Chemotherapy

The use of chemotherapy for the treatment of cancer began in the 1940’s with the use of nitrogen mustard.  In the attempt to discover what is effective in chemotherapy, many new drugs have been developed and tried since then. Chemotherapy is used most often to describe drugs that kill cancer cells directly, and these drugs are sometimes referred to as “anti-cancer” drugs.
Today’s chemotherapy uses more than 100 drugs to treat cancer.  There are even more chemo drugs still under development and investigation.  Various chemotherapy drugs are available to treat breast cancer.  Breast cancer chemotherapy is made of powerful drugs that target and destroy fast-growing breast cancer cells.  The drugs may be used individually or in a combination to increase the effectiveness of the treatment.  Breast cancer chemotherapy is frequently used along with other treatments for breast cancer, such as surgery.  Chemotherapy may also be used as the primary treatment when surgery isn’t an option.  Chemotherapy can help you live longer and reduce your chances of recurrence. It also carries the risk of side effects.  Some of the side effects are temporary and mild but others more serious, and sometimes permanent.  Your doctor can help you decide whether chemotherapy for breast cancer is a good choice for you.  Chemotherapy drugs are given intravenously or orally for treating breast cancer.  The drugs enter the blood stream and travel to all parts of the body, thus reaching cancer cells that may have spread beyond the breast.
Chemotherapy is given in cycles of treatment; and the entire chemotherapy treatment generally lasts several months to one year, depending on the type of drugs given.  A period of recovery is granted after the chemotherapy is finished.
Your doctor considers a number of factors to determine whether and what kind of chemotherapy would be of benefit to you.  The higher your risk of recurrence or metastasis, the more likely chemotherapy will be of benefit. In some cases, characteristics of the breast cancer itself may suggest other more beneficial treatments.  Discuss your own treatment goals and preferences with your doctor.
Factors commonly considered include:
Tumor size and grade. The more advanced the tumor, the more likely chemotherapy may be useful in destroying any stray cancer cells.
Lymph node status. If breast cancer cells were found in your lymph nodes during or before surgery, this is an indication of a higher risk of metastasis and thus an indication for chemotherapy.
Age. Some studies suggest that breast cancer which occurs at a young age is more aggressive than is breast cancer that develops later in life. Thus, doctors may opt for adjuvant chemotherapy when treating younger women to decrease the chances of the cancer spreading to other areas of the body.
Previous treatments. Whether you’ve had chemotherapy before may affect your current treatment regimen.
Chronic health conditions. Certain health problems, such as heart disease or diabetes, may affect your choice of chemotherapy drugs.
Hormonal status. If your breast cancer is sensitive to the hormones estrogen (ER) and progesterone (PR), hormone therapy — with drugs such as tamoxifen, fulvestrant (Faslodex) or aromatase inhibitors (Arimidex, Femara, Aromasin) — may be a better option for post-surgical adjuvant therapy or they may be considered in addition to chemotherapy.
HER2 status. If your breast cancer produces (expresses) too much of a growth-promoting protein known as human growth factor receptor 2 (HER2), your doctor may recommend drugs that specifically target this protein — trastuzumab (Herceptin), lapatinib (Tykerb) — in addition to chemotherapy.