Cancer Treatment Is A Team Effort
One of the first things that can confuse a patient unfamiliar with cancer treatment is who does what, says Morikawa.
At the Rogel Cancer Center, cancer care is multidisciplinary. A team of specialists comes together in a forum called a tumor board to review each patients test results and background information and arrive at a consensus recommendation about treatment.
A patient is likely to interact with doctors from more than one specialty, including:
- Surgical oncology: Removing cancerous tumors and tissue
- Medical oncology: Treating cancer with medications such as chemotherapy or hormone therapy
- Radiation oncology: Treating cancer with radiation
Many times, a patient will meet with a surgeon first, before they meet with a medical oncologist like me, Morikawa says. The surgeon will focus on discussing the procedure to remove the tumor and will refer questions about follow-up chemotherapy to me .
In addition, each of these groups has nurse practitioners or physicians assistants who are part of the team, she notes. The multidisciplinary approach is proven to provide the most comprehensive care, but it takes some practice and patience to direct each question to the specialist best prepared to answer it.
Breast Pain Not Linked To Periods
Its often unclear what causes non-cyclical breast pain.
It can be related to:
- a benign breast condition
- previous surgery to the breast
- injury to the breast
- having larger breasts
- a side effect from a drug treatment, such as certain antidepressant drugs and some herbal remedies such as ginseng
Stress and anxiety can also be linked to breast pain.
Non-cyclical breast pain may be continuous or it may come and go. It can affect women before and after the menopause.
The pain can be in one or both breasts and can affect the whole breast or a specific area. It may be a burning, prickling or stabbing pain, or a feeling of tightness.
Non-cyclical breast pain often goes away by itself over time. This happens in about half the women who experience it.
Dont Be Afraid To Ask All The Questions About Treatment And Surgical Options
Nicole M., 48, wishes shed known that getting a lumpectomy before her mastectomy would leave her with a chest indent. It wasnt just that I had no boobs, Nicole, who was diagnosed with stage 0ductal carcinoma in situ breast cancer in August 2018, tells SELF. It was that I was concave and indented on my right side where the lumpectomy had been. It like a crater.
Nicole dealt with another surprise when using tissue expanders to prepare for her reconstructive surgery this upcoming August. Tissue expanders are saline-filled pouches left beneath the skin post-mastectomy to create room for implants, and Nicole realized that really hot showers made the metal in the expanders uncomfortably hot, too.
Bottom line here: While there are some parts of recovery from breast cancer surgery that itll be hard to anticipate, asking your doctors detailed questions about the processand reading articles like this onemay help.
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Breast Pain Linked To Periods
Many women feel discomfort and lumpiness in both breasts a week or so before their period.
The pain can vary from mild to severe and the breasts can also be tender and sore to touch.
You may experience heaviness, tenderness, a burning, prickling or stabbing pain, or a feeling of tightness.
The pain usually affects both breasts but it can affect just one breast. It can also spread to the armpit, down the arm and to the shoulder blade.
Cyclical breast pain is linked to changing hormone levels during the menstrual cycle. The pain often goes away once a period starts. In some women, this type of pain will go away by itself, but it can come back.
This type of pain usually stops after the menopause, though women taking hormone replacement therapy can also have breast pain.
Breast pain can also be associated with starting to take or changing contraception that contains hormones.
Is My Cancer Hormone Receptor
Ask your doctor whether your cancer has receptors. These are molecules on the cell surface that bind to hormones in the body that can stimulate the tumor to grow.
Specifically ask whether your cancer is estrogen receptor-positive or receptor-negative, or progesterone receptor-positive or receptor-negative. The answer will determine whether or not you can use medicines that block the effect of hormones to treat your breast cancer.
If your biopsy didnt include testing for hormone receptors, ask your doctor to have these tests performed on the biopsy specimen.
Some breast cancer cells have receptors or molecules on the surface that can bind to other proteins in the body. These can stimulate the tumor to grow.
For example, the American Cancer Society recommends that all patients with invasive breast cancer be tested to see if their tumor cells contain high levels of the HER2 protein receptor. This is important because there are additional treatment options for HER2-positive breast cancers.
Ask your oncologist if your cancer is HER2-positive. And if you havent been tested for HER2 protein receptors, ask your oncologist to order the test.
