Breast cancer is treated with local therapies and systemic therapies. Local therapies treat the tumor without affecting other parts of the body, says the American Cancer Society. Examples of this include surgery and radiation. Systemic therapies are dispersed through the bloodstream and are effective against cancer cells that have spread throughout the body. Chemotherapy is one kind of systemic treatment.
Chemotherapy Forms
Chemotherapy can be given by mouth or intravenously, depending on which drug is chosen. Some women have intravenous chemotherapy followed by oral chemotherapy, and some women only have oral chemotherapy. Treatment often depends on the stage of the cancer and characteristics of the cancer itself, says Ramaswamy Govindan in The Washington Manual of Clinical Oncology, 2008.
Common Treatment Regimens
Chemotherapy is often more effective when a combination of drugs are used, and for breast cancer, there are several combinations commonly used, says the American Cancer Society. Three combinations that are used often include cyclophosphomide, methotrexate, and 5-fluorouracil (CMF); cyclophosphomide, doxorubicin, and 5-fluorouracil (CAF); and doxorubicin and cyclophosphomide (AC) (Govindan, 2008). Other combinations include epirubicin and cyclophosphomide (EC), and docetaxel, doxorubicin, and cyclophosphomide, says the American Cancer Society. This is not a complete listing of combinations, so it is important that you and your doctor discuss which option is best for you.
Commonly Used Chemotherapeutic Drugs in Breast Cancer
Cyclophosphamide (brand name Cytoxan) can be given orally or intravenously, and is part of nearly every regimen for breast cancer, says Drs. Carol Turkington and Karen Krag in the 2006 book The A to Z of Breast Cancer. Its side effects can include hair loss, nausea and vomiting, loss of appetite, mouth sores, diarrhea and low blood counts, which can increase risk of infection. Doxorubicin (brand name Adriamycin) is also commonly used in treating breast cancer. This drug can cause damage to the heart, so before it is given, heart function tests are done. Your heart function is also monitored during treatment with doxorubicin and even after treatment. Side effects of this drug include severe nausea and vomiting, hair loss, appetite loss, and it turns urine red for a day or two following administration. 5-fluorouracil (brand name Adrucil) is given intravenously, usually with other drugs. Epirubicin (brand name Ellence) is a drug that is given to women whose cancer has spread to the lymph nodes under the arm after surgery. It can cause nausea and vomiting, mouth sores, and diarrhea. Methotrexate (brand name Mexate), docetaxel (brand name Taxotere), and vincristine (brand name Oncovin) are also other drugs used in treating breast cancer. These also share many of the side effects of the drugs previously mentioned.
Types of Chemotherapy Regimens
Chemotherapy is given in cycles, to allow the body to rest and repair itself. The medication is given, and then there is a break of two or three weeks, depending on the cancer and drugs chosen, before another administration. The length of treatment depends on the stage of cancer, the type of cancer, and the drugs being used.
Dose-dense chemotherapy is when cycles of chemotherapy are given closer together. If a combination is given every three weeks in the standard treatment, a dose-dense approach may give it every two weeks. While this approach has had success in improving survival in some women and reducing the risk of recurrence, it can also have more pronounced side effects.
Clinical Trials
Your doctor may mention the option of taking part in a clinical trial. Clinical trials are research studies with patients that are controlled very carefully. They test different treatments to see whether they work, and how well. Participating in a clinical trial is a good way to receive cutting-edge clinical care while being closely monitored. You have every right not to participate, and your doctors cannot treat you differently if you do not choose to participate. They are not for everyone, but if you are interested, talk to your doctor to see if you would benefit from participation, or if you are eligible to join a study.
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