After you've Finished Your Breast Cancer Treatment

Summarized by Robert W. Griffith, MD
October 23, 2006

Many women who have completed their treatment for breast cancer still have a number of questions. Here are some of them, with helpful answers from the Susan G. Komen Breast Cancer Foundation pages. Robert Griffith, Editor.

I'm done with treatment. What happens now?

As your doctor may have told you, once you have had breast cancer, you have a higher risk for developing a new breast cancer than someone who has never had breast cancer. That's why it's so important to get the follow-up treatment and care your doctor recommends. This is also a good time for you to talk about how you're coping emotionally and psychologically. With proper follow-up, your doctor can keep track of how you are recovering - including taking care of side effects of treatment. In addition, if there is a local (in the breast, chest wall or lymph nodes) recurrence of cancer, it can be detected early when treatment has the best chance to succeed. Your primary care doctor, oncologist, surgeon or you can choose to talk it over with your other doctors and coordinate your follow-up care - whichever you prefer. If you are not sure which way to go, ask other women who they have chosen to coordinate their care, and why. Do not be afraid that you will be left alone, not knowing what to do. You will have the care you need.

The National Comprehensive Cancer Network has established the following guidelines for follow-up of breast cancer treatment:
1. Have a physical examination performed by a doctor every 4 to 6 months for 5 years.
2. Perform breast self-exam (BSE) every month. (For step-by-step breast self-exam instructions, click the first link below.)
3. Have a mammogram every 12 months. For women treated with breast conserving surgery and radiation therapy, have a mammogram 6 months after radiation therapy ends, then of both breasts every 12 months.
4. Understand which symptoms should be reported immediately:

• Any changes in the remaining breast(s) and chest area, unusual pain, loss of appetite or weight, changes in menstrual periods, unusual vaginal bleeding or blurred vision.
• Dizziness, persistent cough, hoarseness, shortness of breath, headaches, backaches or digestive problems that are unusual or persistent.

5. Have a pelvic exam every 12 months if taking tamoxifen and have not had the uterus removed.
6. If you're at higher risk of osteoporosis (such as age over 65; age 60-64 with family history/low body weight; aromatase inhibitor use; treatment-related menopause) you should have a bone mineral density test every 12 months. If you're at a lower risk of osteoporosis, you need an office visit to assess osteoporosis risk, every 12 months.

How will I know if the cancer returns?

Before you complete your cancer treatments, set up follow-up visits with your doctor. Follow-up appointments and monthly breast self-exams will help find recurrent or new breast cancer should this occur.

Am I going to feel sick from now on?

No. As you finish your treatment, you may still be tired. Do not fight this - your body needs the rest.

Aerobic exercise can help speed the recovery process following chemotherapy.

Side effects like nausea and hair loss are temporary, and should go away after treatment ends. If nausea and other side effects continue, be sure to tell your doctor. Swelling of the arm on the affected side - lymphedema - requires special care; see second link below.

There are often specialized support groups for women at various stages of illness or recovery and self-help groups that are run by breast cancer survivors. These groups are an important source of information and support.

Should I re-establish my usual routine?

Getting back to all the things you used to do, even if it takes some time, will help you feel better. Adding preventive health activities like physical activity, a healthy diet and regular tests - such as a bone-density test and a colon exam - are the right ways to maintain your health and may also help you have peace of mind.

Who should I tell about my breast cancer?

It is really up to you. Start with the people you feel most comfortable with. Take your time and wait until you are ready.

Will it ever be over?

Believe it or not, there may come a day when you stop worrying about cancer and live your life without fear. It is normal to have some fear, but this will lessen over time. You can always get support from groups of women who have gone through what you have, and some who are in the same place as you are now.

How do I cope with the stress?

Breast cancer survivors have a number of unique stresses in life, and they often struggle to cope with this stress in healthful ways. One positive and important coping method for survivors is to call on the social support network many people already have available to them. On top of this, regular exercise can also be a great stress-reliever.

There are many sources of social support for breast cancer survivors: spouses or partners, family members, friends, coworkers/colleagues, therapists, spiritual advisors, spiritual communities (such as churches, synagogues and mosques), online/email discussion groups and health care providers. These people who are there for survivors through diagnosis, treatment and beyond are known as co-survivors (see the links below). In addition, many survivors find that they can expand and strengthen their emotional support systems by joining a formal breast cancer support group or by including family, friends and spiritual community members in their treatment and recovery process. There is evidence that women who are supported through social connectedness tend to cope better psychologically with breast cancer. Some researchers think they may even experience better disease outcomes, though this is still under study.

Exercising is another way to deal with daily stress. Many women find that regular exercise makes them feel better and stronger, in addition to helping them regain a sense of control over their bodies (see link below).

In conjunction with National Breast Cancer Awareness Month, Passionately Pink for the Cure is a new, year-round fundraising and education program launched by the Susan G. Komen Breast Cancer Foundation. It kicked off on October 1, 2006. You can learn more at http://www.komen.org

Source

• The Susan G. Komen Breast Cancer Foundation, http://www.komen.org http://www.komen.org

Related Links
How to Do a Breast Self Exam (BSE)
Lymphedema
Co-Survivors Webpage
Cancer Survivors Network
WebMD: Breast Cancer and Exercise

Please take a moment to give us your comments. For questions about Health matters you may check our "Questions & Answers" Portal and Service.