jueves, 18 de octubre de 2018

Living with Breast Cancer

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By Yolanda Smith, B.Pharm.Reviewed by Susha Cheriyedath, M.Sc.

Women with breast cancer, who have undergone treatment to eradicate the abnormal cell growth and come out on the other side as a survivor, can experience a complex set of challenges as they recover.

In particular, there can be complex emotional and physical changes to face as they continue with their lives. Learning to adjust to these changes can be stressful, and every woman will respond differently.

Physical Changes

For women who have had a mastectomy, they will need to make decisions about whether they’d like to have a breast reconstruction.

This can be a difficult choice for many women, as there is often a lack of desire for additional therapy but a significant feeling of loss about no longer having the breasts.

Some women may choose to wear a prosthesis, others will opt for a breast reconstruction, and others will decide to continue as they are. The right choice for each patient depends on her personal preference.

For patients diagnosed with breast cancer before the age of menopause, the treatment for breast cancer can often induce early-onset menopause symptoms.

Symptoms such as hot flashes, vaginal dryness, and loss of libido may be more distressing for these women as they occur more suddenly and earlier than they expected.

Cognitive Changes

Many patients who undergo chemotherapy as a treatment for cancer report a reduction in mental clarity following the treatment.

For many women, this can continue for several months or years after the conclusion of therapy and affect their performance at work and ability to fit back into everyday activities.

They may have difficulty remembering things or struggle with multitasking. These changes will usually improve with time, and there are strategies to help individuals to cope in the meantime, such as keeping a detailed planner to keep track of important dates and ideas.

Emotional Changes

Many women find that the emotional aspect of having breast cancer and the treatments for the condition to be taxing.

In particular, the loss of breasts for women who have had a mastectomy can be associated with a loss of part of their feminity, which can lead to sensitive feelings surrounding this.

Additionally, although there is a significant relief to have completed treatment, many women are worried about the recurrence of cancer, which can take an emotional toll on their mind.

Fertility and Pregnancy

Some treatments for breast cancer can interfere with a woman’s ability to conceive, and there is currently no test to determine the fertility status of a woman following therapy.

In general, if a woman does not experience a period for more than a year, it is most probable that the transition to menopause will be permanent and it won’t be possible for her to have children via natural conception.

Some women may conceive after having treatments for breast cancer, and current evidence does not indicate any increased risk of cancer recurrence related to the pregnancy.

Follow-up Care

Life for women who have achieved remission for breast cancer will quickly become aware of the ongoing nature of the disease and the need for follow-up care to monitor the situation.

Regular medical appointments are recommended, particularly in the first few years following treatment, to assess changes and look out for any signs that may be indicative of cancer recurrence.

Some side effects of cancer or cancer treatment may be delayed and become noticeable several weeks or months later.

Follow-up care usually includes:

Medical appointments with a doctor to discuss health and symptoms and have routine tests.
Mammograms or MRI to detect changes in the breast tissue.
Pelvic exams to detect early signs or uterine cancer, which is a possible side effect of some hormonal treatments for breast cancer (e.g. tamoxifen or toremifene)
Bone density test to monitor bone health because osteoporosis is a possible side effect of some medications for breast cancer (e.g. anastrozole, letrozole, or exemestane)

Transitioning to “Normal Life” and Support

It is essential for women to give themselves some room and realize that what is normal now might be different to what they considered as normal before the diagnosis, and this is okay.

Finally, the support network around a woman who is recovering from breast cancer plays a key role in promoting her health.

If the family and friends of the affected woman can be understanding of the situation and offer help when needed, this can have an immeasurable benefit for the woman.

Clear communication is essential for this support to happen in a positive way. It can often be difficult for family and friends to truly understand how the woman is feeling, and they may expect the woman to return to their “old self” more quickly than the woman feels she is able to.

However, it is important for them to attempt to understand as best they can and provide their love and support throughout the recovery process.