GP Update Breast Cancer

Managing the side effects of breast cancer treatment

The common symptoms associated with breast cancer treatment, and strategies used for dealing with them

16 August 2018

Multiple symptoms are often experienced by breast cancer survivors. These symptoms may be a result of the disease itself or of the associated treatment.

The table below outlines the five common symptoms associated with breast cancer treatment, along with strategies used for dealing with the symptoms.

The Big Five Overview Strategy
Fatigue
  • May persist for months following treatment
  • Non specific, multi dimensional construct that is poorly understood
  • Strongly correlated with low mood, depression
  • Research often sees it as a consequence of other side effects
  • There is a noted correlation with chemotherapy but none with disease stage or risk of recurrence
  • Gentle exercise – 3 times 10 minutes per day
  • Keeping a diary
  • Relaxation strategies and anxiety management
  • Mindfulness / meditation
  • Avoiding caffeine, alcohol, drugs
  • Sleep hygiene
Drop in mood
  • Low mood
  • Depression
  • Fear of recurrence
  • Patient education and self-management
  • Exercise
  • Support groups
  • Social media
  • Walking groups
Arthralgia
  • Symmetrical joint pains most commonly affecting wrists, hands and knees
  • Carpel tunnel and trigger finger
  • Patient education prior to starting treatment
  • Acupuncture
  • Vitamin D
  • Weight loss
  • Exercise - yoga, pilates
  • Low dose steroid
  • RMH booklet available – ‘Physiotherapy advice for patients experiencing AI induced arthralgia’
Vasomotor symptoms
  • Sudden increase in blood flow – extreme heat, flushing, perspiration, chills and anxiety
  • Interrupting sleep, concentration, work and body image
  • Education
  • Practical measures
  • Exercise
  • Weight loss
  • Acupuncture
  • Mindfulness
  • Consider SSRIs
Vaginal atrophy
  • Irritation, burning, itching, chafing
  • Dryness
  • Light bleeding
  • Inflammation
  • Persistent smelly discharge due to altered pH
  • Cotton underwear, going commando, avoiding tight clothes
  • Sexual activity/masturbation can be helpful if comfortable and desire is there
  • Non-hormonal topical therapies
  • Hormonal preparations
  • Pelvic floor exercises and relaxation
  • Full assessment

Longer-term symptoms have also been reported by breast cancer survivors and include:

  • Cardiac health
  • Bone health
  • Lymphoedema

The Royal Marsden provides a variety of support mechanisms to those struggling with the side effects of breast cancer treatment, including:

  • End of treatment consultations and carefully developed care plans
  • Group sessions led by Advanced Nurse Practitioners
  • Holistic assessment
  • Health and wellbeing events
  • Open access helpline
  • Spring into action clinics

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