will see your doctor regularly while you are having treatment. Before each dose of chemotherapy you will have a blood test and a consultation with your medical oncologist to review your treatment. You will be able to discuss any side effects you have experienced and to ask questions. If necessary, the treatment can be adjusted for the next cycle.

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How Is Breast Cancer Chemotherapy Administered

Chemotherapy is commonly prescribed along with other treatment methods such as hormonal and targeted therapies. It can also be used to shrink a tumor before surgery for easier and safer removal, referred to as neoadjuvant chemotherapy.If you receive chemotherapy, your doctor will administer it in short courses with several weeks in between to allow your normal cells to recover. This treatment period can be a challenging time emotionally and physically. It is important for you to develop a support team of family or friends that can help comfort and encourage you in this time.

How Is Chemotherapy Given

Tackling the long

Many different drugs and combinations of drugs can be used to treat breast cancer. Chemotherapy can be taken as tablets or capsules, or injected through an intravenous drip. Chemotherapy for breast cancer is usually given through a drip. The way that treatment is given depends on the specific drugs that are being used.

Chemotherapy is co-ordinated by a medical oncologist and is given by specialist cancer nurses in the chemotherapy unit at a hospital. Chemotherapy is usually given over a few hours as a day-only treatment, so you can go home on the same day. Some women find it helpful to have someone available to drive them home after treatment in case they feel unwell. Chemotherapy is not normally painful although some people find the drip uncomfortable.

Chemotherapy for breast cancer is usually given in treatment cycles. Typically, you would go to the hospital for the day every three weeks and this would be repeated until you have had four or six treatments. Sometimes chemotherapy is given more often than every three weeks, for example it can be given as a weekly cycle for eight to twelve cycles. Your doctor will explain the schedule that has been recommended for you.

The common chemotherapy drugs for breast cancer include:

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Are There Ways To Prevent Hair Loss With Chemotherapy

Not everyone loses hair when receiving chemotherapy, but many people do. Some peoples hair only thins. Others lose the majority or all of their hair.

Using a cold cap can reduce hair loss. Cold caps cool your scalp before, during and after chemotherapy treatment. Cooling tightens the blood vessels in your scalp, potentially reducing how much chemotherapy goes to your hair follicles.

People may choose to wear a wig as a result of hair loss. Some private insurance companies may help cover wig costs if your doctor prescribes a cranial prosthesis or hair prosthesis. Medicare Parts A and B do not cover wigs, but the costs may be tax-deductible.

Decrease In Blood Cell Counts:

Why it happens: Red blood cells carry oxygen throughout your body, white blood cells help fight infection, and platelets help stop bleeding. These normal, healthy cells divide rapidly, just like the cancer cells, which is why chemo often affects these benign cells in addition to the cancer cells.

How to handle anemia :

  • Get at least eight hours of sleep each night
  • Take short naps during the day
  • Limit your activities by setting priorities of what you need to get completed for the day
  • Accept help when your family and friends offer
  • Eat a well-balanced diet that contains all the calories and protein your body needs to keep your weight up and repair tissues that have been harmed by the chemo

How to handle infections :

  • Wash your hands with soap and water
  • Carry hand sanitizer
  • Use sanitizing wipes to clean surfaces and items that you touch
  • Be gentle and thorough when you wipe after a bowel movement
  • Take good care of your skin and clean cuts right away
  • Stay away from people who are sick or crowds
  • Wash raw vegetables and fruits before eating them
  • Do not eat raw or undercooked fish, seafood, meat, chicken, or eggs
  • If you are a pet owner, have someone else clean up animal waste
  • Do not get a flu shot or other vaccine without first checking with your cancer doctor or nurse.

How to handle a low platelet count:

Your doctor or nurse will order blood tests to find out your blood counts throughout your chemo treatment.

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