Chemotherapy for Breast Cancer
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INFORMATION AND ADVICE Austria CHEMOTHERAPY Brustkrebs Deutschland e. V. Österreichische Krebshilfe-Gesellschaft [Breast Cancer Germany, registered association] [Austrian Cancer Aid Association] FOR BREAST CANCER – Lise-Meitner-Str. 7 Tuchlauben 19 HOW DO I DEAL 85662 Hohenbrunn (district of Munich) AT-1010 Vienna Tel.: +49 (0) 89 / 41 61 98 00 Tel.: +43 (0) 1 / 796 64 50 WITH SIDE EFFECTS? Fax: +49 (0) 89 / 41 61 98 01 Fax: +43 (0) 1 / 796 64 50-9 Free hotline: 0800 0 117 112 www.krebshilfe.net E-Mail: [email protected] DE-HAL-18-00041 (V2.0): 12/2020; HAL0129B www.brustkrebsdeutschland.de Switzerland Deutsche Krebsgesellschaft e. V. [German Cancer Association, registered association] Krebsliga Schweiz Kuno-Fischer-Str. 8 [Cancer League Switzerland] 14057 Berlin Effingerstrasse 40 Tel: + 49 (0) 30 322932-90 CH-3001 Bern Fax: + 49 (0) 30 3229329-22 Tel.: +41 (0) 31 389 91 00 www.krebsgesellschaft.de Fax: +41 (0) 31 389 91 60 [email protected] Krebsinformationsdienst Deutsches Krebsforschungszentrum Cancer telephone and helpline [Cancer Information Service Free hotline: +41 (0) 800 11 88 11 German Cancer Research Centre] E-mail: [email protected] Im Neuenheimer Feld 280 Forum: www.krebsforum.ch 69120 Heidelberg Free hotline: +49 (0) 800 / 420 30 40 www.krebsinformationsdienst.de Stiftung Deutsche Krebshilfe-Infonetz Krebs [German Cancer Aid Foundation-Cancer Information Network] Buschstr. 32 53113 Bonn Tel.: +49 (0) 800 / 80 70 88 77 (free of charge) Mon. to Fri. 8.00 – 17.00 www.infonetz-krebs.de Distribution in Germany: Distribution in Austria: Distribution in Switzerland: Englisch Eisai GmbH Eisai GesmbH, Saturn Tower Eisai Pharma AG Edmund-Rumpler-Straße 3 Leonard-Bernstein-Straße 10 Leutschenbachstrasse 95 60549 Frankfurt am Main A-1220 Vienna CH-8050 Zurich [email protected] [email protected] Tel.: +41 (0) 44 / 306 12 12 INTRODUCTION HELP WITH SELF-HELP Palliative chemotherapy: Therapy with cytostatics aimed at prolonging survival time and improving quality of life. Palliative chemotherapy is used when a cancer is Often, the doctor’s advice just isn’t sufficient.Many problems associated with Chemotherapies have been used for over 60 years in the fight too far advanced to be curable breast cancer can be better discussed with other people who are affected. against cancer. A great deal has happened during this time: The Progression: Advance of a disease substances used are increasingly effective, the combinations are It can be a great help to exchange views and to know that others share the same fate. increasingly sophisticated, and their use is increasingly well Recurrence: Reappearance of a disease, relapse Particularly in the case of breast cancer, there is now a great deal of self-help available in Germany. Below, we have compiled important addresses and links for you. tolerated. Regimen: Doctors use the term chemotherapy regimen to describe the combination, dose and cycle taken as a whole Frauenselbsthilfe nach Krebs e. V. „Haus der Krebsselbsthilfe“ The days are long gone when chemotherapy was viewed as the [Self-help for women after cancer, registered association, Remission: Partial or complete regression of a disease last hope for cancer patients. Its range of application has now been “House of cancer self-help”] extended to include the early stages of disease. As adjuvant therapy Senology: The branch of medicine dealing with the female breast Thomas-Mann-Straße 40 (see Glossary), it serves to ensure successful treatment, and as 53111 Bonn Supportive therapy: Measures aimed at supporting and/or making a treatment Tel.: +49 (0) 228 / 33 889 – 402 neoadjuvant therapy (see Glossary), it is even used before surgery. (e.g. chemotherapy) more tolerable Fax: +49 (0) 228 / 33 889 – 401 www.frauenselbsthilfe.de Systemic therapy: Therapy in which an active substance is distributed via the blood New active substances and modes of action supplement the throughout the entire body. In cancer, e.g. chemotherapy or antihormone therapy therapeutic arsenal, continuously making new therapy options mamazone – Frauen und Forschung gegen Brustkrebs e. V. against cancer possible. For those affected, this can mean a con- Tumour: Tissue swelling, e.g. due to proliferation of cells. A distinction is made [mamazone – Women and research against breast cancer, registered between benign and malignant tumours association] siderable gain in survival time and often in quality of life PO box 31 02 20 as well. After all, it shouldn’t be forgotten that tumours and their 86063 Augsburg metastases cause symptoms that can considerably impair quality of Tel.: +49 (0) 821 / 5213 - 144 life. Fax: +49 (0) 821 / 5213 – 143 www.mamazone.de Nevertheless, chemotherapy is always a stressful treatment. Über den Berg e. V. Doctors try to alleviate the side effects by means of concomitant Gemeinnütziger Verein zur Verbesserung der Lebensqualität von therapies. In this brochure, we have compiled information about Krebspatienten durch Bewegung und Sport what you can do yourself in order to make the unpleasant effects of [Turning the corner, registered association chemotherapy more tolerable. Friendly society for improving the quality of life of cancer patients through exercise and sport] Kaiser-Otto-Straße 48 We hope you will find the brochure informative and wish you all the 50259 Pulheim best, Tel.: +49 (0) 2234 981 72 66 www.