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Can Breast Cancer Affect Your Eyes

What About Other Treatments That I Hear About

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When you have cancer you might hear about other ways to treat the cancer or treat your symptoms. These may not always be standard medical treatments. These treatments may be vitamins, herbs, diets, and other things. You may wonder about these treatments.

Some of these are known to help, but many have not been tested. Some have been shown not to help. A few have even been found to be harmful. Talk to your doctor about anything youre thinking about using, whether its a vitamin, a diet, or anything else.

How To Deal With Eyesight And Eye Changes Caused By Cancer Drugs

The following drugs can cause cataracts:

  • some chemotherapy drugs
  • long term steroid therapy
  • the hormone therapy tamoxifen

A cataract is clouding of the lens of the eye which leads to slow loss of vision. If you have cataracts you might:

  • have cloudy or blurry vision
  • have trouble seeing in the dark night driving may be difficult
  • find colours may appear faded or dull
  • find lights appear to be too bright, or there may be a halo around lights
  • have to change your glasses or contact lens prescription often
  • have double vision, which gradually gets worse

Let your doctor or nurse know if you have any of these changes. If necessary, you can have the clouded lens removed and replaced with a false lens. You have this operation under local anaesthetic.

Some cancer drugs can make your eyes more sensitive to light. Doctors call this photophobia.

Treatments that might cause photophobia include:

  • cytarabine
  • drugs used for photodynamic therapy treatment

You may find that light hurts your eyes and is even painful.

Some people notice pain when they go from a dark to a light area. Most people are sensitive to light when they go outside during the daytime.

Tips for dealing with sensitivity to light
  • Wear dark glasses to lower the amount of light going into your eyes.
  • Avoid direct sunlight or bright indoor light.
  • Inflammation of the eye caused by an infection can cause light sensitivity treating the infection can help.
  • Steroid eye drops may help your doctor or nurse can prescribe these.

Symptoms Of Eye Cancer

Deby, Facty Staff

There are many kinds of cancer which can affect the eye. The most common ones are lymphoma, eye melanoma, retinoblastoma , and squamous cell carcinoma. At times, eye cancer can develop in the tissues that surround the eyeball. It may even spread from the eyes to the different parts of the body. The symptoms of eye cancer are quite easy to identify unlike other types of cancer. Although, some are obscure and without symptoms. This is why it’s very important to have regular eye examinations.

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Responses Of Ocular Metastases To Treatment

Treatment regimens for breast cancer with ocular metastatic complications are diverse and reflect the disease pattern in the individual patient. Retrospective audits of clinical practice reported in the literature generally indicate tailoring the treatment to the patient’s needs .

Therapy can be limited to the eye if systemic metastases are absent , although most patients have systemic metastases and require some form of chemotherapy or hormone therapy. Responses can be favourable, and complete regression of choroidal metastasis after monotherapy , as well as combined chemotherapy, have been reported . Systemic chemotherapy has also been reported to reduce the rate of failure of radiotherapy when administered sequentially .

How Is Yale Medicine Unique In The Care Of Eye Cancer

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Yale Medicine has ophthalmologists who can provide comprehensive eye exams. We recommend that everyone has annual eye exams with an eye doctor, especially if there is a family history of skin cancer, Dr. Lim says.

Yale Medicine is the only major academic medical center in Connecticut to have a full-time ocular oncologist. Dr. Lim trained at Wills Eye Hospital in Philadelphia, specializing in ocular oncology and plastic surgery for the eye. At Yale Medicine, she often works with other specialists, including otolaryngologists and neurosurgeons, to surgically remove tumors in a way that protects nearby delicate structures that could affect a patients sight.

Dr. Lim often works with other types of specialists to diagnose and treat cancers that originate in other parts of the body and spread to the eye. She also treats patients who need care for eye problems that develop as a result of treatment for cancer in other parts of the body. I work with medical oncologists daily to help patients who are being treated with immunotherapy for other types of cancer. These powerful agents that stimulate the immune response in the body have really changed the treatment paradigm for skin cancer and other types of cancer, including some patients with uveal melanoma, she says. But they can have side effects that range from mild dry eye to potential vision loss. Luckily, these side effects are rare, and when we detect them early, we can treat them.

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Breast Cancer Is Linked To Poor Oral Health And Gum Disease

Several large-scale studies have determined that gum disease and poor oral health are linked to breast cancer. One recent study, published in the Journal of Breast Cancer Research and Treatment, found that women with chronic gum disease are much more likely to develop breast cancer, a finding confirmed by several other international studies.

Poor oral health is also linked to a number of serious illnesses, such as prostate cancer, pneumonia, stroke, heart disease, and diabetes, as well as low birth weight and premature birth among pregnant mothers.

But why? Research suggests that chronic inflammation and the increased presence of multiple strains of bacteria and viruses not only lead to other infections and suppress the immune response to bacterial threats, but can even contribute to abnormal cell changes, resulting in certain cancers.

If your gums are tender and red, and bleed when you brush or floss, you may have gum disease. Visit a dentist soon, especially if you are undergoing treatment for breast cancer or any serious illness. The presence of gum disease not only puts you at risk of infection, but can also impact your cancer treatments.

