Chemotherapy drugs kill or disable cancer cells. Chemotherapy is a treatment option for most types of breast cancer. The decision to use chemotherapy is based on the tumor stage and certain tumor characteristics (such as hormone receptor status), as well as your age, overall health and personal preferences.
Chemotherapy for early and locally advanced breast cancer
Chemotherapy after breast surgery (adjuvant chemotherapy)
For those with early breast cancer, chemotherapy is usually given after breast surgery (called adjuvant chemotherapy), but before radiation therapy. Adjuvant chemotherapy helps lower the risk of breast cancer recurrence by getting rid of cancer cells that might still be present in the body.
Chemotherapy before breast surgery (neoadjuvant chemotherapy)
Chemotherapy is sometimes used before surgery (called neoadjuvant or preoperative chemotherapy). In women with large tumors who need a mastectomy, neoadjuvant chemotherapy may shrink the tumor enough that a lumpectomy becomes an option.
In women with locally advanced breast cancer, neoadjuvant chemotherapy can reduce the size of the tumor in the breast and/or in the lymph nodes, and make it easier to surgically remove the cancer.
Learn more about neoadjuvant chemotherapy.
Chemotherapy for metastatic breast cancer
For those with metastatic breast cancer, chemotherapy is used to kill cancer cells that have spread from the breast to other parts of the body. Chemotherapy can reduce cancer-related symptoms and prolong survival.
Learn more about treatment for metastatic breast cancer.
Chemotherapy treatment guidelines
Although exact chemotherapy plans vary from person to person, treatment guidelines help ensure quality care. These guidelines are based on the latest research and the consensus of experts. The National Comprehensive Care Network (NCCN) and American Society of Clinical Oncology (ASCO) are two respected organizations that regularly update and post their guidelines online. The National Cancer Institute (NCI) also has overviews of treatment options.
Importance of following your breast cancer treatment plan
Breast cancer treatment is most effective when all parts of the treatment plan are followed. So, it is important to follow your treatment plan (for medications and other therapies) prescribed by your health care provider in terms of:
Completing oral chemotherapy
Side effects are one reason people have trouble completing oral chemotherapy . Although most side effects go away shortly after chemotherapy ends, preventing or treating symptoms can help you complete your course of chemotherapy. You should never feel you have to endure side effects, such as nausea. Talk to your health care provider about any side effects you are having. He/she may be able to prescribe medications to treat your side effects or change your treatment plan to reduce them.
Learn more about the side effects of chemotherapy.
If you have trouble remembering to take oral chemotherapy or medications to treat side effects, a daily pillbox or setting an alarm on your watch or mobile device (you may be able to download a mobile app) may help .
Learn more about the importance of following your breast cancer treatment plan.
Completing intravenous (IV) chemotherapy
If you have transportation, child care or elder care issues that make getting to IV chemotherapy treatments difficult, there may be resources that can help. Getting to and from the treatment can be hard, especially if you live far away. If you need a ride to and from treatment or have child care or elder care needs, there are resources to help. Family and friends often want to help, but do not know how. These are ways they may be helpful to you. And, some organizations offer programs to assist with transportation, child care and elder care costs. Others offer lodging if you need a place to stay overnight so that you can get treatment.
Don’t hesitate to ask for help from your co-survivors or contact organizations that offer help with transportation, lodging, child care or elder care. Find a list of resources.
Prescription drug assistance
Chemotherapy drug costs can quickly become a financial burden for you and your family. Medicare and many insurance providers offer prescription drug plans. One may already be included in your policy or you may be able to buy an extra plan for prescriptions.
Some drugs are off-patent and a generic form may be available. Generic drugs are cheaper than the name brands, but are just as effective. You may also qualify for assistance from programs that help with drug costs or offer low-cost or free prescriptions.
Learn more about insurance plans and prescription drug assistance programs.
Susan G. Komen® position on fairness in oral chemotherapy drug coverage
While intravenously (IV) chemotherapy is a well-known part of cancer treatment, an increasing number of chemotherapy drugs today can be taken by mouth (oral). Insurance policies have not kept pace with these advances in chemotherapy. As a result, people often find themselves facing high out-of-pocket costs when filling their prescriptions for oral chemotherapy (sometimes costing thousands of dollars per month). This disparity exists because IV chemotherapy is usually covered under a health insurance plan’s medical benefit, whereas oral chemotherapy is usually covered under a plan’s prescription drug benefit.
High prescription drug costs are a barrier to care. High costs can prevent people from getting the medications prescribed by their health care providers. No one should be forced to get less appropriate treatment simply because an insurer provides more coverage for IV chemotherapy than oral chemotherapy.
Komen supports efforts at the state and federal level to require insurers to provide equal (or better) coverage for oral chemotherapy as they provide for IV chemotherapy to ensure people have access to affordable, appropriate treatment for their cancer.
*Please note, the information provided within Komen Perspectives articles is only current as of the date of posting. Therefore, some information may be out of date at this time.