What is chemotherapy? In cancer treatment, chemotherapy refers to the use of drugs whose main effect is either to kill or to slow the growth of rapidly multiplying cancer cells. Chemotherapy often includes using a combination of drugs, since this approach is more effective than using a single drug alone. There are many drug combinations used to treat breast cancer. Ask your doctor for specific information and side effects you can expect from your chemotherapy medications. How is chemotherapy given? Chemotherapy drugs are given intravenously (directly into the vein) or orally (by mouth). Once the drugs enter the bloodstream, they are delivered to all parts of the body to reach cancer cells that may have spread beyond the breast. As a result, chemotherapy is considered a systemic form of breast cancer treatment. Chemotherapy is given in cycles of treatment followed by a brief recovery period. When given after surgery, the entire chemotherapy treatment generally lasts three to six months, depending on the type of drugs given. When chemotherapy is being used to treat breast cancer that has spread to other organs, chemotherapy may be given for a longer period of time (years). When is chemotherapy given? Chemotherapy is sometimes given before surgery (called neoadjuvant treatment) in order to shrink the tumor so it can be removed more easily or so that a lumpectomy can be performed instead of a mastectomy. When breast cancer is localized only to the breast or lymph nodes, chemotherapy may be given after a lumpectomy or mastectomy. This is known as adjuvant treatment and may help reduce the chance of breast cancer recurrence. Chemotherapy may also be given as the main treatment for women whose cancer has spread to other parts of the body outside of the breast and lymph nodes. This spread is known as metastatic breast cancer and occurs in a small number of women at the time of diagnosis or when the cancer recurs some time after initial treatment for localized breast cancer. What are the potential side effects of chemotherapy drugs? The specific side effects you may experience will depend on the type and amount of medications you are given and how long you are taking them. The most common temporary side effects include: Nausea and vomiting Loss of appetite Hair loss Mouth sores Higher risk of infection (due to decreased white blood cells) Bruising or bleeding Fatigue Changes in menstrual cycle Premature menopause (not having any more menstrual periods) and infertility (not being able to become pregnant) are potential permanent complications of chemotherapy. Heart damage can be a permanent complication of some chemotherapy. Please contact your health care provider about specific side effects you can expect to experience from your specific chemotherapy medications. Also discuss troubling or unmanageable side effects with your provider. Can I still work while receiving chemotherapy treatments? Yes. Most people are able to continue working while they are being treated with chemotherapy. You may have to adjust your work schedule while receiving chemotherapy, especially if you have side effects. It may be possible to schedule your treatments later in the day or right before the weekend so they don’t interfere as much with your work schedule. How will I know if the chemotherapy treatments are working? Some people may think that their chemotherapy treatment is not working if they do not experience side effects. However, this is a myth. If you are receiving adjuvant chemotherapy (after surgery that removed all of the known cancer), it is not possible for your doctor to directly determine whether the treatment is working because there are no tumor cells left to assess. However, adjuvant chemotherapy treatments have been proven helpful in studies in which some women were given chemotherapy, while others were not. If you are receiving chemotherapy for metastatic disease, the effects will be monitored, routinely, by blood tests, scans, and/or other imaging studies. These may include CT scans, bone scans, and/or X-rays). After completing adjuvant chemotherapy, your doctor will evaluate your progress through periodic physical examinations, routine mammography, and appropriate testing if a new problem develops.