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Chemotherapy (also called chemo) is one of the most common breast cancer treatments. Medications used in chemotherapy travel around the body to kill cancer cells or prevent them from growing.
Data from 2015 from the National Cancer Institute shows that nearly 65 percent of women with cancer in the lymph nodes received chemotherapy treatments. However, researchers have developed newer testing methods, such as Oncotype DX, that show who is most likely to benefit from chemotherapy. Now, more individual with breast cancer can avoid chemotherapy if it’s unlikely to benefit them.
For those who still need it, researchers continue to introduce new chemotherapy drugs and regimens that can more effectively treat breast cancer. A medical oncologist (cancer specialist) usually oversees these treatments.
Chemotherapy may be given at different times during your treatment journey, such as:
As you get chemotherapy treatments, your doctor will use various tests to measure how well the chemotherapy is working. If your current treatment plan isn’t working, you may be switched to different chemotherapy drugs.
How well chemotherapy works affects your prognosis (outlook). If chemotherapy is successful, you have a better chance of living longer and the odds of your cancer returning are lower.
During your first chemo appointment, you may undergo basic tests such as blood tests, temperature checks, and blood pressure tests. A nurse will start an intravenous (IV) line or set up an infusion into your chemo port, central line, or peripherally inserted central catheter (PICC) line. You may receive other medications, such as anti-nausea or antianxiety drugs, and then receive chemotherapy.
Some MyBCTeam members have discussed what to expect from the first chemotherapy session for breast cancer. “I had my first chemotherapy treatment last Thursday — not fun, but not as bad as I worried it would be,” said one member. “The nurses are great and if you tell them you’re scared, they can be pretty reassuring.”
Another MyBCTeam member said, “My stress dropped a notch after my first chemo session. It helped me to know what to expect. Drink as much as you can, eat when you can, and sleep when you need it! Chemo isn’t fun, but it is doable!”
The length of each chemotherapy session depends on the drugs you are receiving. Treatments often last a few hours.
One MyBCTeam member mentioned a lengthy first chemo session: “I was stuck there for 8 hours because I had to take four different drugs. At least they gave me a window seat.”
After receiving chemotherapy, you can expect to stay at the clinic for about 30 minutes as your doctor monitors you for any unusual reactions.
Remember after receiving infusions, you will likely need someone to drive you home. For a few days after your appointment, you may feel tired or nauseous. Your health care provider may prescribe additional medications for side effects or recommend things to eat or drink that may help you feel better. For example, crystallized ginger can be an excellent remedy for nausea. You may want to suck on mints or chew gum.
Chemotherapy may leave you too tired to do some of the things you used to do, which requires some adjustments. “It takes me several days to do all the tasks that I used to do in one day because at the end of the day I’m worn out, or the next day, I have less energy,” wrote one member. “I’ve learned the hard way — be the tortoise and not the hare.”
There are many chemotherapy options for breast cancer. Your treatment plan depends on factors like what type of breast cancer you have, your breast cancer stage (how far it has spread), whether there is cancer in your lymph nodes, how old you are, and your general health.
Your chemotherapy regimen is a plan that lists the types of chemotherapy drugs you are taking, the dosages of each, and how often you will receive them.
Chemotherapy drugs are most often given intravenously (injected into a vein) in a hospital, clinic, or doctor’s office. Some come in the form of a pill that you take at home.
Many people with breast cancer receive a combination of two or three chemotherapy medications. Common options include:
Specific types of breast cancer may be treated with different regimens. For example, advanced breast cancer may be treated with just one chemotherapy drug. People with HER2-positive breast cancer may receive targeted therapy drugs at the same time as chemotherapy. People with triple-negative breast cancer may receive immunotherapy at the same time as chemotherapy.
Chemotherapy for breast cancer often lasts several months. It may last longer if your cancer has spread, if the cancer is responding, and if you are tolerating the treatment well.
You will usually get chemotherapy in cycles. Each cycle is one or more treatments followed by a rest period. One cycle could include a single treatment followed by a few weeks of rest, getting treatment once per week for three weeks followed by a rest week, or something in between.
