How To Reduce Side Effects Of Side Effects Of Breast Cancer Treatment
One of the first things that a woman who has gone through breast cancer treatment should do is to get a mammogram. A mammogram is an x-ray that helps detect any signs of breast cancer. However, getting a mammogram can sometimes be uncomfortable. One way to reduce this discomfort is by using liquid nitrogen to cool down the tip of the wand used in the mammogram. There are side effects to treatments that can be reduced by following a number of tips. It is also important to note that the treatment options for breast cancer are different depending on the type of cancer, including how much time has passed since diagnosis, and age.
Feeling Vague: ‘chemo Brain’
While being treated with chemotherapy, some women feel vague as if theyre in a fog or find they have memory or concentration problems. This is often referred to as chemo brain.
It is not clear exactly what causes these memory and concentration problems in people with cancer, so calling them chemo brain may not be accurate. Mild cognitive impairment is a more accurate description used by doctors. Another term is cognitive dysfunction.
People use the word cognitive or cognition in different ways. Most people who have cognitive changes are able to do everyday things. But they may notice they arent able to do some things quite as well as before they had cancer. Some of the symptoms people describe include:
- memory loss and forgetting things you normally remember
- difficulty finding the right word for something
- difficulty following the flow of a conversation
- trouble focusing on or doing more than one thing at a time
- difficulty organising things or planning ahead.
Ongoing research is being conducted to better understand how best to manage the symptoms of cognitive impairment related to chemotherapy. There are some strategies that have been suggested that might be helpful, including:
Reducing Your Risk Of Infection And Bleeding
You can help reduce the risk of infection and bleeding by:
- Regularly washing and drying your hands thoroughly
- Cleaning any cuts and grazes and cover with a dressing or plaster
- Avoiding people who are unwell or may be infectious
- Eating as healthily as possible, and following any advice about food and drink given to you by your hospital
- Drinking plenty of fluids
- Storing and cooking food correctly
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How Is Chemotherapy Given For Breast Cancer
Chemotherapy drugs are given intravenously or orally . Once the drugs enter the bloodstream, they are delivered to all parts of the body to reach cancer cells that may have spread beyond the breast. As a result, chemotherapy is considered a systemic form of breast cancer treatment.
Chemotherapy is given in cycles of treatment followed by a brief recovery period. When given after surgery, the entire chemotherapy treatment generally lasts three to six months, depending on the type of drugs given. When chemotherapy is being used to treat breast cancer that has spread to other organs, chemotherapy may be given for a longer period of time .
Here Are Some Common Side Effects Of Treatment For Breast Cancer Along With Ways To Cope With Them:
Nausea and vomiting. These symptoms may be caused by chemotherapy. Your health care team can prescribe medications to help manage these side effects. Your team may also recommend working with a dietitian, who can provide tips on eating and how to stay hydrated during chemotherapy.
Fatigue. Fatigue is a feeling of extreme tiredness. Your doctor can treat fatigue with prescription medications. Exercise may also help you cope with fatigue.
Chemobrain. Problems with memory, attention and concentration are sometimes referred to by patients as chemobrain. Talk with your doctor if you notice any symptoms of chemobrainhe or she can recommended treatments. Tips for what you can do on your own to cope with chemobrain can be found on CancerCares fact sheet, Combating Chemobrain: Tips for Keeping Your Memory Sharp.
Lymphedema. Lymphedema is a painful swelling, usually in an arm or leg, which happens when the bodys lymphatic fluid fails to circulate properly and builds up in soft tissue. Your doctor or nurse can give you tips to prevent and reduce the swelling. Some treatments for lymphedema include wearing a specially fitted compression sleeve that helps drain the fluid. Your health care team may also refer you to a program of special exercises that are taught by a trained physical therapist and are known to help reduce these side effects.
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Changes In The Shape Size And Feel Of The Breast
In time radiotherapy can cause the breast tissue to change shape or shrink in size a little. This can happen to your natural breast tissue or a reconstructed breast.
After radiotherapy, the breast might feel hard and less stretchy. This is due to a side effect called radiation fibrosis. This side effect is usually mild.
Sometimes the breast can shrink a little over time. This is because radiotherapy can make the breast tissue contract so that the breast gradually gets smaller.
An implant in a reconstructed breast can become hard and may need replacing.
Let your surgeon know of any changes, they may be able to do some minor surgical adjustments to improve the look.
When Is Chemotherapy Used
Not all women with breast cancer will need chemo, but there are several situations in which chemo may be recommended:
- After surgery : Adjuvant chemo might be given to try to kill any cancer cells that might have been left behind or have spread but can’t be seen, even on imaging tests. If these cells were allowed to grow, they could form new tumors in other places in the body. Adjuvant chemo can lower the risk of breast cancer coming back.
