Breast Cancer: What Happens After Treatment?
For many women, completing breast cancer treatment is often accompanied by a sense of relief -- especially, of course, if it appears that the treatment was successful. But hard on the heels of treatment, most survivors begin to wonder about the chances of a recurrence; what they can do to prevent or lower the likelihood of recurrence; if and how the cancer might continue to affect them in the near and long term; and a multitude of other questions. Here are 10 frequently asked questions, and straightforward answers, about what happens after breast cancer treatment.
What happens after I’m done with treatment?
Following any major medical treatment, you should discuss in detail a follow-up plan with your doctor. After all, a person who has already had breast cancer is at greater risk for developing a new breast cancer than someone who has never had cancer before. Having regular follow-ups with your doctor will help determine how well you are recovering and monitor any possible side effects.
Do I need to continue to seek medical care?
Yes, absolutely. Follow-up treatment may include general physical examinations, x-rays, mammograms and pelvic exams. Depending on the type of follow-up care you are receiving, you may need to visit the doctor anywhere from two to four times a year -- and possibly more if you are experiencing serious side effects.
Will I have lingering symptoms?
It’s possible that you will. Some symptoms that women have reported experiencing following breast cancer treatment include blurred vision, headaches, dizziness, chest pain, weight loss and unusual vaginal bleeding. If you experience any of these symptoms -- or, in fact, any others that concern or alarm you -- consult your doctor right away on what to do next.
Are there possible long-term side effects?
It's certainly possible. If a woman has had radiation therapy to the axillary lymph nodes (in the underarm area) or has had any removed, she may be at risk of developing lymphedema in the following weeks or even years after the surgery. Lymphedema occurs when lymphatic fluid builds up and causes swelling in the arm and hand, and sometimes in the chest or back. Lymphedema (which currently has no cure) can be controlled with various treatments, including targeted exercise regimens, Avoiding excessive or prolonged constriction of the affected body part(s), avoiding trauma (protecting against falls, etc.), and more.
What is “chemo brain”?
If you’ve heard this phrase before, it refers to the phenomenon of patients experiencing mental changes following chemotherapy and/or the effects of other treatments. Such mental changes may include trouble multi-tasking, difficulty focusing, and forgetfulness. For some people, the effects are only temporary, while for others, the mental changes are long-term. Chemo brain is a relatively new area of research, so its exact causes are not yet known.
How will I know if the cancer comes back?
It is important to establish a follow-up care plan with your doctor so that any signs and symptoms of recurrent or new breast cancer can be detected and treated as early as possible. Women should also conduct monthly breast self-examinations. Here is how to do a breast self-exam.
If the cancer comes back, will it come back in the same place?
It depends. If the cancer comes back in the same breast or same side of the chest wall, this is referred to as local recurrence. The other two types of recurrence are regional — when the cancer recurs in the axillary lymph nodes or lymph nodes around the collar bone — and distant, when the cancer metastasizes outside the breast and surrounding lymph nodes.
What are the chances of my cancer coming back?
Chances of breast cancer recurrence depend partially on the type of treatment a patient originally received. For women who have had lumpectomy plus radiation therapy, the chance of local recurrence is about seven to 12 percent in 10 years. For women who have had mastectomy and whose lymph nodes did not contain cancer, the chance of local recurrence is about six percent in five years. For women who have had a mastectomy and who had cancer in one to three lymph nodes, the chance of local recurrence is about 16 percent in five years; when there has been cancer in four or more lymph nodes, the number jumps to about 26 percent.
What are the risk factors for breast cancer recurrence?
The following list includes some factors that can increase risk of breast cancer recurrence after receiving treatment:
- Large tumor size
- Being under age 35
- Having inflammatory breast cancer
- Cancer that has spread to many lymph nodes
- Having a lumpectomy with no radiation treatment
Can I enjoy the same lifestyle I did before I was diagnosed?
Breast cancer survivors may have to be more cautious about choices they make regarding their health and lifestyle in order to reduce risk of recurrence. According to the World Cancer Research Fund and American Institute for Cancer Research (WCRF/AICR), women who meet the following recommendations may reduce their risk of recurrence by nearly 50 percent.
- Limit alcohol intake. Studies have found that consuming no more than one alcoholic drink per day may reduce breast cancer risk by more than one-third. Sugary drinks should also be avoided.
- Limit meat intake. Experts recommend consuming a mostly plant-based diet and aiming to consume at least five servings of fruits and vegetables and at least one serving of whole grains per day. Salty and processed foods should also be limited, and nutrient-rich foods should be favored over supplements.
- Manage weight. Women should eat a healthy diet and get at least 30 minutes of exercise per day in order to manage their weight. A typically healthy body mass index (BMI) is 18.5 to 25; women should strive to stay in this range and avoid becoming either under or overweight.