1. Home
  2. Medical oncology
  3. Breast
  4. Neoadjuvant/Adjuvant
  5. 4103-Breast neoadjuvant/adjuvant PACLitaxel weekly

Patient information - Breast cancer neoadjuvant/adjuvant - Paclitaxel weekly

On this page
Expand all Collapse all Back to top

This information sheet outlines your treatment. It should be reviewed together with your doctor, nurse or pharmacist to address any questions or concerns.

The treatment schedule below explains when you will receive the medicines and how they are given.  Your doctor, nurse or pharmacist will be able to explain how your treatment works in more detail.

This treatment can be given either before or after surgery. The aim of neoadjuvant (before surgery) treatment is to shrink the tumour to make it easier to remove. Your doctor will advise which treatment plan is recommended for you.

The treatment schedule below explains how the drug for this treatment is given. 

Paclitaxel
This treatment cycle is repeated every 7 days. You will have 12 cycles. Your doctor will discuss your treatment plan with you.
Day Treatment How it is given How long it takes
1 Paclitaxel (pak-li-TAX-el) By a drip into a vein About 1.5 hours

Anticancer drugs (drugs used to treat cancer) can sometimes cause serious problems. It is important to get medical help immediately if you become unwell.

Emergency

IMMEDIATELY go to your nearest hospital Emergency Department, or contact your doctor or nurse if you have any of the following at any time:

Emergency contact details

Ask your doctor or nurse from your treating team who to contact if you have a problem

 

  • a temperature of 38ºC or higher
  • chills, sweats, shivers or shakes
  • shortness of breath
  • uncontrolled vomiting or diarrhoea
  • pain, tingling or discomfort in your chest or arms
  • you become unwell.
Daytime:
Night/weekend:
Other instructions:

During your treatment immediately tell the doctor or nurse looking after you if you get any of the following problems: 

  • leaking from the area where the drugs are being given 
  • pain, stinging, swelling or redness in the area where the drugs are being given or at any injection sites
  • a skin rash, itching, feeling short of breath, wheezing, fever, shivers, or feeling dizzy or unwell in any way (allergic reaction).

Changes to your dose or treatment delays

Sometimes a treatment may be started at a lower dose or the dose needs to be changed during treatment. There may also be times when your treatment is delayed. This can happen if your doctor thinks you are likely to have severe side effects, if you get severe side effects, if your blood counts are affected and causing delays in treatment, or if you are finding it hard to cope with the treatment. This is called a dose reduction, dose change or treatment delay. Your doctor will explain if you need any changes or delays to your treatment and the reason why.

Blood tests and monitoring

Anti-cancer drugs can reduce the number of blood cells in your body. You will need to have regular blood tests to check that your blood cell count has returned to normal. If your blood count is low, your treatment may be delayed until it has returned to normal. Your doctor or nurse will tell you when to have these blood tests.

Treatment before surgery (neoadjuvant therapy)

For more information see the eviQ patient information sheet on Anti-cancer therapy before breast cancer surgery (neoadjuvant therapy).

Other medications given during this treatment

  • Anti-sickness (anti-nausea) medication: you may be given some anti-sickness medication. Make sure you take this medication as your doctor or nurse tells you, even if you don’t feel sick. This can help to prevent the sickness starting.
  • G-CSF: you may be given injection(s) of a drug called G-CSF (also called filgrastim, lipegfilgrastim or pegfilgrastim) under your skin. This helps to boost your white blood cell count. Your white blood cells help to fight infection. Lipegfilgrastim and pegfilgrastim are given once. Filgrastim is given for several days until your white blood cells recover. Your doctor will decide if you need this medication. Follow this link to read more information on how to give this injection opens in a new tab or window.

  • Paclitaxel premedication: before your treatment with paclitaxel you may need to take some tablets called a premedication to help prevent you from having a reaction to the paclitaxel. The following table may be used to remind you when to take your premedication. Ask your doctor, nurse or pharmacist to fill it out for you. Sometimes after the first 4 treatments, if you have not had a reaction to paclitaxel, you may not be required to take any premedication.

    Tablet Dose When to take
         
         
         

    Tell your doctor or nurse if you have not taken your premedication before you have your treatment.

Cancer treatments can cause damage to normal cells in your body, which can cause side effects. Everyone gets different side effects, and some people will have more problems than others.

The table below shows some of the side effects you may get with this treatment. You are unlikely to get all of those listed and you may also get some side effects that have not been listed.

Tell your doctor or nurse about any side effects that worry you. Follow the instructions below and those given to you by your doctor or nurse.

