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Chemotherapy works by destroying cancer cells. Tests or scans may not detect very small numbers of cancer cells so systemic treatment is often given where there's a risk of cancer cells, even though the tests for these cells may be negative.
Cancer cells grow by dividing in a disorderly and uncontrolled way. Chemotherapy interferes with their ability to divide and grow.
Different chemotherapy drugs work in different ways and attack the cancer cells at different phases of their growth. This is why a combination of drugs is often used.
Chemotherapy is used in a number of ways. It’s often given in addition to surgery and radiotherapy.
Chemotherapy is most commonly given as an adjuvant treatment, which means it is given as additional treatment usually after surgery.
Some people may be offered neo-adjuvant chemotherapy; this term refers to chemotherapy treatment that is given before surgery has taken place.
Chemotherapy is usually given after surgery, and before radiotherapy. It usually starts between three and four weeks after surgery, giving your body some time to recover from the effects of the operation.
Sometimes chemotherapy is given before surgery. It may be used in this way to slow the growth of tumours that are growing rapidly or to shrink larger tumours.
Chemotherapy may also be used to slow down the growth of secondary cancer (cancer that has spread from the original tumour to other parts of the body) and to help relieve pain (palliative treatment).
You’ll usually be offered chemotherapy if cancer cells have been found in the lymph nodes under the arm. Even if there is no spread to the nodes, chemotherapy may be offered if the tumour is over a certain size (over 2 cm), or if the cancer cells are dividing rapidly, which means that the risk of them spreading is greater.
Research shows that people of all ages may benefit from chemotherapy. How effective it is depends on:
The benefits of chemotherapy are often clear, but if they are less obvious it can be difficult to decide whether or not to have the treatment. You’ll need to weigh up the likely benefits against the potential side effects.
Your decision may be influenced by personal priorities, your family, and your work commitments. It’s important for you to discuss these issues openly with your cancer specialist or breast care nurse, who will help and support you with your decision.
Chemotherapy for breast cancer is usually given as a series of treatments every two to four weeks over a period of four to six months. This can vary, depending on the type and stage of your cancer, your general health and the combination of drugs used.
The gap between courses of treatment gives your body time to recover from any short-term side effects that might occur.
You’ll normally be given your treatment as an outpatient so you’ll be able to go home the same day. On each treatment day, you should expect to be at the hospital for most of the day to allow for waiting time and for treatment.
With some types of chemotherapy you may be given your first treatment as an inpatient and stay in hospital overnight.