Are There Any Lasting Side Effects Of Chemotherapy
Sometimes people do experience problems that may not go away. For example, some of the drugs used for breast cancer may weaken the heart. Your doctor may check your heart before, during, and after treatment. A rare side effect of chemotherapy is that occasionally, years after treatment, a few women have developed leukemia .Some chemotherapy drugs can damage the ovaries. If you have not gone through menopause yet, you may have hot flashes and vaginal dryness. Your menstrual periods may no longer be regular or they may stop. You may become infertile .
Which Types Of Breast Cancers Do Well With Less Chemotherapy
Research in the last two decades has shown that two types of breast cancer respond well to less-intensive chemotherapyor none at allin some cases:
- HR-positive: This is the largest breast cancer subtype, accounting for as many as 75% of all cases. The majority of women diagnosed with this subtype of breast cancer have no lymph node cancer at the time of diagnosis. Both for these women and many with positive lymph nodes, hormonal therapy is the most important treatment, and chemotherapy may not be needed, Dr. Winer says.
- HER2-positive. This aggressive breast cancer makes up 15 to 20% of breast cancer cases. Once a deadly disease, even in its early stages, it is now curable in more than 90% of cases, Dr. Winer explains. In early HER2-positive cancers, weve found that very limited courses of chemotherapy can be just as effective as treatment that is more extreme, he says.
Breast Cancer: Types Of Treatment
Have questions about breast cancer? Ask here.
ON THIS PAGE: You will learn about the different types of treatments doctors use for people with breast cancer. Use the menu to see other pages.
This section explains the types of treatments, also known as therapies, that are the standard of care for early-stage and locally advanced breast cancer. Standard of care means the best treatments known. When making treatment plan decisions, you are encouraged to discuss with your doctor whether clinical trials are an option. A clinical trial is a research study that tests a new approach to treatment. Doctors learn through clinical trials whether a new treatment is safe, effective, and possibly better than the standard treatment. Clinical trials can test a new drug and how often it should be given, a new combination of standard treatments, or new doses of standard drugs or other treatments. Some clinical trials also test giving less drug or radiation treatment or doing less extensive surgery than what is usually done as the standard of care. Clinical trials are an option for all stages of cancer. Your doctor can help you consider all your treatment options. Learn more about clinical trials in the About Clinical Trials and Latest Research sections of this guide.
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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
Targeted Therapy For Her2
In about 15% to 20% of breast cancers, the cancer cells make too much of a growth-promoting protein known as HER2 . These cancers, known as HER2-positive breastcancers, tend to grow and spread more aggressively than HER2-negative breast cancers. Different types of drugs have been developed that target the HER2 protein.
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Side Effects Of Breast Cancer Chemotherapy
Chemotherapy usually works by attacking rapidly dividing cells. This means that chemotherapy can harm not only cancer cells but also healthy cells that are dividing rapidly, like the ones that cause your hair to grow.
Whether you have side effects from breast cancer chemotherapy will depend on the details of your treatment plan. The care teams at MSK are committed to helping you feel your best during and after treatment. During treatment, well watch carefully for your reaction to the drugs and adjust the drugs or dose as necessary. Well also continue to monitor you for possible long-term effects after your treatment ends.
We offer a variety of other specialized services to support you during your treatment. Many MSK patients find that our Integrative Medicine Service can be a valuable part of their treatment plan. Programs include massage, acupuncture, hypnotherapy, meditation, visualization, music therapy, and nutritional counseling.
One side effect of chemotherapy can be hair loss. MSK offers scalp cooling to help minimize hair loss. Learn more about scalp cooling, or ask your care team for more information.
Physical Emotional And Social Effects Of Cancer
In general, cancer and its treatment cause physical symptoms and side effects, as well as emotional, social, and financial effects. Managing all of these effects is called palliative care or supportive care. It is an important part of your care that is included along with treatments intended to slow, stop, or eliminate the cancer.
Supportive care focuses on improving how you feel during treatment by managing symptoms and supporting patients and their families with other, non-medical needs. Any person, regardless of age or type and stage of cancer, may receive this type of care. And it often works best when it is started right after a cancer diagnosis. People who receive supportive care along with treatment for the cancer often have less severe symptoms, better quality of life, and report that they are more satisfied with treatment.
Supportive care treatments vary widely and often include medication, nutritional changes, relaxation techniques, emotional and spiritual support, and other therapies.
Music therapy, meditation, stress management, and yoga for reducing anxiety and stress.
Meditation, relaxation, yoga, massage, and music therapy for depression and to improve other mood problems.
Meditation and yoga to improve general quality of life.
Acupressure and acupuncture to help with nausea and vomiting from chemotherapy.
