Chemotherapy for advanced breast cancer

Chemotherapy can shrink or slow the growth of ABC, by destroying cancer cells, or disrupting their growth. It also destroys all rapidly dividing cells. These include hair follicles, nails, bone marrow and digestive system cells, which is why side effects such as hair loss and low blood counts may occur.

Fortunately, our bodies are remarkable at healing and even when normal cells are damaged, they can grow back. 

Chemotherapy is one of the main treatments for ABC. It may be given after you have had hormone therapy, or as your first treatment if:

• the cancer does not have receptors for oestrogen (ER- negative)
• the cancer is in the liver or lungs
• the cancer is growing quickly.

The first chemotherapy drug used is referred to as first line treatment. When ABC no longer responds, other drugs can be used sequentially. These are referred to as second and third line treatments.

There are many types of chemotherapy; your oncologist will explain which drug, or drugs, are best for you, based on the characteristics of your cancer, your general health and your preferences. Chemotherapy drugs may be used on their own or in combination and will also depend on any previous chemotherapy you have had.

Chemotherapy drugs commonly used to treat ABC include:

• capecitabine (Xeloda)
• carboplatin
• cyclophosphamide
• docetaxel (Taxotere)
• doxorubin (Adriamycin)
• epirubicin (Pharmorubicin)
• eribulin (halaven)
• gemictabine (Gemzar)
• paclitaxel (Taxol)
• vinorelbine injection (Navelbine)
• oral vinorelbine.

Chemotherapy is commonly delivered by drip (known as intravenous infusion), or in tablet form.

Chemotherapy drugs can cause side effects and these will differ between drugs. Some common side effects are:

• a sore mouth
• nausea and vomiting
• fatigue
• hair loss
• peripheral neuropathy - nerve damage which can cause numbness, tingling and pain in the hands and feet
• neutropenia - reduced white blood cells
  
• brain fog ("chemo brain")

Your oncologist and clinical nurse specialist will give you information on your treatment and the most likely side effects. Not everyone experiences these, but if you are concerned, speak to your oncologist or nurse.

Watch our webinar: “Managing chemo and radiation side effects” which provides helpful tips to manage the side effects of these treatments to help boost your quality of life.