Beyond Chemotherapy – Overview of Drugs

Chemotherapy drugs are often linked to cancer treatment; however, there are other medications that are used during the treatment period. These medications can be divided into three separate categories including:

  • Those used to treat the cancer itself
  • Those used to manage pain
  • Those used to manage other side effects from breast cancer treatment

Drugs Used to Treat Breast Cancer

Breast cancer is often treated with a combination of different medicines both for cure and to prevent recurrence. Typically, chemotherapy is combined with some of the following drugs[2]:

  • Hormonal therapy – for which there are three drug classes: selective estrogen receptor modulators (SERMs); estrogen receptor downregulators (ERDs) and aromatase inhibitors (AIs)
  • Immunotherapy – monoclonal antibodies directed at one cell type
  • Targeted therapy – these drugs have one specific receptor or protein that they target to shut down the growth of cancer cells[2]
Name of Drug Characteristics Class Target
Anastrozole Non steroidal. Selective  anti-neoplastic AI – hormonal therapy, targeted therapy hormone receptor +, post menopausal, advanced or metastatic breast cancer
Bevacizumab (Avastin) Monoclonal antibody Immunotherapy, targeted therapy Inhibits vascular endothelial growth factor (VEGF)
Etanidazole increases the effectiveness of radiation therapy
Exemestane (Aromasin) SteroidalAnti-neoplastic AI, hormonal therapy anticancer – decreases estrogen production and suppresses growth of estrogen-dependant tumors
Fulvestrant (Faslodex)  Anti-neoplastic ERDs Estrogen antagonist
Imiquimod(Aldara) Immune response modifier Topical treatment Boosts body’s own immune system
Indomethacin Nonsteroidal anti inflammatory drug (NSAID) Powder, injection Reduces tumor- induced suppression of the immune system, increases the effectiveness of other anti-cancer drugs
Lapatinib(Tykerb) Dual tyrosine kinase inhibitor Oral dual tyrosine kinase Interrupts HER2 signaling pathway
Letrozole Anti-neoplastic, Non steroidalGlucocorticoid Aromatase inhibitor Shuts down postmenopausal estrogen production
 
Pamidronate biphosphonate Oncologics Reduces bone loss associated with menopause
Raloxifene (Evista) SERM Postmenopausal treatment of breast cancer
Tamoxifen Anti-neoplastic, Nonsteroidal antiestrogen SERMs Hormonal therapy Inhibits the role of estrogen in tumor growth
Trastuzumab (Herceptin) Monoclonal antibody Immunotherapy Prevents recurrence in human epidermal growth factor receptor (HER-2) + breast cancer patients

Drugs Used to Manage Pain

Sometimes cancer can be painful if it invades nerves that provide sensation to bone, skin or other organs.[3] Certain procedures and types of treatment can cause pain as well, requiring some form of medication to be taken for pain control.

Name of the drug/medication Type When to use Purpose
Acetaminophen  Aminophenol derivative Mild pain, body aches Block pain impulses
Fentanyl citrate opioid analgesic Severe pain pain relief, form of a patch or lollipop
Ibuprofen   NSAID Mild to moderate pain Reduces pain and fever
Levorphanal (Levo-Dromoran) narcotic Severe pain IV or oral, pain relief
Meperidine (Demerol) Opioid analgesic for short term treatment of moderate to severe pain Control occasional episodes of pain
Morphine opioid analgesic Moderate to severe pain  IV or oral

 

Drugs to Manage the Side Effects of Other Treatments

While being treated for cancer, some of the drugs can cause side effects that are unpleasant. The following is a list of side effects and the most common medicines used to alleviate or prevent them[4].

  • Loss of appetite – megestrol (Megace) and dronabil (Marinol)[5]
  • Diarrhea – for mild diarrhea over-the-counter medicines are acceptable, if more severe, ask your medical professional
  • Gas –over-the-counter products are acceptable
  • Leg cramps – try to stay hydrated, drinking plenty of water and avoiding caffeine or alcohol
  • Mouth sores –antiseptic mouth wash can help but try to avoid acidic foods and drink as well if possible
  • Nausea – the most common medicines used are Zofran, Compazine and Phenergan
  • Nausea and vomiting –these medicines are typically given to prevent nausea and vomiting while you are receiving chemotherapy – Dexamethasone (Decadron), toracan, chlorpromazine (Thorazine), dronabil (Marinal), granisetron (Kytril), dolasetron mesylate (Anzemet)
  • Skin – Your skin may have a light burn from radiation treatment. It can also be itchy or dry due to the side effects of other forms of cancer treatment like chemotherapy.  Ask your doctor before applying any vitamin creams or lotions[6]

While some of these remedies are readily available at a local pharmacy, you should not use any medications or lotions until you have cleared it with your doctor.

Conclusion

It seems counterintuitive to treat ailments caused by medication with more medication. However, side effects from breast cancer treatment drugs are inevitable. Fortunately, we do have medications that can treat these side effects and relieve them while you are being treated for your cancer.

References

1 Ricks, D (2005). Breast Cancer Basics and Beyond. Alameda, CA: Hunter House, Inc.

2 Kluvers, W (2010). Nursing 2010 Drug Handbook. New York: Lippincott, Williams and Williams.

3 Ricks, op. cit.

4 Turkington, C; and Krag, K (2005). The Encycopedia of Breast Cancer. New York: FOF.

5 Block, K (2009). Life Over Cancer. New York: Bantam Books.

6 American Cancer Society (2009). Complete Guide to Complementary and Alternative Cancer Therapies. Atlanta: American Cancer Society.

This article was originally published on July 27,2012 and last revision and update of it was 9/2/2015.