Immediate (onset hours to days)

Allergic reaction

  • Allergic reactions are uncommon but can be life threatening.
  • If you feel unwell during the infusion or shortly after it, or:
    • get a fever, shivers or shakes
    • feel dizzy, faint , confused or anxious
    • start wheezing or have difficulty breathing
    • have a rash, itch or redness of the face

While you are in hospital: Tell your doctor or nurse immediately.

After you leave: Contact your doctor or nurse immediately, or go to the nearest hospital Emergency Department.

Nausea and vomiting

  • You may feel sick (nausea) or be sick (vomit).
  • Take your anti-sickness medication as directed even if you don’t feel sick.
  • Drink plenty of fluids (unless you are fluid restricted).
  • Eat small meals more frequently.
  • Try food that does not require much preparation.
  • Try bland foods like dry biscuits or toast.
  • Gentle exercise may help with nausea.
  • Ask your doctor or nurse for eviQ patient information - Nausea and vomiting during cancer treatment. 
  • Tell your doctor or nurse immediately, or go to the nearest hospital Emergency Department if you have uncontrolled vomiting or feel dizzy or light-headed.

Taste and smell changes

  • You may find that food loses its taste or tastes different.
  • These changes are likely to go away with time.
  • Do your mouth care regularly.
  • Chew on sugar-free gum or eat sugar-free mints.
  • Add flavour to your food with sauces and herbs.
  • Ask your doctor or nurse for eviQ patient information - Taste and smell changes during cancer treatment.

Early (onset days to weeks)

Infection risk (neutropenia)

  • This treatment lowers the amount of white blood cells in your body. The type of white blood cells that help to fight infection are called neutrophils. Having low level of neutrophils is called neutropenia. If you have neutropenia, you are at greater risk of getting an infection. It also means that your body can’t fight infections as well as usual. This is a serious side effect, and can be life threatening.
  • Wash your hands often.
  • Keep a thermometer at home and take your temperature regularly, and if you feel unwell.
  • Do your mouth care regularly.
  • Inspect your central line site (if you have one) daily for any redness, pus or swelling.
  • Limit contact with people who are sick.
  • Learn how to recognise the signs of infection.
  • Ask your doctor or nurse for eviQ patient information - Infection during cancer treatment.
  • Tell your doctor or nurse immediately, or go to the nearest hospital Emergency Department if you get any of the following signs or symptoms:
    • a temperature of 38°C or higher
    • chills, shivers, sweats or shakes
    • a sore throat or cough
    • uncontrolled diarrhoea
    • shortness of breath
    • a fast heartbeat
    •  become unwell even without a temperature.

Low platelets (thrombocytopenia)

  • This treatment lowers the amount of platelets in your blood. Platelets help your blood to clot. When they are low, you are at an increased risk of bleeding and bruising.
  • Try not to bruise or cut yourself.
  • Avoid contact sport or vigorous exercise. 
  • Clear your nose by blowing gently.
  • Avoid constipation.
  • Brush your teeth with a soft toothbrush.
  • Don't take aspirin, ibuprofen or other similar anti-inflammatory medications unless your doctor tells you to.
  • Tell your doctor or nurse if you have any bruising or bleeding. 
  • Tell your doctor or nurse immediately, or go to your nearest hospital Emergency Department if you have any uncontrolled bleeding.

Tiredness and lack of energy (fatigue)

  • You may feel very tired, have no energy, sleep a lot, and not be able to do normal activities or things you enjoy.
  • Do not drive or operate machinery if you are feeling tired.
  • Nap for short periods (only 1 hour at a time)
  • Prioritise your tasks to ensure the best use of your energy.
  • Eat a well balanced diet and drink plenty of fluids (unless you are fluid restricted).
  • Try some gentle exercise daily.
  • Allow your friends and family to help.
  • Tell your doctor or nurse if you get any of the symptoms listed above.

Diarrhoea

  • You may get bowel motions (stools, poo) that are more frequent or more liquid.
  • You may also get bloating, cramping or pain.
  • Take your antidiarrhoeal medication as directed by your doctor.
  • Drink plenty of fluids (unless you are fluid restricted).
  • Eat and drink small amounts more often.
  • Avoid spicy foods, dairy products, high fibre foods, and coffee.
  • Ask your doctor or nurse for eviQ patient information - Diarrhoea during cancer treatment. 
  • Tell your doctor or nurse immediately, or go to your nearest hospital Emergency Department if your diarrhoea is not controlled, you have 4 or more loose bowel motions per day, and if you feel dizzy or light-headed.

