Breast Cancer Survivors: 10 things to guard against

PJ Hamel | March 20, 2013

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A clean bill of health after a fierce battle with breast cancer is a wonderful thing. But it’s important to stay on guard for other conditions that breast cancer survivors have an increased risk of developing.

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Endometrial/uterine cancer

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The issue: Taking tamoxifen, a long-term hormone therapy drug given to many survivors, increases the risk of endometrial and uterine cancer. Your response: Ask your doctor about the warning signs of these cancers; report any symptoms to your oncologist.

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The issue: Radiation and removal of lymph nodes increases the risk of lymphedema, a painful swelling of the trunk and arm that, if untreated, can lead to cellulitis–which can prove fatal. Your response: Be careful not to injure your arm on the side where you had surgery. Guard against cuts, burns (including sunburn), insect bites, and muscle injuries or fatigue. Report any swelling to your doctor.

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Ovarian cancer

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The issue: Survivors of breast cancer may be at higher risk for ovarian cancer, due to a possible genetic link between the two diseases. Your response: Ask your doctor if you’re a candidate for genetic testing to determine if you’re at higher risk for ovarian cancer. If testing determines you’re at higher risk, consider a hysterectomy.

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Cardiac issues

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The issue: Breast cancer survivors who’ve undergone radiation are often at risk for cardiac issues, starting within a couple of years of the end of treatment, and continuing for 20 years or more. Your response: Be aware that your risk of heart attack or coronary blockage is up to 79 percent higher (for high-dose radiation) than it is for other women. Make sure your GP knows of your increased risk; and follow a heart-healthy lifestyle.

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Menopausal side effects

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The issue: Women whose chemotherapy drives them into premature menopause experience a wide range of long-lasting side effects, both emotional and physical. Taking an aromatase inhibitor as part of long-term treatment exacerbates those side effects. Your response: Some treatments for menopausal side effects increase your risk of breast cancer recurrence. Speak to your oncologist about which are safe to use.

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Blood clots/stroke

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The issue: Women who undergo long-term hormone therapy in the form of tamoxifen are at increased risk for blood clots (especially in the lungs and legs), and stroke. Your response: Immediately report any leg pain and/or swelling; or chest pain/shortness of breath; or numbness; trouble speaking, walking, or seeing; or sudden, severe headache to your doctor.

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Chemo brain

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The issue: Survivors who’ve had chemotherapy often experience “chemo brain,” a distressing loss of cognitive ability and mental functioning. This usually clears up with time, but many say they never return to their former mental acuity. Your response: Don’t panic; you’ll probably improve over time. In the meantime, make lists; cut back on multi-tasking; and exercise your brain (crossword puzzles, Sudoku).

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Bone loss

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The issue: Taking aromatase inhibitors (Femara, Aromasin, Arimidex) to prevent cancer recurrence increases your risk of osteopenia/osteoporosis – loss of bone density that can lead to weakened bones and fractures. Your response: Ask your doctor to schedule regular DEXA scans to track any bone changes. If loss occurs, ask whether you need bisphosphonate drugs to slow down bone deterioration.

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Other cancers

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The issue: Women who’ve had radiation are at increased risk for sarcoma, a type of cancer most commonly occurring in bones and cartilage. Women who’ve had chemotherapy are at greater risk for bladder and blood cancers (e.g., leukemia). Your response: speak to your oncologist. Identify other cancers for which you might be at risk, then know the symptoms for these other cancers.

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The issue: Women treated with certain types of chemo drugs, usually Taxol/Taxotere, may experience long term/permanent tingling and pain in the feet, legs, hands and arms. This can affect balance and use of the hands. Your response: Ask your oncologist about painkillers and antidepressants to treat pain, or physical therapy, massage and acupuncture, which some women report helpful.