überdenberg.de your Eisai GmbH WHAT IS CHEMOTHERAPY? Colloquially, chemotherapy is a medicinal treatment of cancer with cytostatics, i.e. with natural or synthetic substances that inhibit cell growth. Occasionally, doctors also use the term chemotherapy for the medicinal treatment of infections. The topic of this brochure is chemotherapy in breast cancer. HOW DO CYTOSTATICS WORK? The cytostatics used in chemotherapy inhibit cell growth by disrupting processes associated with cell division or cell growth. As tumour cells divide very rapidly and in an uncontrolled manner, they are more susceptible to cytostatics than healthy cells. Furthermore, healthy cells possess repair mechanisms, which are absent in tumour cells. Nevertheless, every chemotherapy always impacts on healthy tissue as well. Particularly affected are those tissues and organs that undergo rapid renewal and in which many cell divisions thus occur. These include the blood-forming cells and the mucous membranes. The effect and side effects of cytostatics are therefore closely associated with one another. Cell division: Most cytostatics impair tumour growth by disrupting cell division. 3 HOW ARE CYTOSTATICS USED? Cytostatics vary in their origin and mode of action. Some cytostatics are chemically defined compounds, others have their origin in the plant or animal kingdom. For all cytostatics, it is the case that the dose makes the effect. If one administers too little, the cancer cells are not killed off in sufficient numbers; if one administers too much, the healthy body cells are damaged too severely. Breaks, during which the normal body cells can recover, are also important for the tolerability of chemotherapy. At the same time, the cancer cells start to divide again during the breaks and are thus more susceptible to cytostatics again. Usually, therefore, several doses are given consecutively, followed by a break before the next administration. Doctors call the period from the first dose until the end of a treatment break a cycle. However, it is not only the correct dose and the correct dosage cycle that are important. Many cytostatics are used in combination with adjuvant drugs, which are administered together with the actual active substances. Other cytostatics are more effective or better tolerated if they are administered at a low dose but in combination with another cytostatic. Doctors call the combination, dose and cycle taken as a whole the chemotherapy regimen. It is not for nothing that the expression sounds a little dictatorial; with chemotherapies there is little scope for experimentation. WHAT IS THE AIM OF CHEMOTHERAPY? The aim of chemotherapy depends on the stage of a disease and the treatment situ- ation in each case. In some cases, it is advisable to begin chemotherapy even before the surgical removal of the tumour. This so-called neoadjuvant chemotherapy aims to reduce the tumour and thus make it more easily operable. In some cases, no operation is possible at all without the neoadjuvant therapy. In other cases, less extensive surgery can be performed after neoadjuvant chemotherapy and the breast more often preserved. The so-called adjuvant chemotherapy is performed shortly after surgical removal of the tumour. It aims to completely destroy the last remaining tumour cells after the operation and thus to cure the cancer. The problem in cancer therapy is that even a single surviving cancer cell is sufficient to cause a relapse. Even if the tumour was apparently completely removed, individual microscopically small offshoots can stay behind. The smallest metastases of cancer cells, known as micrometastases, can also hide anywhere in the body and cannot be detected by any medical imaging method. Adjuvant chemotherapy is performed as a precaution in order to destroy these cells as well. In the later stages of breast cancer, chemotherapy is used to reduce the tumour and its metastases, thereby keeping the cancer in check. This usually goes well for quite a long period. If a cytostatic loses its efficacy, another active substance can be used in treatment. There are thus several therapeutic options available for treating the cancer. They are usually numbered consecutively and referred to as first-line therapy, second-line therapy, etc. Chemotherapies can be used at various stages of breast cancer. 5 TABLETS OR INFUSIONS? Cytostatics are available as tablets, injections or infusions. The various dosage forms have no effect at all on the efficacy or tolerability of a cytostatic. For patients who require intravenous cytostatics more frequently or over a long period, it can be advisable to implant a “port”. A port is a small metal device (port chamber/ port reservoir), which is usually inserted under the skin below the collar bone.