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Chemotherapy For Metastatic Breast Cancer
Advances in treatment are making it possible for women with metastatic breast cancer to live for many years. New drug therapies can not only slow down or stop a tumors growth but also keep symptoms at bay.
Which treatment your doctor recommends will vary based on your medical history, age, and breast cancer type, among other factors. Combinations of drugs are commonly prescribed for women with early-stage disease. Most women with advanced breast cancer generally receive only one drug at a time.
Chemotherapy drugs that MSK doctors commonly prescribe for advanced breast cancer include:
Women with advanced disease can also benefit from genomic testing. This is also called tumor sequencing or molecular profiling. It is offered to all MSK patients with metastatic breast cancer. Genomic testing involves looking at the cancer cells to see if there are any genetic mutations that could be linked to the specific type of breast cancer you have.
Our experts use a highly sophisticated testing approach developed by MSK researchers called MSK-IMPACT. The information gained from MSK-IMPACT can help us personalize your care. We can rule out drug therapies that may not work for you or sometimes recommend cutting-edge clinical trials designed to target the specific mutations in your tumor.
What To Expect During Treatment
You usually get chemo in an outpatient center at a hospital or clinic. If you have early stage breast cancer, youâll probably get treatments for 3 to 6 months. It may last longer for advanced breast cancer. Youâll have treatment in cycles, which could be just once a week or as often as three times a week. If youâre getting radiation and chemo together, youâll get the radiation after the chemo treatment. You may want to have someone drive you home the first few times until you know how it affects you.
On the day of treatment:
- Technicians will take some of your blood for tests.
- Your doctor will go over the blood test results and talk about your overall health.
- The doctor orders the treatment.
- Youâll meet with the person on your health care team whoâs going to give you the chemo.
- Theyâll check your temperature, pulse, and blood pressure.
- Theyâll put the IV into your vein.
- Theyâll give you medications to prevent nausea, anxiety, and inflammation along with the chemotherapy.
- When your treatment is done, theyâll remove your IV and check your vital signs again.
- Youâll get prescriptions for dugs you can take at home to help with side effects.
- Theyâll tell you what is OK to eat and drink once youâre home.
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Chemotherapy For Breast Cancer
Chemotherapy uses anti-cancer drugs that may be given intravenously or by mouth. The drugs travel through the bloodstream to reach cancer cells in most parts of the body. Sometimes, if cancer spreads to the spinal fluid, which surrounds and cushions the brain and spinal cord, chemo may be given directly into in this area .
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Complementary And Alternative Medicine
Complementary and alternative medicine are medicines and health practices that are not standard cancer treatments. Complementary medicine is used in addition to standard treatments, and alternative medicine is used instead of standard treatments. Meditation, yoga, and supplements like vitamins and herbs are some examples.
Many kinds of complementary and alternative medicine have not been tested scientifically and may not be safe. Talk to your doctor about the risks and benefits before you start any kind of complementary or alternative medicine.
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What To Expect After Chemo
Once youâre home, you need to take care of yourself and take steps to manage chemo side effects. These include:
- Take medications the doctor prescribed for side effects.
- Stay away from anyone with a cold or infection — chemo makes it harder for your body to fight germs.
- Drink lots of fluids for the first 8 hours to move the medicine through your body.
- Manage bodily fluids and waste that may have traces of chemo. Usually, this means flushing the toilet twice.
Youâll see your doctor every 4 to 6 months for the next 5 years after treatment ends.
Immunotherapy For Breast Cancer
Immunotherapy is the use of medicines to boost a persons own immune system to recognize and destroy cancer cells more effectively. Immunotherapy typically works on specific proteins involved in the immune system to enhance the immune response. These drugs have side effects different from those of chemotherapy.
Some immunotherapy drugs, for example, monoclonal antibodies, work in more than one way to control cancer cells and may also be considered targeted therapy because they block a specific protein on the cancer cell to keep it from growing.
Immunotherapy is used to treat some types of breast cancer.
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Menstrual Changes And Fertility Issues
For younger women, changes in menstrual periods are a common side effect of chemo. Premature menopause and infertility may occur and could be permanent. If this happens, there is an increased risk of heart disease, bone loss, and osteoporosis. There are medicines that can treat or help prevent bone loss.
Even if your periods stop while you are on chemo, you may still be able to get pregnant. Getting pregnant while on chemo could lead to birth defects and interfere with treatment. If you have not gone through menopause before treatment and are sexually active, its important to discuss using birth control with your doctor. It is not a good idea for women with hormone receptor-positive breast cancer to take hormonal birth control , so its important to talk with both your oncologist and your gynecologist about what options would be best for you. When women have finished treatment , they can safely go on to have children, but it’s not safe to get pregnant while being treated.
