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When, where and how you have chemotherapy

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

When you have it

You usually have chemotherapy every 2 or 4 weeks. You have the drugs for around 1 to 5 days and then have a break. Each 3 or 4 week period is called a cycle. You might have up to 8 cycles of chemotherapy.

Before surgery

You’re likely to have chemotherapy before surgery if you have a large tumour or if it has spread into the surrounding tissue. You might also have it if you have a type of breast cancer called inflammatory breast cancer.

Chemotherapy before surgery is called neo adjuvant therapy. The aims are to:

  • shrink the tumour down - this can mean having less surgery, for example you might be able to have just the tumour removed (a lumpectomy) instead of the whole breast (mastectomy)
  • lower the risk of the cancer coming back

After surgery

Doctors use chemotherapy after surgery when there is a risk that cancer cells could have spread to another part of the body.

The aim is to reduce the risk of the cancer coming back in the future.

Your specialist may recommend that you have chemotherapy for one or more of the following reasons:

  • the lymph nodes under your arm contained breast cancer cells
  • you had a large tumour in your breast
  • the breast cancer cells were high grade (grade 3)
  • the cancer cells didn't have hormone receptors and so hormone therapy is not likely to work well

Chemotherapy after surgery is called adjuvant therapy.

Chemotherapy is also used to treat breast cancer that has spread to another part of the body (advanced cancer).

Types of chemotherapy

There are a number of chemotherapy drugs used to treat breast cancer. You usually have a combination of 2 or 3 drugs together.

The type of drugs you have depends on different factors. These factors include your risk of the cancer coming back and whether you have other medical conditions, such as heart problems.

How you have chemotherapy

You have the treatment through a drip into your arm or hand. A nurse puts a small tube (a cannula) into one of your veins and connects the drip to it.

You might need a central line. This is a long plastic tube that gives the drugs into a large vein, either in your chest or through a vein in your arm. It stays in while you’re having treatment, which may be for a few months.

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 newspapers, books or electronic devices to 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.

Before you start chemotherapy

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

The pharmacists make chemotherapy for each person individually. They do this once your blood test results have come through. It’s worked out based on your weight, height and general health.

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 any signs of infection such as a temperature higher than 37.5C 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.

Most side effects only last for a few days or so. Your treatment team can help to manage any side effects that you have.

Early menopause

If you are still having periods (pre menopausal), chemotherapy can stop your ovaries from making the hormone oestrogen. This means you might have an early menopause and become infertile. This can be very difficult to cope with if you wanted to have a child in the future.

For some women, the ovaries begin to work again after treatment. This depends on your age when you have treatment, and the types of chemotherapy drugs you have. If you haven’t had a period a year after your treatment, unfortunately it’s not likely that your ovaries will recover.

Your doctor will talk to you before starting treatment about possible ways of preserving fertility.

When you go home

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.

If you have any questions about chemotherapy, you can talk to Cancer Research UK's information nurses on freephone 0808 800 4040, 9am to 5pm, Monday to Friday.

Information and help

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