Chemotherapy for Breast Cancer - Full Guide, Procedure Cycles

Chemotherapy (chemo) for breast cancer is a treatment that uses drugs to kill cancer cells. It is generally given intravenously (infusion through a vein) or as a pill. These drugs circulate in the bloodstream, disrupting the growth of malignant cells throughout the body. The oncologist may use one specific type of chemotherapy drug, combine different drugs, or use it with other treatments.

Common Chemotherapy Drugs Used for Breast Cancer

Chemotherapy drugs for breast cancer in the early stage are generally given for three to six months. They include: 

1. Anthracyclines (doxorubicin and epirubicin)

2. Taxanes (docetaxel and paclitaxel) 

Drugs for advanced breast cancer are administered for more than six months. These include the following: 

1. Abemaciclib 

2. Albumin-bound paclitaxel 

3. Capecitabine 

4. Eribulin 

5. Ixabepilone 

Please Note: The drugs mentioned here are for informational purposes only and should not be considered medical advice. Treatment plans and drug choices vary depending on patient needs and medical conditions. Always consult your oncologist or physician for personalised recommendations and guidance.

Chemotherapy may not be necessary for all women with breast cancer, but it is often recommended in specific situations. These include the following: 

1. Neoadjuvant Chemotherapy (Before Surgery): This treatment is used before surgery to treat tumours that are too big or involve various lymph nodes. However, it is not suitable for all women diagnosed with breast cancer. You should consult your doctor to determine if you are the right candidate for treatment. 

2. Adjuvant Chemotherapy (After Surgery): This type of chemotherapy destroys any remaining cancer cells after surgery or those that spread but cannot be seen on imaging tests. These cells could grow if not treated, forming new tumours in other body parts. Adjuvant chemotherapy can decrease the risk of breast cancer recurrence.

3. For Metastatic Breast Cancer: Chemotherapy can also be administered as the primary treatment for cancer that spreads outside the breast to distant organs like the lungs or liver.

Chemotherapy drugs for breast cancer stage 4 or earlier stages can be given by mouth as a pill. However, generally, it is given as an intravenous infusion into the vein. This can be done in the following ways: 

1. An IV needle and catheter in the hand or wrist 

2. A catheter port implanted in the chest (it stays in place throughout the chemo treatment to avoid finding a vein at each session)

How many chemotherapy sessions are needed for breast cancer?

Chemotherapy for cancer is administered in cycles. A cycle refers to the time from one round of chemotherapy to the beginning of the next. Each session is followed by a period of recovery. Most patients undergo 4 to 8 cycles of chemotherapy for breast cancer, depending on the treatment plan and individual needs. 

Each cycle usually involves two to three treatments, which may happen weekly, every two weeks, or every three to four weeks. Generally, chemo for early-stage breast cancers lasts for three to six months. For advanced breast cancer, the treatment can last for up to a year.   

An oncologist personalises the chemotherapy treatment according to the breast cancer type, stage, and test results. It is important to understand what you can expect to plan accordingly: 

1. Initial Evaluation: The oncologist assesses your overall health, including pre-existing conditions. They discuss the type of chemotherapy regimen suitable for your cancer stage and type. You also undergo various tests, such as blood work, to evaluate organ function and identify any potential risks.

2. Treatment Plan: The doctor explains the details of your chemotherapy treatment plan. This includes the drugs to be used, the frequency of treatment, and the potential side effects. 

3. Port or IV Placement: Chemotherapy drugs are usually delivered through an intravenous (IV) line. To avoid repeated needle sticks, a port or catheter may be required, especially for long-term treatments.

