BREAST CANCER cHEMOTHERAPY
CHEMOTHERAPY AND BREAST CANCER
Chemotherapy is what it says. Chemicals are combined to be used as a form of therapy intended to kill the cancer cells within us. If the right combination and dosage are given, these drugs can target and destroy breast cancer cells.
Killing cancer cells is not the same as curing cancer. Killing off the opposition doesn’t mean it will not take stock and return. The history of war makes that clear and frankly, I’m not sure that there isn’t some sort of causation between the hostilities we create in the outside world, and what happens to us on the inside (our bodies, in this case, our breasts). Either way, cancer is the opposition and chemotherapy in the main, is societies weapon of choice. Effectively, it’s a machine gun and in such a war, chemotherapy as a defence against breast cancer is not without its own fallout (side effects).
Although chemotherapy won’t cure your breast cancer it can do the following,
- Get rid of it and keep it at bay
- Shrink the tumor
- Relieve your symptoms and
- Help to extend your life
In the case of breast cancer spreading from your breast into your lymph nodes to other parts of your body, the primary goal is to achieve points 2 – 4.
HOW DO YOU TAKE CHEMOTHERAPY?
I think for me, this was the most frightening part of my breast cancer experience. Because I’d heard so much about it, I was truly scared. Stupidly, I didn’t take anyone with me at first and on that visit, my frame of mind was so poor, the nurses would not allow me to have the treatment.
IF YOU’RE GOING TO DO IT, DO IT POSITIVELY
AND DEFINITELY TAKE SOMEONE WITH YOU
Fortunately, Juliet dropped everything and came to my rescue. Once she was by my side I could calm down and not focus on what looked like huge syringes of pink liquid going into my arm. Psychologically, I absolutely hated it and ended up being referred to the psychiatric unit to get my head straight. Throughout my breast cancer treatment, I had regular clinical psychological sessions which really helped a great deal. I’m very grateful to Jane Hutton, my clinical psychologist at Kings College, London.
So, the point is, chemotherapy is usually injected directly into a vein through a needle or taken by mouth as pills. It’s used in addition to other treatments, such as surgery, radiation or hormone therapy.
Your doctors will recommend the best type of chemo for you with the options again like this,
- Chemotherapy is given into a vein (intravenous chemotherapy) – Normally in hospital with medicine being given through a tube in a vein in your hand, arm or chest.
- Or you can have a kind little port attached to your chest that remains throughout your treatment. I chose against it because I didn’t want to be reminded of chemo once I left the hospital. Still, it might work for you especially if you have trouble trying to find veins for the needle injection. Towards the end, it was really difficult to find a vein in my arm because they literally go, disappearing with all the stuff injected into them, I think.
- I was also given injections (steroids) to take home with me, so I learned to inject myself and honestly, it wasn’t difficult or a painful thing to do once I got my head around it.
- Chemotherapy tablets (oral chemotherapy) are an alternative option – which is normally taken as a course of treatment at home, with regular check-ups in the hospital. It wasn’t offered to me and that might’ve been because I wasn’t a suitable candidate. In truth, I didn’t know such tablets existed and in hindsight, I would’ve asked about them had I known.
You could be treated with one type of chemotherapy or a combination of different types. Typically, you’ll have several treatments spread over a good few months.
BE IN PEACE BECAUSE ANGER WEAKENS YOUR IMMUNE SYSTEM.
DIFFERENT TYPES OF CHEMOTHERAPY DRUGS
I don’t know how useful this is to you but apparently, there are different types of chemo. This information was completely beyond me when I was diagnosed. Honestly, I had no interest in what differences there were, but just in case you do.
Apparently, 100 types of chemotherapy drugs exist but the main ones include,
- Alkylating agents: These ones stop cells from making copies of themselves by damaging their DNA.
- Antimetabolites: Antimetabolites also stops cancer cells from copying themselves by pretending they are the real ones.
- Anti-tumor antibiotics: This type of drug changes the DNA structure inside cancer cells to stop them from growing and multiplying.
- Topoisomerase inhibitors: Apparently, DNA within the body needs the enzyme topoisomerase to multiply but topoisomerase inhibitors stop this which leads cancer cells to die.
- Mitotic inhibitors: Cell division, also known as mitosis, is a crucial part of cancer growth in the body. Mitotic inhibitors stop growth.
- DNA repair enzyme inhibitors: DNA repair enzyme inhibitors stop cancer cells from repairing themselves, causing their eventual death.
- Plant alkaloids: Plant alkaloids are agents derived from plants that stop cancer cells from dividing in the body, stopping cancer spread and growth.
- Antineoplastics: This type is designed to target and kill cancer cells.
Sorry, I honestly do not know one from the other. The fact that there’s a plant-based one is attractive, and yet I have no idea about the effectiveness of any of them. Remember, I am not a medical doctor, but you have this very brief bit of information above in case you need it for whatever reason.