Chemotherapy schedules can disrupt your everyday life, making it harder to go to work or school, get things done around the home, or take care of family. Many medical oncologists are willing to work with you to build a schedule that best fits your needs.
Try not to skip any appointments, but if you need to, talk to your health care team to rearrange your schedule. If there’s a major event you’re unwilling to miss, your treatment schedule will likely be flexible enough to allow you to attend.
Find out ahead of time which chemotherapy drugs you will be receiving and research possible side effects so you know how to prepare. For example, if you’re at risk of hair loss, you could buy a wig or use a cold cap to prevent hair loss.
Some members of MyBCTeam prepared in this way. “I cut my hair into a short do before starting chemo and had it donated,” commented one person. “I ordered a wig at the same time.”
If you are of childbearing age, you may want to talk to your doctor about whether it’s safe to use birth control. If your breast cancer is hormone receptor-positive, you shouldn’t take birth control options that contain hormones.
You’ll also want to make necessary arrangements for work, school, or other responsibilities. You may need to spend a lot of time in the clinic receiving treatments, and you may feel extra tired for a couple of days after chemotherapy. However, many people continue going to work during their treatments.
One member wrote, “I planned on working through chemotherapy, but it did a number on me. Of course, maybe age has something to do with it too. I was 68 when diagnosed.” Another chimed in with how working helped them manage their treatments: “For me, working was good. It was normalizing and a great distraction.”
“While I was so glad to get back a piece of my old life, I came home exhausted,” said another member. “Be aware of what your job and home demands are and be willing to cut back on other activities so that you don’t wear yourself out.”
In some cases, you may have a device implanted under your skin for chemotherapy injections. These devices — called chemo ports, central lines, or PICC lines — help you avoid multiple needle sticks. If you need one of these devices, it can be implanted at any time during your chemotherapy regimen.
To prepare for chemotherapy, pack a bag to bring to your appointment. You will want something to do and items to help you stay comfortable during your infusion.
You may want to bring:
“Pack yourself a chemo bag full of comfy, happy things (blankie, music, books, movies, snacks, drinks, etc.),” recommended one member.
You can also get ready by properly fueling your body before your appointment. “I don’t know if I would eat a huge breakfast, but for sure eat something,” wrote one member. “Also, start hydrating the day before and the morning of your infusion.”
Although chemotherapy can kill cancer cells, it can also damage your healthy cells and cause side effects. These health problems aren’t the same for everyone, and different drugs may lead to different effects.
Common side effects of breast cancer chemotherapy include:
Side effects of chemo can be difficult to deal with. However, there are many types of medications, lifestyle changes, and other strategies for managing chemotherapy side effects. Be sure to let your oncology nurse know about any side effects you experience.
Some chemotherapy side effects, called late effects, can last for months, years, or even a lifetime after chemotherapy. Chemotherapy drugs can cause long-term damage to organs like your heart, lungs, and reproductive organs. These late effects vary from person to person.
Possible late effects of chemotherapy for breast cancer include:
MyBCTeam members have shared their experiences with late effects of chemotherapy for breast cancer. One member said, “I get an echocardiogram every three months. I never had heart issues until chemo.”
Another added, “Fertility was not discussed other than my oncologist knowing that I have no children yet but definitely want some when this is all said and done. He said that was definitely possible. So I did as they stated and went to see a fertility doctor or endocrinologist.”
Talk to your doctor if you have concerns about late effects of chemotherapy for breast cancer.
MyBCTeam is the social network for people with breast cancer and their loved ones. On MyBCTeam, more than 74,000 members come together to ask questions, give advice, and share their stories with others who understand life with breast cancer.
Have you had chemotherapy for breast cancer? Can you offer any tips for people who will be going through chemo soon? Share your experiences in the comments below, or start a conversation by posting on your Activities page.
Maybell Nieves, M.D.
graduated from Central University of Venezuela, where she completed medical school and general surgery training.
Learn more about her here.
Maureen McNulty
studied molecular genetics and English at Ohio State University.
Learn more about her here.
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