If you think you might want to have children after being treated for breast cancer, talk with your doctor soon after being diagnosed and before you start treatment. For some women, adding medicines, like monthly injections with a luteinizing hormone-releasing hormone analog, along with chemo, can help them have a successful pregnancy after cancer treatment. To learn more, see Female Fertility and Cancer.
Help Getting Through Cancer Treatment
People with cancer need support and information, no matter what stage of illness they may be in. Knowing all of your options and finding the resources you need will help you make informed decisions about your care.
Whether you are thinking about treatment, getting treatment, or not being treated at all, you can still get supportive care to help with pain or other symptoms. Communicating with your cancer care team is important so you understand your diagnosis, what treatment is recommended, and ways to maintain or improve your quality of life.
Different types of programs and support services may be helpful, and can be an important part of your care. These might include nursing or social work services, financial aid, nutritional advice, rehab, or spiritual help.
The American Cancer Society also has programs and services including rides to treatment, lodging, and more to help you get through treatment. Call our National Cancer Information Center at 1-800-227-2345 and speak with one of our trained specialists.
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Selective Estrogen Receptor Modulators
Selective estrogen receptor modulators block the potentially harmful effects of the hormone estrogen in the breasts but allow it to function in other areas where it has a beneficial effect, such as the bones.
One of the most commonly used hormone therapies of this type is tamoxifen. Doctors may use it to prevent cancer from returning after surgery. It can also be used to treat women with advanced breast cancer.
Tamoxifen is taken daily by mouth. Women with early breast cancer may take the drug for as long as 5 to 10 years.
What Are The Causes And Risk Factors For Angiosarcoma Of The Breast
Cancer begins with out-of-control growth of abnormal cells. What kicks off this process in primary angiosarcoma of the breast is not clear and risk factors are largely unknown.
Angiosarcoma can sometimes run in families. Some research suggests a possible genetic predisposition to develop this type of cancer, but more studies are needed in this area. Exposure to cancer-causing chemicals may also play a role in angiosarcoma.
Secondary angiosarcoma of the breast is caused by previous radiation treatment or chronic lymphedema due to breast cancer. It has a median onset age of 70 years, and generally happens about 10.5 years after radiation therapy.
Treating Stage Iii Inflammatory Breast Cancer
IBC that has not spread outside the breast or to nearby lymph nodes is stage III. Treatment usually starts with chemotherapy to try to shrink the tumor. If the cancer is HER2-positive, targeted therapy is given along with the chemo. This is typically followed by surgery to remove the cancer. Radiation therapy often follows surgery. Sometimes, more chemo may be given after surgery but before radiation. If the cancer is hormone receptor-positive , hormone therapy is given as well . Combining these treatments has improved survival significantly over the years.
What Happens After Chemotherapy For Breast Cancer
Immediately after chemotherapy, you may feel sleepy or nauseated. Typically, the side effects of chemotherapy go away after you complete all prescribed cycles.
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Targeted Therapy Vs Chemotherapy
Chemotherapy is a type of cancer treatment that works by killing fast-growing cells in your body to help prevent the growth and spread of cancer cells. It can be given as an oral medication or administered through an IV.
But because chemotherapy can kill both healthy and cancerous cells in your body, it can cause many side effects.
On the other hand, targeted therapy is a treatment that attacks cancer cells specifically by interfering with certain pathways that control their growth.
Unlike chemotherapy, targeted therapy is designed to only affect cancer cells, meaning that its less likely to harm the normal, healthy cells in your body. But targeted therapy pills do have side effects as well.
Furthermore, while chemotherapy kills off cancer cells that have already been produced, targeted therapy also works by preventing cancer cells from multiplying and spreading.
Targeted therapy can be administered orally or through an IV for the treatment of breast cancer. Its often used alone or in combination with other cancer treatments, including chemotherapy.
The Types Of Radiotherapy
The type of radiotherapy you have will depend on the type of breast cancer and the type of surgery you have. Some women may not need to have radiotherapy at all.
Types of radiotherapy include:
- breast radiotherapy after breast-conserving surgery, radiation is applied to the whole of the remaining breast tissue
- chest-wall radiotherapy after a mastectomy, radiotherapy is applied to the chest wall
- breast boost some women may be offered a boost of high-dose radiotherapy in the area where the cancer was removed however, this may affect the appearance of your breast, particularly if you have large breasts, and can sometimes have other side effects, including hardening of breast tissue
- radiotherapy to the lymph nodes where radiotherapy is aimed at the armpit and the surrounding area to kill any cancer that may be in the lymph nodes
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