Chemotherapy

For many of our Los Angeles patients, chemotherapy is part of their breast cancer treatment protocol. Chemotherapy uses drugs to stop the growth of cancer cells, either by killing the cells or preventing them from dividing. It’s usually administered in pill form or by IV injection. While we do not administer chemotherapy for breast cancer at our Beverly Hills center, we do offer an innovative port placement procedure to make your chemotherapy experience more comfortable.

Chemotherapy drugs travel throughout your body and kill any rapidly dividing cells. This includes cancer cells, which can grow and spread quickly. However, it also includes some healthy cells, which is why chemotherapy can cause side effects such as nausea, hair loss, and fatigue.

How Is Chemotherapy Used in Breast Cancer Treatment?

Chemotherapy can be used to treat many different types of cancer. It’s often combined with radiation therapy, surgery, and other therapies to treat breast cancer.

Chemotherapy may be administered:

• Before surgery or radiation therapy to shrink the tumor and make it easier to remove.
• In addition to radiation therapy after surgery to kill remaining cancer cells in the body.
• After surgery, in cases when cancer has spread (metastasized) beyond the original site.

What Are the Benefits of Chemotherapy in Treating Breast Cancer?

The benefits of chemotherapy for breast cancer include:

• Slowing the growth of tumors. Chemotherapy drugs hinder the growth of tumors. This may give your doctors more time to determine if your cancer has spread beyond your breast tissue and to treat it as appropriate.
• Treating metastatic disease. Breast cancers that have spread beyond their original site are called metastatic cancers because they have spread to other parts of the body—usually other organs such as the liver or lungs.

How Long Does Treatment Usually Last?

The duration of chemotherapy treatment depends on the type of breast cancer and whether it has spread to other parts of the body.

If cancer has spread beyond the breast, adjuvant chemotherapy is often recommended. This means that treatment is taken after surgery to kill any remaining cancer cells that may be present in nearby lymph nodes or other areas of the body.

Chemotherapy is typically given in cycles, during which your doctor administers a specific type or combination of drugs. The length of each cycle may vary from one week to several months, depending on the type and dose of the drug used and your response to treatment.

What Are the Side Effects of Chemotherapy?

The most common side effects of chemotherapy are nausea, vomiting, and loss of appetite.

Other common side effects include:

• Hair loss (which may be reduced with the use of a cold cap during treatment)
• Fatigue
• Dry mouth and throat
• Skin rashes and discoloration of the skin or nails
• Blood count changes (low red blood cells can cause anemia, while low platelets can cause bruising)
• Cognitive changes, such as difficulty concentrating or memory loss, may occur during treatment with certain types of chemotherapy but resolve when treatment ends.

Chemotherapy may also weaken your immune system, making you more susceptible to infections. It’s crucial to take good care of yourself during treatment.

What Happens Before Chemotherapy Begins?

Before starting chemotherapy, your doctor will typically do blood work and order imaging tests such as CT, MRI, or PET scans. These tests are necessary to make sure that your cancer hasn’t spread beyond your breast and that it’s not affecting any other parts of your body.

A PICC line (peripherally inserted central catheter) or port may be placed before starting chemotherapy as a conduit for administering medications.

What Is a Port?

A port is a soft, flexible tubing threaded into the bloodstream and attached to a device that can be accessed from a needle through the skin. This eliminates the repeated need for finding a vein for IV access or blood lab draws.

If you require chemotherapy, treatment is often much easier if you first undergo the placement of a port to seamlessly allow the administration of IV medicine and blood sampling.

What Are the Benefits of a Port?

A port is placed at the beginning of treatment and left in throughout the process. The tubing and port sites where the needle is inserted are situated beneath the skin, allowing you to participate in all your normal activities. You can go about your daily routine knowing that when it’s time for your chemo, the port will make treatment easier by allowing dedicated and reliable access to your bloodstream.

Who Is a Good Candidate for a Port?

Ports are beneficial for patients receiving chemotherapy medicines that can cause irritation or scarring to veins, particularly small veins near the periphery of the arms. If you have difficult IV access or struggle with giving blood or having an IV placed, you will significantly benefit from a port.

How Are Ports Traditionally Placed?

Many health care providers perform port placement using a local anesthetic and slight IV sedation, typically placing the port near the collarbone. While this procedure is a quick and straightforward way to allow easy access to the center of the chest, it often leaves the patient with a visible bulge and unsightly scar after treatment ends.

How Are Ports Placed at Bedford Breast Center?

At Bedford Breast Center, we place ports through a site in the underarm so that the port is easily accessible in the collarbone area. But unlike traditional placement, the port isn’t visible, and there’s no visible scar after treatment. The port can be easily removed through the same underarm incision made when it was placed.

At Bedford Breast Center, we want you to complete your breast cancer treatment with as few permanent reminders as possible. We want you to successfully eradicate your cancer and look and feel like the best version of yourself when treatment ends.

What Is the Procedure for Port Placement?

Port placement is a short procedure that takes 1 to 2 hours to complete. The area where the implanted port is placed (underarm) will be cleaned and numbed with a local anesthetic. The surgeon makes a tiny incision (approximately 1 to 2mm) close to the armpit and a larger incision (around 2cm) in the inner part of the upper arm close to the biceps muscle.

The catheter is inserted through the larger incision, tunneled under your skin to the first incision, and threaded into one of the large veins near your neck, ending near the top of the heart. The surgeon will close the incisions with sutures, which the body will gradually absorb, or with surgical glue.

What Is Recovery from Port Placement Like?

You may experience some discomfort around your incision sites and where the catheter was threaded under your skin. This should resolve within 24 to 48 hours, and you may take over-the-counter pain medications until the discomfort subsides.

Avoid wearing a tight bra or carrying a bag across your chest for the rest of the day. Plan to relax at home afterward. You can eat and drink as usual, but expect to be a bit sore and tired. The dressing will be removed a few days later, and then you can shower or bathe. The stitches will dissolve over time.

Watch for any signs of infection and inform your doctor immediately if you notice any pain, swelling, fluid around the incisions, redness, chest pain, shortness of breath, swelling on the arms, dizziness, or fever.

How Do I Care for My Port?

Ports typically require little care. Your nurse can guide you through maintenance requirements, such as cleaning the area and preventing infection. A healthcare provider should flush out your port every four weeks to prevent the catheter from becoming blocked. If the port becomes blocked with blood or medication, it may need to be removed.