Chemotherapy consists of a combination of various products working synergistically towards halting cell division which is particularly rapid in tumorous cells.
The combinations used are those known to be effective on this type of cancer: FEC (fluorouracil, epirubicin, cyclophosphamide) chemotherapy and taxanes (taxotere and taxol) are the most conventional ones but other products are available.
Chemotherapy can be used at various stages of the disease in combination with radiotherapy, hormone therapy and a target treatment.
Adjuvant chemotherapy is the term used to refer to chemotherapy given after a surgical operation for the purpose of destroying suspected residual cells not detectable by the tests performed during the assessment. The indication is based on histological and immunohistological features defining the risk of a subsequent recurrence. It is after a cross-disciplinary consultation that this decision is taken.
Neoadjuvant treatment is the term used when chemotherapy is initially recommended, prior to surgery, to reduce the size of the lesion and facilitate conservative surgery if this could not be considered initially. Its effectiveness will be regularly measured by the reduction the size of the tumour. The oncologist and the breast surgeon will examine you to evaluate the size of the tumour and will recommend a mammogram/ultrasound during the chemotherapy treatments.
Chemotherapy can also be used in the case of an advanced or metastatic disease, initially, or later in the evolution of the disease in the event of a relapse. The effect of the treatment is viewed by means of radiological follow-up.
While chemotherapy once bore the stamp of a pejorative connotation, its effects are much better tolerated nowadays. Effective products are currently available to combat the nausea and vomiting which can at times be reduced to vague gastrointestinal discomfort. Hair loss cannot unfortunately be avoided but you can benefit from beauty advice. The health insurance fund partly contributes to the reimbursement for wigs, scarves and hats. Susceptibility to infection is temporary but it is important for it to be monitored. Sometimes fatigue requires an adjustment in activity.
How does this work?
Chemotherapy is almost always administered intravenously, although certain drugs are given by mouth. Administration is by way of venous perfusion or in a Port-A-Cath®, a small chamber implanted under the skin by means of a minor surgical operation and connected directly to the deep venous system. The Port-A-Cath® is kept permanently in place during the chemotherapy period or even longer for safe, easy chemotherapy administration.
Most of the treatments can be given in a day hospital setting. The length of the perfusion varies between 30 and 60 minutes. Before each treatment, the red blood cell range, white blood cell range and platelet range are tested and a consultation is held with the medical oncologist at the Breast care clinic. It is estimated that the patient will be in the hospital for a total of 4 hours.
The first time the patient is administered chemotherapy, she will be given a private room at the day hospital so that an explanation of what is entailed in her treatment can be given in a calm, quiet environment. She may afterwards be given a single, two-bed or four-bed room. Some treatments can also be given in a comfortable armchair.
The psychologist sees her on the 1st day. As the first chemotherapy treatment is an emotional experience involving a reorganisation of daily life, the psychologist will be available at any time, free of charge, to you and your close ones.