Treatment · 8 minute read
Treatment, in plain English.
Surgery, chemotherapy, radiotherapy, hormone therapy. Most people have some combination of these. Here's what each one is, why it might be used, and what to expect.
Surgery
Almost everyone with breast cancer has surgery — usually as the first step in treatment. The aim is to remove the cancer (and a small margin of healthy tissue around it).
- Lumpectomy (also called wide local excision) — removes the lump and a margin of surrounding tissue. The breast is preserved. Usually followed by radiotherapy.
- Mastectomy — removes the whole breast. Sometimes recommended if the tumour is large or in more than one place. Reconstruction may be offered.
- Lymph node surgery — usually a sentinel node biopsy, where 1-3 nearby lymph nodes are tested. Sometimes a wider clearance is needed.
Recovery from surgery typically takes 2-6 weeks. You'll have drains for a few days, and you'll be sore — but most people are back on their feet within a week or two.
Chemotherapy
Chemotherapy is drug treatment that travels around the whole body, killing cancer cells. It's not always needed — it depends on the type and stage of the cancer.
It's usually given in cycles, every 2-3 weeks, over a period of 3-6 months. Most people have it as a drip in their arm, sometimes through a port fitted under the skin.
Side effects vary, but commonly include tiredness, nausea, hair loss, mouth ulcers, and a weakened immune system. Most are manageable with anti-sickness meds and rest — and the team will help you through them.
The cold cap machine at St Bernard's — funded by BCSG donations — significantly reduces hair loss for many people during chemo. Ask your oncologist if you're a candidate.
Radiotherapy
Radiotherapy uses targeted X-ray beams to destroy any cancer cells left behind after surgery. Most lumpectomy patients have it. Some mastectomy patients do too.
It's usually given as daily sessions, Monday to Friday, for 3-5 weeks. Each session takes just a few minutes — most of the time is positioning.
Side effects are mostly local — tiredness, and skin that looks and feels like sunburn on the treated area. These usually settle within a few weeks of finishing.
Hormone (endocrine) therapy
About 75% of breast cancers are "hormone-receptor positive" — meaning they grow in response to oestrogen or progesterone. For these cancers, hormone therapy reduces the chance of the cancer coming back.
It's usually a daily tablet — tamoxifen, anastrozole, letrozole, or similar — taken for 5-10 years after the rest of treatment finishes.
Side effects vary: menopausal symptoms (hot flushes, joint pain, low mood) are common. Most people find they ease over time, and the team will support you to manage them.
Targeted & immunotherapy
If your cancer is HER2-positive, you may also have targeted drugs (like trastuzumab/Herceptin) for a year. For some specific types, immunotherapy is also used. Your team will explain what applies to you.
Things people ask about coping.
How do I manage chemo fatigue?
Rest when you need to. A short walk most days — even 10 minutes — helps more than total rest. Accept help with shopping, school runs, cooking. We can pair you with a volunteer who's been through it.
What can I do about the menopausal symptoms from hormone therapy?
Speak to your oncologist — there are non-hormonal medications that help. Lifestyle changes (cooler bedroom, lighter bedding, layered clothing, regular exercise, less alcohol) make a real difference. Acupuncture helps some people.
Where can I get a wig in Gibraltar?
BCSG can advise on local hairdressers who specialise in wig fitting, and on the wig allowance available via the GHA. Call us — we'll point you to the right person.
My skin is reacting badly to radiotherapy. What helps?
Loose cotton clothing, no perfumed soaps, gentle moisturisers (your team will recommend), no sunlight on the treated skin. Mention any blistering to the team — they have creams that help.
When can I exercise again?
Sooner than you think. Gentle walking from week one. Shoulder exercises — given to you by the physio — start within days. Swimming and weights usually OK by 6-8 weeks. Cardio and pilates help with fatigue and recovery.
Treatment is a marathon. You don't run it alone.
From hospital visits to lifts home, from a chat over coffee to a voucher when nothing fits — we'll be there for the whole of it.