Chemotherapy

Chemotherapy is the use of anticancer drugs designed to slow the growth of any remaining cancer cells or kill them. The drugs used are called ‘cytotoxic’ drugs. They travel in the bloodstream throughout the body and aim to kill any cancer cells that may have spread beyond the breast.

Side effects
Most people have heard of some of the side effects from chemotherapy, from temporary hair loss to nausea. A lot of the side effects can be controlled making the treatment easier to tolerate. Be prepared to ask for help if you are feeling uncomfortable or finding the side effects difficult to cope with. Not everybody experiences side effects but some people may experience a lot. Side effects from chemotherapy vary depending on the type of drug, the dosage, how often it is given, and the person receiving the medicine. They can include fatigue, hair loss, nausea, a lowered white blood cell count, anaemia, mouth sores, nerve pain, muscle pain, and menopausal symptoms.

If you suffer hair loss, remember that it isn’t permanent and the new hair that grows back may be a different colour and feel different. Hair usually begins to grow back about a month after the end of the last treatment.

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Some chemotherapy drugs are less likely to make you nauseated than others, but most nausea can be controlled or prevented altogether.

A lowered white blood cell count can lead to severe infection. If you get an infection your doctor needs to know urgently. You may need to be admitted to hospital for intravenous antibiotics. Your next dose of chemotherapy might have to be delayed, or you might be prescribed a lower dosage.

Drugs
Different chemotherapy drugs are used depending on the type of breast cancer you have, and your general health. Your treatment might last between 3 and 6 months but it could be as long as 9 months. This does not mean that if you have 9 months of treatment your cancer is worse. It can just mean that your cancer may respond better to that combination of drugs.

Most chemotherapy drugs are given intravenously (into a vein), although some may be administered orally (by mouth). Several chemotherapy drugs are given in combination.

Chemotherapy drugs work by damaging cancer cells and normal cells. Cancer cells have an impaired repair mechanism and die when damaged while normal cells can shut down, repair themselves and then go back to work.

Herceptin
Between 20 and 25% of women who get breast cancer have tumours with what is called a “receptor protein” called HER2. Tumours that contain these receptor proteins are referred to as “HER2 positive”. The receptor receives signals from growth factors produced by cancer cells telling the cancer to grow faster.

If your tumour is HER2 positive, you may be given Herceptin as part of your treatment. Herceptin is a monoclonal antibody which can destroy the HER2 receptor protein. This stops the tumour from growing and allows the immune system to kill cancer cells.

A 12 month course of Herceptin is currently funded in New Zealand.

Hints
- You may have a taste of metal in your mouth making all food taste the same. Avoid your favourite food until after you have finished treatment. Have muffins or snack food available. Keeping food in your stomach can make you feel a lot better. Feeling hungry often makes you nauseated
- Drink constantly. Keep flushing the treatment through your body.
- Find things and people that make you laugh.
- Go easy on yourself. If you want to sleep – SLEEP. If you want to cry – CRY. If you do not want to talk about it – DON’T.
- Have a confidant – someone to talk to – whether this person is a stranger or your best friend. Talking can help.

Your family and friends will be scared as well. Let them look after you – it helps them feel as if they are doing something. If you feel that they are ‘mothering’ you too much, then talk to them about it. They just need to know what they can do. Some people will not know what to say or will be too scared to say something that may upset you. Approach them – if you start the conversation, it lets them know whether to say something about your situation or to ignore it. You have had more time to “get used” to your cancer than they have. You may need to start the discussion.

During treatment, you will be susceptible to picking up ‘bugs’, which can turn nasty very quickly. Seek medical advice as soon as any symptoms develop.
 
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