Living With Breast Cancer During and After Treatment

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A breast cancer diagnosis can be a life-changing event. People with breast cancer deal with physical and emotional changes during and after treatment. These changes might include fatigue, nausea, stress, menopausal symptoms, sexual side effects, and poor body image. 

Monitoring for the recurrence of cancer can be worrisome, but it is a crucial part of post-treatment care. Read on to learn what it's like living with breast cancer.

During Treatment

Breast cancer treatment comes with a long list of side effects that vary depending on the type of treatment but almost always include fatigue and nausea. Treatments can include surgery, chemotherapy, radiation, hormone therapy, targeted therapy, or immunotherapy.

Fatigue

Fatigue is the most common side effect of cancer treatment. It differs from regular fatigue in that it doesn't resolve with resting or taking it easy. Cancer-related fatigue feels consuming and affects daily activities. It can even continue for some time after treatment is completed.

Tell a healthcare provider if you're experiencing fatigue during breast cancer treatment. They can order tests to check for an underlying cause like anemia, which cancer itself or its treatments can exacerbate.

Healthcare providers may also suggest pain-management adjustments, nutritional changes, and ways to help you sleep better and longer. Exercise may feel counterintuitive, but three to five hours of moderate physical activity per week can ease cancer-related fatigue.

Nausea

Nausea is another common side effect of breast cancer treatment, especially when receiving chemotherapy. It's important that you speak to a healthcare provider about managing nausea. It can lead to vomiting, which can then lead to dehydration and malnutrition.

There are several medications, called antiemetics, that work to reduce nausea. Some people may also want to ask about medical cannabis. Cannabis might have potential benefits for reducing nausea and increasing appetite. Others may find relief via ginger tea, chews, or lozenges.

Mental Health Effects

Breast cancer treatment is not only physically taxing but also mentally challenging. It's normal for people with breast cancer to feel stressed, anxious, and depressed. You might question the success of your treatment, feel isolated due to a lack of social support, or worry about the cost of treatment.

It's important to take care of your physical self and manage the side effects of treatment. Just don't forget about your mental health needs.

Many people with breast cancer find support through therapy. You can look for a therapist who specializes in cancer or chronic illness. Others benefit from medication, breast cancer support groups, meditation, or activities like writing, journaling, and gentle exercising. Reach out to a healthcare provider right away or dial 988 if you're feeling helpless or are thinking about self-harm.

After Treatment

People with breast cancer require care after their treatment is completed to keep an eye on cancer coming back. Treatment side effects can linger, and new ones (known as late side effects) can show up months or even years after treatment.

Follow-Up Care and Monitoring for Recurrence

The American Society of Clinical Oncology (ASCO) recommends standard exams and procedures. These methods monitor for the recurrence of breast cancer.

Men

The ASCO recommends (if possible) an annual mammogram of the treated breast for men who have had a lumpectomy to remove breast cancer. Men with a history of breast cancer and a genetic mutation that increases their risk of breast cancer may have an annual mammogram in the opposite (non-treated) breast.

Women

Recommendations for women include a physical exam every three to six months for three years following the completion of treatment. Experts then advise women to be examined every six to twelve months for the next two years and once every year after that.

A healthcare provider will check your breasts or chest (depending on if you've undergone a mastectomy), chest wall, and underarms. They'll also check for:

  • Abdominal pain or tenderness
  • Bone tenderness and bone density
  • Cardiac changes
  • Lung changes
  • Neurological changes

A healthcare provider will also perform a gynecologic exam. A gynecologic exam is especially important for those who were treated with tamoxifen. This hormone therapy can increase the chances of endometrial cancer.

Next is a mammogram. Women typically receive a diagnostic mammogram every year for three to five years after breast cancer treatment. They can usually later switch to screening mammograms after that. Mammography might not be recommended if you've had a mastectomy. A healthcare provider will rely on a physical exam and may recommend an MRI.

Other tests, including X-rays, CT scans, and PET scans, are not standard after breast cancer treatment in those without symptoms. These tests may be recommended in people who have symptoms or if standard follow-up procedures suggest cancer recurrence.