- Before surgery : Neoadjuvant chemo might be given to try to shrink the tumor so it can be removed with less extensive surgery. Because of this, neoadjuvant chemo is often used to treat cancers that are too big to be removed by surgery when first diagnosed . Also, by giving chemo before the tumor is removed, doctors can see how the cancer responds to it. If the first set of chemo drugs doesnt shrink the tumor, your doctor will know that other drugs are needed. It should also kill any cancer cells that have spread but can’t be seen. Just like adjuvant chemo, neoadjuvant chemo can lower the risk of breast cancer coming back.
For certain types of breast cancer, if there are tumor cells still found at the time of surgery , you may be offered more chemotherapy after surgery to reduce the chances of the cancer coming back .
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How Will I Know If The Chemotherapy Treatments Are Working
Some people may think that their chemotherapy treatment is not working if they do not experience side effects. However, this is a myth.
If you are receiving adjuvant chemotherapy , it is not possible for your doctor to directly determine whether the treatment is working because there are no tumor cells left to assess. However, adjuvant chemotherapy treatments have been proven helpful in studies in which some women were given chemotherapy, while others were not. If you are receiving chemotherapy for metastatic disease, the effects will be monitored, routinely, by blood tests, scans, and/or other imaging studies. These may include CT scans, bone scans, and/or X-rays).
After completing adjuvant chemotherapy, your doctor will evaluate your progress through periodic physical examinations, routine mammography, and appropriate testing if a new problem develops.
Last reviewed by a Cleveland Clinic medical professional on 09/05/2013.
References
Radiation Therapy For Breast Cancer
Radiation therapy is a common treatment of breast cancer. It can be used to reduce the risk of recurrence and slow or stop the growth or spread of the original tumor. Side effects of cancer treatment can include hair loss, fatigue, nausea, vomiting, mouth sores, and mouth ulcers. To help decrease these side effects, patients should eat healthy food throughout their day. Radiation therapy is a type of cancer treatment that uses high-energy x-rays or other types of radiation to attack cancer cells. The radiation destroys the tumor cells and can also destroy healthy tissue in the area around the tumor. The radiation treatments can also make it harder for you to have children later on if you get breast cancer before you are ready to have kids.
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The Effects Of Breast Cancer On The Body
At first, breast cancer affects the breast area only. You may notice changes in your breasts themselves. Other symptoms arent so obvious until you detect them during a self-exam.
Sometimes your doctor may also see breast cancer tumors on a mammogram or other imaging machine before you notice symptoms.
Like other cancers, breast cancer is broken down into stages. Stage 0 is the earliest stage with the fewest noticeable symptoms. Stage 4 indicates the cancer has spread to other parts of the body.
If breast cancer spreads to other parts of the body, it may cause symptoms in those particular areas, too. Affected areas may include the:
- liver
- bones
- brain
The early effects of breast cancer can depend on the exact type of breast cancer you have.
Concentration And Memory Problems
After treatment for breast cancer, some women have difficulties concentrating and remembering things. Doctors call this cognitive impairment.
It is also sometimes called chemo brain or chemo fog. But these changes can also happen with other cancer treatments, such as hormonal therapy.
An early menopause may result in similar symptoms, or make them worse.
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Coping With The Costs Of Cancer
Cancer treatment can be expensive. It may be a source of stress and anxiety for people with cancer and their families. In addition to treatment costs, many people find they have extra, unplanned expenses related to their care. For some people, the high cost of medical care stops them from following or completing their cancer treatment plan. This can put their health at risk and may lead to higher costs in the future. Patients and their families are encouraged to talk about financial concerns with a member of their health care team. Learn more about managing financial considerations in a separate part of this website.
Managing Symptoms And Side Effects
Breast cancer and its treatment can cause a number of symptoms and side effects. The greatest influence on the type of symptoms and side effects that you experience will be the sites your cancer has spread to and the type of treatment you are having. Other factors such as your general health and wellbeing will also play a part in how your symptoms may affect you.
Read BCNA’s My Journey online tool article Managing symptoms and treatment side effects for more information.
The following section also provides information on managing a wide range of symptoms and side effects. Remember, everyone is different and you are unlikely to experience all of these symptoms or side effects. Some people experience very few or have only mild side effects or symptoms.
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Prescription Medications For Pain
Panadeine Forte is a stronger codeine-containing analgesic, but you will need a prescription from your oncologist or GP to purchase it.
Opiate painkillers are prescription drugs that provide the backbone of managing moderate or more severe pain. There are quite a number of different versions of opiate painkillers, and new ones are introduced from time to time. The usual approach is the use of a slow-release form these are either oral medications or patches that are placed on the skin and renewed every few days. Examples are:
- Oxycontin, Targin and Endone
- MSContin or Kapanol
- Jurnista and Dilaudid
- Durogesic patches.
