Chemotherapy
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.
Joanne explains what the chemo was like in practical terms and how she would visit the hospital for testing, go home, and receive chemo the next day.
Written testimony
In the beginning… we hear about people on chemotherapy. You think they’re on chemotherapy and they’re hooked up to IV for all this time, like somebody’s doing chemo. But you’re in for one day or two days, the day before you need blood work done and the next day you need to be hooked up for a couple hours or I don’t know, maybe it was the whole day. I think people believed that your off a week of chemo and then the 2 weeks that you’re not on it. It’s the week of taking oral drugs and leading up to that 1 day on the IV for me. So I don’t think I knew. Some people when I’d talk to them realized that that’s all it is. It’s just that 1 day a week that you’re over to the hospital hooked up to IV.
Women described different chemotherapy treatments depending on their personal circumstances. Some received chemotherapy weekly and others once every two or three weeks. Some women also received different combinations of chemotherapy during their treatment. Isla said: “It’s very scary and daunting at the beginning of the first treatment, I feel for any woman walking in there because nobody gets good at chemo.” Malika said: “Chemotherapy is a poison that is healing us.” Most women had undergone chemotherapy after surgery but a few had it before surgery.
Susanne felt comfortable in a welcoming and cozy environment for her chemo.
Transcript
Oh going to (city in BC) was so hard. The chemo itself, preparing for that, having a sense of humour about it. Our old hospital had a very small chemo department. It was an old hospital room with the 4 beds that they transformed and it was pretty full of […]
Considering chemo
Tina and Laurie considered chemotherapy but decided against it. Tina felt she would not be able to deal with it physically.
Laurie requested more testing, did her own research, and then presented her recommendation to her doctor.
Transcript
And currently in Quebec if you have no nodes positive they will allow you to get the Oncotype DX* test which tests your genetic components in your tumour. Then based on your Oncotype results, you can see whether it’s beneficial or not to do the chemotherapy. But as soon as […]
At Melissa's first oncology appointment she felt that the decisions were already made for her, she took some time to reflect on her options.
Transcript
Initially when I had gone for my follow-up, with my surgeon, she had mentioned, you know, the fact that I would likely have to do chemotherapy based on the histology of the sample. My mom had not done chemotherapy for her first round when she had breast cancer. So it was […]
Treatment sessions
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.
Carol felt very sick after the first chemotherapy, so the nurses advised her to take the anti-nausea medication for the next round.
Transcript
The first session is really, I think, the hardest because you don’t really… they try and explain to you what the side effects are and what could happen and what’s going to happen but I think it’s harder than you can imagine the first time. And there’s, I don’t normally […]
Debbra found another oncologist with the help of a social worker; her experience with chemotherapy improved after that.
Transcript
My first experience was extremely exhausting because it was fighting, it was trying to figure out what was going on. I was very disillusioned with, with how bad the healthcare system was and then I was lucky, I had a great social worker. The social worker allowed me to put […]
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.
One of the hardest thing for Margaret was the pain caused by the Neulasta injections that she had to give herself.
Transcript
One, yeah, every 3 weeks, and I was very lucky I think from what other people experience. I certainly did have a few days where I felt really awful. One of my biggest complaints I think or my biggest hardships of it were the nausea and the pain. The pain […]
Side-effects
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.
It really helped Nadia (B) to take her medication consistently; she did not experience many side-effects.
Transcript
I was very fortunate with the chemo because a lot of people said there’s a lot of side-effects. So mostly, first of all, I didn’t feel too much nausea. It was there constantly but because I used to sleep so much it didn’t affect me as much and because I […]
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.
Hair loss
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’.
One of the hardest things for Nalie was to shave her head but at the same time she wanted to show others that there is nothing wrong with being bald.
Transcript
Yeah, hair loss was probably the hardest thing for me especially because I used to have long hair down to the butt. My hair was really, really nice, everyone… I used to curl it, everyone used to love the hairstyles I used to do. At 20 something years old, as […]