4. Treatment Preparation: It is important to prepare for the first appointment by considering the following: 

1. Prioritise rest

2. Stay active with light exercise

3. Maintain a healthy diet with fruits, vegetables, and whole grains

4. Manage stress effectively

5. Prevent infections, including colds

6. Visit a dentist to check for oral infections

Chemotherapy for breast cancer can take place at the doctor’s office, hospital, clinic, or home. Not all sessions follow the same steps, but they generally include the following: 

1. You meet with the healthcare team member who is administering the treatment.

2. A brief physical exam checks your temperature, pulse, and blood pressure.

3. An IV catheter is inserted.

4. You are given medications to prevent side effects like nausea, anxiety, or inflammation.

5. The chemotherapy drugs are administered, which can take several hours.

What to expect after chemotherapy?

After the treatment, the healthcare team removes the IV and checks your vital signs. Once home, you must follow these steps to manage the side effects of chemotherapy: 

1. Take medications prescribed by the doctor for side effects. 

2. Avoid contact with people who have colds or infections, as chemotherapy weakens your immune system.

3. Drink lots of fluids in the first eight hours to move the medicine through the body. 

4. Follow the doctor’s advice on what to eat and drink.

5. Safely handle bodily fluids, like urine, stool, and semen, as they may contain chemotherapy drugs for 48 hours. This includes simple precautions like flushing the toilet twice after use.

You will have follow-up appointments with the doctor every four to six months after the treatment ends. 

Chemotherapy targets fast-growing cancer cells. However, it can also affect fast-growing healthy cells, like those in hair follicles, bone marrow, and the digestive tract. This can cause short-term side effects, including the following: 

1. Hair loss 

2. Nausea and vomiting 

3. Fatigue 

4. Loss of appetite 

5. Mouth sores

6. Diarrhoea or constipation 

7. Dry and itchy skin and brittle nails

8. A greater risk of infection due to fewer white blood cells 

9. Nerve damage (neuropathy)

10. Chemo brain (problems with cognitive function that affect concentration and memory) 

11. Anxiety 

12. Increased bruising or bleeding 

Generally, side effects resolve after treatment or within a year after completing chemotherapy. However, some drugs may cause long-term side effects, such as: 

1. Heart problems (coronary artery disease, arrhythmia, congestive heart failure) 

2. Lung damage (inflammation, trouble breathing, thickening of the lung lining) 

3. Hormone issues (mood shifts, bladder control problems, fewer periods)

4. Bone or joint damage (osteoporosis, joint pain, osteopenia)

5. Reproductive issues (infertility, premature menopause)

6. Damage to the brain, spinal cord, and peripheral nerves

7. Secondary cancers like acute leukaemia or myelodysplasia 

When to call a doctor?

Your oncologist will schedule regular appointments during treatment. Contact them right away or visit the emergency room if you experience the following: 

1. Fever above 100.4 F

2. Chills

3. Shortness of breath or chest pain 

4. Sudden confusion 

5. Severe headache and stiffness in the neck

Chemotherapy costs for breast cancer in India can differ widely, depending on the number of cycles, type of hospital, location, etc. The price range is as follows: 

The cost mentioned above is estimated. Please get in touch with HexaHealth experts for accurate and up-to-date prices. 

Eating a nutritious diet during chemotherapy for breast cancer helps manage side effects and supports recovery. Here are the key dietary recommendations: 

1. High-Protein Foods: These help repair tissues and maintain strength. Sources include lean meats, fish, eggs, beans, and legumes. 

2. Healthy Snacks: Quick, nutritious snacks like hard-boiled eggs, nuts, and dried fruit help boost energy. 

3. Healthy Fats: Avocados, nut butter, and olive oil support overall health and energy. 

4. Fibre-Rich Foods: They support digestion and prevent constipation. Examples include oats, barley, flaxseed, lentils, and berries. 

It is important to avoid certain foods that can increase the risk of infections or worsen side effects. These include: 

1. Raw fish and shellfish 

2. Raw nuts 

3. Expired and perishable foods 

4. Leftovers in the refrigerator for more than three days 

5. Fatty, spicy, or sugary foods

Chemotherapy for breast cancer helps eliminate cancer cells and lower the risk of recurrence. It is often essential for improving outcomes, especially in more advanced stages. While side effects can be challenging, your care team will help manage them.