NCCN Guidelines for Patients® | Stages I and II Breast Cancer - page 49

NCCN Guidelines for Patients
Stages I and II Breast Cancer, Version 1.2014
Chemotherapy/HER2 inhibitors Side effects of chemotherapy and HER2 inhibitors
Side effects of chemotherapy
Unhealthy and unpleasant outcomes
The reactions to chemotherapy and HER2 inhibitors
differ among women. Some women have many side
effects. Other women have few. Some side effects
can be very serious while others can be unpleasant
but not serious.
Side effects of chemotherapy depend on the drug
type, amount taken, length of treatment, and the
person. In general, side effects are caused by the
death of fast-growing cells. These cells are found in
the hair follicle, gut, mouth, and blood. Thus, common
side effects of chemotherapy include low blood
cell counts, not feeling hungry, nausea, vomiting,
diarrhea, hair loss, and mouth sores. Other side
effects may include anxiety, fatigue, and peripheral
neuropathy. Peripheral neuropathy is numbness or
tingling of nerves in the hands and feet.
Pre-menopausal women may start menopause
early because of the chemotherapy drugs. Even if
menstrual periods return after chemotherapy, you
may still be unable to have babies. However, don’t
depend on chemotherapy for birth control. You may
become pregnant while on chemotherapy, which can
cause birth defects. If you had menstrual periods
before chemotherapy, use birth control but not birth
control made of hormones, such as “the pill.” Talk to
your doctors for more information.
HER2 inhibitors
Allergic reactions are common with the first or
second dose of trastuzumab. You may need to take
medicine for allergies. You may also have a mild
flu-like response to the first dose of trastuzumab
that includes fever, chills, headache, muscle aches,
and nausea. This response is less common with
the second and third doses. Other side effects may
include damage to the heart and rarely to the lungs.
Common side effects of pertuzumab are diarrhea,
nausea, and feeling tired and weak. Less common
side effects include skin rash, low white blood cell
counts, mouth sores, and hair loss. It is not yet clear
if pertuzumab damages the heart, although similar
drugs do.
Not all the side effects of chemotherapy and HER2
inhibitors are listed here. Please ask your treatment
team for a complete list. If a side effect bothers you,
tell your treatment team. There may be ways to help
you feel better.
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