Nerve damage (peripheral neuropathy)

  • You may notice a change in the sensations in your hands and feet, including:
    • tingling or pins and needles
    • numbness or loss of feeling
    • pain.
  • You may find it difficult to do everyday activities, such as doing up buttons or picking up small objects. 
  • Test water temperature with your elbow when bathing to avoid burns.
  • Use rubber gloves, pot holders and oven mitts in the kitchen.
  • Wear rubber shoes or boots when working in the garden or garage.
  • Keep rooms well lit and uncluttered.
  • Ask your doctor or nurse for eviQ patient information  – Nerve problems during cancer treatment. 
  • Tell your doctor or nurse if you get any of the symptoms listed above.

Mouth pain and soreness (mucositis)

  • You may have:
    • bleeding gums
    • mouth ulcers
    • a white coating on your tongue
    • pain in the mouth or throat
    • difficulty eating or swallowing.
  • Avoid spicy, acidic or crunchy foods and very hot or cold food and drinks.
  • Try bland and soft foods.
  • Brush your teeth gently with a soft toothbrush after each meal and at bedtime. If you normally floss continue to do so.
  • Rinse your mouth after you eat and brush your teeth, using either:
    • 1/4 teaspoon of salt in 1 cup of warm water, or
    •  1/4 teaspoon of bicarbonate of soda in 1 cup of warm water
  • Ask your doctor or nurse for eviQ patient information - Mouth and throat problems during cancer treatment. 
  • Tell your doctor or nurse if you get any of the symptoms listed above.

Skin rash

  • You may get a red, bumpy rash and dry, itchy skin. 
  • Moisturise your skin with a gentle non-perfumed moisturising cream like sorbolene or aqueous cream.
  • Do not scratch your skin.
  • Protect your skin from the sun by wearing sun-protective clothing, a wide-brimmed hat, sunglasses and sunscreen of SPF 50 or higher.
  • Talk to your doctor or nurse about other ways to manage your skin rash.

Joint and muscle pain and stiffness

  • You may get muscle, joint or general body pain and stiffness.
  • Applying a heat pack to affected areas may help.
  • Talk to your doctor or nurse about other ways to manage these symptoms. You may need medication to help with any pain.

Late (onset weeks to months)

Low red blood cells (anaemia)

  • You may feel dizzy, light-headed, tired and appear more pale than usual.
  • Tell your doctor or nurse if you have any of these signs or symptoms. You might need a blood transfusion.
  • Tell your doctor or nurse immediately, or go to the nearest hospital Emergency Department if you have any chest pain, trouble breathing, or feel like your heart is racing.

Hair loss (alopecia)

  • Your hair may start to fall out from your head and body.
  • Hair loss usually starts 2 to 3 weeks after your first treatment.
  • You may become completely bald and your scalp might feel tender.
  • Use a gentle shampoo and a soft brush.
  • Take care with hair products like hairspray, hair dye, bleaches and perms.
  • Protect your scalp from the cold with a hat, scarf or wig.
  • Protect your scalp from the sun with a hat or sunscreen of SPF 50 or higher.
  • Moisturise your scalp to prevent itching.
  • Ask your doctor or nurse about the Look Good Feel Better opens in a new tab or window program 

Nail changes

  • Your nails may:
    • grow more slowly
    • become darker
    • develop ridges or white lines
    •  become brittle and flaky
  • In some cases, you may lose your nails completely.
  • Keep your nails clean and short.
  • Avoid things like biting your fingernails, getting a manicure, pedicure or false nails.
  • Wear gloves when you wash the dishes, work in the garden, or clean the house.

Delayed (onset months to years)

Menopausal symptoms

  • You may get:
    • hot flushes or night sweats
    • mood changes
    • vaginal dryness
    • irregular or no periods.
  • You may also:
    • have trouble sleeping
    •  find sex painful or lose interest in sex
  • These symptoms may go away after treatment, or the menopause may be permanent.
  • If you have sex you should use contraception as there is still a risk of pregnancy. Talk to your doctor about what form of contraception is right for you.
  • Talk to your doctor or nurse about ways to manage these symptoms.

Chemotherapy safety

  • Learn how to keep you and your family safe while you are having anticancer drugs.
  • See our patient information sheet - Chemotherapy safety at home. 

Blood clot risk

  • Cancer and anticancer drugs can increase the risk of a blood clot (thrombosis).
  • Tell your doctor if you have a family history of blood clots.
  • A blood clot can cause pain, redness, swelling in your arms or legs, shortness of breath or chest pain.
  • If you have any of these symptoms go to your nearest hospital Emergency Department.

