Long-Term Effects of Breast Cancer Treatment: How to Prepare
13 Apr 2017
We’ve previously discussed how you can manage some of the short-term side effects of different breast cancer treatments. But there are also several long-term side effects of breast cancer that you should be aware of. The sooner you can prepare yourself for these side effects, the more your quality of life after breast cancer treatment will benefit.
That being said, it’s extremely difficult to predict which long-term side effects you may experience. This is because you handle certain drugs and treatments differently than other women. Still, it’s a good idea for you to know about some of the common side effects that you may be facing.
Early menopause is a common long-term side effect caused by chemotherapy and hormone therapy.
If you’re under the age of 40, these treatments can temporarily stop your regular menstrual cycle. In most situations, your periods do return several months or years after treatment has finished. However, you may still experience menopause earlier than average due to the damage that the chemotherapy drugs caused to your ovaries.
The effects of the treatment drugs are different if you’re over the age of 40. In this situation, you’ll most likely experience a permanent halt in your menstrual cycles. As a result, you’ll experience all the normal symptoms of menopause. This includes vaginal dryness and hot flashes. These symptoms are often more severe because they resulted from a sudden onset of menopause.
This problem can also negatively affect your bone health. The density of your bones may decrease and you may experience joint and muscle aches. This is another reason to consider weight training (it strengthens bones). Be proactive and consult with your physician and/or a Pink Ribbon Program-certified instructor regarding beneficial exercises during and after breast cancer treatment. And be sure to check out tomorrow’s (April 14, 2017) post here that features the founder of the Pink Ribbon Program explaining myths and facts about exercise after breast cancer.
For many women, the idea of early menopause is extremely distressing. Not only does it cause additional discomfort during your breast cancer treatment, it can also affect your future plans to have children. If you plan on having children after your breast cancer treatment, you may discuss your option with a fertility specialist. They may recommend that you store some of your embryos in case you experience permanent early menopause.
On the other hand, research shows that cancer treatment during pregnancy (even first trimester) is most likely safe for the baby, so getting pregnant prior to treatment may be an option for you. And if you’re wondering about breastfeeding during or after treatment for breast cancer, check out some of our articles on the topic. Of course, make sure to discuss these things with your doctor.
Currently, there aren’t any known treatments that prevent early menopause and protect the ovaries from damage during breast cancer treatment. This is why planning ahead is extremely important in the management of this side effect.
This side effect usually results from chemotherapy and is particularly common if you also experience early menopause.
During chemotherapy, you’ll most likely have a less active lifestyle due to the many short-term side effects of treatment (although it’s still best to engage in moderate exercise as able). On top of that, many chemotherapy drugs change how your metabolism functions and often slows it down. As a result, you’re likely to gain some weight.
According to Komen, women who had chemotherapy to treat breast cancer had a 65 percent higher chance of gaining weight than women who didn’t have chemotherapy. On average, women gain between 5 to 15 pounds. Since this amount is so small, you may not want to put in the effort to lose the extra weight. However, the more weight your gain during treatment, the less likely you are to return to your pre-diagnosis weight.
Although weight gain is technically a long-term side effect, it can easily be managed. Make sure you regularly eat three meals a day to keep your metabolism functioning properly. And do your best to avoid snacks. Focus on eating foods that are high in fiber, protein, and healthy fat. You can also manage your weight by eating each meal slowly and avoiding other activities while you eat. Finally, consider meeting with a dietitian and/or personal trainer to help. If you’re lucky, there’s a Pink Ribbon Program-certified fitness instructor in your area. They’re specially trained to help women get back in shape after breast cancer. Even if not, you can still give one of them a call, or enroll in their online program (it’s only $20 for three months!).
Another common side effect of chemotherapy, cognitive problems can be either short-term or long-term side effects. In many cases, these issues last for several years after your treatment. Fortunately, they do generally go away over time.
Cognitive problems related to chemotherapy revolve around your ability to multi-task, concentrate and memorize things. It is believed the stress and anxiety are the primary cause of these problems. As such, you may start experiencing problems with concentration or multi-tasking following your diagnosis. However, chemotherapy does appear to worsen these cognitive problems. Unfortunately, it is unclear whether it is the chemotherapy drugs that worsen the issue or the additional stress of going through treatment.
Despite not being well understood, cognitive problems are manageable. Getting extra rest during your treatment phase can improve the functioning of your brain. It can also be helpful to plan all of your days and use calendars to remember important dates. Patient navigators can help you with keeping track of clinic visits, as can friends and family. Meanwhile, you should use a pill box to keep track of your medications.
