Chemotherapy for metastatic breast cancer
Chemotherapy, a systemic therapy, is given by infusion into a vein or is taken as a pill. It kills rapidly dividing cells in order to slow or stop the growth of cancer. In many cases, chemotherapy will be given after other treatments stop working against the cancer.
Together with your doctor, you will consider the physical and emotional side effects of chemotherapy. Depending on the type of cancer you have, your age and treatments you’ve had in the past, your doctor may or may not recommend chemotherapy.
Whether you get chemotherapy depends on many factors, such as:
- The type of cells in the breast cancer
- Your age and whether you have gone through menopause
- The presence or absence of estrogen and progesterone receptors
- The amount of HER2 protein on the surface of the cancer cells
- Which treatments you received in the past
- How much cancer, if any, is in your organs
There are many different kinds of chemotherapy. Your doctor will decide the best treatment for you based on the cancer’s traits and your treatment goals.
You may receive chemotherapy for a long time if it continues to slow or stop the cancer growth and it does not interfere with your quality of life. If it isn’t working or is causing side effects you don’t want to live with, you and your doctor may decide to switch to a different treatment.
Your doctor or nurse also may recommend an access port, sometimes called a port-a-cath, to make giving chemotherapy safer and easier. This device is placed under your skin in the upper part of your chest and connects to a major vein. A port lets you avoid repeated needlesticks in the arm and reduces the risk of certain chemotherapy-related side effects.
Another option is a PICC line, or peripherally inserted central catheter, a long, flexible tube inserted into a vein in the arm that gives access to larger veins.
Chemotherapy causes side effects because it kills all quickly dividing cells—including those that affect hair and nail growth and those in your bone marrow and digestive system.
Each medicine has a different set of side effects. These may include hair loss, nausea, vomiting, diarrhea, weight gain or loss, fatigue, insomnia, dry mouth, dry skin, mouth sores, infection and low blood counts (anemia). Chemotherapy may also cause sexual side effects such as vaginal dryness, decreased interest in sexual intimacy and pain or discomfort during sex.
It may sound scary to think of being “on chemo” for a long time. But remember that chemotherapy affects different people in different ways. Some people have many side effects, while others have very few.
Balancing your treatment with the physical and emotional side effects is important. Talk with your healthcare providers so they can help you have the best quality of life, no matter what treatment you are receiving.
There are many ways to help prevent and manage side effects. Don’t wait until you feel discomfort! Talk with your doctor about side effects before you start treatment. Some side effects, like nausea, can be prevented altogether. Your doctors can give you medicine ahead of time and offer practical tips for managing side effects once they start.