Chemotherapy is a drug treatment that targets the cancer but it does have important side effects. It is injected into a vein over multiple sessions, and usually given after surgery for breast cancer. The goal is to destroy any remaining cancer cells at the tumour location, as well as cells that may have spread to other parts of the body. Chemotherapy helps reduce the risk of recurrence. For very large breast cancer tumours, chemotherapy may be given before surgery. The goal of chemotherapy before surgery is to shrink the tumour so that it is easier to operate on. This is known as “neoadjuvant chemotherapy”. Not all women we interviewed received chemotherapy; some women, for example, underwent a lumpectomy and radiation therapy. In this page we present the experiences of women who told us about their chemotherapy treatment.
Tina and Laurie considered chemotherapy but decided against it. Tina felt she would not be able to deal with it physically.
For some women chemotherapy was less difficult than they expected, such as for Melissa and Sirkka, who had a few sores in their mouths but not a lot of nausea. Medication for nausea helped several women.
White blood cells
Some women had reduced white blood cells because of chemotherapy and had to be treated for this. Christine, for example, was admitted to the hospital as her blood count went down to zero; she was advised to take Neulasta to help her white blood cell count recover. May-Lie had to have Neulasta injections and described the intense pain this caused; she took codeine for the pain.
Women mentioned the more common side effects of chemotherapy: hair loss, fatigue, weight changes, loss of taste and appetite changes, aching bones, nausea, tingling toes or fingers (neuropathy), black nails or loss of nails, painful or restless legs, loss of concentration, mouth and vaginal sores, and bad moods or aggressive feelings. Some women also experienced other side-effects that were less common, such as Malika's burning sensation in her body and her tears. May-Lie had a strong urge to be active and hospital staff called her a 'walkaholic'. Ginette had such mouth pain that she had difficulty eating. There was considerable variation in the type and intensity of side effects that women described, and in their reactions to them.
Nadia (B) mentions in the clip that nails can turn black, it happens in some cases that women have discolored nails. Undergoing chemotherapy treatments can also cause infertility or an early onset of menopause. Young women had to therefore decide, before chemotherapy started, if they wished to undergo cryo preservation (egg freezing) to increase their chances of being able to get pregnant after the treatment. You can read more about this in Preserving fertility.
A common side-effect of chemotherapy is the loss of hair. Women described losing their hair in different ways and at different times. For some, this started a 10 days after their first treatment and for others it started around the 3rd week. Some women gradually lost their hair and others described the process as 'fast and furious'. Iceni, for example, remembered a clump of hair blowing away in the wind during a storm. Debbra's hair only thinned following her first treatment. Another thing sometimes noted was the remarkable loss of all body hair, including the hair on arms and legs, eyebrows and eyelashes, pubic hair but also the hair in their nose.
Women made very personal choices around anticipating hair loss. Some women shaved their hair before it started to fall out and others tried to keep their hair for as long as possible. Julie decided to try many different haircuts before taking it all off; Melissa donated her hair to an organization that made wigs for children with cancer; and Christine ended up participating in a fashion show just after her head was shaved which was, in her words, ‘a real gift’.
Donna says "I'm one of the few people that lost weight on chemotherapy it's the worst, worst diet in the world." Most women that we spoke with gained weight during treatment, but felt that there were several contributors, such as steroids, reduced activity when feeling unwell, changed appetite, and early onset of menopause. This was a sensitive issue for some women who felt uneasy with their weight gain. Women also described difficulties eating which led to changed eating habits – eating smaller, more frequent amounts, and eating before treatment. Shelley loved eating more smoothies. Please visit Physical activity and diet changes to read more about this. Julie felt like she was in another body. Others were happy to have gained weight as expected.
Less common as a side effect but noticed by some was 'chemo brain'. Chemo brain is a common term used by cancer survivors to describe thinking and memory problems that can occur after cancer treatment. Chemo brain can also be called chemo fog, chemotherapy-related cognitive impairment or cognitive dysfunction. Melissa and Christine described chemo brain as losing their words, an inability to say certain words, or just a 'duh' moment. For Melissa, the words would suddenly pop up later which has affected her confidence a little. Iceni initially thought she had Alzheimer's as she would constantly forget things.
Different things helped women to cope with chemotherapy and its consequences, but having company and staying as active as possible was a common theme. Having company during the treatment was important for Shelley and helped her keep calm. Sirkka loved going out in the fresh air even when she was feeling really sick and worked on getting her 'mind over matter'. Carol's children helped her to keep going. Christa tried to reduce the exposure to her unborn baby and belly by uncovering it and tried to keep her belly cold. Shelley describes a loss of her fine motor coordination and did things like playing with playdough to get that back to normal again. Melissa thinks she might have pushed herself a bit too hard in continuing her normal routine; likewise, Jeanette's nurse told her not to push so hard after she told her proudly that she did a 6 km hike. Please visit Work and finances to read more about how women combined work and chemotherapy. Keeping a sense of humour was also important to many women we spoke to, you can read more about this in Coping strategies and Positive effects on self.