Adjuvant Therapy for Breast Cancer
Adjuvant therapy usually begins within 6 weeks after surgery, based on the results of clinical trials in which the therapy was started within that time period. Doctors do not know how effective adjuvant therapy is in reducing the chance of recurrence when treatment is started at a later time.
Chemotherapy is administered by mouth or by injection into a blood vessel. Either way, the drugs enter the bloodstream and travel throughout the body. Chemotherapy is given in cycles: a treatment period followed by a recovery period, then another treatment period, and so on. Most patients receive treatment in an outpatient part of the hospital or at the doctor's office. Adjuvant chemotherapy usually lasts for 3 to 6 months.
In adjuvant hormone therapy, tamoxifen is taken orally (by mouth). Tamoxifen enters the bloodstream and travels throughout the body. Most women take tamoxifen every day for 5 years. Studies have indicated that taking tamoxifen for longer than 5 years is not any more effective than taking it for 5 years. Premenopausal women may receive hormones by injection to suppress ovarian function. Alternatively, surgery can be performed to remove the ovaries.
As with any medical procedure or treatment, there is a risk of potential side effects with adjuvant therapy.
The side effects of chemotherapy depend mainly on the drugs the patient receives. As with other types of treatment, side effects vary from person to person. In general, anticancer drugs affect rapidly dividing cells. These include blood cells, which fight infection, cause the blood to clot, and carry oxygen to all parts of the body. When blood cells are affected by anticancer drugs, patients are more likely to get infections, bruise or bleed easily, and may have less energy during treatment and for some time afterward. Cells in hair follicles and cells that line the digestive tract also divide rapidly. As a result of chemotherapy, patients may lose their hair and may have other side effects, such as loss of appetite, nausea, vomiting, diarrhea, or mouth sores.
Doctors can prescribe medications to help control nausea and vomiting caused by chemotherapy. They also monitor patients for any signs of other problems, and may adjust the dose or treatment schedule if problems arise. In addition, doctors advise women who have a lowered resistance to infection because of low blood-cell counts to avoid crowds and people who are sick or have colds. The side effects of chemotherapy are generally short-term problems. They gradually go away during the recovery part of the chemotherapy cycle or after the treatment is over.