It’s rare for women to experience heart problems as the result of their breast cancer treatment. But it’s still a possibility.
Heart problems can result from chemotherapy or radiation therapy. Yet it is more often seen among women who have had chemotherapy. The development of certain heart problems depends on the specific chemotherapy drug you are given. Most heart problems have been linked to trastuzumab, doxorubicin, and epirubicin. If your physician prescribes any of these chemotherapy drugs, they should carefully measure your heart function before and during treatment.
Heart problems can sometimes be avoided when heart damage is caught early on. Once any signs of heart damage is found, the chemotherapy drugs causing the damage should be stopped. If you’ve already developed a heart problem, you must follow your physician’s recommendations for treatment and lifestyle changes to reduce your risk of harm.
Lymphedema is a condition that results following a lumpectomy or mastectomy. It can also be caused by radiation therapy. This condition causes the fluid from the lymph nodes to collect in the arm, back, chest, or fingers. As a result, the affected area swells up.
Most cases of lymphedema develop within three years following your breast surgery. The condition is often accompanied by a feeling of tightness in the hand or arm or tightness in the skin. Your arm and hand may also become red and painful as lymphedema develops. If you notice any of these signs, you should discuss them with your physician right away.
There are a few things that increase your risk of developing lymphedema. These include having a large number of axillary lymph nodes removes, being overweight, and having cancer in a large number of axillary lymph nodes. Fortunately, you’re much less likely to develop lymphedema than women in the past.
Lymphedema Treatment and Prevention
Once lymphedema has developed, you cannot cure it. However, treatment can reduce pain and improve movement. Wearing a compression sleeve pushes fluid out of the arm and reduces tightness. Meanwhile, certain exercises can improve your condition, as can good skin and nail care.
You can also reduce your risk of developing lymphedema by taking extra steps to prevent infection or injury following your breast surgery. Always keep your skin clean and moisturized and wear gloves when doing any sort of work around the house. When getting blood drawn, use the arm that’s not at risk for developing lymphedema. You can further reduce your risk by resting your at-risk arm at an elevated position, avoiding sunburns, and using insect repellent while outside.
Being aware that lymphedema is a possible side effect also helps because you can report some of the first signs of the condition to your physician. This won’t stop lymphedema from developing, but it can make treatments more effective.
Changes to the Breast
If you’re going through breast cancer, you know that your breast will most likely change. However, there are some changes that are brought on by radiation therapy. This is part of the reason why certain types of breast reconstruction are not recommended if you are receiving radiation therapy following your mastectomy.
There are several changes that you may notice when you get radiation therapy. But the most common changes relate to the color and shape of your breast.
Over time, radiation therapy often alters the firmness of the breast. The skin around the treated area may also appear firmer. Further, radiation therapy can shrink the size of the breast. Meanwhile, the skin around the treated area may become tanned or develop a red discoloration. This discoloration may disappear for your once treatment is done. However, some women do note that these changes in color have been permanent.
Beyond changes in firmness, size, and color, radiation therapy can damage the nerves. You may experience numbness and pain around the treated area following radiation therapy. While this is not always a permanent change, it can limit your ability to breastfeed. However, many women can still breastfeed after and between radiation treatments. It may also limit your options for breast reconstruction.
Finally, you may experience some cell damage resulting from radiation therapy. Depending on the specific cells that are affected and the amount of damage, this can have long-term effects on your health.
Since radiation therapy for breast cancer typically targets the chest area, your lungs and heart are the most at risk. Extensive damage to either organ can cause certain life-threatening conditions. If you receive radiation therapy anywhere else on the body, then different organs may be at risk. Some people experience fertility, sexual, and bladder problems after receiving radiation to their pelvis and abdomen.
While the risk of extensive cell damage is relatively low, it’s a good idea to discuss your concerns with a physician. Doing so provides you with more detailed information about your personal risks related to radiation therapy.
We certainly did not cover every long-term side effect of breast cancer and breast cancer treatment. To learn more, please feel free to look at Johns Hopkins Medicine’s article about the subject. It includes a list of common long-term side effects, along with a couple videos.
You can also check out Komen’s article about the long-term and late effects of breast cancer. Through that, you can find articles discussing each specific long-term side effect.
We know that it’s no fun to consider these possibilities, but at least you’re now familiar with them. You know you’re not alone if you do experience them, and you may even find ways to lessen their impact on your life.
01 Aug 2017 - I'm Taking Charge - Life After Breast Cancer