List of effective medications for Breast Cancer treatment

Being the most frequently occurring cancer in women, nearly 2.1 million women are diagnosed with breast cancer every year. Due to limited resources and inadequate health systems, a majority of women are able to detect their breast cancer at the later stages. Chemotherapy is the most preferred form of treatment that is used to treat breast cancer in all stages. 

Medications used to treat breast cancer

There are certain medications that are prescribed alone or in combination with other drugs for treating breast cancer. Some of them have been mentioned as follows:

PALBOCICLIB- DOSAGE, USAGE AND SIDE EFFECTS 

For treating both locally advanced and secondary breast cancer, Palbociclib can be useful. If you have not received any treatment before, this drug may be prescribed in combination with an aromatase inhibitor. Usually, this medicine is taken over a 4-weeks cycle. If you’re taking it with the inhibitor, then for the first 3 weeks, take one tablet every day at an interval of 24 hours, with or without food. After 21 days, the doctor usually suggests a rest period of one week so that the body can cope with the drug. However, the aromatase inhibitor will continue daily for 28 days. 

In some cases, doctors might also give Palbociclib with Fulvestrant. Take Palbociclib for the first 21 days daily and rest for 7 days. Along with that, Fulvestrant 500mg is given every 2 weeks for the first 3 doses that reduce to only once a month throughout the treatment. Commonly known as intramuscular injections, they are used to conduct a new type of endocrine therapy that is seen to work with the ongoing form of treatment as well as with a different approach. Note that the typical dose for Palbociclib is 125 mg. 

A series of blood tests and other medical examinations will be conducted before starting the treatment to check if the body is healthy enough to handle the side effects. Palbociclib consists of lactose; therefore, it cannot be recommended to patients with lactose intolerance. 

Side Effects

• Affecting the healthy blood cells of the body
• Increasing risks of infections
• Bruising and bleeding 
• Sore mouth 
• Loss of appetite 
• Fatigue
• Diarrhea 
• Excessive hair loss, leading towards balding 
• Nausea and vomiting 
• Skin rash 

CAPECITABINE- DOSAGE, USAGE AND SIDE EFFECTS 

This oral antimetabolic chemotherapy drug is consumed in tablet form that travels into the bloodstream through the digestive system and gets converted to five fluorouracil that interferes with the multiplication of cancer cells. In most cases, it is given alone. However, exceptions are there when Capecitabine is prescribed with other chemotherapy medications. It is effective for patients who have both primary breast cancer as well as metastatic breast cancer.

It is taken in cycles. Available in two different strengths- 150mg and 500 mg, Capecitabine is taken in tablet form twice a day for 2 weeks followed by a week of rest for the body. It is recommended not to break the Capecitabine 500 mg tablet and swallow them whole with water after half an hour of completing a meal, one during the morning and the other during the evening. In some cases, it is also prescribed to continue it for 3 weeks. In case you miss a dose, contact your doctor for further guidance. It is better to strict to the original dosage and not to double it the following day. 

Side Effects 

• Abdominal pain
• Nausea and vomiting 
• Unusual sensation in palms (Palmar-Plantar syndrome)
• Tiredness 
• Mouth sores or ulcers
• Loss of appetite 
• Unusual bruising and peeling 
• Hair loss (Alopecia- A condition where the patient loses all the body hair, including eyelashes and eyebrows)

In extreme cases where you get fever, chills, chest pain, or heartburn, it is better to contact your doctor. 

TRASTUZUMAB- DOSAGE, USAGE AND SIDE EFFECTS

This drug is used for targeted therapy of breast cancer. Patients diagnosed with HER2 positive breast cancer are prescribed to have this medication because its sole function is to attach itself to the HER2 protein on the cancer cells to block their growth. Before surgery, it is also given to prevent cancer from spreading and after surgery or chemotherapy to reduce the risk of relapse. 