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Planning Financially For Breast Cancer Treatment
An unexpected cancer diagnosis often comes with a heavy financial burden. Treatments such as chemotherapy and radiation, surgeries, and medications throughout the treatment journey can come as a shock, especially if they turn out to be out-of-pocket expenses. Medical bills can create additional stress in already trying times, so it’s important that patients understand any and all expenses that may arise during breast cancer treatment.
Patients should always contact their insurance company to see what expenses will be covered by insurance and what resources will require funds from elsewhere. Crowdfunding via sites like GoFundMe has become a popular way to cover medical and living expenses throughout the treatment journey, as patients look to the support of their friends, family, and even generous strangers in their community. If a patient is diagnosed with breast cancer after receiving a misdiagnosis, compensation from a successful medical malpractice lawsuit can also help ease the financial stress of growing medical bills.
Statistics On Breast Cancer And Pain
A breast tumora hard clump of breast cancer cellsdoesn’t usually cause breast pain unless it reaches the size of 2 centimeters in diameter or greater. But a tumor can be larger than 2 centimeters and still not cause pain.
For many women, breast pain is not their reporting symptom. One study found that only 6% of women reported breast pain as their main symptom. While most women with breast cancer report that a breast lump was their main symptom, 1 in 6 report a different symptom, including breast pain.
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Undergoing Medical Screening For Breast Cancer
Signs And Symptoms Of Breast Cancer
In its early stages, breast cancer may not cause any symptoms. In many cases, a tumor may be too small to be felt, but an abnormality can still be seen on a mammogram.
If a tumor can be felt, the first sign is usually a new lump in the breast that was not there before. However, not all lumps are cancer.
Each type of breast cancer can cause a variety of symptoms. Many of these symptoms are similar, but some can be different. Symptoms for the most common breast cancers include:
- a breast lump or tissue thickening that feels different than surrounding tissue and has developed recently
- breast pain
- changes to the appearance of the skin on your breasts
- a lump or swelling under your arm
If you have any of these symptoms, it doesnt necessarily mean you have breast cancer. For instance, pain in your breast or a breast lump can be caused by a benign cyst.
Still, if you find a lump in your breast or have other symptoms, you should see your doctor for further examination and testing.
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Youre Experiencing Abnormal Discharge
While nipple discharge from breast milk is totally normal, if youre noticing discharge thats clear or bloody, thats something you should get checked out since it could be a sign of breast cancer, says the National Breast Cancer Foundation. If you have discharge thats milky, it could be something else, like hormonal changes or certain medication use.
After My Breast Cancer Surgery Will I Need Radiation Or Chemotherapy Or Both
The stage of breast cancer helps determine which treatment regimen your oncologist will recommend. After breast-sparing surgery, radiation treatments may be used to help destroy remaining breast cancer cells. Radiation therapy is typically given after surgery to lower the chance of a cancer recurrence. Adjuvant breast cancer chemotherapy may be used after surgery to destroy remaining cancer cells not killed during surgery.
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Breast Cancer: What If You Did Nothing
Why some women with early-stage breast cancer choose to do nothing
The cover of this past weeks issue of TIME magazine features the torso of a woman, her hands shielding her breasts, and a single question: What if I decide to just do nothing? The question is jarring because we know what its referring to: the asker has breast cancer, and she wants to know if the best course of action is no action at all.
Its a radical idea, to do nothing when faced with a breast cancer diagnosis, particularly this month, when were surrounded by pink products and encouraged to join the fight to beat breast cancer. And when we know that breast cancer is the most common cancer diagnosis in Canadian women, and that 5,000 women in this country die each year from the disease, it seems astonishing that a woman would choose to wait and watch. But as TIME author Siobhan OConnor writes in her article, Why Doctors are Rethinking Breast Cancer Treatment,research suggests that some women with early-stage breast cancer are being over treated.
New research released in August brought this issue to public attention. The study, published in the journal JAMA Oncology, followed 100,000 diagnosed with ductal carcinoma in situ , also known as Stage 0 breast cancer, for 20 years. Researchers discovered that no matter the course of treatment the women had roughly the same chance of dying from breast cancer as the average woman does .
