Breast cancer – chemotherapy

Chemotherapy involves combinations of drugs that kill or stop
the growth of cancer cells throughout the body.
 

Chemotherapy is a drug treatment started soon after breast
surgery and may be continued for months or years. In the case of
localised breast cancer (cancer that has not spread to other parts
of the body), Chemotherapy delays the return of the cancer and can
prolong (extend) survival in most women. Often several chemotherapy
drugs are used, as this is more effective than using a single
drug.

Chemotherapy may also be used in cases where the cancer has
spread to other parts of the body. Use of Chemotherapy drugs in
these cases usually relieves symptoms and improves quality of life
and may extend the life of the patient slightly (when used with
surgery). 

Chemotherapy drugs can be administered in a number of ways. The
most common way is via injection into a vein (intravenously) where
the drugs are given over several minutes. The drugs may be mixed in
with a large volume of fluid and injected over a longer time period
(hours or days), via a drip or infusion. Chemotherapy drugs can
also be administered via an injection into a muscle (intramuscular
injection) or via an injection beneath the skin (subcutaneous
injection). Chemotherapy is sometimes administered via injection
into the fluid surrounding the spine or in the form of
tablets. 

Chemotherapy may involve visits to a clinic or hospital and
some patients are required to stay in hospital after their drugs
have been administered. Most Chemotherapy treatments involve
periods of drug treatment separated by ‘rest’ periods that allow
the body to recover from side effects of Chemotherapy. The number
and frequency of treatments required by a patient depends on the
type of cancer and the drugs given. Most Chemotherapy treatments
last from six to twelve months.

DIET HINTS

Extra fluid is required in the 48 hours following intra-venous
Chemotherapy so that the body can break down and excrete
Chemotherapy drugs. Faster excretion of Chemotherapy drugs after
treatment will help to reduce severity of side effects. If the
Chemotherapy drugs are administered by mouth, extra fluid is
required on the days that the drugs are taken. Ask your Doctor how
much fluid you should be drinking. Remember that soups, jellies,
iced-blocks and fruit, as well as fluid drinks, help to give you
extra liquids.

Dietary Advice during Chemotherapy. 

• Avoid eating favourite foods within about 24 hours of
  Chemotherapy treatment so that if treatment causes nausea and
  vomiting, there will not be negative associations with these foods
  at a later time. 
• Eat a low fat (less than 3 tablespoons or 40 grams fat/oil per
  day), high carbohydrate (complex carbohydrate (starch) foods such
  as grains, fruits and vegetables) diet with small quantities of
  good quality protein. White meat chicken, fish and eggs are easy to
  digest. Protein powder-based smoothies are also good ways to add
  extra protein. Patients who cannot eat solid foods but can tolerate
  liquids are recommended to supplement fluids with milk powder,
  low-fat yoghurt, eggs, honey or other drink supplements.

Dietary Advice Between treatments: 

Eat a balanced diet. This will enable the body to feel as
energetic as possible and improve the body’s ability to heal and to
fight infection, tolerate the Chemotherapy treatment with fewer
side effects and keep body weight at an appropriate level. The
following steps are recommended: 

1. Enjoy a wide variety of nutritious foods.
2. Eat plenty of breads and cereals (preferably wholegrain),
   vegetables (including legumes such as those found in the peas and
   bean families) and fruits.
3. Eat a diet low in fat and, in particular, low in saturated
   fat.
4. If you drink alcohol, limit your intake.
5. Eat only a moderate amount of sugars and foods containing added
   sugars.
6. Choose low salt foods and use salt sparingly.
    

See the Cancer – Nutrition topic for further
information. 

SIDE EFFECTS

Side effects of Chemotherapy treatment include nausea,
vomiting, tiredness, mouth sores and hair loss. Chemotherapy
patients may also be more prone to infections and bleeding for
several months and 1 or 2 out of every 1000 women receiving
Chemotherapy will die from complications caused by infection or
bleeding.

VITAMINS/MINERALS/HERBS

Always consult your Doctor before taking any supplements
during Chemotherapy. Many anti-cancer drugs work by altering the
levels of vitamins in the body, so taking vitamin supplements may
interfere with this process. The safest advice is to eat a well
balanced diet in order to receive an adequate intake of
nutrients.

ORGANISATIONS & SUPPORT GROUPS

See the Australian Cancer Society topic on the
Healthpoint.

PHARMACIST’S ADVICE

Ask your Pharmacist for advice.

1. Your Pharmacy stocks a range of mouthwashes for maintaining
   dental hygiene during Chemotherapy.
2. Ask your Pharmacist about nutritional drink supplements to
   boost calorie and nutrient requirements during Chemotherapy.
3. See the other topics in the Breast Cancer group on the
   Healthpoint.