Chemotherapy is a treatment which uses drugs to destroy cancer cells. It is sometimes used after breast cancer surgery to kill any undetectable cancer cells that may be left in the breast or lymph nodes.
Chemotherapy can lower the risk of breast cancer coming back.
Chemotherapy can also be used before surgery. This is called neoadjuvant chemotherapy.
Will I need chemotherapy?
Many women with breast cancer are referred to a medical oncologist to discuss whether or not chemotherapy is recommended for them. Chemotherapy is offered to some women as an additional treatment to surgery, radiotherapy, and/or hormonal therapy.
A molecular test is a test that can predict the likelihood of an individual cancer recurring (coming back) and provide information to help you decide whether or not you may benefit from chemotherapy or some other breast cancer treatments.
Your doctor may talk to you about molecular tests currently available, including:
- Oncotype DX
These tests are not covered by Medicare and can be quite expensive – up to several thousand dollars. For further information about molecular testing, visit the Breast cancer pathology page or talk to your surgeon or medical oncologist.
How does chemotherapy work?
Chemotherapy works by attacking fast-growing cells in your body, including cancer cells. There are many different types of chemotherapy; your medical oncologist will talk to you about what’s most suitable for you. Sometimes more than one type of treatment may be effective for you, and you may be asked to decide which one to have. Your medical oncologist can tell you about the pros and cons of each.
Some questions you might like to ask include:
- What are the possible side effects of each treatment?
- How long is the course of each treatment?
- How will the treatment fit in with my lifestyle and personal circumstances?
Some chemotherapy drugs are given in tablet form, however, most are administered intravenously (by needle into a vein in the arm or hand). As a result, it is useful to drink plenty of fluids, relax and keep your hands and arms warm, as this can help the nurse or doctor find your veins.
What are the side effects?
Chemotherapy is sometimes referred to as a systemic treatment, because it affects all parts of your body. Unfortunately, it can attack fast-growing healthy cells, such as hair follicles, as well as cancer cells. This causes unwanted side effects such as fatigue, nausea and hair loss. Your medical oncologist or oncology nurse can give you information on ways to manage these side effects.
If side effects are affecting your daily life, it’s important to discuss them with a member of your medical team. In some instances, your oncologist may be able to change your chemotherapy drug to one that has fewer side effects.
Chemotherapy drugs all work differently and have different side effects. Not all women will suffer side effects from chemotherapy. If you don’t experience side effects, it does not mean that the drugs aren't working.
Hair loss (alopecia) can be one of the most upsetting side effects of chemotherapy. The Hair loss page contains useful information and strategies on how to deal with hair loss.
Nausea and vomiting are common side effects of chemotherapy. You may be given anti-nausea medication before your chemotherapy to take home with you, in case you need it later. Let your doctor know if you have nausea and/or vomiting that lasts for more than 24 hours. It’s easy to become dehydrated quickly, and your doctor can help with this.
During chemotherapy, women sometimes develop mouth ulcers and changes in taste. Rinsing your mouth regularly with bicarbonate of soda can help to prevent ulcers, even before you begin chemotherapy. If ulcers do develop, you may find it gentler to use a child’s toothbrush to brush your teeth. Eating soft mints can help get rid of the metallic taste that you may experience. If you have a sore mouth and are not eating properly, chilled drinks such as smoothies from the blender can be good.
Chemotherapy can reduce your oestrogen levels and cause periods to stop, either temporarily or altogether. This is called early menopause. You may experience some of the symptoms of menopause, such as hot flushes and night sweats. BCNA’s Menopause and breast cancer booklet provides practical tips to help manage the symptoms of menopause. You can download or order a copy from our Booklets and fact sheets page.
As chemotherapy reduces the level of oestrogen in your body, it can also reduce your bone density and increase your risk of bone fractures. The Bone health page of this website provides more information on how to improve bone health. You can also download BCNA’s Bone health fact sheet from the Booklets and fact sheets page.
Nail changes are a common side effect of some chemotherapy treatments. The Nail changes page provides more information on the changes that may occur to your nails, including what you can do manage nail changes.
Fatigue is very common during chemotherapy. Many women describe it as being quite different from normal tiredness. The Fatigue page contains more information on how to manage fatigue. You can also find more information in our section on physical wellbeing.
Some women who have chemotherapy say that they experience a side effect known as 'chemo brain' or 'chemo fog'. It is best described as feeling vague. Some women say they have trouble remembering things and find they aren't as organised as usual. The Chemo brain page includes suggestions on how to manage the effects of chemo brain.
Loss of fertility
Chemotherapy may reduce a woman’s fertility and reduce her chance of having children in the future. There are a number of factors that contribute to this issue, including a woman’s age, and the type of treatment she has and how it affects her ovaries. There are a number of methods for preserving fertility. The Breast cancer in young women page has more information on this issue.
- BCNA’s free My Journey Kit contains more information on chemotherapy.
- Join our online network if you think talking to others online and sharing experiences will help.
- Download Cancer Council's Understanding chemotherapy booklet.
- The Westmead Breast Cancer Institute's section on Chemotherapy for breast cancer contains extensive information, including side effects and some frequently asked questions.
- The Australasian Menopause Society website has fact sheets on treatment of menopausal symptoms in breast cancer, early menopause due to chemotherapy, osteoporosis and managing life with menopausal symptoms.