A: Radiation has several side effects. The most common include:
- Skin reactions on or near the radiated area. You may notice itchiness, dryness, soreness, redness and blistering. Wearing loose-fitting cotton shirts and bras, avoiding harsh soaps, using moisturizer specially formulated for women undergoing radiation therapy, dusting the breast area with cornstarch to absorb moisture and reduce friction, and keeping the treated area away from sun and chlorine can help minimize these side effects. Salves and medications may also be prescribed to ease discomfort. Ask your radiation nurse and radiation oncologist for suggestions on ways to keep your skin moist and comfortable.
- Fatigue. Because the effects of radiation treatment build up over time, your fatigue may increase later in your treatments. Expect to feel tired in the last few weeks of treatment, and plan time for naps and resting. Minimizing stress, maintaining a balanced diet and establishing an exercise routine can help boost your energy. And remember to ask for and accept help when you need it.
- Pain because of swelling and irritation of the nerves in the tissues. Anti-inflammatory medications such as acetaminophen (like Tylenol) and ibuprofen (for example, Advil) can help ease any pain you may have during treatment. Ask your doctor or pharmacist before starting any medicine.
Other less common side effects may include lymphedema, rib fractures and some rare cancers. Talk with your doctor about the risks, benefits and side effects of radiation in order to make the best decision for you. You may also want to think about joining a support group to talk to others who are going through the same treatment. To find someone to talk to, call the Breast Cancer Helpline at (888) 753-LBBC (5222). We can match you with a woman who is in a situation similar to yours.
A: Chemotherapy affects different people in different ways. Some people have many side effects, while others have very few of them. Your chances for having side effects depend on how healthy you are prior to before treatment, the type of cancer, the stage of the cancer, and the kind and dose of chemotherapy you receive.
Common side effects of chemotherapy include:
- Nausea and vomiting. Drinking lots of fluids, eating bland foods and avoiding large meals, acupuncture, taking anti-nausea medicine, and reducing anxiety through meditation can help minimize mild nausea. If you use an anti-nausea medicine, make sure to take it as prescribed; these medicines work better when taken before nausea develops. If you have severe nausea, your doctor can prescribe stronger anti-nausea medications such as steroids or administer intravenous fluids. Talk to your doctor if you experience nausea more than three days after chemotherapy and you are already taking anti-nausea medications.
- Hair loss from chemotherapy, although temporary, is one of the most visible and most emotionally disturbing side effects of cancer treatment. Your hair may fall out completely, thin or not fall out at all, depending on which chemotherapy medication you are taking. Your reaction to hair loss from cancer treatment may vary and depend on several things, including your individual feelings about and cultural importance of hair, how much hair loss is expected and whether you have enough information to prepare for the loss. Even with enough information, you may still feel truly devastated when your hair begins to fall out. Preparing ahead of time for your hair loss can help you feel more in control. Using mild shampoos and soft brushes and wearing a wig or scarf can help minimize the impact of hair loss.
- Fatigue is often a result of anemia, or a lower number of red blood cells than normal. There are several treatments for anemia, including some vitamins and minerals and blood transfusions. Remember to get plenty of rest, get moderate exercise, eat a well-balanced diet and accept help from others for daily chores and activities.
- Infection. Because chemotherapy affects all dividing cells, it sometimes damages fast-growing, non-cancerous cells in your body, like white blood cells that protect the body from infection. Your doctor may prescribe medicines such as filgrastim (Neupogen) if your white blood cell counts drop. Washing your hands with anti-bacterial soap, staying away from people who are sick and avoiding cuts can also minimize your risk of infection.
- Menopausal symptoms and the resulting loss of estrogen can lead to bone loss and cause hot flashes, night sweats, vaginal dryness and loss of interest in sex. Chemotherapy may cause temporary or permanent infertility depending on type and dosage of mediation and your age at the onset of treatment. Talk to your doctor about medications you can take to protect your bones. If you are of childbearing age and you are interested in continuing your family after chemotherapy is over, discuss your options and concerns with your doctor. For more information, you may also visit our website community for young women affected by breast cancer.
