Therapies that circulate through your bloodstream to attack cancer cells wherever they may have spread are called “systemic” treatments. The most common systemic treatments for breast cancer are chemotherapy and hormonal therapy.
If your doctor suggests chemotherapy in addition to surgery, the reason is to increase your chances of a cure. Chemotherapy drugs may be given by mouth or by infusion into a vein or injection into a muscle. Then they enter your bloodstream and travel throughout your body, killing cancer cells that may have spread from the original site, thus making your cancer less likely to return somewhere else.
The reason chemotherapy works is that it kills fast-growing cells, which include cancer cells but also other cells, such as hair follicles. This is one reason for many of the typical side effects of chemotherapy treatment, such as hair loss.
Chemotherapy for Seattle Cancer Care Alliance (SCCA) patients who need infusions takes place in the Infusion Suite on the fifth floor of the SCCA clinic.
- Neoadjuvant chemotherapy—chemotherapy given before surgery
- Adjuvant chemotherapy—chemotherapy given after surgery
- Dose density—how much chemotherapy is given and how often
- Side effects—how chemotherapy may affect the rest of your body
Chemotherapy given before surgery, or neoadjuvant chemotherapy, is the standard treatment for women whose tumors are too large to remove with surgery alone and still get a cosmetically acceptable outcome. It is also the standard treatment for women with inflammatory breast cancer.
Successful neoadjuvant chemotherapy will shrink your tumor before surgery, making it easier to remove. This treatment will also decrease your chances of a recurrence (your cancer coming back). For a small number of women, having neoadjuvant chemotherapy may allow them to have breast-conserving surgery, such as a lumpectomy, rather than a mastectomy.
Your team may also recommend neoadjuvant chemotherapy in order to see how sensitive your cancer is to treatment before your tumor is removed. This can be part of standard treatment or a clinical study.
Chemotherapy given after surgery, or adjuvant chemotherapy, has been proven to improve the cure rate and overall survival rate for breast cancer patients. Adjuvant chemotherapy may reduce your risk of a recurrence of breast cancer by as much as 40 percent. Doctors and researchers at SCCA are working to find new and more effective chemotherapy drugs and combinations of drugs. They are also studying new ways of delivering chemotherapy drugs to make them as effective as possible and to reduce the side effects.
One change in chemotherapy that is being studied by SCCA oncologists relates to dose density, or the amount of the drug given in a certain period of time. Researchers are looking at the frequency of chemotherapy treatments, as well as the size of the dose, to find the most effective combination for killing cancer cells.
They have found that some chemotherapy drugs that are normally given to breast cancer patients once every three weeks are more effective if they are given more often in smaller doses. In addition, side effects are less troubling with the smaller dose. SCCA doctors pioneered this way of giving chemotherapy.
The side effects of chemotherapy vary according to the drugs that are used. The most common side effects include nausea, vomiting, hair loss, and fatigue. Other possible side effects include mouth sores and an increased chance of bleeding, infection, or anemia. Patients tolerate chemotherapy much better than in the past because of new drugs that help control side effects.
Your team at SCCA will talk with you about the specific side effects you might experience, and we will help you prevent, reduce or manage these effects as best as possible. You can find general information in the symptom management section.