Treatment and Specific Side Effects

One of the many decisions you will make about your cancer treatment is choosing a doctor, a team and a cancer center that has the expertise and personal touch that makes you feel comfortable, respected and known. It’s critical to feel confident and trust the people who are treating you and to be able to communicate with them.

Second Opinion
You have the right to a second, and even third, opinion at any point in your cancer experience. A second opinion can help you confirm your diagnosis, understand your treatment options, provide you with access to clinical trials, and help you determine which health care team you would like to work with.

There are several treatment options for breast cancer, depending on the cancer stage and the person’s age and general health.

  • Surgery - The most common treatment for breast cancer. As with other types of surgery, side effects include pain or discomfort, risk of infection and some mobility restrictions right after surgery. There are several different types:
    - Lumpectomy also called breast-sparing surgery, breast-conserving surgery, and segmental or partial mastectomy, this involves removing the tumor and some surrounding tissue, but not the entire breast.
    - Mastectomy In this operation, the entire breast is removed. Often, the surgeon removes lymph nodes under the arm as well. After surgery, some people also undergo radiation therapy. Some also choose to have breast reconstruction or plastic surgery to rebuild the shape of the breast.
  • Radiation Therapy - Most people receive some form of adjuvant radiation. Side effects depend on dose and most frequently include irritation and fatigue. Bras and other clothing may rub the treated area and cause soreness.
  • Chemotherapy – Uses drugs to kill cancer cells. This is usually a combination of drugs administered as intravenous (IV) infusions. Chemotherapy can include: docetaxel (Taxotere®), paclitaxel (Taxol®, Onxal™), platinum agents (cisplatin, carboplatin), vinorelbine (Navelbine®), capecitabine (Xeloda®), liposomal doxorubicin (Doxil®), gemcitabine (Gemzar®), mitoxantrone, ixabepilone (Ixempra®), albumin-bound paclitaxel (nab-paclitaxel or Abraxane®) and eribulin (Halaven®). Side effects and their severity vary based of the drugs used. More common side effects include hair loss, nausea and vomiting, lowering of blood counts with resulting fatigue and infection, tingling or numbness related to nerve damage, weakening of the heart (this is rare), damage to the ovaries that may result in infertility or early menopause.
  • Hormone Therapy - Doctors use drugs that block the hormone estrogen, which fuels breast cancer growth. Hormone therapy can include: Tamoifen, Toremifene (Fareston®), fulvestrant (Faslodex®), letrozole (Femara®), anastrozole (Arimidex®), exemestane (Aromasin®), goserelin (Zoladex®), leuprolide (Lupron®), and megestrol acetate (Megace®). Side effects of hormone therapy depend on the drug or treatment type, but can be similar to those of menopause (hot flashes, mood changes, vaginal dryness, etc.). Younger women may be advised to consider surgical removal of their ovaries or to take an estrogen blocker. Older women have other options, including the use of medications that specifically interrupt the production of small amounts of estrogen in various tissues.
  • Targeted Therapy - Certain drugs are now available that can target markers on breast cancer cells and kill them. These are often antibodies or drugs that target the signals that direct the growth of cancerous cells. Targeted therapies can include: trastuzumab (Herceptin®), pertuzumab (Perjeta®), ado-trastuzumab emtansine (Kadcyla™), lapatinib (Tykerb®), palbociclib (Ibrance®) and everolimus (Afinitor®). These treatments can only be used if your cancer has the specific markers that the drug targets. Targeted therapy side effects are usually less severe than chemotherapy, but can include fever, chills, pain, weakness, nausea, vomiting, diarrhea, headaches, rashes or difficulty breathing. These side effects usually decrease after the first treatment.

Open to Options®
If you are facing a cancer treatment decision, Open to Options® is a research-proven program that can help you prepare a list of questions to share with your doctor. In less than an hour, our Open to Options® specialists can help you create a written list of specific questions about your concerns for your doctor.

  • Clinical Trials - You or your doctor may be interested in pursuing a clinical trial. Clinical trials offer patients the opportunity to benefit from new combinations of therapies while also advancing the pace of knowledge about the disease and treatment options.

    If your doctor has not mentioned a clinical trial as an option, be proactive and ask if it is right for you. Although there is much information about clinical trials on the internet, it is important to talk with your doctor so you can find out if the right trial exists for you. Each trial has specific guidelines and eligibility criteria, as well as exclusions based on prior treatments, overall health, and stage of your disease. Your doctor or nurse will also be able to explain to you what participating in a clinical will entail and how it may affect your care and daily life.

For more information on breast cancer and treatment options, check out CSC’s Frankly Speaking About Cancer: Breast Cancer fact sheet.

Updated June 3, 2015