Chemotherapy for breast cancer, including preoperative neoadjuvant chemotherapy and postoperative adjuvant chemotherapy, is an important part of the comprehensive treatment of breast cancer and belongs to systemic treatment. Chemotherapy generally takes 6-8 cycles (usually 21 days for one cycle), which is a long and painful period in the process of comprehensive treatment for patients, and requires close cooperation between doctors and patients, especially many patients take outpatient chemotherapy, which may lead to more serious complications if not handled carefully.
Based on our experience in chemotherapy, it is deeply necessary for patients and their families to have a preliminary understanding of some issues during chemotherapy in order to better cooperate with doctors to successfully complete chemotherapy. The relevant issues are introduced as follows.
I. Pre-chemotherapy preparation
1, preoperative neoadjuvant chemotherapy patients in the puncture biopsy to confirm the diagnosis as soon as possible to start chemotherapy; postoperative adjuvant chemotherapy in the recovery from surgery (wound healing, generally within 1 month after surgery) to start chemotherapy;
2.Before chemotherapy, the patient’s height and weight must be measured to calculate the body surface area and decide the chemotherapy dose;
3, before chemotherapy is generally recommended to perform large venipuncture to establish long-term venous access to reduce drug leakage damage tissue;
4.Patients with preoperative neoadjuvant chemotherapy need to have sentinel lymph node biopsy before chemotherapy to clarify axillary staging;
5.Patients with normal blood, heart, liver and kidney function tests before chemotherapy, or assessed by the doctor whether chemotherapy can be administered.
II. Chemotherapy drugs
The commonly used chemotherapeutic drugs for breast cancer are: anthracyclines (A, such as epirubicin EPI, birubicin THP, etc.), paclitaxel (T, paclitaxel or doxorubicin), cyclophosphamide (C), fluorouracil (F), etc;
2, generally choose combination regimens such as: AT, CAF, TAC, TC, AC-T, etc., generally 3-week regimens, or two-week regimens;
3.A cycle of chemotherapy is usually infused for 3-4 days, chemotherapy drugs are usually used on the first and second day, and the rest of the daily infusion is to reduce chemotherapy reactions and enhance the efficacy of drugs, patients should know which bottle is chemotherapy drugs and pay attention to drug reactions;
Side effects of chemotherapy and treatment
This is one of the most common and problematic side effects of chemotherapy for breast cancer. Almost every patient will experience bone marrow suppression and decrease in white blood cells. At this time, serious complications such as infection will occur if not handled properly. We usually check the blood routine on days 4, 7 and 10, and use leukostimulants (granulocyte colony-stimulating factor) on days 5-8. Most patients need subcutaneous leukostimulants to get through the extreme phase of chemotherapy. Each person has a different pattern and should keep in mind the changing pattern of their own bone marrow suppression. If patients have fever or special weakness after chemotherapy, they should check their blood picture immediately and seek prompt treatment from their doctors;
2. Allergic reactions A few people may have serious allergic reactions to paclitaxel drugs, so pretreatment is necessary. That is, dexamethasone tablets in two divided doses 12 hours before paclitaxel infusion (usually the second day of chemotherapy) or orally for 3 days before and after docetaxel infusion, patients remember! Only liposomal paclitaxel does not require oral dexamethasone tablets due to drug modification;
3, other side effects Commonly, there are gastrointestinal reactions (nausea and vomiting), peripheral nerve damage, elevated transaminases, bone pain, etc., all of which are temporary. Hair loss can occur in almost everyone, making patients distressed, but it is also temporary, and new hair will grow after six months, and some are even better than the previous ones, so there is no need to worry.
Fourth, the patient precautions
1, during chemotherapy pay attention to strengthen nutrition, to easily absorb, protein vitamin enough, and eat more blood food such as pig liver, bone soup, etc.;
2, can eat some blood health products such as gum, red dates, etc., can also take oral blood Sheng, vitamin B4, etc.;
3, chemotherapy period due to the decline in resistance to pay special attention to prevent colds, etc., to enhance warmth, in chemotherapy 2-12 days with a mask;
4, large vein care is a relatively troublesome thing, especially most patients between chemotherapy are at home. Generally, the intravenous cannula needs to be flushed with heparin dilution 1-2 times a week to prevent blockage, and the wound can be changed once a week (film change), and the nurses in our department should be informed of the care, and the patients from overseas can flush the tube and change the film in the local community hospital.