Not knowing what to expect can be very distressing. Many people worry about the side effects they might get. But most side effects can be controlled. You should be told what side effects to report as well as details of who to contact, day or night, if you have any concerns or are unwell. Your chemotherapy team and breast care nurse can help with any questions you have. You can also call us free on for information and support. You can also speak to someone who has had chemotherapy through our Someone Like Me service. Many hospitals will arrange a chemotherapy information session.
A nurse will discuss how and when your chemotherapy will be given and how side effects can be managed. You may have extra blood tests and some people might be given an ECG electrocardiogram , a simple test that checks your heart rhythm. Your height and weight will also be measured. You should be given a hour contact number or told who to contact if you feel unwell at any time during your treatment, including at night or at the weekends.
You will usually be asked to sign a consent form before you start chemotherapy. The benefits and risks of the treatment should be explained before you sign. This is because if the number of blood cells in the body is too low, treatment may need to be delayed. Most hospital specialists advise using barrier protection such as condoms for a few days after treatment.
Your specialist will usually recommend barrier methods of contraception, such as condoms. The contraceptive pill is not usually recommended because it contains hormones. Emergency contraception such as the morning after pill can still be used. Find out more about sex and intimacy. Check with your specialist team or GP before having any complementary therapies , and mention your breast cancer and treatment to any therapist you see. You may be able to eat normally throughout chemotherapy or your eating habits may change because of side effects.
Find out more about diet during treatment. Tell your specialist about any vitamin and mineral supplements you take or would like to start taking.
The evidence is conflicting about how safe it is to take vitamin supplements, particularly high-dose antioxidants including vitamins A, C and E, Co-enzyme Q10 and selenium , during chemotherapy. Some studies suggest they might make the chemotherapy less effective, while other studies point towards them helping reduce chemotherapy side effects. Because the safety evidence is not clear many specialists recommend not taking high-dose antioxidant supplements during chemotherapy. Read our tips for travelling with breast cancer. Live vaccines include measles, rubella German measles , polio, BCG tuberculosis , shingles and yellow fever.
Live vaccines contain a small amount of live virus or bacteria. If you have a weakened immune system, which you may do during chemotherapy, they could be harmful.
Talk to your GP or specialist before having any vaccinations. If someone you live with needs to have a live vaccine speak to your specialist or GP. They can advise what precautions you may need to take depending on the vaccination. Anyone at risk of a weakened immune system, and therefore more prone to infection, should have the flu vaccine.
This includes people due to have or already having chemotherapy. To hear from us, enter your email address below. Skip to main content.
Breast Cancer: Follow-up Care and Monitoring
Home Information and support Facing breast cancer Going through breast cancer treatment. Radiotherapy for primary breast cancer Hormone therapy. Things to be aware of during treatment 1. Back to top 2. After surgery Chemotherapy is given after surgery for primary breast cancer to reduce the risk of cancer coming back in the future. Before surgery Chemotherapy may be given before surgery to slow the growth of rapidly growing breast cancer. Chemotherapy given before surgery is called primary or neo-adjuvant chemotherapy. Secondary breast cancer Chemotherapy can be given to people with secondary breast cancer , when breast cancer cells have spread to another part of the body.
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Chemotherapy drugs Find out about the drugs used for chemotherapy. Benefits of chemotherapy The benefit of chemotherapy might be clear for some people but less clear in other cases. Genomic assays also called gene expression profiling or gene assays When the benefit of chemotherapy is less certain your specialist team may suggest a test called a genomic assay. EndoPredict The EndoPredict test predicts how likely the cancer is to spread within ten years. Oncotype DX Oncotype DX is a test that predicts how likely the cancer is to return and the likely benefit of having chemotherapy.
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Making decisions You may be asked to decide if you want to have chemotherapy. Step 3: A ssess your patient's values and preferences. Step 4: R each a decision with your patient. Step 5: E valuate your patient's decision. This user's guide is designed to help you and your practice implement shared decisionmaking between clinicians and patients to improve health care for all.
Please note that references to patients in this guide also include caregivers and family members. Implementing shared decisionmaking in your practice encourages your patients to be more involved in their health care decisions. This may be different from "usual practice" that, according to numerous studies, does not always include asking patients their preferred role in the decisionmaking process, adjusting care to meet patients' preferences, or the use of evidence-based decision aids and other tools to support patient decisionmaking. This guide highlights a number of "how to" strategies for starting, maintaining, and evaluating a shared decisionmaking program in clinical practice settings of all sizes.
It is supplemented with numerous case examples from a number of organizations that have implemented shared decisionmaking in varied ways to improve the quality of care that they provide to their patients. This guide also highlights and encourages the application of patient-centered outcomes research tools and decision support resources available from the Agency for Healthcare Research and Quality AHRQ and other organizations.
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Information and suggestions in this guide are based on a growing body of research, literature, and interviews with health care experts who have implemented evidence-based shared decisionmaking.. Just like introducing any other innovation into practice, implementing shared decisionmaking requires leadership and a coordinated plan to make it work.
Here are some of the key activities that a clinical practice should consider as part of the shared decisionmaking planning process.
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Each of these activities is described in the subsections that follow. Additional resources that you may find helpful are described at the end of this user's guide. Obtaining the full commitment and support of practice leaders and administrators is critical to putting the pieces into place for the successful implementation of shared decisionmaking.
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This is the first step in changing the organizational culture to be more supportive of patient-centered care, including shared decisionmaking. AHRQ's Achieving Patient-Centered Care with Shared Decisionmaking: A Brief for Administrators and Practice Leaders Tool 9 contains information about shared decisionmaking and how adopting this patient-centered method can help practices meet the mandates of new patient-centered laws and programs. This tool should be shared and discussed with administrators who make the decisions in the practice. Deciding to implement shared decisionmaking and the use of evidence-based educational materials in the practice starts at the top of the administrative chain of command.
In addition to leadership buy-in, it also helps to have a shared decisionmaking champion on board—someone who is widely respected by other staff members, committed to the value of shared decisionmaking, and willing to engage others. Start your implementation by appointing a shared decisionmaking team. Having a team will engage staff who can help develop an approach that is appropriate for your clinical setting. The examples provided in this document show that shared decisionmaking can be implemented in many different ways.
AHRQ's consumer research summaries and patient decision aids see Decision Support Resources section , along with other evidence-based resources, can be used directly with patients by treating clinicians and other clinical support staff during patient encounters. Some institutions hire health coaches or health educators to work closely with patients to outline their options about treatments. Other practices mail patients a decision aid or a written recommendation to review a patient decision aid available on a specific Web site prior to their office visit.
Think about what approach will work best for your practice, so you can plan your shared decisionmaking approach effectively. Share your plans with clinic staff and incorporate their feedback into your plan to maximize acceptance.
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Many clinicians don't understand that implementing a shared decisionmaking approach doesn't have to take more time. It's an understandable concern, since health care professionals already feel they have too little time with patients. In reality, with training, studies have found that clinicians can implement shared decisionmaking without increasing the length of the consultation time.
Every staff member who interacts with patients needs to understand shared decisionmaking and his or her role in the shared decisionmaking process. This FREE, 1-day train-the-trainer workshop is designed to provide basic information on implementing shared decisionmaking in practice, specific communication skills, dialogue with patients, and how to find resources and educational materials to augment use of evidence-based practice with shared decisionmaking in real life clinic settings.
The SHARE Approach workshop is offered multiple times a year across the country to train health professionals and practice leaders who in turn train others in their local health care settings and institutions. AHRQ also provides supportive materials and a shared decisionmaking toolkit for use in training clinic staff www.
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