What you can expect

Timing and frequency of chemotherapy sessions

Chemotherapy for breast cancer is given in cycles. The cycle for chemotherapy can vary from once a week to once every three weeks. Each treatment session is followed by a period of recovery.

Typically, if you have early-stage breast cancer, you'll undergo chemotherapy treatments for three to six months, but your doctor will adjust the timing to your circumstances. If you have advanced breast cancer, treatment may continue beyond six months.

If you have early-stage breast cancer and you are also scheduled to receive radiation therapy, it usually happens after chemotherapy.

Common drug combinations

There are many chemotherapy drugs available. Because each person is different, your doctor will tailor the type and dose of medications (regimen) — often a combination of two or three chemotherapy drugs — to your type of breast cancer and medical history.

Where chemotherapy is given

Breast cancer chemotherapy sessions can take place at your doctor's office, at an outpatient unit in a hospital or clinic, or at home.

How chemotherapy is given

Chemotherapy drugs can be given in a variety of ways, including as pills you take at home. Most often they're injected into a vein (IV). This can be done through:

• An IV needle and tube (catheter) in your hand or wrist.
• A catheter port implanted in your chest before beginning chemotherapy. This port stays in place for the duration of your chemotherapy treatment and eliminates the need to find a suitable vein at each treatment session.

A typical chemotherapy session

Not all chemotherapy sessions are alike, but a session might follow this order:

• You have a blood sample drawn for a blood count and other blood tests.
• You meet with your doctor to review your blood test results and assess your overall health.
• Your doctor orders the chemotherapy.
• You meet with the member of your health care team who's administering your chemotherapy.
• You undergo a brief physical exam to check your temperature, pulse and blood pressure.
• You have the IV catheter inserted.
• You receive medications to prevent side effects such as nausea, anxiety or inflammation.
• You receive the chemotherapy drugs. This may take up to several hours.

After a chemotherapy session

Following a chemotherapy session, you may:

• Have your temporary IV catheter removed.
• Have your vital signs checked.
• Review side effects with your doctor.
• Receive prescriptions for medications you can take at home to help with side effects.
• Be advised on what to eat and drink.
• Receive instructions on proper handling of bodily fluids, such as urine, stool, vomit, semen and vaginal secretions, as these may contain some of the chemotherapy drugs for the next 48 hours. This may simply involve flushing the toilet twice after use.

Some people feel fine after a chemotherapy session and can return to their schedules and activities. Others may feel side effects more quickly. You may want to arrange for someone to drive you home afterward, at least for the first few sessions, until you see how you feel.

During the course of chemotherapy

After a few sessions, you may be able to predict more accurately when you'll feel fine and when you may need to cut back on activities. Marking your calendar or keeping a journal may help you track your general response to chemotherapy sessions and plan events accordingly.

Following your treatment plan closely is the best way to get the most benefit from chemotherapy. If side effects become too bothersome, discuss them with your doctor. He or she may be able to adjust the dose or type of chemotherapy medication you're receiving or prescribe other medications to help relieve some symptoms such as nausea. If the number of white cells in your blood drops, your doctor may stop your chemotherapy until your white cells return to a safe level.

Relaxation techniques such as meditation and deep breathing may help reduce stress. And exercise has been shown to help improve sleep and lessen fatigue caused by chemotherapy. Wearing wigs, hats or turbans can make hair loss less obvious.