Trastuzumab is an intravenous drug that is given as a drip into the veins or injected into the fatty tissue of the subcutaneous region in your thigh. Usually, intravenous infusion takes over one and a half hours. The second procedure takes about 5 minutes, where the drug is injected into the right and left thighs. It usually continues for a year to complete 18 cycles after surgery. However, if you are taking it before surgery, it usually lasts for 4 to 6 cycles. 

Trastuzumab is not recommended for patients with heart problems or having high blood pressure. That is why several medical tests are conducted to check if your body is fit for it. An ECG is also essential to test the condition of your heart before starting this treatment. 

Side Effects

• Flu-like symptoms causing fever, chills and mild body pain
• Nausea and vomiting 
• Diarrhea 
• Tiredness and fatigue 
• Blood clots leading to shortness of breath, swelling and redness in arms, tightness in the chest, excessive coughs 
• Joint and muscle pain 
• Soreness in thighs (at the injection site) 
• Unusual bruising due to drop in platelet number 

THIOTEPA- DOSAGE, USAGE AND SIDE EFFECTS

Thiotepa is an alkylating agent used in chemotherapy to treat advanced or metastatic breast cancer and should be given alone or in combination with other drugs. It is also prescribed after surgery to decrease the chances of cancer coming back. It is given intravenously. The normal dose of Thiotepa in adults is 0.3 to 0.4mg/kg, and it is given once every 4 weeks. However, the schedules and doses are individualized depending on the stage of cancer and the health condition of the patient. Taking this drug is followed by maintenance therapy of about a week so that the correlation between dose and blood counts is maintained. 

Side Effects

• Decreasing white blood cells that makes the body prone to catching infections
• Bruising and bleeding 
• Nausea and vomiting 
• Loss of appetite 
• Unusual tiredness and fatigue
• Hair loss 
• Irregularity of the menstrual cycle 
• Mouth sores and ulcers
• Nosebleed 

RIBOCICLIB- DOSAGE, USAGE AND SIDE EFFECTS

Ribociclib is typically prescribed with an aromatase inhibitor to treat the secondary or advanced stage as well as recurrent breast cancer. It is given alongside hormonal therapy drug Fulvestrant in patients suffering from HER2 negative type of breast cancer. The sole purpose is to lower the amount of estrogen in the body to block their actions on breast cancer cells. The inhibitors of Ribociclib interfere with the kinase protein to stop the cancer cells from growing further. 

It is taken on a 28-days cycle- Ribociclib 200mg (one pill) every day for 3 weeks, with or without food. That is followed by a rest of 7 days, but the aromatase inhibitor needs to be continued during this time. In case you are prescribed Fulvestrant, take the Ribociclib pills for 21 days while the Fulvestrant injection is given every 2 weeks for the first phase of the treatment. After that, it is only given once a month, depending on the response from your body. 

If you are on Ribociclilb, it is mandatory to refrain from eating grapefruit or drinking grapefruit juice. In case you vomit after a pill, do not take another one. Wait for the next day to resume the normal dose. Since this drug can slow or nullify the effects of other medications, it is suggested to inform the doctor about your current prescriptions and medical history in detail. 

Side Effects

• Nausea and vomiting
• Fatigue
• Excessive hair loss
• Back pain 
• Low WBC count 
• Painful mouth sores 
• Unusual sweating 
• Hot flashes 
• Constipation 

EVEROLIMUS- DOSAGE, USAGE AND SIDE EFFECTS

Used in combination with Aromasin, Everolimus is used to treat postmenopausal women suffering from advanced stage HER2-negative breast cancer. This drug is an mTOR inhibitor that interferes with the kinase so that the cancer cells do not get sufficient energy to grow. Everolimus tablets are taken orally every day, at the same time, with or without food. The usual dosage is 10mg per day and needs to be continued in the same manner unless the body responds to treatment or some unacceptable side effects start surfacing. 

