Chemotherapy is the use of any drug or medication to treat disease. For example, antibiotics are a type of chemotherapy. Today, however, the word chemotherapy has come to refer to medications used for treating cancer.
Chemotherapy travels in the bloodstream and can reach cancer cells in distant organs that may have not been removed by surgery or may not be the target of radiation treatment.
Chemotherapy is used in 3 ways to treat breast cancer:
Cancers are made up of billions of cells that can travel from one part of the body to the other. Cancers that develop away from the original tumour are known as metastases. When only a few cancer cells have traveled away from the original tumour, doctors may be unable to detect them even with sophisticated scans and blood tests. These tiny metastatic deposits can grow and ultimately cause incurable disease.
Because we cannot detect these tiny metastases we need to learn from the experience of other women over years of research, which patients may be at a high risk of recurrent disease at some time in the future and which patients may be cured with surgery alone.
The goal of chemotherapy is to reduce the number of recurrences and to increase the number of women who are cured after a diagnosis of breast cancer. Research has shown that both premenopausal and postmenopausal women benefit from chemotherapy, and that chemotherapy given at the time of diagnosis can significantly reduce the risk of the cancer recurring.
Studies suggest that chemotherapy can decrease the risk of recurrence by about 25% to 33%. This means that:
The recommendations for chemotherapy depend on your risk category as determined by your pathology report and on the evidence that chemotherapy works. This evidence is constantly changing as new studies are reported, as new drug combinations are tested and as we learn more about how breast cancer behaves. We know that chemotherapy does not guarantee a cure, because many women relapse after treatment. Better chemotherapy is needed, and research is ongoing, and there are a number of new chemotherapy combinations. You should discuss with your doctor why you may need chemotherapy and which chemotherapy is best for you.
A risk/benefit assessment helps your doctor to evaluate the:
In other words, your doctor needs to determine if the potential benefits outweigh the side effects in your situation.
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