Breast Cancer Screening Guidelines

The U.S. Preventative Services Task Force (USPSTF) advises women and people assigned female at birth to get mammograms every two years starting at age 40. This is 10 years earlier than the previous guidelines. More research is needed on whether people with dense breasts need additional screenings and the potential benefits and risks of screening those older than 75.

Early Menopause

Menopausal symptoms are common after breast cancer treatment and may include:

  • Emotional and mood changes
  • Hot flashes
  • Night sweats
  • Trouble sleeping
  • Vaginal changes, including dryness

It's important to talk to a healthcare provider if you have any of these symptoms after breast cancer treatment. Hormone-replacement therapy (HRT) is not usually recommended for early menopause or menopausal symptoms after breast cancer treatment. HRT can increase the chances of recurrence. Healthcare providers typically advise lifestyle changes and complementary therapies.

Antidepressants, including selective serotonin reuptake inhibitors (SSRIs) and serotonin and norepinephrine reuptake inhibitors (SNRIs), can help reduce hot flashes. These drugs also come with their own set of side effects. Post-treatment menopausal symptoms often go away on their own over time.

Sexual Side Effects

You can experience sexual side effects, both mental and physical, after breast cancer treatment. These may include:

  • Loss of libido (sexual desire)
  • Vaginal dryness
  • Pain during intercourse
  • Changes in self-esteem

Many people feel embarrassed and ashamed, not knowing who to turn to for help. Some might not know what kind of help exists. They may think addressing their sexual health is "frivolous" or wasting their healthcare providers' time. Healthcare providers, too, need to do a better job of making space for these important conversations.

Sexual well-being is actually closely linked with quality of life after breast cancer. A healthcare provider might recommend vaginal moisturizers or lubricants and vaginal dilators to ease dryness and discomfort. They can also recommend pelvic floor therapy. This type of physical therapy targets the muscles that support the urinary and reproductive organs.

Just as important as tending to physical side effects is caring for emotional ones. Behavior interventions that help include in-person or online sexual health programs, support groups, and therapy.

These tools help by:

  • Educating people about their "new" bodies
  • Helping them re-discover what feels good
  • Increasing self-esteem
  • Reducing anxiety and distress surrounding sex
  • Teaching them how to communicate with partners

Less is known about how men fare after breast cancer treatment, but they may also experience side effects. Taking estrogen-receptor-blocking drugs, such as tamoxifen, may lead to hot flashes and sexual dysfunction. Speak with a healthcare provider if you experience these or other symptoms.

Body Image

Breast cancer can have a negative impact on body image, especially in people who've undergone mastectomies (breast removal surgery). Some people report negative emotions about the appearance of scars. Others might feel less attractive than before surgery, incomplete, less feminine, or less sexually desirable.

The severity of these feelings can depend on a person's culture, support system, how they felt about themselves before surgery, their partner's attitude, and societal pressures or expectations. People who undergo mastectomy also make highly personal and often stressful decisions. You may need to decide whether to have breast reconstructive surgery, wear a prosthesis or padding, or "go flat" (mastectomy without reconstruction or prosthesis).

It's normal to wrestle with confusing feelings after breast removal surgery. Connecting with other people who've had a mastectomy can be so helpful. Having a support system that understands what you're going through is invaluable. An experienced therapist can guide you as you sort out your thoughts and feelings.

It can also be affirming to find new ways of connecting with your body. Examples include dancing, running, yoga, meditation, painting, or viewing your body in a mirror without judgment. Perhaps the most important is to treat yourself with kindness and compassion as you navigate your changing body.

A Quick Review

Fatigue, nausea, and stress are among the most disruptive side effects during breast cancer treatment. You may experience various side effects from treatment, even when treatment is complete.

A healthcare provider may advise follow-up exams and procedures to monitor for the recurrence of breast cancer. There are many tools available to help with the physical and mental effects of breast cancer during and after treatment.

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15 Sources
Health.com uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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