Medications and vaccinations

  • Before you start treatment, tell your doctor and pharmacist about any medications you are taking, including over-the-counter products, vitamins or herbal supplements. 
  • Don’t stop or start any medications during treatment without talking to your doctor and pharmacist first.
  • Paracetamol is safe to take if you have a headache or other mild aches and pains. It is recommended that you avoid taking aspirin, ibuprofen and other anti-inflammatory type medications for pain while you are having treatment. However, if these medications have been prescribed by your doctor, do not stop taking them without speaking with your doctor.
  • Do not have any vaccinations without discussing with the doctor who is managing your cancer treatment.
  • People you live with should be fully vaccinated, including having live vaccines according to the current vaccination schedule. Extra care needs to be taken with hand washing and careful disposal of soiled nappies for infants who have recently received the rotavirus vaccine.

Other medical and dental treatment

  • If you go to hospital or any other medical appointment (including dental appointments), always tell the person treating you that you are receiving anticancer drugs.
  • Before you have any dental treatment, talk to your doctor. 

Diet

  • While you are receiving this treatment it is important that you try to maintain a healthy diet.
  • Grapefruit and grapefruit juice can interact with your medication and should be avoided while you are on this treatment. 
  • Speak to your doctor or nurse about whether drinking alcohol is safe with your treatment.
  • If you have any concerns about recent weight loss or weight gain or questions about your diet, ask to speak to a dietitian.
  • Avoid drinking or cooking with untreated water (e.g. water from rainwater tanks, bores or rivers) due to risk of contamination. If you intend to drink or cook with rainwater, you should bring it to a boil and allow the water to cool down before drinking or cooking with it. For more information see the NSW Health - Rainwater tanks opens in a new tab or window webpage.

Fertility

  • Some cancer treatments can reduce your fertility. This can make it difficult or impossible to get pregnant or father a child.
  • Talk to your doctor or nurse before you start any treatment. Depending on your situation there may be fertility sparing options available to you and/or your partner, discuss these with your doctor or nurse. 

Pregnancy and breastfeeding 

  • Some cancer treatments can be dangerous to unborn babies. Talk to your doctor or nurse if you think there is any chance that you could be pregnant.
  • Do not try to get pregnant or father a child during this treatment. Contraception should be used during treatment and after stopping treatment. Ask your doctor or nurse about what type of contraception you should use.
  • If you are planning pregnancy/fatherhood after completing this treatment, talk to your doctor. Some doctors advise waiting between 6 months and 2 years after treatment.
  • Do not breastfeed if you are on this treatment, as anti-cancer medications can also pass into breast milk.

Sex life and sexuality 

  • The desire to have sex may decrease as a result of this treatment or its side effects. 
  • Your emotions and the way you feel about yourself may also be affected by this treatment. 
  • It may help to discuss your concerns with your partner and doctor or nurse.

Quitting smoking

  • It is never too late to quit smoking. Quitting smoking is one of the best things you can do to help your treatment work better.
  • There are many effective tools to improve your chances of quitting.
  • Talk to your treating team for more information and referral to a smoking cessation support service.

Staying active

  • Research shows that exercise, no matter how small, has many benefits for people during and after cancer treatment.
  • Talk to your doctor before starting an exercise program. Your doctor can advise whether you need a modified exercise program.

For more information about cancer treatment, side effects and side effect management see our Patient and carers section. 

Telephone support

  • Call Cancer Council on 13 11 20 for cancer information and support.

Breast cancer information

General cancer information and support

Quit smoking information and support

Quitting smoking is helpful even after you have been diagnosed with cancer. The following resources provide useful information and support to help you quit smoking. Talk to your treating team about any other questions you may have.

This document is a guide only and cannot cover every possible situation. Your treating team will consider your individual situation when making decisions about your care. Contact your doctor, nurse, pharmacist, or radiation therapist if you have any questions or concerns about your treatment, or you are having problems coping with side effects. While eviQ aims to provide reliable information, eviQ and the Cancer Institute NSW do not endorse or accept responsibility for the accuracy, currency, reliability or correctness of the content of linked external information sources. Use of this document is subject to eviQ’s disclaimer available at www.eviQ.org.au

Send feedback for this page

First approved:
Last reviewed:
Review due:

The currency of this information is guaranteed only up until the date of printing, for any updates please check:

https://www.eviq.org.au/pi/4103

30 Jun 2025