Understanding and Managing the Side Effects of Breast Cancer Treatment

Breast cancer is the most common type of cancer in women. According to the American Cancer Society, women in the United States have a 1 in 8 chance of developing breast cancer at some point in their life.

Nevertheless, receiving a breast cancer diagnosis can be frightening and overwhelming. Many questions and concerns may come to mind, including worries about the potential side effects of breast cancer treatment.

We’ve got you covered as you take your first steps on your breast cancer journey. Below, we’ll discuss different breast cancer treatments, including their short- and long-term effects, and ways to cope. Keep reading to learn more.

There are several types of treatments for breast cancer. Let’s explore each of them briefly.

Surgery

Surgery is often one of the first treatment steps for people with breast cancer. Depending on the location and size of a tumor, surgery may remove some breast tissue (breast-conserving surgery) or all of the breast tissue (mastectomy).

Chemotherapy

Chemotherapy (chemo) drugs can kill cancer cells or slow their growth. There are several situations where chemo may be used for breast cancer:

• before breast cancer surgery to shrink a tumor (neoadjuvant chemo)
• after breast cancer surgery to help lower the chances of the cancer coming back (adjuvant chemo)
• when breast cancer has spread (metastasized) to more distant tissues

Hormone therapy

Some breast cancers have receptors that grow in response to the hormones estrogen and progesterone. Hormone therapy aims to block the activity of these receptors, preventing the cancer cells from growing.

Common hormone therapy drugs include:

• tamoxifen (Soltamox)
• anastrozole (Arimidex)
• fulvestrant (Faslodex)

Targeted therapy

Targeted therapy drugs are designed to home in on specific biomarkers that are on the outside or inside of cancer cells. HER2 is an example of a biomarker that’s targeted by many of these drugs.

Common drugs used for targeted therapy include:

• trastuzumab (Herceptin)
• pertuzumab (Perjeta)
• trastuzumab deruxtecan (Enhertu)

Immunotherapy

Immunotherapy boosts your immune system’s ability to respond to cancer cells. While there are a few types of immunotherapy for cancer, a type called an immune checkpoint inhibitor is one that doctors may use for some breast cancers.

Pembrolizumab (Keytruda) is a common immunotherapy drug.

Radiation therapy

Radiation therapy uses high energy radiation to kill cancer cells. Doctors often use it after breast cancer surgery to help reduce the chances of cancer returning.

Short-term side effects are the ones that happen immediately or shortly after starting a treatment. They’re often temporary and ease when treatment concludes.

There’s generally a good bit of overlap in short-term side effects from the different types of breast cancer treatment. Some to be aware of include:

• fatigue
• digestive side effects like:
  • nausea and vomiting
  • diarrhea
  • constipation
  • reduced appetite
  • mouth sores
• headache
• body aches and pains
• hair loss
• skin rashes or reactions
• low blood cell counts, which can lead to:
  • anemia
  • increased infection risk
  • easy bleeding or bruising
• sexual changes, such as:
  • hot flashes
  • vaginal dryness
  • menstrual cycle changes

It’s important to know that short-term side effects can vary widely, even within treatment types. For example, two different targeted therapy drugs may have pretty different sets of common side effects.

Also, keep in mind that the type and intensity of side effects can vary by person as well.

Breast cancer treatment also has long-term side effects. These are side effects that can develop or persist long after your treatment has ended. You may also see them called late effects.

A 2018 study found that 5 years after breast cancer treatment, 3% of women continued to experience side effects, including:

• impaired thinking ability
• difficulty sleeping
• sexual issues, such as vaginal dryness
• hot flashes
• pain
• fatigue

Other potential long-term effects of breast cancer treatment are:

• infertility
• early menopause
• altered breast appearance and feel
• bone loss
• brain fog
• neuropathy
• lymphedema
• heart damage
• depression and anxiety

Similar to the short-term side effects of breast cancer treatment, long-term side effects can depend on the exact type of treatment received. They may also vary greatly between people. No two individual experiences are exactly alike.

As we’ve seen, breast cancer treatments can lead to a wide variety of short-term side effects. Because of this, it’s normal not to know where to start when it comes to managing them.

Here are some basic management strategies you can use to help cope with the short-term side effects of breast cancer treatments.

Fatigue

Fatigue is a very common side effect. However, there are steps you can take to curb it:

• Aim to get at least 8 hours of sleep every night.
• Stay active and get regular physical activity, which can help reduce fatigue and increase energy.
• Prioritize which activities to do and which to skip.
• Take the time to rest when you need it.
• Focus on staying hydrated and consuming nutritious foods and drinks.
• Try out ways to ease stress, such as meditation or yoga.
• Ask for help with daily tasks when you need it.

Digestive side effects

The digestive side effects of breast cancer treatment can make it difficult or painful to eat. To help out with this, try some of the following:

• Listen to your body and avoid foods that make you feel worse.
• Eat several small meals throughout the day instead of a few large ones.
• If solid foods are unappetizing or hard to keep down, focus on liquids, such as smoothies or soups, that provide calories and protein.
• Drink plenty of fluids to stay hydrated.
• Select high fiber foods to help with constipation and low fiber foods to help with diarrhea.
• Ask your doctor about anti-nausea medication.
• For mouth sores, try foods that are soft and at room temperature or cooler. Also avoid spicy, acidic, or sugary foods that can cause mouth irritation.

