What is it like to live with breast cancer during and after treatment?

What is it like to live with breast cancer during and after treatment?

Experiencing a breast cancer diagnosis can profoundly impact one's life. Throughout and following treatment, individuals confront a spectrum of physical and emotional adjustments, encompassing fatigue, nausea, stress, menopausal manifestations (in females), sexual complications, and challenges related to body image. Furthermore, vigilance for cancer recurrence constitutes a significant aspect of post-treatment care, albeit accompanied by apprehension.

Throughout breast cancer treatment:

individuals encounter a diverse array of side effects, which differ based on the specific type of treatment administered, whether it be surgery, chemotherapy, radiation, hormone therapy, targeted therapy, or immunotherapy. However, fatigue and nausea emerge as near-constant companions across these treatment modalities.

• Fatigue

is the most prevalent side effect experienced during cancer treatment. Distinguishing itself from ordinary tiredness, cancer-related fatigue persists even with rest and significantly impacts daily functioning. It may persist beyond the completion of treatment.

If you're grappling with fatigue amid breast cancer treatment, it's crucial to communicate with your healthcare provider. They can conduct tests to identify potential underlying causes such as anemia, which may be exacerbated by cancer or its treatments.

Medical professionals may recommend adjustments in pain management, dietary alterations, and strategies to improve sleep quality and duration. Despite seeming counterintuitive, engaging in three to five hours of moderate physical activity per week has been demonstrated to alleviate the effects of cancer-related fatigue.

• Nausea

represents another prevalent side effect encountered during breast cancer treatment, particularly with chemotherapy. It's crucial to discuss nausea management with your healthcare provider to prevent potential complications like vomiting, which may result in dehydration and malnutrition.

Medical practitioners often prescribe antiemetic medications to alleviate nausea. Some individuals may also inquire about the potential benefits of medical cannabis for reducing nausea and stimulating appetite. Additionally, remedies such as ginger tea, chews, or lozenges may provide relief for some.

• The Psychological Impact

Breast cancer treatment exacts not only physical tolls but also profound mental challenges. It's common for both women and men undergoing breast cancer treatment to experience heightened levels of stress, anxiety, and depression. Questions about treatment efficacy, feelings of isolation stemming from limited social support, or concerns about the financial burden of treatment can all contribute to this mental strain. Therefore, alongside managing the physical side effects of treatment, attending to your mental healthcare needs is equally vital.

Numerous coping strategies can offer support to individuals grappling with breast cancer. These include therapy, particularly with a therapist specializing in cancer or chronic illness, mental health medications, participation in breast cancer support groups, engaging in expressive activities such as writing, journaling, or creating art, gentle exercise if feasible, and incorporating meditation or other mindfulness practices into daily routines. It's crucial to reach out to your care team promptly or contact the U.S.-based mental health hotline at 988 if you're experiencing feelings of helplessness or contemplating self-harm.

After the Completion of Treatment:

Following the completion of treatment, individuals with breast cancer necessitate ongoing care to monitor for potential cancer recurrence. Additionally, lingering treatment side effects or the emergence of new ones, known as late side effects, can manifest months or even years after treatment cessation.

• Follow-up care and monitoring for breast cancer

recurrence are guided by recommendations from the American Society of Clinical Oncology (ASCO).

For Men: For men who have undergone lumpectomy to remove breast cancer, ASCO suggests, if feasible, an annual mammogram in the treated breast. Men with a history of breast cancer and a genetic predisposition for the disease may also undergo an annual mammogram in the opposite (non-treated) breast.

For Women: Women are advised to undergo a physical exam every three to six months for three years post-treatment, followed by evaluations every six to twelve months for the subsequent two years, and then annually thereafter.

During these examinations, the healthcare provider assesses the breasts or chest (depending on mastectomy status), chest wall, and underarms. Additionally, evaluations for bone tenderness and density, lung changes, abdominal symptoms, cardiac and neurological changes, and gynecologic health (especially pertinent for those treated with tamoxifen) are conducted.

Routine mammograms are typically performed annually for three to five years post-treatment, transitioning to screening mammograms thereafter. Mastectomy patients may require alternative imaging modalities such as MRI.

While X-rays, CT scans, and PET scans are not routinely recommended for asymptomatic patients post-treatment, they may be warranted if symptoms arise or if standard follow-up protocols suggest cancer recurrence.

• Experiencing menopausal symptoms

post-breast cancer treatment is common and may manifest as hot flashes, night sweats, vaginal dryness, sleep disturbances, mood swings, incontinence, and increased risk of osteoporosis. If you're encountering any of these symptoms following treatment, discussing them with your doctor is crucial.

While hormone replacement therapy (HRT) is typically avoided due to its potential to heighten the risk of cancer recurrence, lifestyle adjustments and complementary therapies are often recommended.

In some cases, antidepressants like SSRIs (selective serotonin reuptake inhibitors) or SNRIs (serotonin and norepinephrine reuptake inhibitors) may be prescribed to alleviate symptoms like hot flashes, although they can also entail side effects. Notably, many post-treatment menopausal symptoms tend to diminish over time without intervention.

• sexual side effects

Following breast cancer treatment, women may encounter a spectrum of sexual side effects, encompassing both physical discomfort and emotional challenges. These may include a decreased libido, vaginal dryness, pain during intercourse, and alterations in self-esteem. Many individuals grapple with these issues silently, hindered by feelings of embarrassment, shame, or uncertainty about where to seek help. However, addressing sexual health concerns is integral to enhancing post-treatment quality of life, and healthcare providers must create safe spaces for these discussions.

For physical symptoms such as dryness and discomfort, healthcare providers can recommend treatments such as vaginal moisturizers, lubricants, or vaginal dilators. Pelvic floor therapy, a form of physical therapy targeting the muscles supporting urinary and reproductive organs, may also be beneficial.

• body image

Breast cancer, particularly in those who have undergone mastectomies, often leads to significant challenges with body image. Following mastectomy, many women experience negative emotions regarding the appearance of scars, feeling less attractive, incomplete, or less feminine. The severity of these emotions can be influenced by various factors, including cultural background, support networks, pre-surgery self-perception, partner attitudes, and societal expectations.

Women facing mastectomy also confront highly personal decisions about breast reconstruction, prostheses, or opting for a flat chest. It's common to grapple with conflicting emotions post-surgery, underscoring the importance of connecting with fellow mastectomy survivors for mutual support. Moreover, seeking guidance from experienced therapists can assist individuals in sorting through societal norms and personal feelings.

Exploring new avenues of body connection can also be empowering. Activities like dancing, swimming, yoga, painting, or simply viewing one's body in a mirror without judgment can foster self-acceptance. Ultimately, it's crucial for mastectomy patients to practice self-compassion as they navigate their evolving relationship with their bodies.