Life After Breast Cancer

Congratulations, you’ve beaten cancer! Now that you’re free from surgery and radiation, with a clean bill of health, you may be pleased (or not) with the results of reconstructive surgery (if you had it). You may be wondering about the long-term effects of the treatments you’ve endured.

Although you should be jumping for joy at this point, many women reflect on the experience and wonder, “What now?” Many fear that the cancer will recur, and little things, like a pain in the chest, a bruise, or cough, things you used to ignore, now raise alarm bells. Around you people keep saying, “It’s time to get on with your life.” The fact is, though, breast cancer changes us on many levels.

Some women feel abandoned by their physicians even though they may still be attending follow-up visits for several years. Others have difficulty sharing their experience and end up emotionally isolated and alone. To minimize the risks of cancer recurring, follow these special recommendations.

Black Cohosh and Hot Flashes

Some survivors may still be taking chemotherapy drugs like tamoxifen for an additional five years. The sudden onset of menopause is a side-effect of long-term tamoxifen therapy, with symptoms of severe hot flashes, mood swings, vaginal dryness, and night sweats. Until recently, women were told to just deal with these symptoms because treatments to stop hot flashes may also increase estrogen, definitely something we do not want to encourage in women with estrogen-receptor-positive cancers or those preventing the recurrence of this cancer.

Now very well-designed studies are showing tamoxifen-induced hot flashes can be treated non-hormonally. Two new studies on black cohosh, which confirm what some of the older studies have shown, have found that not only is black cohosh not estrogenic but also has an effect on inhibiting breast cancer cells. Breast Cancer Research and Treatment published a study in February 2004 showing that the triterpene glycoside deoxyacteine found in the standardized extract of black cohosh, inhibited the growth of human breast cancer cells.

Another study published in Maturitas in March 2003 examined the effects of black cohosh on hot flashes caused by tamoxifen in 136 young premenopausal breast cancer survivors age 35 to 52 years. After treatment with segmental or total mastectomy, radiation therapy, and chemotherapy, participants were open-label randomly assigned to receive tamoxifen 20 mg per day orally or tamoxifen plus black cohosh. Duration of treatment was five years for tamoxifen, according to international standards for adjuvant therapies, and 12 months for black cohosh plus tamoxifen. Follow-up included clinical assessment every two months; the primary endpoint was to record the number and intensity of hot flashes. Almost half of patients receiving the combination of tamoxifen and black cohosh were free of hot flashes, while severe hot flashes were reported by 73.9 percent of the tamoxifen-only group.

Researchers found that hot flashes were the most frequent adverse reaction to tamoxifen in breast cancer survivors. The combined administration of tamoxifen plus black cohosh for a period of 12 months allowed satisfactory reduction in the number and severity of hot flashes.

Hot flashes are not the only side-effect of tamoxifen. It is important that if you have any bleeding that you follow up with your physician immediately as endometrial cancer is a side-effect of the drug.

Coenzyme Q₁₀ for Heart Health

During radiation therapy it is not uncommon for the heart to be irradiated as well, even though more sophisticated low-dose radiation is employed today. Cardiovascular complications can occur, including pericarditis, myocardial fibrosis, muscular dysfunction, and valvular abnormalities or conduction disturbances. Those who were treated with mastectomy (removal of the breast) along with radiation and younger women appear to be at highest risk of cardiovascular side-effects. As well, certain chemotherapeutic drugs can contribute to heart complications.

To improve heart health coenzyme Q₁₀ in doses of 100 to 200 mg per day should be combined with a good multivitamin with minerals. Interestingly, research has also shown that women with stage four breast cancer who consumed more than 300 mg of coenzyme Q₁₀ had excellent results: tumours shrunk and a better quality of life was obtained. To prevent the recurrence of breast cancer and deal with the side-effects of treatment, include this vital nutrient.

Exercise and Mood

If you were a body builder or a runner before breast cancer, then you can still be one now. Exercise has been found to alleviate depression and anxiety, reduce the number and severity of hot flashes, and aid cardiovascular health, among other benefits. A study published in Oncology Nurse Forum found that breast cancer survivors who exercised 30 to 40 minutes four times per week had significantly less depression and anxiety over time compared to those who did not exercise. The researchers also reported that when a physician recommended exercise as part of the recovery process the women adhered to the exercise program.

Healing Heart, Soul, and Mind

Breast cancer hits at the centre of our womanhood and healing takes time. Some women are ashamed of their cancer and don’t want anyone to know. Psychologists have found that those who tell their co-workers, friends, and family have faster recovery times, most likely because of the strong emotional support they gain.

Until the early 1980s, breast cancer was surrounded by secrecy; then brave individuals such as former First Ladies Betty Ford and Nancy Reagan, and founder of the Susan G. Komen Breast Cancer Foundation, Nancy Brinker, began speaking publicly about the personal impact of the disease, increasing awareness of breast cancer and making it more acceptable to talk about openly.

Women from all walks of life, from famous actresses to grandmothers to single women, can make a difference in spreading the word about ways to prevent breast cancer. Some women heal themselves by writing about their experience; others join an agency to promote better detection, prevention, and treatment techniques. For many it is healing to help others in similar situations.

The mind can be a powerful ally or a dangerous enemy. From psychoneuroimmunology we know that emotions and attitudes play a role in how the immune system operates. Researchers study people who “feel” lonely and those who “feel” trapped. The operative word is “feel” as they may not actually be trapped or alone, but they feel they are. In such emotional states our immune function declines and we are left vulnerable to colds, flu, and more serious diseases. Robert Ornstein and David Sopel, in Healthy Pleasures (Perseus, 1990), maintain that good habits contribute less to healthy vitality than a positive attitude that promotes enjoyment of simple pleasures.

Purge negative emotions of anger and hatred. Carpe diem: seize the day and live life to its fullest. Seek your spiritual side as the power of prayer cannot be underestimated. Believe in yourself. Negative self-talk and continually doubting your abilities will hamper you body’s ability to heal. Notice the beauty around you: smell the flowers, watch the sunset, and listen to the wind. The world is at your feet: you have beaten cancer.

As cancer becomes a part of your past and the memories fade, look to a future with wonderful rewards, especially for those who continue on the life-long path of learning toward optimal health.