ASK THE EXPERT MANAGING LONG-TERM EFFECTS OF BREAST CANCER TREATMENT
BCNA Consumer Representative Naveena Nekkalapudi
Medical Oncologist Professor Bogda Koczwara
B reast cancer side effects, some of which are long term and can be physically and emotionally challenging. BCNA recently presented a webcast with Medical Oncologist Professor Bogda Koczwara and BCNA Consumer Representative Naveena Nekkalapudi about how to best manage long-term side effects. They answer some more questions on this important topic in this issue of The Beacon . The information in this article is not a substitute for medical advice. Please speak to your treating team for specific advice. treatments can cause a range of HOW CAN I MANAGE LONG- TERM SIDE EFFECTS OF BONE AND JOINT PAIN? Bogda: Joint stiffness and pain can be distressing side effects of aromatase inhibitors. Exercise and healthy weight seem to protect from joint symptoms, while exercise, especially yoga, can help manage joint pain. Acupuncture and painkillers such as paracetamol can also help. Your doctor may identify other conditions
WHAT CAN I DO? Bogda: It is normal to struggle through a range of emotions. The first step is to acknowledge that it is ok to feel them and consider asking for help. Peer support can be incredibly beneficial as can specific resources, such as BCNA’s excellent Upfront about Breast Cancer podcast series by Dr Charlotte Tottman . In some cases, you may need professional help. Your GP can provide a referral. Naveena: I found it helpful to journal about my thoughts and feelings. I also chose a couple of friends as confidants to share my concerns with. I would make time for fun things, such as catching up with friends, or distract myself with jigsaw puzzles, reading, gardening or exercising/playing with the dog to break the ‘worry loop’. I HAVEN’T HAD A GOOD NIGHT’S SLEEP SINCE I STARTED MY DRUGS AFTER TREATMENT. WHAT COULD HELP ME? Bogda: Start with the basics: establish a pre-bed routine, avoid alcohol and caffeine, remove screens from the bedroom, and limit daytime naps. If these strategies do not help, identify what is interfering with your sleep,
Naveena: Try to stay as active as possible to maintain your stamina. I did not do much during treatment so it took me a very long time to recover my energy levels. WHAT CAN I DO TO HELP MY SOFT, BRITTLE NAILS AND TINGLING IN MY FINGERS? Bogda: To manage brittle nails, ensure that they are trimmed short and wear good footwear and gloves if you’re gardening. A multivitamin may help if your diet is deficient. Tingling in fingers may be a symptom of many conditions, including peripheral neuropathy or carpal tunnel. See your doctor to find out what the cause is and how to manage it. Naveena: During chemotherapy, I painted my nails a very dark colour to protect the nail bed. Now I go to a salon that offers the Signature Nail System (SNS), which prevents my nails from breaking. Plunging my hands and feet into uncooked rice helped alleviate the tingling when it was really bad. THE SIDE EFFECTS FROM TREATMENT ARE DIFFICULT, BUT I AM REALLY STRUGGLING WITH THE EMOTIONS I AM FEELING BECAUSE OF THEM.
that predispose you to pain, recommend specialised treatments or change your hormone-blocking treatment to one that does not cause these symptoms. 1,2 Naveena: I tried to maintain a healthy weight by doing exercises, such as swimming and water aerobics, that eased pressure on my joints. I also enrolled for a breast cancer rehab program offered at my local private hospital. Some public hospitals offer similar programs. The exercise physiotherapists understood the limitations of a cancer survivor and tailored activities to suit me. I AM IN MY THIRD WEEK OF TAKING A NEW DRUG AND I AM REALLY STRUGGLING WITH THE HOT FLUSHES, NIGHT SWEATS AND JOINT PAIN. WHEN WILL THESE SIDE EFFECTS BE MORE MANAGEABLE? Bogda: Hot flushes and joint pain tend to improve over time but that does not mean that you just need to grin and bear it. Acupuncture may reduce these symptoms and is great for joint
such as hot flushes, anxiety or pain, and ask your GP for help to manage them. Naveena: I am now seven years post active treatment and I still have trouble sleeping! I try to go to bed at the same time every evening, play some sleep music, and have a notepad next to my bed to capture any urgent thoughts. I also take a short afternoon nap to catch up on sleep on those days when none of these strategies work!
stiffness. Managing any coexisting health concerns such as weight gain and poor sleep is important. Ask your treating team if there’s an alternative hormone-blocking therapy with fewer side effects. Some antidepressant medications may also help. Naveena: I sleep with a fan on, wear cotton pyjamas and use a lighter doona to manage hot flushes. I also take pain medication prescribed by a pain specialist. IS THERE ANY DANGER IN PUSHING THROUGH FATIGUE? I HAVE BEEN TOLD MOVING MY BODY WILL HELP EVEN THOUGH I AM TIRED. Bogda: It is a delicate balance. You do not want to overdo it, but gentle exercise is one of the best ways of managing fatigue. Ask your GP for a medical assessment to check if you have any conditions that contribute to your fatigue. Then, identify your baseline level of physical activity and work from there. If your baseline is a 10-minute walk twice a week, try increasing it to 12 minutes or maybe 10 minutes three times a week.
Watch the Managing long-term side effects of breast cancer treatment webcast
Read more about managing side effects via My Journey
1. Management of Aromatase Inhibitor–Induced Musculoskeletal Symptoms | JCO Oncology Practice (ascopubs.org) 2. Efficacy of management strategies for aromatase inhibitor-induced arthralgia in breast cancer patients: a systematic review - Nahm - 2018 - Asia-Pacific Journal of Clinical Oncology - Wiley Online Library
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September 2022 | Issue 92
Breast Cancer Network Australia
bcna.org.au
Issue 92 | September 2022
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