About chemotherapy treatment

Chemotherapy treatment uses anti-cancer drugs (‘cytotoxic’ drugs) to destroy cancer cells. Cancer progresses when the cancer cells divide and grow. Chemotherapy drugs interfere with the cancer cells’ ability to divide and grow.

Not everyone with early breast cancer or metastatic breast cancer will have chemotherapy.

If your medical oncologist is thinking about chemotherapy, they will discuss:

• why they think it's the right treatment for you
• which combinations of medications are most appropriate.

How chemotherapy drugs work

Chemotherapy works by damaging fast-growing cells in your body.

Cancer cells usually grow and divide faster than normal cells. They can’t repair themselves when they are damaged, which makes chemotherapy effective.

Unfortunately, chemotherapy can affect some of the normal fast-growing cells in the body. This damage is why you get side effects of chemotherapy, such as hair loss, nausea, and mouth and stomach issues.

Normal cells, unlike cancer cells, usually recover from the damage. This is why most side effects of chemotherapy are temporary and not permanent.

Chemotherapy is a ‘systemic’ treatment – it treats the whole body, not just a local area. This reduces the chance the cancer will come back in the breast and elsewhere in the body. 

Most chemotherapy drugs are given ‘intravenously’. An intravenous or IV drip delivers the drug through thin tube (‘cannula’) into a vein in your arm or hand.

If you need chemotherapy regularly, you may have a port or PICC instead of a cannula. This means you don’t need a cannula inserted each time. Find out about ports and PICCs.

Some chemotherapy drugs are in tablet (oral medication) form.

Sometimes, doctors recommend a combination of oral tablets and intravenous chemotherapy.

Where chemotherapy happens

Chemotherapy treatment usually happens in a clinic or hospital. It is an outpatient treatment, so you don’t need to stay in overnight.

Your chemotherapy is usually given by a chemotherapy nurse in a room or ward. This may be called a 'chemotherapy day unit, ‘day chemotherapy unit’, or 'infusjon suite'.

If you live in a rural area (or in some areas of the city), it might be possible for a nurse to give you treatment in your home or at work.

In most instances, you can choose the day of the week that you have treatment.

Cycles of chemotherapy

You usually have chemotherapy in ‘cycles’. Each cycle is a short period of treatment that happens usually every 3 or 4 weeks. This is followed by a period with no treatment to give your body a chance to recover between treatments.

Your chemotherapy plan – the number of cycles, the length of the treatment period and the length of the rest period – depends on:

• the type of breast cancer - early or metastatic
• the stage, grade and subtype of your breast cancer, such as triple negative or HER2-positive
• the type of chemotherapy.

Treatment usually continues until:

• the drugs are no longer controlling the cancer, or
• the side effects are too much for you.

After your first type of chemotherapy, you may be able to have a break. Sometimes a hormone-blocking therapy can be tried next. Or, you may need another chemotherapy treatment.

Doctors will recommend a new type or line of treatment when there are signs the cancer is active. Signs include:

• you develop new symptoms, or existing symptoms become worse
• results from scans show the cancer is growing
• findings when the doctor does a physical examination.

This next treatment will proceed as it did for the first line of treatment.

For chemo to be successful, you need to have the right dose at the right time. Sometimes your dose might be reduced or delayed to help you manage side effects. It's important to have a balance between effectiveness and side effects.

If you are concerned about the effect of any change or delay, talk to your medical oncologist.

Prepare before your treatment

Drink lots of water the night before and the morning of your chemotherapy. This helps the chemotherapy nurses find a good vein in your hand or arm for the intravenous drugs.
Keep your body and your arms warm.

Don’t wear sleeves that are too tight or make it hard for you to move.

Take care of your veins during chemo

Sometimes, nurses may recommend you have a ‘port’ or a ‘PICC’. This is easier if:

• it’s hard for nurses to find a vein each time you have treatment
• you are going to have intravenous treatment for a long time.

Find out about ports and PICCs.

Vaccinations and chemotherapy

Always talk to your oncologist before you receive any vaccination to make sure it is safe for you. Some vaccines contain live viruses that can cause issues in people with an altered immune system.

Information is also available at Department of Health – who can be immunised?.