Pain

Pain related to breast cancer treatment can come in a variety of forms. These can include body aches and pains, headaches, and nerve pain. Pain can be constant or intermittent.

Treatment depends on the type of pain you’re experiencing.

If you’re experiencing pain, ask your doctor about medications that can help ease it. It may also help to try out techniques that help you relax and center yourself, such as meditation, yoga, and deep breathing.

Hair loss

Losing your hair during your cancer treatment can be distressing. However, not every breast cancer treatment is associated with this side effect.

Ask your doctor whether hair loss happens with your specific treatment. If so, you may choose to wear a wig as you begin to lose hair. Try picking out a wig before your treatment so it can be matched as best as possible to your natural hair.

After you’ve lost your hair, take steps to protect your scalp. Try to stay out of direct sunlight and avoid places that are either very hot or very cold.

Skin rashes or reactions

Some breast cancer treatments can cause uncomfortable rashes or skin reactions. Follow these tips to help ease these side effects:

• Aim to keep your skin clean and dry.
• Focus on short showers in water that’s cool or room temperature.
• Gently pat yourself dry instead of wiping or rubbing with a towel.
• Moisturize after showering.
• Use skin care products that don’t irritate your skin.
• Wear clothes made from soft, breathable fabrics.
• Stay out of direct sunlight and use high SPF sunscreen if your treatment causes sun sensitivity.

Low blood cell counts

Low blood cell counts can lead to anemia, increased infections, and easy bleeding.

For anemia, try to:

• get plenty of sleep at night
• reduce your daily activities or ask others to help you out as needed
• eat a balanced diet

To prevent contracting an infection:

• Get up to date on any vaccinations before starting treatment.
• Wash your hands frequently.
• Regularly clean high touch surfaces in your home.
• Avoid contact with people who are sick.
• Clean any cuts or scrapes right after they happen.
• Cook foods to their safe cooking temperature.
• Thoroughly wash fresh produce before eating it.

To address easy bleeding or bruising:

• Take extra care going about your daily activities, especially when they come with a risk of nicks, scrapes, and cuts.
• Remove trip hazards around your home and add padding to sharp furniture edges.
• Avoid contact sports or strenuous exercise that could lead to injury.

Sexual side effects

Sexual side effects from breast cancer treatments can include but aren’t limited to:

• vaginal dryness
• hot flashes
• changes in menstrual periods

Talk with your doctor about whether it’s OK to have sex during your treatment. If so, be sure to take steps to prevent becoming pregnant, as some cancer treatments can be very harmful to a developing fetus.

Some medications can help with vaginal dryness, so ask your doctor about them. It may also be helpful to use a lubricant during sex.

Dressing in layers that you can easily remove can help greatly when a hot flash comes on. It may also be beneficial to keep a handheld fan on you as well.

According to the National Cancer Institute, making healthy lifestyle choices can help manage some types of long-term side effects. This can include doing things like:

• Eating a balanced diet: Focus on a diet that’s high in fresh fruits and veggies, whole grains, and lean protein sources. Ask your doctor for dietary pointers that are tailored to your specific situation.
• Exercising: It’s still important to get regular exercise that includes both cardio and weight-bearing exercise. Talk with your doctor about the types of activities that would be appropriate for you.
• Getting enough sleep: Set up a sleeping and waking schedule you can stick to. Also, create an environment that promotes good sleep by making sure it’s dark, quiet, and a comfortable temperature.
• Reducing stress levels: Take steps to lower your stress levels. Some examples of things to try include doing yoga, curling up with a book, and doing a hobby you enjoy.
• Limiting alcohol: Drink alcohol in moderation or not at all.
• Avoiding smoking: Aim to avoid using cigarettes and other tobacco-based products.

Additionally, many of the long-term effects of breast cancer treatment can be managed by working with your doctor. This can include things like:

• taking medications to help with your symptoms
• participating in therapy or counseling
• doing physical therapy or occupational therapy

As such, don’t hesitate to contact your doctor if you have concerning symptoms in the weeks, months, or years after your breast cancer treatment concludes.

It may be beneficial to seek out support resources while you’re being treated for breast cancer. These can provide you with more information, access to assistance, and ways to connect with others.

Some examples of support resources to check out include the following:

• The American Cancer Society offers ways for people with breast cancer to connect with each other through message boards and the Reach to Recovery program.
• Breastcancer.org has a wealth of information about breast cancer as well as an online community where you can connect with others experiencing similar things to you.
• After Breast Cancer Diagnosis provides free emotional support and mentorship to people who have breast cancer.
• CancerCare offers free support services for people with cancer and their loved ones.
• The Bezzy Breast Cancer app is an online community tailored to those living with breast cancer. You can download for free on iTunes and Google.

Another great resource is your care team. They may be able to point you toward resources or support groups that are associated with your treatment center or are available in your area.

Breast cancer treatment can cause many side effects. Short-term side effects happen while you’re undergoing treatment. Long-term side effects can come on months to years after your treatment has concluded.

Experiencing treatment-related side effects can be challenging. However, there are a variety of strategies you can use to help manage them.

Your doctor and care team are there to help. Be sure to ask them about the potential side effects specific to your breast cancer treatment and the things you can do to help address them.