Because cancer is part of your body, it is difficult to find and kill cancer cells without harming your own body. Most cancer treatments have some side-effects, but just as each patient has an individualised treatment plan, each patient may have different responses to the different treatments.
If you are undergoing cancer treatment it is important to keep in close contact with your family doctor and your specialist doctors. They will help you manage the side-effects more easily.
Any operation can cause pain in the region surrounding the operation site. This pain should be short lasting and you should speak to your specialist doctor or nurse to help you with painkillers for a limited time. Pain can sometimes be a sign of infection so it is important if the pain is getting worse and not better to seek advice.
After a mastectomy, women can sometimes experience ‘phantom breast pains’ which means they experience feelings of pain or tenderness that appear to come from the breast that is no longer there. This is because the nerves to that breast have been cut as part of the mastectomy operation. Sometimes it takes some time for the body to learn that the breast is no longer there and adjust to the sensation of no longer having a breast. This may still happen even when the breast has been immediately reconstructed.
Pain can sometimes be a sign of infection so it is important if the pain is getting worse and not better to seek advice.
In order to remove a breast, the nerves in the skin and tissues below must be cut. This will lead to a feeling of numbness in the area the nerve supplied, normally over the skin of the chest area, and often in the inner aspect of the upper arm. It is normal to lose some sensation in these regions and it can take a number of years for sensation to return.
It is also important to remember if you have reconstruction of the nipple, that this nipple will not have the sensation of your previous nipple.
When a woman undergoes mastectomy it can take some time for her to adjust to the new feeling of weight distribution in her chest, particularly if she is large breasted. There may be feelings of imbalance, which can cause compensation in the muscles of the back and shoulders leading to pain. This can often be avoided with the consideration of immediate reconstruction of the breast or breast reduction on the other side. An external prosthesis in the bra can also require getting used to.
When a woman undergoes operation and removal of some of the glands under the arm, it can cause swelling in the arm from retained water. This is called lymphedema. The risk of lymphedema is increased when cancer treatment also includes radiation to the armpit.
Approximately one in ten women who have gland surgery will get lymphedema, and this can range from mild swelling to a debilitating condition. A specialist physiotherapist can help with exercises to improve the drainage of the arm, and there are many implements and garments to wear which can also aid the condition.
Patients with lymphedema can prevent the situation from getting worse by avoiding lifting heavy weights, exercising the arm and alerting their doctor to any signs of infection in the arm
Following any major breast surgery the pain of the operation, together with difficulty moving the arm due to drains and bandages, can lead to stiffness in the shoulder and pain on moving the arm. At its worst this can lead to a frozen shoulder, which may require orthopaedic treatment.
Many years ago patients were advised not to move the arm and shoulder for a long time after a breast operation and this made the problem far more common and more severe.
During radiation treatment the skin on and around the breast can become very sensitive and tender. It can be itchy or red too. This is because of the radiation, and will settle down after the treatment ends. Sometimes the skin colour can change or fine veins (‘telangiectasia’) develop over the skin around a mastectomy scar. These are small changes which may be permanent. It is important to discuss any skin lotions or creams a patient might wish to use during treatment with the radiation therapist before using them.
In most women, radiation does not affect the breast shape in any way. Sometimes however, when radiation therapy is used after a lumpectomy or breast conserving surgery, the treatment can result in the breast changing in density or size. The breast can become larger due to swelling within the breast during treatment, and in the long term the breast can become smaller or firmer.
Many women find radiation can leave them feeling tired and fatigued after treatment, particularly later on in cancer management. The fact that the regime requires daily hospital visits can also leave a patient suffering from exhaustion.
The side-effects of chemotherapy drugs depend heavily on which of the drugs are used and in what combination. Most of the side-effects of chemotherapy occur because, along with killing the cancer cells in your body, the chemotherapy can damage some of your ordinary cells. The cells that are most frequently damaged are those that divide and multiple often. These include the cells of the hair and skin, and cells of the gut and intestine. More serious side-effects can include a depressed immune system with an increased risk of infection, and easy bruising or bleeding.
These occur as the cells of the gut are damaged or killed by the chemotherapy agents and take time to replenish. Most of these side-effects can be managed well by your doctor and most of them go away during the recovery part of the chemotherapy cycle.
Many patients fear losing their hair and are surprised to find that many chemotherapy agents do not cause this side-effect. Even if the hair is lost, it will most commonly grow back after the treatment is finished. The selection of wigs and scarves available for women who have lost their hair is extensive, and many charities will support women in looking their best even during chemotherapy.
The sensation of numbness can be uncomfortable or frustrating for a patient. It is a side-effect of some of the chemotherapy agents given in Breast Cancer. Oncology doctors work hard to prevent this becoming a problem in the long term.
Hormonal treatments are designed to starve Breast Cancer of the female hormones it feeds on. It does this by preventing the body making the hormone or preventing it getting to the cancer. This can simulate the menopause in most women who take these treatments. The side-effects are therefore effects of the menopause.
Most of the hormone medications given to patients can affect the joints and bones in some way. They can cause arthritic pains in the joints or muscular aches that can be difficult to tolerate. Some of the medications can also cause thinning of the bones which should be monitored by your doctor.
A hot flash is a sudden rush of blood to the face and neck that can last for anything between a few seconds and an hour. It is difficult to treat with medication but relaxation and loose clothing can often help to cope with these events. The same hormone deprivation that causes this can also cause your vagina to be dry which may cause increased infections in the bladder and painful intercourse.
Some hormonal medications can increase your risk of developing clots (‘thrombosis’) in the veins of the legs and arms. It is important if you take hormone medications to tell doctors if this has ever happened to you before as it may affect the medication you are given.