The Aromatase inhibitor is used to prevent the reaction of estrogen on the cancer cells for the postmenopausal women. They block the enzyme aromatase so that there is less estrogen to stimulate the further growth of the hormone receptor-positive breast cancer cells. If you are pregnant or breastfeeding, this drug should be avoided. It can harm the fetus as well as cause complications while breastfeeding.  

Side Effects

• Mouth ulcers and painful sores 
• Body getting prone to catching an infection 
• Skin rash
• Diarrhea 
• Loss of appetite 
• Bone thinning and weakening
• Unusual weight loss
• Hoarseness 
• Urine inflammation

There are certain side effects that need immediate medical attention-

• Lung problems- recognized by shortness of breath, chest pain and unusual coughs
• Kidney and liver problems. If you have been diagnosed with diabetes in the past, these problems have a chance of resurfacing. 

LAPATINIB- DOSAGE, USAGE AND SIDE EFFECTS

This drug is used to conduct biological targeted therapy for treating HER2 positive secondary breast cancer. In most cases, Lapatinib is suggested in combination with other treatments such as chemotherapy and hormone therapy. It blocks the HER2 protein, which plays a major part in the growth and survival of breast cancer cells. 

Usually, the 21-days cycle is followed in this case where one Lapatinib tablet of 1250mg (Standard dose) is taken each day orally. Doctors recommend taking this tablet one hour before or one hour after having a meal. If your body is responding well to the treatment, it needs to be continued further. However, the dosage and combination drugs may vary for hormone receptor-positive patients. If unbearable toxicity or life-threatening side effects are observed, doctors will stop the medication immediately. Lapatinib may also be offered to the patient as a part of clinical trials. 

While on this drug, one should avoid taking vitamin supplements or herbal medicines. Avoid grapefruit and grapefruit juice as well. 

Side Effects

• Extreme tiredness causing fatigue
• Loss of appetite
• Nausea and vomiting 
• Diarrhea
• Skin rashes, dry and itchy skin 
• Dark urine
• Lightheadedness 

Contact your doctor if you experience a chronic cough or shortness of breath because Lapatinib is seen to have a negative impact on the lungs. Severe liver problems may also be seen that can be recognized by itchiness or yellowing of the eyes. Lastly, breast cancer patients have a fair risk of blood clots while undergoing treatment. 

PACLITAXEL- DOSAGE, USAGE AND SIDE EFFECTS

This chemotherapy drug is given to patients suffering from primary breast cancer. This drug helps to conduct Adjuvant therapy after surgery to reduce the risk of relapse. Under the circumstances where the patient is going for radiotherapy or hormone therapy, Paclitaxel is given first. 

It is an intravenous drug that is given through a drip into a vein of the arm. Your doctor may prescribe Paclitaxel alone or with other chemotherapy drugs. You will be the Paclitaxel injection once every three weeks. It can be decreased to two doses per week following the progress of the treatment. The in-between gap is to give your body some time to recover as well as normalize the number of blood cells. It usually takes three hours per session. Between every session, the patient will be prescribed additional drugs to lessen the risk of unwanted reactions. The typical dose of Paclitaxel for an adult breast cancer patient is 175mg/m2 IV every 3 weeks. 

Side Effects

• Nausea and vomiting
• Excessive hair loss
• Skin reactions, rashes, itchiness 
• Fatigue 
• Low blood pressure 
• A decreasing number of normal blood cells (WBC, RBC, and platelets) 
• Bruising and bleeding 
• Joint and muscle pain 
• Sore mouth, ulcers  

You may also experience soreness, swelling, and discoloration of the skin on the injection site. However, it is known to fade away with time.

BOTTOM-LINE

Before starting these drugs, a chemotherapy information session is mandatory where the patient is informed in detail about the medications, side effects, and how to manage those efficiently. Medical tests are also equally important to determine whether the body will be able to handle it. 

Disclaimer: The content in the above-mentioned is solely to inform the people. We don’t intend to claim the effectiveness of the medications for the given illness.