Chemotherapy is quite a common therapy for treatment of most of the cancers. In it with the use of medicines, cancer cells of the body are weakened and destroyed. This therapy also in the process destroys the cancer cells present at the original site of the cancer growth and also other cells that might have spread to the other parts of the body. It is also referred to as “chemo” in short and it is a “systemic” therapy. By systemic it implies that it is injected in the body through the blood stream and thus affecting the entire body.
A number of chemotherapy medicines are available for various types of cancers and predominantly in it a combination of two or more medicines are combined with any other type of therapy for breast cancer treatment.
Chemotherapy is one therapy which treats any and all stages of breast cancer, including recurrent and metastatic cancer. These chemotherapy treatments are specifically altered and designed as per every individual cancer being treated. To prescribe specific chemotherapy medicines, a doctor needs information on which the treatment is based. He needs information like the stage of the cancer, hormone-receptor and HER2 status. Medical history of the patient is also considered along with the menopausal status of the woman. For pregnant women, chemotherapy is safe after the first trimester.
For any cancer to classify as early-stage breast cancer, it would fall in the category of stage 0, stage I, stages IIA and IIB, and some stage III. (Read More About Breast Cancer Stages)
Chemotherapy is used both before and after surgery, as per the need of the condition. In post surgical cases, chemotherapy prevents the cancer from recurring by destroying any leftover cells thus reducing the risk of cancer developing again. In pre surgical cases, it shrinks the tumor growth, so that less tissue has to be removed during surgery.
Chemotherapy regime for individual patient is different but there are a few basic general guidelines based which provide an insight as to what kind of patient with what kind of cancer is highly likely to benefit from chemotherapy.
This treatment of chemotherapy is usually favourable for patients if their cancer is present in the lymph nodes. This may be irrespective of the size of tumour or the menopausal status of the woman.
In premenopausal women, who have invasive breast cancer, usually doctors recommend treatments which are more aggressive. This is because of the fact that the breast cancer teds to be more aggressive in premenopausal women, thus chemotherapy is given in combination with other treatments.
In early stage breast cancer, if the cancer status is hormone-receptor-negative and HER2-positive, Chemotherapy may be recommended. Cancers with hormone-receptor-negative and HER2-positive status are more aggressive kind of cancers.
For estrogen-receptor-positive breast cancer, with the help of Oncotype DX test, he doctor may find out the recurrence risk of the cancer and if chemotherapy would benefit the patient.
For Non Invasive cancers and in-situ cancers like DCIS, chemotherapy is not usually recommended. This is because non invasive cancers do not have the tendency to spread to other parts of the body.
For a cancer to classify as advanced-stage breast cancer, it falls in the category of some stage III and stage IV cancer.
By metastatic disease one implies the breast cancer which is not localized but has invaded and surrounding lymph nodes affecting other parts of the body. Stage IV cancer is termed as Metastatic cancer .
In advanced-stage breast cancer , the treatment of chemotherapy combats the disease destroying or damaging the cancer cells in as many numbers as possible. Chemotherapy treatment is a “systemic” therapy and as such affects the whole body. Thus it is recommended more in treatment of advanced-stage breast cancer. With the advancement in research and advent of newer chemotherapy medicines, many advanced stage breast cancer patients are living longer.
Chemotherapy treatment in advanced stage breast cancer is specific to each individual patient but it is based on few general principles and guidelines.
For patients who have had previous chemotherapy treatments, it is recommended that only one chemotherapy medicine is used at a time before, for treatment of advanced-stage disease. This ensures that the patient benefits from the chemo and has minimum possible side effects.
Chemotherapy side effects unless pose a problem, usually chemotherapy is continued. It is only discontinued if the side effects from chemo are causing problems or the medicines have become ineffective.
When used in combination, chemotherapy medicines have known to be more effective, thus in advanced-stage cancers doctors recommend combining treatments for best results.
In cases where with earlier chemotherapy treatments, there has been no effect on the cancer or there has been a recurrence of the cancer - a different chemotherapy regime may be recommended.
Also for cancers which are hormone receptor positive, hormonal therapy may be used by the treating doctor for treatment of the cancer, which may be prior to or post giving chemotherapy.
In cases of metastatic cancer when chemotherapy forms a part of treatment regime, to assess the benefit from chemotherapy and the body’s response to the therapy, the doctor may conduct various tests. These tests may include blood cell counts, blood tumor marker tests, bone scans, chest X rays, MRI,CT scans, PET scans.