Chemotherapy in breast cancer

A 65 year lady was presented to my clinic a year ago with left breast lump for 6 months. All the workout done and it was confirmed as cancer. She was counseled for surgery but she refused and defaulted treatment.
She came again 6 months later. Now, the left breast lump was huge.
very huge breast tumour over left breast.

She requested for surgery. But, at this moment surgery can not be done as the tumour was huge, making surgery difficult and risky.
Instead she was offered a chemotherapy.

Chemotherapy is a treatment that use anti-cancer drugs to destroy cancer cells. Women with breast cancer usually received chemotherapy in either of these forms:

• before surgery, like in this patient, to make the tumour shrink, then patient will undergo surgery. This is called "neoadjuvant chemotherapy".
• after surgery, and this is called "adjuvant chemotherapy.

There are many anti-cancer drugs for breast cancer available in my hospitals, among others are:

• cyclophosphamide
• epirubicin
• fluorouracil (5FU) (5FU)
• methotrexate
• paclitaxel (Taxol) (Taxol)
• doxorubicin (Adriamycin®) (Adriamycin®)
• docetaxel (Taxotere®). (Taxotere®).

In higher centres with oncologist there is a newer drug called "targeted treatment" like Herceptin. But this treatment is expensive, patient needs to pay almost RM100, 000 to have this anti-cancer drug for a year.

Patients will received combination of anti-cancer drugs, like:

• FEC – 5FU, epirubicin and cyclophosphamide
• AC – doxorubicin (Adriamycin®) and cyclophosphamide
• CMF – cyclophosphamide, methotrexate and 5FU
• E-CMF – epirubicin and CMF
• FEC-T – FEC plus docetaxel (Taxotere®

Usually, chemotherapy is given as injection form. In our hospital, patients needs to be admitted to have the treatment. In other bigger hospital, the treatment can be given as an outpatient. After the treatment, there is followed by a rest period of a few weeks, which allows the body to recover from any side effects of the treatment.

Side effects from chemotherapy is common. The usual side effects are:

• nausea and vomiting
• tiredness
• sore mouth
• increased risk of infection
• hair loss

Fortunately, the side effects are minimal and we do give patients some medication to reduce the side effects.


Back to the patient, she has completed the chemotherapy.
Alhamdulilah, the tumour shrink remarkably and she is scheduled for surgery probably next week.

See..no more tumour..amazing right????