Facing Decisions

The very mention of chemotherapy is frightening. You may immediately envision months and months of nausea, debilitating fatigue, risk of infection, and, above all, hair loss. And as you sit with your doctor to discuss your options, you will be faced with an alphabet soup of chemotherapy treatment options and drug combinations to consider—AC, AC then T, CEF, CMF, CAF, FAC, TAC, CVAP—and many more. Having so many options may seem confusing. And you may wonder about the side effects that go with each option.

Here are three important facts to keep in mind:

• Your alphabet soup of options is not nearly so overwhelming when you and your doctor discuss your particular cancer characteristics and the course of treatment that will work best for you. By using different chemotherapy agents—alone or in combination—doctors have developed highly effective treatment plans that vary in duration and dosage. Large studies with thousands of women have allowed physicians to refine chemotherapy treatments to maximize the benefit and reduce the side effects.
  
• With the exception of hair loss, the short-term side effects of chemotherapy can be managed through supportive medications and lifestyle changes that can help reduce nausea, fatigue, and the risk of infection.
• Don't turn down chemotherapy just because of your age. Older women in relatively good health can live a long time and can benefit from chemotherapy in the same ways as younger women. Side effects of chemotherapy are generally no worse in older women and can be significantly eased by medications, rest, and diet.

This section discusses chemotherapy as "adjuvant therapy"—like adding an extra insurance policy after surgery—for women with early-stage breast cancer. The information here does not apply to the use of chemotherapy to treat metastatic disease—breast cancer that has spread beyond the breast and its nearby lymph nodes to other areas of the body.