CHEMOTHERAPY FOR BLACK PATIENTS
Many of the problems with chemotherapy from an African heritage perspective, is the chemotherapy combinations that are formulated based upon research and studies carried out on white women.
This implies some biological (genetic) differences exist between us as black and white women. In fact, there is a Recent Report from September 2021 that confirms there are no genetic differences between black and white women with regard to the mutated BRCA gene. Whether genetic differences exist where chemotherapy responses are concerned, has been suggested in this following report.
A large international Study of January 2020 says there are possible genetic differences with chemotherapy. This extensive study found a fundamental difference between black and white women when taking chemotherapy, in the area of neuropathy.
NEUROPATHY
There’s a substance that is taken from the bark of a Western Yew Tree as a base for chemotherapy. The substance is chemically turned into something called Taxanes. This stuff is at the heart of inhibiting (holding back) the growth of cancer cells. The problem is these Taxanes impact the nervous system known as neuropathy. Apparently, all chemotherapy causes neuropathy but there are real differences in the impact between black and white women. This study says nerve damage is more severe and common among black people.
In my own case, I found neuropathy incredibly painful. The tips of my fingers and toes felt like I had acute pins and needles in them which hurt especially during the night when I was hot. It was so painful I struggled to sleep. In the end, I got help from a reflexologist at Guys Hospital. She told me this was peripheral neuropathy – my nerve endings had crystalised and she very gently broke down the crystals by massaging the tip of my toes especially. She was activating damaged nerve fibres. I had three or four sessions with her before I began to feel better.
- Admittedly, I am a vegan and a lack of vitamin B12 can cause the same symptoms so bear that in mind. Following her lead, I learned to massage the crystals away myself and don’t think I was short of vitamin B12.
- In this international study referred to above, the risk for neuropathy, grade 2 or grade 3, was about double among black women compared with those of other races.
KNOWN RISK FACTORS
- Older patients experience more neuropathy,
- Obese patients have higher rates of neuropathy.
- BMI and rates of diabetes are a bit higher for African Americans, so those could be contributors
However, by no means do they account for everything. Generic factors were considered for black patients.
- A gene called FCAMR, important for the immune system, seemed to protect African Americans from chemotherapy.
- Using whole-exome sequencing (which is part (1.5%) of an entire genome sequence) they found that patients who carried variants in a gene called SBF2had a lot more neuropathy.
- If you carry two genetic variants in SBF2, you get the most common form of hereditary neuropathy, called Charcot-Marie-Tooth disease (CMT). This group of inherited conditions damages the peripheral nerves. It’s also known as hereditary motor and sensor.
- If you carry one variant, you don’t get CMT, but if you get exposed to a taxane or a drug that can cause neuropathy, you’re predisposed to it.
This is but another reason why the future points one day, to populations having their entire genome sequencing known.
BLACK NEUROPATHY AND CHEMOTHERAPY
Higher levels of neuropathy compel oncologists to lower the toxicity of chemotherapy and shorten treatments. Significantly, this does produce lower-quality outcomes – the chemotherapy is not so effective.
This is one of the reasons why there are many calls for black populations to get more involved in clinical trials. New studies are calling for you to take part and be involved in shaping medication for our future health. As a form of precision medicine, the goal is to determine which taxane is right for which individual African American (African heritage) person, based on their genetic makeup and preferences.
CAN CANCER SPREAD WHILE ON CHEMOTHERAPY?
The short answer is YES. Researchers have now discovered that chemotherapy treating breast cancer produces small sacks of fluid (vesicles) that may help them spread to other organs.
CANCER RESISTANT CHEMOTHERAPY
Not all tumors shrink under chemotherapy. If the tumor is resistant to neoadjuvant (early initial) therapy, this could indicate the development of metastatic disease, meaning the tumor could spread to other organs, such as to the bones or lungs.
HOW DOES CHEMOTHERAPY FEEL?
The day after your first treatment you may feel very tired. Plan on resting, as this gives your body the chance to respond to the chemotherapy and begin the recovery cycle. Remember that chemo affects every cell in your body. Stay well-hydrated by drinking lots of water or juice.
GENERAL SYMPTOMS
- Hair loss
- Nail changes (black)
- Mouth sores
- Loss of appetite or weight changes
- Increased appetite from steroids
- Nausea and vomiting
- Diarrhea
- Pink urine
- Shortening of breath
- Symptoms accumulate as the weeks go on.
- Like you’re carrying heavy liquid lead in your belly
- Loss of taste
- Vulnerable to the cold
- Body aches
- Boredom
AFRICA
Effective cancer treatment strategies in Africa need to focus on providing basic care, making efforts to diagnose cancers earlier, making treatments more accessible and affordable, promoting research that is more applicable to local conditions in an African setting, and striving for public health initiatives that will benefit most patients with advanced-stage disease.