Watch For Ocular Effects Of Breast Cancer Drugs

When a patient with an eye condition walks into an ophthalmologists office, the fact that she has been treated for breast cancer may not raise warning flags for the clinician. But theres accumulating evidence that ocular conditions such as dry eye, retinopathy, and cataracts may be at least partly due to some breast cancer medications.

Only a small percentage of breast cancer patients experience clinically evident ocular side effects from their medications. Nevertheless, because these drugs are so widely used, the related eye conditions may affect many women. The breast cancer medication most commonly identified with ocular side effects is tamoxifen. However, chemotherapy agents, such as 5-fluorouracil , can also have ocular side effects. And more researchers are becoming concerned that the drugs known as aromatase inhibitors, which now are often prescribed as adjuvant endocrine therapy, may also have adverse effects on the eye, including small retinal hemorrhages, increased incidence of floaters, and dry eye.

Tamoxifen Retinopathy
White or yellow refractile crystals around the macula are a characteristic finding in tamoxifen retinopathy

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Drugs That Can Affect Your Eyes

Doctors use many different types of drugs to treat cancer. Some of them may cause changes to your eyes or eyesight.

Usually, the effects are temporary and will go away when you stop taking the drug. But some effects may be long term.

Changes to your eyesight and eyes can be uncomfortable and upsetting. These changes can make your usual activities hard to do and as a result, affect your quality of life.

Eye changes are most likely to happen with some:

  • chemotherapy drugs
  • targeted cancer drugs
  • immunotherapies

Some hormone therapies can cause eye problems, but they are usually mild. Some bisphosphonates and long term steroid treatments sometimes cause eye problems.

Drugs affect people in different ways. It is not possible to tell in advance who will have particular side effects. It depends on:

  • the drug or combination of drugs you are having
  • the dose
  • how you react to the drug
  • how you have reacted to drug treatment in the past

How Is Eye Cancer Diagnosed

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An eye doctor will perform a complete eye exam using equipment such as a silt lamp, which emits a narrow, intense beam of light, and an indirect ophthalmoscope, which provides a wide view of the inside of the eye. He or she is looking for a mass in the eye that can be dome-shaped or have a mushroom configuration. It could be elevated or small and flat.

A specialist may then use multiple imaging modalities to get as much information about the qualities of a tumor as possible. This might include ultrasound to determine the density of the mass, as well as to look at its features and measure its thickness. Optical coherence tomography is an imaging tool that illuminates the retinal layers to assess the subtle presence of fluid, which is a sign of tumor activity. Sometimes magnetic resonance imaging can help as well.

In some cases, the doctor will perform a fine needle biopsy to take a small sample of the tumor cells. This will be sent to a cytopathologist . The cytopathologist will analyze the sample to confirm the diagnosis within a few days.

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Most Common Places It Spreads

It’s still breast cancer, even if it’s in another organ. For example, if breast cancer spreads to your lungs, that doesn’t mean you have lung cancer. Although it can spread to any part of your body, there are certain places it’s most likely to go to, including the lymph nodes, bones, liver, lungs, and brain.

Here Are Some Steps That Can Help Facilitate Reconnecting To Your Body After Breast Cancer:

  • Try to identify those harmful messages from the media, our culture, friends and family about the female body. Try to reflect on which of these messages are now influencing you. How do you feel about them as you reflect? Do you think they are placing pressure on you to conform to some specific way of looking, or being as a person?
  • Try to use a more women-centered and nurturing approach in considering your own sense of self. For example, try thinking in a critical way about these external messages and what they are really saying. For example, you might begin by questioning the notion that there is one right body type, or that womens bodies need to be constantly fixed, altered and take up less space. Consider whether those who spread these messages and encourage these ways of thinking have womens best interests in mind.
  • In order to move forward it is helpful to “rebuild” your sense of self by getting to know yourself now and redefining who you are, especially as you may have discovered new things about yourself. Think about or write about what the breast cancer experience has brought to you. What did you learn about yourself? What do you find yourself wanting or valuing now? What does femininity, beauty or health mean to you after going through treatment for breast cancer? What do you find is important now in bringing you happiness?
  • Be kind and more compassionate to yourself and try to find time for some daily self-compassion. You have been through so much.
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    Addressing Oral Side Effects And Complications During Chemotherapy

    Undergoing breast cancer treatment is challenging enough, and dealing with oral side effects impacts your quality of life. Your dentist can suggest oral rinses, lozenges, sprays, toothpastes, chewing gum, and more to address these side effects. Many of products contain xylitol to combat bacteria, like Xylimelts, lozenges that slowly dissolve and can be used day or night to treat dry mouth.

    Chemotherapy suppresses the immune system, lowering your natural protection against infection, so its important to resolve dental problems before beginning cancer treatment. Complete any necessary dental work and have your teeth cleaned about a month before beginning chemotherapy or radiation.

    Gentle oral hygiene is the key to avoiding infections in the mouth, which are particularly dangerous in combination with a suppressed immune system.

