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Treatment side effects

Treatment side effects, and the fear of them, can be the source of major physical and emotional stress for young women with breast cancer.

Because they vary in intensity with each person, it’s hard to know exactly what you’re facing when you’re weighing your treatment options. Worst possible scenarios (we all go there) and fear of the unknown can make us crazy with worry, but most treatment side effects can be controlled and quite often they go away when your treatment ends.

Talk to your doctor or nurse about the possible side effects of your specific treatment. Knowing more can help you feel in control of what’s happening to your body.

Common chemo side effects

Chemotherapy uses various combinations of drugs to kill cells throughout the body that multiply quickly.

This makes it very effective at stopping the spread of cancer cells, which is great news. But it also zaps fast-multiplying healthy cells – like the ones in our mouth, intestines, bone marrow (where blood cells are made) and scalp – which is not such great news.

Different chemo drugs have different side effects, but the most common among them are:

• nausea and vomiting
• fatigue
• hair loss
• mouth ulcers
• bladder irritation
• diarrhea
• sensitivity to smell

If you’re experiencing any of these side effects, talk to your doctor or nurse. A lot can be done to relieve or reduce them. In some cases, changes in your treatment can help.

The fertility effect

Chemotherapy can have temporary or permanent effects on a pre-menopausal woman’s fertility.

These effects vary from drug to drug and person to person. You may have other menopausal symptoms, such as hot flashes, during treatment. But all of these effects may well end when your treatment ends, returning you to a normal menstrual cycle and fertility.

If you are concerned about the permanent loss of your fertility, talk to your doctor about what can be done to help.

The Herceptin effect

Prescribed after chemotherapy, Herceptin’s job is to block HER2 and lower the risk of your breast cancer recurring.

Typical side effects of Herceptin are mild. You may get flu-like symptoms after each dose, but there are medicines that can help make you feel better. Less typically, Herceptin can cause heart problems, so you will be monitored on this drug. If you already have heart problems, you may not be able to take Herceptin.

Lymphedema

Lymphedema is a long-term swelling caused by poor drainage of excess fluid.

It can appear in the hand(s) and arm(s) and sometimes on the same side as the breast treated for cancer. It can occur months or even years after surgery or radiation. The more lymph nodes you have removed as part of your breast cancer treatment, the more likely you are to develop lymphedema.

For most women the symptoms are mild; others may experience discomfort or pain. The skin on your arm(s) may become dry and tight and your arm(s) may feel heavy, restricting its mobility.

After your breast operation, your arm may swell for a short time. This isn’t really lymphedema.

If you have swelling or feel pain on the same side that you had your surgery, see your doctor or breast care nurse.

Although there is no cure for lymphedema, there are exercises and specialized massages that can help reduce the effects.

Changes in your appearance

Common treatment side effects that cause unwelcome changes in your appearance can be upsetting, but there are lots of ways to cope well with each of them.

Hair loss can happen during chemo. You may lose the hair on your head as well as your eyebrows, eyelashes and pubic hairs. It will likely grow back after your treatment ends, but it may be a new colour or texture.

To keep your hair for as long as possible:

• be gentle in combing or styling your hair (give the flat iron a rest for now)
• use mild shampoos
• forgo permanents or relaxers
• cut your hair short to make it look fuller

To cover your head is your choice:

• think in advance about if and how you would want to cover your head
• discuss it with your family and/or friends
• scarves, hats, wigs and false eyelashes are all options
• try some out before you lose your hair to see what feels right for you

Skin Problems, such as redness, irritation and dryness, can often result from radiation.

These side effects can sometimes cause discomfort, but in many cases you can relieve and even prevent them.

• Treat your skin like you would if you had a sunburn. But not all lotions can be used during treatment, so always check with your doctor first.
• Don’t shave the underarm area of the treated side; if you must, use an electric razor.
• Protect your skin from the sun with doctor-approved sunscreen (at least SPF 15) during and after your treatment.

Weight gain or loss can create stress over your body image. Some people gain weight with chemo. If this is a problem for you, you can:

• try to maintain your normal body weight with a balanced diet and exercise. Sometimes just walking and simple stretches do the trick.
• buy some new clothes that are comfortable and flattering – nothing like fashion therapy to offset stress
• accessorize – makeup, jewelry or even a new handbag has a way of diverting attention away from the negative

Breast surgery changes your body

Whether you’re left with a small scar or you’ve had an entire breast removed, your feelings about it are unique to you and how you choose to proceed is a decision you make for yourself. Many women who have undergone mastectomies and even lumpectomies opt for breast reconstruction. Some women prefer to go with prosthesis and some accept their battle wounds.

Breast reconstruction

This an operation that uses a breast implant or tissue from somewhere else in your body to construct a new breast that looks as much like your other breast as possible. You may be able to have it done at the same time as your mastectomy or lumpectomy. Talk to your surgeon about your options and concerns.

Breast prostheses

These are artificial breast forms that you can wear inside your bra. You can also get a prosthetic silicone nipple, so when you’re dressed you look the same as before your breast cancer surgery. Talk to your breast care nurse about the various types of breast prosthesis products available.

Bone Density

Bone density refers to the amount of calcium and minerals in an area of bone and is a measurement of bone strength. After the age of 35, bone loss increases naturally with age and can eventually lead to a condition called osteoporosis, which leaves bones fragile and prone to breaking. Pre-menopausal women who have been treated for breast cancer with chemotherapy may be at an increased risk of developing osteoporosis.

Osteoporosis in women who have had breast cancer is often treated with bisphosphonates. These drugs may also be prescribed alongside an aromatase inhibitor to protect against the possible effects on the bones. Bisphosphonates are also used to treat secondary breast cancer in the bone.

If you develop osteoporosis, you will be advised about any drug treatment that is necessary as well as diet and lifestyle changes that may help.

The fertility effect

Concerned about fertility? Check-in with our friends at Fertile Future.

Tell your story

TellHER2 is a social network designed to connect, support and inspire Canadian women touched by HER2+ breast cancer.

Breast cancer now what?

Breast cancer now what? the website where you will find information, online support and resources for young women with breast cancer.