What To Say To Someone In Treatment For Breast Cancer
After the initial diagnosis and as cancer treatment gets underway, Ms. Grosklags says, in all the days, weeks, and months that follow, people will continue to need support. Active or ongoing treatment will bring new challenges. Remind your loved one that you want to be of help, and give concrete examples of things you are willing and able to do. Try to be flexible and adjust to the persons changing needs and emotions. Hold space for all of it, says Ms. Grosklags. You might consider asking:
- How can I help in the way that works best for you?
- If you have pain, is it being managed?
- Are you having trouble with any side effects?
- Are you feeling safe?
- Do you feel supported?
Still not sure how to communicate with your loved one? You dont have to be perfect just lend a caring ear. Let your loved one know youre there to listen whenever they feel like talking.
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What Do Breast Lumps Feel Like
How breast lumps feel depends on their cause, location, and growth. They can vary from painful, hard, and immobile to soft, painless, and easily moveable.
Lumps are most likely to be cancerous if they do not cause pain and are hard, unevenly shaped, and immobile.
Other breast lumps can feel different:
- Fibroadenoma lumps tend to be painless, easily movable, smooth, and rounded. They may disappear on their own.
- Breast cysts are smooth but firm.
- Breast abscesses and mastitis usually cause painful, swollen lumps, and there may also be a fever and flushing around the affected skin.
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Tests To Determine Specific Types Of Treatment
You’ll also need tests that show whether the cancer will respond to specific types of treatment. The results of these tests can give your doctors a more complete picture of the type of cancer you have and how best to treat it. The types of test you could be offered are discussed below.
In some cases, breast cancer cells can be stimulated to grow by hormones that occur naturally in your body, such as oestrogen and progesterone.
If this is the case, the cancer may be treated by stopping the effects of the hormones, or by lowering the level of these hormones in your body. This is known as “hormone therapy”.
During a hormone receptor test, a sample of cancer cells will be taken from your breast and tested to see if they respond to either oestrogen or progesterone. If the hormone is able to attach to the cancer cells , they’re known as “hormone receptor positive”.
While hormones can encourage the growth of some types of breast cancer, other types are stimulated by a protein called human epidermal growth factor receptor 2 .
These types of cancer can be diagnosed using a HER2 test, and treated with medication to block the effects of HER2. This is known as “biological” or “targeted” therapy.
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Living With Breast Cancer
Being diagnosed with breast cancer can affect daily life in many ways, depending on what stage it’s at and the treatment you will have.
How people cope with the diagnosis and treatment varies from person to person. There are several forms of support available, if you need it.
Forms of support may include:
- family and friends, who can be a powerful support system
- communicating with other people in the same situation
- finding out as much as possible about your condition
- not trying to do too much or overexerting yourself
- making time for yourself
Find out more about living with breast cancer.
Symptoms Of Secondary Breast Cancer
Secondary breast cancer means that a cancer that began in the breast has spread to another part of the body. Secondary cancer can also be called advanced or metastatic cancer.
It might not mean that you have secondary breast cancer if you have the symptoms described below. They can be caused by other conditions.
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Coping With Breast Pain
Breast pain can be very distressing, and many women worry that they may have breast cancer. In most cases breast pain will be the result of normal changes in the breasts.
Even though you may feel reassured that your breast pain is normal and you dont have breast cancer, the pain often remains. This can be upsetting, especially if your specialist cant tell you the exact cause of your breast pain.
Women affected by breast pain may feel many different emotions, including fear, frustration or helplessness. Although understanding more about your breast pain wont cure it, it may help you to get back some control over your life.
Having severe, long-lasting breast pain can sometimes affect a womans daily activities which may cause anxiety and, for some, depression. However, this isnt the case for most women and their pain can be helped or managed.
Having breast pain doesnt increase your risk of breast cancer. However, its still important to be breast aware and go back to your GP if the pain increases or changes, or you notice any other changes in your breasts.
How Is Chemotherapy For Breast Cancer 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 breast cancer. If a woman has breast cancer in both breasts, the central line will most likely be placed on the side that had fewer lymph nodes removed or involved with cancer.
Chemo is given in cycles, followed by a rest period to give you time to recover from the effects of the drugs. Chemo cycles are most often 2 or 3 weeks long. The schedule varies depending on the drugs used. For example, with some drugs, chemo is given only on the first day of the cycle. With others, it is given one day a week for a few weeks or every other week. Then, at the end of the cycle, the chemo schedule repeats to start the next cycle.
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