Many people are frightened about the idea of having chemotherapy, due to the possible side effects. However most of the side effects can be well controlled with medicines. Nevertheless, it is a treatment that people would prefer to avoid if they could and when their doctor suggests chemotherapy some people ask what would happen if they didn't have it.
When a breast cancer has spread to other organs of the body, treatment with chemotherapy is designed to try to shrink the growth and to improve symptoms, with the aim of promoting quality of life and prolonging life if possible. Unfortunately a cure really isn't possible in this situation.
Making decisions about treatment in these circumstances is always difficult.
Unfortunately the benefits of chemotherapy cannot be guaranteed. A minority of women will find that the treatment does not shrink the cancer cells and they will therefore have the side effects of the treatment without any benefit. The fitter a person is from a general point of view the more likely they are to have benefit and less likely to have side effects.
The alternatives to having chemotherapy are to try hormonal treatments (other than tamoxifen). The hormonal therapies may control the cancer for a time and give fewer side effects. However the chance of an improvement with these drugs is often smaller than with chemotherapy. The other option is to have supportive or palliative treatment, which is aimed not at controlling the cancer itself but at easing symptoms as and when they develop and helping to get the best possible quality of life.
Although your cancer is now advanced many women with this type of breast cancer can get an improvement in symptoms and live for longer as a result of chemotherapy treatment.
It is a good idea to discuss your concerns about chemotherapy with your doctor and breast care nurse. They should be able to explain about the pros and cons of having chemotherapy and the benefits that you might hope to expect. This may help you make the choice whether to have chemotherapy or not.