Chemotherapy For Breast Cancer: Overcoming The Side Effects

In In The News by Barbara Jacoby

By: Dr. Omiete Charles-Davies

Chemotherapy is the use of drugs or chemicals to treat an illness or disease, which in this case is, breast cancer.

It involves giving patients anti-cancer drugs called cytotoxic drugs – which literally means cell (cyto) killing (toxic).

Chemotherapy is used to also control the spread of breast cancer, reduce symptoms or prevent a recurrence. Chemotherapy for breast cancer treatment comes in many forms:

  • Used singly treat breast cancer.
  • Used in association with radiotherapy. This is called chemoradiation. This is embarked on to increase the chances of treatment success.
  • Used before surgery or radiation therapy (called neoadjuvant therapy) to shrink the tumour, or after surgery or radiation therapy (called adjuvant therapy) to kill remnant cells and to help prevent it from returning.

How Does Chemotherapy Work?

Chemotherapy drugs work by stopping the process of division in both tumor cells (cancer) and healthy cells. Healthy cells are better able to repair themselves, however, whilst cancer cells are more likely to die.
The fact that chemotherapy acts on dividing cells can explain some of its side-effects. Cells in the body that divide frequently (like skin and hair cells, cells lining the digestive system and bone marrow cells which make blood cells) are therefore vulnerable to chemotherapy. This is why these parts of the body are often affected by chemotherapy.

How Often and For How Long Is Chemotherapy?

Chemotherapy has to be planned carefully. Treatment may be every day, every week, or every month. It’s usually given as a series of sessions of treatment, commonly once every three weeks. Each session of chemotherapy destroys the cancer cells may harm normal body cells. After each treatment session, there’s usually a period of rest to let the body’s cells recover before the next session

A session and the rest period is known as a cycle. A series of cycles make up a course of treatment. For instance, one might receive 1 week of chemotherapy followed by 3 weeks of rest. These 4 weeks make up one cycle.

What Are The Common Side Effects Of Chemotherapy And How Can One Cope?

As explained, chemotherapy affects both healthy and cancer cells. Not everybody gets to have side effects when they receive chemotherapy.

Furthermore, most side effects are temporary and will disappear when chemotherapy is stopped. Different drug regimens (combinations) and drug types cause side effects.

Side effects resulting from chemotherapy for breast cancer can occur immediately – short term side effects; or over time – long term side effects.

The following are the commonest side effects of chemotherapy use and how to overcome them.

Short term side effects

  1. Hair loss:

This is due to the action of chemotherapy on the rapidly dividing hair cells which leads them to prematurely die, causing hair loss.

It is one of the most conspicuous features of chemotherapy use as it is mostly on the head. It is commonly noticed as early as two weeks after commencement of chemotherapy and restoration starts a few weeks after the end of the chemotherapy regimen.

How to cope:

One may decide to get a wig or get a haircut and wear a scarf, bandana or cap, for cosmetic reasons. Some hospitals also offer a scalp cooling cap which is designed to reduce hair loss.

  1. Soreness of the mouth:

Mucosal cells in the mouth are strongly affected by chemotherapy drugs and this may cause oral sores and ulcers. Taste may also be affected.

How to cope:

If there are sores or ulcers, the managing team should be informed. They will provide painkillers and mouthwashes. Vigorous brushing should be avoided as well as hot and spicy foods. If these sores persist, seeing a dentist may be necessary.

  1. Skin changes:

Changes in skin sensitivity and colour may be noticed as early as in the first month of treatment. This is further accentuated by dryness of the skin and newly developed sensitivity to sunlight. There may be nail changes and discolouration.

How to cope:

A moisturiser cream and covering with a hat or an umbrella when going out in the sun can help. A cream with a sun protector factor (SPF) is necessary and the avoidance of tight-fitting shoes if toenails are affected.

  1. Nausea and vomiting:

This may occur immediately chemotherapy is given or a few hours to days after each course is given. To combat this, the doctor will prescribe medications that will help curtail nausea and vomiting because it is a common side effect of anti-cancer drugs.

