Chemotherapy for secondary breast cancer

Chemotherapy uses anti cancer (cytotoxic) drugs to destroy cancer cells. The drugs circulate throughout the body in the bloodstream.

Aim of chemotherapy

Chemotherapy for secondary breast cancer can relieve symptoms. It can also control the cancer and improve your quality of life for a time, but it can’t cure the disease.

For some people treatment can control the cancer for many months or years.

Types of chemotherapy

In many situations, the chemotherapy drugs for secondary breast cancer are the same as those used for early breast cancer.

The chemotherapy drugs you have depend on:

  • what chemotherapy drugs you've had before
  • how well the cancer responded to those drugs
  • what side effects you had
  • your general health and fitness

Chemotherapy drugs that doctors often use for secondary breast cancer include:

  • docetaxel (Taxotere)
  • vinorelbine (Navelbine)
  • capecitabine (Xeloda)
  • paclitaxel (Taxol)
  • nab paclitaxel (Abraxane)
  • gemcitabine (Gemzar)
  • epirubicin (Pharmorubicin)
  • eribulin mesylate (Halaven)
  • carboplatin
  • cyclophosphamide
  • fluorouracil (5FU)

You may have one drug or a combination of drugs, for example, gemcitabine and paclitaxel, or capecitabine and docetaxel.

How you have chemotherapy

You may have chemotherapy directly into your bloodstream through a drip (intravenously). Some chemotherapy drugs are tablets or capsules that you swallow, such as capecitabine.

You might have treatment through a long plastic tube that goes into a large vein in your chest. The tube stays in place throughout the course of treatment. This can be a:

  • central line
  • PICC line
  • portacath

If you don't have a central line, you might have treatment through a thin short tube (a cannula). The cannula goes into a vein in your arm each time you have treatment

Taking your tablets or capsules

You must take tablets and capsules according to the instructions your doctor or pharmacist gives you.

Whether you have a full or empty stomach can affect how much of a drug gets into your bloodstream.

You should take the right dose, not more or less.

Talk to your healthcare team before you stop taking or miss a dose of a cancer drug.

When you have it

You usually have chemotherapy as cycles of treatment. This means that you have one chemotherapy drug or a combination of drugs then a rest to allow your body to recover.

Each cycle of treatment varies depending on what you are having. 

Where you have chemotherapy

You usually have treatment into your bloodstream at the cancer day clinic. You might sit in a chair for a few hours so it’s a good idea to take things in to do. For example, newspapers, books or electronic devices can all help to pass the time. You can usually bring a friend or family member with you.

You have some types of chemotherapy over several days. You might be able to have some drugs through a small portable pump that you take home.

For some types of chemotherapy you have to stay in a hospital ward. This could be overnight or for a couple of days.

Some hospitals may give certain chemotherapy treatments to you at home. Your doctor or nurse can tell you more about this.

Before you start chemotherapy

You need to have blood tests to make sure it’s safe to start treatment. You usually have these the day before or on the day you start treatment. You have blood tests before each round or cycle of treatment.

Your doctors and pharmacists work out your chemotherapy dose based on your blood cell levels, and your weight, height and general health.

Dietary or herbal supplements and chemotherapy

Let your doctors know if you take any supplements or if you’re prescribed them by an alternative or complementary therapy practitioner.

It’s unclear how some nutritional or herbal supplements might interact with chemotherapy. Some could be harmful.

Side effects

Common chemotherapy side effects include:

  • feeling sick
  • loss of appetite
  • losing weight
  • feeling very tired
  • a lower resistance to infections
  • bleeding and bruising easily
  • diarrhoea or constipation
  • hair loss
Contact your doctor or nurse immediately if you have signs of infection. These include a temperature above 37.5C or below 36C, or generally feeling unwell. Infections can make you very unwell very quickly.

Side effects depend on:

  • which drugs you have
  • how much of each drug you have
  • how you react

Tell your treatment team about any side effects that you have.

Chemotherapy for breast cancer can be difficult to cope with. Tell your doctor or nurse about any problems or side effects that you have. The nurse will give you telephone numbers to call if you have any problems at home.

Electrochemotherapy for breast cancer that has spread to the skin

Sometimes breast cancer cells can start growing in the skin. It may start to grow on or near the scar after an operation to remove the primary cancer. Or it can grow in other parts of the body. This is secondary or metastatic breast cancer in the skin.  

The skin may become itchy, red and painful.

Electrochemotherapy is a way of getting chemotherapy into cancer cells. It is a combination of:

  • chemotherapy injected into the tumour or bloodstream
  • an electric pulse to send the chemotherapy into the cancer cells (called electroporation)

This treatment can shrink the skin secondaries and help to relieve symptoms such as pain. 

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