How you prepare

Assess the potential benefit of chemotherapy

When deciding whether chemotherapy is right for you, your doctor considers:

• Cancer size and grade. Larger cancers and higher grade cancers are more likely to recur and are more likely to benefit from chemotherapy.
• Lymph node status. If your breast cancer has spread to your lymph nodes, your doctor may recommend chemotherapy.
• Age. Breast cancer that occurs at a younger age may be more aggressive than cancer that develops later in life. So doctors may recommend that younger people with breast cancer undergo chemotherapy.
• Previous treatments. If you've had chemotherapy before, your doctor considers this when developing your treatment plan.
• Your general health and other medical conditions. Your overall health may affect your ability to tolerate side effects of chemotherapy. Certain health problems, such as heart disease or diabetes, may affect which drugs are selected for your chemotherapy.
• Hormone receptor status. If your cancer cells have receptors for the hormones estrogen and progesterone, your doctor may recommend hormone therapy in addition to chemotherapy.
• HER2 status. If your breast cancer produces too much of a growth-promoting protein known as HER2, your doctor may recommend chemotherapy and drugs that specifically target this protein.

• Genetic profile. For certain types of breast cancer such as hormone receptor positive breast cancer, your doctor may have your cancer cells tested to learn more about their genetic makeup.

  Gene expression profiling tests, such as Oncotype DX, EndoPredict and MammaPrint, may help predict the risk of recurrence and give your doctor an idea of how your cancer cells might respond to chemotherapy. If it's not clear whether you'd benefit from chemotherapy, these tests can be helpful. But they're not useful for everyone and are only used in certain situations.

• Your preferences. Talk with your doctor about your preferences for your care. These can be taken into consideration, especially when multiple options for therapy are available.

Take steps to improve your overall health

Make healthy choices before cancer treatment so you'll feel strong as your treatment begins. Continuing healthy choices during treatment may help minimize side effects.

Your doctor may recommend that you:

• Get plenty of rest.
• Stay active and make the time to exercise.
• Eat a balanced diet rich in fruits, vegetables and whole grains.
• Minimize stress.
• Avoid infections, such as the common cold and the flu. Talk with your doctor about recommended vaccinations, including annual flu vaccines. Also engage in behavior to reduce the risk of infection while on active chemotherapy, such as washing hands or using hand sanitizer before eating and using gloves while doing yardwork.
• See your dentist for any signs of infection in your teeth or gums.
• Undergo blood tests to check your liver and kidney function and tests to check your heart function. If problems show up, your doctor may delay your treatment or select a chemotherapy drug and dosage that is safer for you.

Plan ahead for side effects

Ask your doctor what side effects you can expect during and after chemotherapy. If you know what to expect, you can prepare. For example, if your chemotherapy treatment will cause infertility, you may wish to store sperm, fertilized eggs (embryos) or eggs for future use. If your chemotherapy will cause hair loss, consider a wig or a head covering, or talk to your doctor about measures that may prevent hair loss.

Make arrangements for help at home and at work

Most people are able to continue working and doing their usual activities during chemotherapy. Your doctor can give you an idea of how much the chemotherapy will affect your usual activities, but it's difficult to predict just how you'll feel.

Prepare by asking for time off work or help at home for the first few days after treatment. If you'll be in the hospital during chemotherapy treatment, arrange to take time off work and find someone to take care of your usual responsibilities at home.

Tell your doctor about any drugs or supplements you're taking

Medications or supplements you're taking, including any herbal supplements, vitamins or over-the-counter drugs, may affect the way the chemotherapy drugs work. Your doctor may suggest alternative medications or that you not take the medications or supplements for a period before or after a chemotherapy session.

The day of treatment

Your doctor or nurse will let you know what you can and can't eat or drink on the day of your chemotherapy session. It may help to take a family member or friend with you to the treatment session for support and companionship.