How Chemotherapy Works and Whether It's Right for You

Chemotherapy is medicine, given intravenously or orally, that is generally aimed at killing stray cancer cells after surgery. (It can also be used to try to reduce the size of tumors before a lumpectomy, a treatment called neoadjuvant chemotherapy.) It's very effective for breast cancer patients: One important study of women who got more than one chemotherapy drug found that for those under 50 with early-stage breast cancer, the risk of recurrence a decade later dropped by 7% to 11%; for women ages 50 to 69, the risk was cut about 2% to 3%.

Women's feelings about chemotherapy are anything but simple, however. While the hospital visits are no fun, the mystery of what side effects these powerful drugs may have on your body can be especially intimidating.

Is chemotherapy right for you?
In deciding whether to go the chemo route, your medical oncologist will take into account not only the specifics of your diagnosis, but also other factors including your age (an older patient has fewer years for recurrence, for example) and your overall health (if you have another condition, the toxicity from the chemo could be too much).

"You're looking at the tumor and the patient—both come into play," says Julie R. Gralow, MD, director of breast medical oncology at the University of Washington and Fred Hutchinson Cancer Research Center in Seattle. "Statistically, there would be a benefit to reduce recurrences and deaths that's greater than the side effects, but sometimes in talking to a patient you decide [chemotherapy] would be the wrong thing. You have to take her whole life into account."

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