How to cope:

In the event of continued nausea and vomiting despite taking medicines earlier prescribed, the doctor should be informed. There is a large pool of drugs to select from. Eating small but frequent fractions of food throughout the day is beneficial.

  1. Gut changes:

After chemotherapy is started, one may experience diarrhea, constipation or both at regular intervals. This is because the cells in the digestive system are affected by chemotherapy. Diarrhea, the increase in frequency and fluidity of stools is a common side effect of chemotherapy and may be disconcerting or life-threatening.

How to cope:

Milk based or sugary foods; spicy, greasy or raw food items should be avoided. Drink a lot of water and eat low-fibre food items like rice or bananas. If you are constipated, increase your water and fruits intake. You should report any diarrhea or constipation that persists after these tips to your doctor. Here’s a poop chart that describes different textures and colors of stool.

  1. Fatigue:

This is a common side effect of chemotherapy, usually resulting from the treatment and/or other factors like low appetite or lack of sleep.

How to cope:

You should take your time to rest when afforded the opportunity and also seek help with day to day activities. If you are very worried about your tiredness, speak with your doctor about it.

  1. Infection:

Chemotherapy drugs reduce the number of white blood cells in your blood and at their production site through their action. These cells are responsible for providing defence from disease-causing organisms. When you begin chemotherapy, you may become more susceptible to infections such as common cold or a cough.

How to cope:

To forestall this, practice good personal hygiene and avoid contact with individuals with a cold, cough or skin infections. If you have a fever or feel unwell, contact your healthcare team.

  1. Bruising and bleeding:

A common side effect seen in patients undergoing chemotherapy treatment, bleeding is more erratic and bruises are easily incurred. This is because your blood components responsible for curtailing bleeding are lowered by the chemotherapy agents.

How to cope:

It is important to avoid rigorous or dangerous physical activities. Wash your hands often and avoid using sharp objects like razor blades for trimming your nails or shaving. You should also report non-healing wounds or a persistently bleeding site to your doctor.

Long term side effects

  1. Low sex drive and Infertility:

Some cancer medications affect your libido and fertility but it generally resolves after treatment. Typically, your healthcare team will inform you prior to the commencement of the regimen that features such medications.

How to cope:

You may choose to store sperm if you are a man. For women, it is advised to avoid pregnancy during treatment. If you are currently pregnant, treatment may be delayed to avoid harming your child.

  1. Emotional toll:

Many people are often taken aback by the flurry of activities from diagnosis to the institution of treatment. This takes an emotional toll and causes them grief. It is noted that support groups for women who have survived breast cancer and those currently undergoing treatment helps recently diagnosed women garner courage and motivation to go through treatment.

How to cope:

You should join a local support group if you need any support. Some of these groups also have volunteers who can help you with your daily activities.

  1. Heart disease:

Some chemotherapy agents can weaken the heart muscle fibres. When included as part of the regimen for your care, your healthcare team will request a few investigations before starting chemotherapy so as to get a picture of current state of your health and to assess the extent of the damage at the end of chemotherapy.

How to cope:

Endeavor to follow your doctor’s recommendation on screening and follow-up tests to assess your cardiac function. If you notice any symptoms, inform your doctor.

  1. Development of cancer:

Chemotherapy may trigger other cancers (e.g. Leukemia) several years after treatment.

How to cope:

When treatment is completed, ensure you go for periodic follow-up.

  1.   Menopausal symptoms:

Some women have menopausal symptoms like hot flushes, vaginal dryness, bone pain and mood changes. This is because chemotherapy affects the ovaries, temporarily affecting their performance. Your periods may also be affected during treatment.

How to cope: Inform your doctors if you have these symptoms. There are medications designed to help treat these menopausal symptoms.

Author Bio:

Dr. Charles-Davies has a degree in medicine and surgery is the founder of 25 Doctors, a health information brand. For fun, he loves to travel and experience new cultures.