- Memory loss, or "chemo brain," has been reported by many women during and immediately after chemotherapy treatment. Getting plenty of sleep, maintaining a routine and reducing stress and anxiety can help you maintain your ability to think clearly and concentrate. Because the connection between chemotherapy and mild memory loss is still unclear, researchers hope to find out how different types of chemotherapy and the dosage and length of treatment affect memory and concentration.
Other possible side effects from chemotherapy include neuropathy (discomfort in the hands and feet), mouth and throat sores, taste and smell changes, diarrhea, and weight gain or loss. Talk with your doctor about the risks, benefits and side effects of chemotherapy in order to make the best decision for you. You may also want to think about joining a support group to talk to others who are going through the same treatment. To find someone to talk to, call the LBBC Breast Cancer Helpline at (888) 753-LBBC (5222). We can match you with a woman who is in a situation similar to yours.
A: Both tamoxifen and the aromatase inhibitors are hormonal therapies, a type of targeted treatment that seeks to prevent your breast cancer from coming back by lessening the effects of estrogen. Hormonal therapies lessen the effects of estrogen by blocking the growth of hormone-sensitive breast cancer cells.
All hormonal therapies, but especially tamoxifen, carry an increased risk of blood clots and stroke. You should discuss any history of heart problems with your doctor, and call your doctor if you notice swelling, redness, discomfort or warmth in your legs. Sometimes you may need to take a blood-thinning medication such as aspirin along with hormonal therapy. Tamoxifen also carries a small but increased risk for uterine (endometrial) cancer. You should report any unexpected vaginal bleeding to your doctor immediately.
Aromatase inhibitors put you at higher risk for bone thinning, osteoporosis and bone fractures. A major study recently found that zoledronic acid (Zometa), a bone-strengthening medication, may prevent bone difficulties. Zoledronic acid is a bisphosphonate, a type of medicine that strengthens and builds bone. There are several bisphosphonates available that help slow or lessen bone thinning.
Aromatase inhibitors may also cause joint pain, which can be relieved by over-the-counter pain medicines. Low vitamin D3 levels can cause joint pain to be worse. If you continue to have joint pain, you should get your vitamin D3 level checked by your doctor.
Other side effects include muscle aches and stiffness, mild nausea and a possible increase in cholesterol levels. Talk to your doctor if you have a family history of heart disease. You may need to watch your cholesterol level carefully and make sure it remains low with lifestyle choices such as a low-fat diet, exercise and losing or maintaining weight.
The most common side effects of both medicines are:
- Hot flashes. Although hot flashes are among the most common complaints about hormonal therapies, recent studies have suggested that women who have them get more benefit from tamoxifen than those who do not. If you take tamoxifen, hot flashes may indicate that the medicine is being converted into a more powerful version in your body. Stopping your treatment for a week or two, then restarting with a lower dose of tamoxifen or aromatase inhibitors (if you are postmenopausal) and slowly increasing the dosage over time may also help your body adjust. Talk to your doctor about these options if hot flashes are a problem for you.
- Fatigue. Because hormonal treatments lessen the effects of estrogen, you may feel a loss of energy. Making time for yourself to do something you enjoy can boost your energy level. Remember to get plenty of rest, get moderate exercise, eat a well-balanced diet and accept help from others for daily chores and activities.
- Difficulty sleeping and night sweats are often caused by the onset of menopause. If your difficulty sleeping is due to menopausal effects such as night sweats, treatment with medications called hypnotics or antihistamines may help you. A variety of other sleeping aids may also be used, including complementary therapies like acupuncture and yoga.
Talk with your doctor about the risks, benefits and side effects of each family of medicines in order to make the best decision for you. You may also want to think about joining a support group to talk to others who are going through the same treatment. To find someone to talk to, call the LBBC Breast Cancer Helpline at (888) 753-LBBC (5222). We can match you with a woman who is in a situation similar to yours.
All FAQs reviewed by Lillie Shockney, RN, BS, MAS