You may also be able to use fast acting pain medication for what is called breakthrough pain pain that occurs despite the slow-release pain medication. Examples of these fast acting medications are:
- Endone, Dilaudid
- morphine mixture
- Actiq, Abstral .
The steroid medication dexamethasone can sometimes be very helpful for pain associated with metastases, such as bone or liver metastases.
Coping With Barriers To Care
Different groups of people experience different rates of new cancer cases and experience different outcomes from their cancer. These differences are called cancer disparities. Disparities are caused in part by real-world barriers to quality medical care and more often negatively affect racial and ethnic minorities, poor people, sexual and gender minorities , adolescent and young adult populations, older adults, and people who live in rural areas or other underserved communities.
If you are having difficulty getting the care you need, talk with a member of your health care team or explore other resources that help support medically underserved people.
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Chemotherapy For Breast Cancer
Chemotherapy uses anticancer drugs to destroy cancer cells. Many women with breast cancer have chemotherapy. Your healthcare team will consider the type of breast cancer you have and your personal needs to plan the drugs, doses and schedules of chemotherapy. You may also receive other treatments to help lessen the side effects of chemotherapy.
Chemotherapy is given for different reasons. You may have chemotherapy to:
- shrink a large tumour before surgery when the cancer hasnt spread outside the breast or lymph nodes
- destroy cancer cells left behind after surgery and reduce the risk that the cancer will come back
- treat cancer that comes back
- relieve pain or control the symptoms of advanced breast cancer
Chemotherapy is usually a systemic therapy. This means that the drugs travel through the bloodstream to reach and destroy cancer cells all over the body, including those that may have broken away from the primary tumour in the breast.
Chemotherapy is generally given every 3 weeks. Sometimes it is given every 2 weeks . Studies have shown that a dose-dense regimen may further lower the risk that breast cancer will come back and it may improve survival.
Alternative Treatments For Breast Cancer
Alternative therapies are beginning to emerge for those with breast cancer. For instance, partial breast irradiation, or PBI, is a radiation therapy focused specifically on the tumour area, rather than the entire breast. Targeting the radiation directly in the right area can reduce the amount of time required for successful radiation therapy. This condition is still being studied but may be helpful in preventing some of the side effects of radiation moving forward.
Another potentially interesting treatment is intensity-modulated radiation therapy, which involves varying levels of radiation directed at the breast to better target the tumour. This helps to lessen the radiation dose and can decrease potential damage to nearby organs. IMRT therapy can also lessen some of the risks of immediate side effects like skin peeling.
Some scientists are also experimenting with proton therapy, which uses x-rays to kill cancer cells. At high energy levels, protons can destroy cancer cells without the same impact as radiation therapy.
As breast cancer treatment continues to evolve, theres hope that future options will present fewer side effects to those recovering from cancer. In the meantime, you can learn more about your risk of developing breast cancer or other cancers with a CircleDNA test. This comprehensive DNA test will reveal mutations in your genes that may indicate a higher risk of cancer, so you can begin to make lifestyle changes that protect you in the future.
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How Is Chemotherapy Given
Chemo drugs for breast cancer are typically given into a vein , either as an injection over a few minutes or as an infusion over a longer period of time. This can be done in a doctors office, infusion center, or in a hospital setting.
Often, a slightly larger and sturdier IV is required in the vein system to administer chemo. These are known as central venous catheters , central venous access devices , or central lines. They are used to put medicines, blood products, nutrients, or fluids right into your blood. They can also be used to take out blood for testing.
There are many different kinds of CVCs. The most common types are the port and the PICC line. For breast cancer patients, the central line is typically placed on the side opposite of the underarm that had lymph nodes removed for the breast cancer surgery.
Chemo is given in cycles, followed by a rest period to give you time to recover from the effects of the drugs. Cycles are most often 2 or 3 weeks long. The schedule varies depending on the drugs used. For example, with some drugs, the chemo is given only on the first day of the cycle. With others, it is given for a few days in a row, or once a week. Then, at the end of the cycle, the chemo schedule repeats to start the next cycle.
Adjuvant and neoadjuvant chemo is often given for a total of 3 to 6 months, depending on the drugs used. The length of treatment for advanced breast cancer depends on how well it is working and what side effects you have.
Managing The Challenges Of Hormone Therapies
Hormone therapy for early breast cancer affects people differently. Some people experience more side effects than others and its not something you can predict before treatment. Many women find that the side effects are often worse at the start of treatment, and can settle down after weeks or months, but some symptoms persist for the duration of treatment.
Hormones occur naturally in the body and control the growth and activity of cells. We know that the female hormones, oestrogen and progesterone, can help some types of breast cancer to grow. Hormone therapy works by reducing the amount of oestrogen in the body or blocking its effects. You can have side effects from hormone therapies because they lower your levels of oestrogen or stop your body from being able to use it.
The side effects you experience will depend on the type of hormone treatment you are on.
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