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About Chemotherapy for Early-stage Breast Cancer
The following is a list of questions to ask your doctor About Chemotherapy for Early-stage Breast Cancer  as well as tips for preparing for these conversations.

What stage is my breast cancer?

Breast cancer is staged based upon characteristics of the tumor: its size and if cancer cells have spread beyond the breast. Breast cancers are classified as stage 0, which is non-invasive, through stage IV, which has spread to other parts of the body. This staging system is used to guide treatment decisions. Early-stage breast cancer is considered to be stage I or II and generally refers to smaller tumors, less than 5 centimeters (2 inches) in diameter. Cancer cells may be present in the lymph nodes in the armpit on the same side as the affected breast, but there is no evidence of spread to distant parts of the body.

Will I need chemotherapy?

Whether or not you will benefit from adjuvant chemotherapy for breast cancer depends upon the stage of your disease, your age and your general health. Chemotherapy can reduce the risk of death from early-stage breast cancer by 25 to 35 percent and prevent recurrence by 25 percent. Everyone will need to weigh the risks and benefits of chemotherapy with their doctor individually.

What are the different types of chemotherapy?

Chemotherapy is typically given after surgery in women with early-stage breast cancer, and is known as adjuvant chemotherapy. In some cases, chemotherapy may be given before surgery to shrink a tumor so that a woman can have a breast-conserving lumpectomy rather than a mastectomy, in which the whole breast is removed. When chemotherapy is given before surgery, it is called neo-adjuvant therapy.

The goal of adjuvant chemotherapy is to destroy any remaining cancer cells that may be in the body after a tumor has been surgically removed to prevent the cancer from recurring. Chemotherapy is usually administered directly into the veins with an IV injection but might be given as a pill or as a shot. Combinations of chemotherapy drugs are used because different drugs damage or kill cancer cells in different ways. The combination of medications you receive will determine how often you receive chemotherapy. They might be given once a day, once a week or even once a month over a set period of time. Chemotherapy is delivered in multiple doses called cycles, where each treatment is followed by several weeks of rest and recovery during which no treatment is given. Chemotherapy combinations often go by acronyms named after the first initial of each drug.

What are the short-term and long-term side effects of therapy?

Chemotherapy works by killing rapidly dividing cells, which includes cancer and healthy cells, such as the cells that line the gut, hair follicles and blood. This is why many women experience short-term side effects such as nausea and vomiting, mouth sores, hair loss, fatigue and infection. Other possible side effects include constipation and diarrhea, dry skin and tingling or weakness in the hands and feet. Chemotherapy can also put premenopausal women into a temporary or permanent menopause because it can stop the ovaries from functioning. This can lead to a loss of fertility, low libido, hot flashes and vaginal dryness.

Is there anything I can do to reduce side effects of chemotherapy?

Today there are many strategies to lessen side effects most commonly associated with chemotherapy and in some cases, these can be given at the same time. Medication is available to minimize chemotherapy-related anemia that leads to fatigue. This drug helps to boost your red blood cell count, upping energy levels. Other drugs can boost white blood cell counts to raise resistance to infection. Antiemetics may also be prescribed to control nausea and vomiting. Eating small nutritious, balanced meals slowly throughout the day will also help keep your energy levels up. Drinking fluids and eating fiber-rich foods can help with constipation and diarrhea; drugs are available if this doesn't work. There are also medications to help soothe mouth sores and good oral care helps, as well. There is no treatment, however, for hair loss.

Many people try complementary medicines to help cope with the stresses of chemotherapy. Activities such as art and music therapy, meditation, yoga or exercise can enhance and distract or even lessen the side effects of chemotherapy. Be sure to discuss these activities with your doctor before you begin.

How you can prepare for this discussion

  • Bring a tape recorder or a friend as another set of ears to your doctor's appointments to be sure you do not miss any of the information
  • Gather all your medical notes and laboratory results in a three-ring binder
  • Educate yourself in advance about treatment options and their side effects
  • Consider your personal goals for treatment.
  • Prepare a list of your concerns and questions in advance
  • List any activities you feel might be affected by treatment to review with your doctor.
  • Talk to other women who have had treatment for breast cancer to find out their experiences
  • Determine the support system available to you during your car
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