Chemotherapy uses cytotoxic drugs to destroy cancer. "Cytotoxic" means toxic for the cells. These drugs do not only alter the way in which cancer cells grow and divide, but they may also affect normal cells.

When is chemotherapy given?

Chemotherapy is often given before surgery to eliminate the tumor or reduce its size (neoadjuvant chemotherapy). If there is any chance that the cancer has spread to another place in the body, administering chemotherapy increases the likelihood of it being controlled.

In other situations, it is given after surgery to reduce the chance of the disease coming back; this is because chemotherapy destroys any cancer cells that may have remained after the operation (adjuvant chemotherapy).

Chemotherapy can also be used if the cancer has spread to other parts of the body. The aim of this is to reduce the size of the tumor so as to improve the symptoms and maintain a good quality of life (palliative chemotherapy).

The most frequently used drugs

The most commonly used drug combinations for breast cancer are:

  • FEC - fluorouracil (5FU), epirubicin, and cyclophosphamide
  • FEC-t - FEC followed by docetaxel
  • AC or EC - doxorubicin and cyclophosphamide or epirubicin and cyclophosphamide
  • CMF - cyclophosphamide, methotrexate, and 5FU
  • E-CMF - epirubicin and CMF.

How is the chemotherapy administered?

Chemotherapy is usually given in the day hospital through an injection in a vein (intravenous) through:

  • A fine, thin tube inserted into one of the veins in your hand or arm.
  • A PICC line: a thin plastic tube placed in a vein on the interior part of your arm.
  • A central line: a plastic tube placed in a vein in your chest.

Chemotherapy is usually given during as part of a treatment session. After each session, you will normally have a period of rest lasting for a few weeks. This lets your body recover from the side effects.

The treatment and rest period make up one treatment cycle. Your specialist will talk to you about how many cycles you are going to have. The duration of each cycle depends on the type of drug administered, though each cycle normally lasts for 1–3 months.