Breast Cancer: From Killer to Chronic Condition

Patient Expert

Breast cancer used to be so deadly that women diagnosed with the disease wouldn’t even utter the word, preferring to whisper “the Big C” instead. Now, according to the National Cancer Institute has shown that a solid majority not only survive – but are battling the side effects of treatment for years afterward.

If you’re just starting treatment, be aware of (and prepare for) any potential side effects that may be permanent. And if you’re dealing with those lasting effects, here’s some advice on how to cope.

The ordeal of cancer treatment

As you go through cancer treatment, everything can become a blur. That shocking initial diagnosis quickly leads to meetings with a general surgeon, a plastic surgeon, an oncologist, radiologist, and hordes of support staff.

You trudge through treatment: for a month or two. Sometimes six months. Maybe even a year. At last, you finish or at least get through the active part. Maybe you need follow-up surgery or a preventive drug regimen that will continue for up to 10 years or more.

Gradually, however, your head clears and you’re able to look back at the progress you’ve made. Surgery has left you scarred, but it also helped save your life. The fatigue, nausea, and pain that come with chemo are now firmly in the rearview mirror. Even the radiation “stain” has begun to fade.

So why is it that your fingers and toes still tingle? Why, despite your best efforts, can’t you shake those 15 pounds you gained during treatment? And what about those bed-drenching night sweats and hot flashes?

I survived cancer, what now?

Your oncologist, the folks in the chemo infusion suite, the radiation technicians – their prime interest was saving your life. Thus, it’s not surprising that, in the heat of battle, no one spends much time talking about what comes next.

Make no mistake, you’ll never go back to your “old” normal. You were in a fight for your life, the kind of battle that inevitably leaves scars. Not just externally, but system-wide, from your metabolism down to your psyche.

Here are some of the lasting effects you might experience as a breast cancer survivor – and the most effective ways to deal with them.

Peripheral neuropathy

The challenge: The pain and tingling in the fingers and toes caused by chemotherapy drugs such as taxanes can be distracting, uncomfortable, and can also cause a loss of balance.

What to do: There isn’t a sure-fire, one-size-fits-all treatment for neuropathy. Your doctor will try a number of different options in hopes that one will work. For information on the latest treatments, read our post Peripheral Neuropathy: New Research Into a Perplexing Problem.

Lackluster hair

The challenge: It used to be that your hair was your “crowning glory.” Now it’s limp, dull, and scanty.

What to do: Some women who’ve lost their hair while taking tamoxifen have had luck with Rogaine and similar hair regrowth treatments. But for most, it’s simply a case of making the best out of a distressing situation.

Fortunately, I’ve come up with a hair-care regimen that’s added both body and shine to my hair. I wash my hair in hot water only and use a high-quality cream rinse, preferably one based on plant oils and other natural ingredients. By working the rinse into my wet hair and leaving it in, my hair is fuller and healthier-looking than it used to be.

Chemo brain

The challenge: Chemotherapy puts the brain under severe chemical stress and can lead to reduced cognitive ability, including memory loss, ability to focus, and shrinking vocabulary. Some women experience these changes, known as “chemo brain,” during chemo treatment and quickly get over them. But for others, the effects linger for months or even years.

What do do: There aren’t any drugs that can treat this condition. Accept your limitations, then deal with them. The following tips can help you cope:

  • Make lists
  • Reduce your multi-tasking
  • Try to learn new things, which “exercises” the brain
  • Laugh when you fail, and try again

Hot flashes/night sweats

The challenge: So you thought those irritating hot flashes brought on by lowered estrogen levels, would disappear once you finished treatment? Not necessarily. Some women continue to experience them for several years.

What to do: If your cancer isn’t hormone-receptive, your doctor may prescribe hormone replacement therapy. But for the approximately 80 percent of survivors with hormone-receptive cancer, there’s no easy fix.\

New evidence suggests that acupuncture might reduce the severity and frequency of hot flashes. Some women try natural remedies, like vitamin E and black cohosh. For more solutions, see our post, “Dealing With Hot Flashes.”

Reduced bone density

The challenge: Chemotherapy, radiation, hormone therapy, and even breast cancer itself can reduce bone density, leading to an increased risk of osteoporosis and fractures.

What to do: First, ask your doctor for a DEXA scan to measure your current bone density. If the scan shows a severe loss, you may be prescribed one of several bisphosphonate drugs, which will help build bone density.

If bone loss is mild, your doctor may advise lifestyle changes such as quitting smoking, reducing alcohol consumption, and exercise as a way to slow the deterioration.

In either case, speak with your doctor about scheduling a DEXA scan every 2 years if tests show any signs of bone loss. This will allow you to see if your counteractive measures are effective.

Weight gain

The challenge: Despite continuing to exercise and eat right – well, as much as possible – during treatment, it’s now a year later and you weigh 10, 15 or 25 pounds more than you did before you had cancer. Whether it’s “emotional” weight gain, the result of a lowered metabolism due to chemical menopause or a combination of both, you’d really like to drop the excess baggage.

What to do: First, accept that you might never reach your pre-cancer weight. And that’s OK. According to the Mayo Clinic, women naturally gain weight during and after menopause due to a lowered metabolism brought on by shrinking muscle mass. If cancer treatment puts you through menopause, weight gain is nearly inevitable.

But that doesn’t mean you can’t lose a few pounds and feel healthy, energetic, flexible and strong again. Weight training builds muscle mass while yoga and Pilates classes help with flexibility. Aerobic exercise can boost your energy and stamina. If all of this sounds daunting, start small by recruiting friends and take a class together. Or simply get outside and walk as much as you can.

Chronic doesn’t mean hopeless

Breast cancer survivorship may be a chronic condition, with a healthy dose of challenges to work through. But consider the definition of chronic: “continuing a long time.” Isn’t that exactly the prognosis you want for the rest of your life?

See More Helpful Articles:

Chemotherapy’s Hidden Side Effect: It’s Devastating

A Guide to Survivorship: Life After Treatment

Stay Healthy – Keep Moving

Taxol Toes: Coping With Peripheral Neuropathy

If You’re Not Worried About Osteoporosis, Should You Be?

Chemo Brain May Last for Years

Breast cancer survivor and award-winning author PJ Hamel, a long-time contributor to the HealthCentral community, counsels women with breast cancer through the volunteer program at her local hospital. She founded and manages a large and active online survivor support network.