    • Use a very soft toothbrush, or even a sponge brush, to avoid damaging the gums, which may be tender and inflamed from treatment
    • Floss gently to avoid causing bleeding
    • Only use alcohol-free rinses, and avoid rinses with saccharin. Mouthwashes with alcohol can dry out your mouth further. A mouthwash containing xylitol will help decrease the overall bacteria in your mouth
    • If you wear dentures, be sure that they fit well and that you keep them very clean

    Are The Diagnostic Procedures Painful

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    Its understandable to feel nervous about having a procedure performed on your eye, but ophthalmologists are often able to make patients comfortable. They numb the eye and use very small, fine instruments, making a procedure like a needle biopsy feel much less invasive than the patient anticipates. As it turns out, patients actually tolerate eye procedures and eye surgery very well, Dr. Lim says.

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    Before You Tell Your Boss

    The first two things to consider are how private or open you want to be, and what you need from your workplace to get through this time.

    âI am pretty much an open book kind of person. I told my supervisors soon after each time I was diagnosed,â says Debbie McCarron of Huntington Beach, CA. She was treated for stage I breast cancer in 2001, stage III in 2009, and stage I again in 2015. McCarron was an executive vice president at a mortgage company, and she now works as a mortgage underwriter.

    âItâs going to depend so intensely on the individual person, their preferences and personality, their workplace and concerns around their workplace, how they feel about privacy, and what kind of job they have,â says Rebecca Nellis, chief mission officer at the nonprofit Cancer and Careers. âWe encourage people to do a lot of fact-finding and a lot of internal thinking before they disclose.â

    If you work at a small company or on a team where people share a great deal of their lives, your answer might be different from someone in a more impersonal workplace who prefers to keep their private life private.

    Telling your workplace also isnât an all-or-nothing proposition. You get to decide whom you tell, when, and how much.

    You could only tell your immediate manager, or only your HR department.

    âIt was important for me to keep doing normal activities, like working,â Shaw says. âI wanted to show other people around me that there isn’t one ‘right’ way to have cancer.â

    Breast Cancer Metastasis To The Eye: Facts And Figures

    Chantel Park, BS Neelema Sinha, BA and Carol L. Shields, MD

    A65-year-old white woman developed painlessblurred vision in the left eye over 10 days. Shegave a history of breast carcinoma diagnosed 5 years previouslyand treated with lumpectomy and radiotherapy. Lymphnode sampling was positive, requiring the use of systemicchemotherapy and hormone therapy with anastrozole . Four years after diagnosis, lung metastaseswere discovered and treated with fulvestrant intramuscular hormone therapy.

    DISCUSSIONBreast carcinoma is the most common cancer to affectwomen in the United States. The incidence is increasing,and one in eight women is anticipated to develop thismalignancy in her lifetime.1 The American Cancer Society estimates cancer prevalence and death based on datafrom the National Cancer Institute, Centers for DiseaseControl and Prevention, and the North AmericanAssociation of Central Cancer Registries. Based on the ACSestimates, it is projected that in the United States in the year2009, there will be a total of 1,479,350 new cancers and562,340 deaths from cancer.2 Interestingly, cancer rates haveslightly decreased in men and women over recent years dueto reduction in lung, prostate, and colorectal cancers inmen and reduction in breast and colorectal cancers inwomen. It is estimated that the reduction in new cancersand cancer deaths over the past 15 years has spared approximately650,000 lives.

    The authors have no financial interests to disclose.

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    Does Immunotherapy Affect The Eyes

    Because immunotherapy generates an immune response in patients, it can cause inflammation of the eyes. Ocular side effects are uncommon they include conjunctivitis, scleritis, intraocular inflammation, Graves ophthalmopathy as well as fluid buildup or edema in and around the eye.

    Occasionally, a bone marrow transplant patient will experience graft-versus-host disease that affects the eyes. Loss of eye pigment, eyelashes or eyebrows or problems involving the cornea can occur.

    Ial Or Full Loss Of Sight

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    You may start to experience partial or full loss of your sight, whether temporarily or permanently. This is a major symptom of eye cancer. You might experience the loss of peripheral vision or start experiencing tunnel vision. This happens when you see things as if you were in a tunnel. Whether you’ve lost only part of your site or all, it this is one of the scarier symptoms. It may signal a more advanced stage of cancer and would mean that you should go to the eye doctor.

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    What Types Of Eye Damage Can Occur

    There are a few types of damage that can occur, including changes in vision, cataracts, and damage to the tear ducts .

    • Cataracts are cloudy areas in the lens of the eye. Symptoms of cataracts include blurry vision, light sensitivity, trouble seeing at night, double vision in one eye, seeing halos around objects, needing a brighter light to read, fading or yellowing of colors.
    • Radiation can cause damage to the lacrimal glands . This can cause a loss of or decrease in tear production and chronic dry eye. This puts you at a higher risk of corneal infections.
    • Other possible side effects related to radiation include shrinkage or loss of the eye, corneal abrasions , ulcers, glaucoma, and damage to the optic nerve that can lead to vision loss or blindness.
    • Denileukin diftitox can cause blurry vision or a loss of color vision, which could continue after treatment.

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