Breast Cancer, Metastatic or Recurrent
Home Treatment
During treatment for metastatic or recurrent breast cancer, you can use home treatment to help manage the side effects that often occur with breast cancer or cancer treatment. Home treatment may be all that is needed to manage the following common problems. In general, healthy habits such as eating a balanced diet and getting enough sleep and exercise may help control your symptoms. Be sure to follow any instructions and take any medicines your doctor has given you to treat these symptoms.
- Nausea or vomiting. If you have problems with nausea and vomiting while you are taking chemotherapy or receiving radiation therapy, let your doctor know. Medicine is available to prevent and treat nausea and vomiting that may be caused by treatment. It is important to let your doctor know if you have nausea or vomiting in spite of the use of this medicine. Home treatment for nausea or vomiting includes watching for and treating early signs of dehydration, such as a dry mouth, sticky saliva, and reduced urine output with dark yellow urine. For more information on how to deal with these side effects, see:
- Pain. Not all forms of cancer or cancer treatment cause pain. If you have pain, many treatments are available to relieve it. Be sure to follow the instructions and take the medicines that your doctor has given you to treat these symptoms. You may use home treatment for pain to improve your physical and mental well-being. Be sure to discuss with your doctor any home treatment you use for pain.
- Diarrhea. Some chemotherapy medicines can cause diarrhea. Let your doctor know if you have diarrhea while you are on treatment. Radiation therapy to the chest should not cause diarrhea. Home treatment for diarrhea includes resting your stomach and being alert for signs of dehydration. Check with your doctor before you use any non-prescription medicines for your diarrhea.
- Constipation. Pain medicines, chemotherapy, and medicines used to treat nausea and vomiting related to chemotherapy can sometimes cause constipation. Let your doctor know if you have problems with constipation after surgery or while you are on chemotherapy. Radiation therapy to the chest should not cause constipation. Home treatment for constipation includes gentle exercise along with enough fluids and a diet that is high in fruits, vegetables, and fibres. Check with your doctor before you use a laxative for constipation.
- Fatigue. Breast cancer and treatment for it can cause fatigue. Your emotional reaction to a diagnosis of breast cancer and the stress related to treatment may make you feel tired. Some fatigue is expected after surgery and during both chemotherapy and radiation therapy. Fatigue is often worse at the end of treatment or just after treatment is completed. Home treatment for fatigue includes making sure you get extra rest while you are receiving chemotherapy or radiation therapy. Let your symptoms be your guide. You may be able to stay with your usual routine and just get some extra sleep. Let your doctor know if you are feeling unusually tired.
You may have other issues, including:
- Hair loss from chemotherapy. This can be emotionally distressing. Not all chemotherapy medicines cause hair loss, and some people have only mild thinning that is noticeable only to them. Other treatments, including hormone therapy (such as tamoxifen) and radiation therapy, do not cause hair loss. Talk to your doctor about whether hair loss is an expected side effect with the medicines you receive.
- Swelling of the arm (lymphedema). Normally, lymph nodes filter fluid as it flows through them, trapping bacteria, viruses, and other foreign substances, which are then destroyed by white blood cells called lymphocytes. Lymph nodes are removed from under the arm to help determine the stage of your breast cancer. When these lymph nodes are removed in an axillary dissection, fluid can build up in the affected arm, and you can develop lymphedema. Medicines such as tamoxifen, radiation therapy, and injury to the lymph nodes can also cause lymphedema. Not everyone will have a problem with lymphedema. You can reduce your risk of developing lymphedema by protecting your arm on the side where you had surgery and letting your doctor know right away if you have swelling or redness in that arm. For more information, see:
- Sleep problems. If you have trouble sleeping, you may find that having a regular bedtime, getting some exercise during the day, avoiding naps, and using other tips to relieve sleep problems may help you sleep more easily. Tell your doctor if you continue to have difficulty sleeping.
Emotional needs
If your breast cancer has come back, you may feel angry or frustrated and may second-guess your previous treatments. And you may lose hope. But some women live for many years, managing their cancer like a long-term health problem. The treatment decisions you and your doctor made in the past were the right ones at that time. But now, new decisions must be made and treatment objectives must be explored.
- You may be able to reduce your stress by talking about your feelings to others. Stress and tension affect our emotions. By discussing your feelings with others, you may be able to understand and cope with them. Learning relaxation techniques may also help you reduce your stress.
- Expressing yourself through writing, crafts, dance, or art is a good tension reliever. Some dance, writing, or art groups especially for individuals diagnosed with cancer may be available.
- Join a support group. Talking about a problem with your spouse, a good friend, or other people with similar problems is a valuable way to reduce tension and stress. Social support is very important both during and after treatment. Talk to your doctor or contact the Canadian Cancer Society to find out about support groups in your area. If you have access to the Internet, you may also find an online support group.
- Your feelings about your body may change after a diagnosis of breast cancer and the need for treatment. Adapting to your body image changes may involve talking openly about your concerns with your partner and discussing your feelings with your doctor. Your doctor may also be able to refer you to organizations that can offer additional support and information.
If your reaction is interfering with your ability to make decisions about your health, it is important to talk with your doctor. Your cancer treatment centre may offer psychological or financial services.
End-of-life issues
A time may come when your goals or the goals of your loved ones may change from treating an illness to maintaining your comfort and dignity. Talk to your doctor about prescription medicines to help you manage pain and other symptoms that may happen along with metastatic breast cancer. Your oncologist will be able to address questions or concerns about maintaining your comfort when cure is no longer an option. Hospice palliative care professionals can provide care in the comfortable surroundings of your home. For more information, see the topic Hospice Palliative Care.
You may wish to discuss with your doctor and your family any health care issues and other legal issues that arise near the end of life. It may be helpful and comforting to state your health care choices in writing (with an advance directive or living will) while you are still able to make and communicate these decisions.
Think about your treatment options and which kind of treatment will be best for you. You may wish to choose a substitute decision-maker to make and carry out decisions about your care if you become unable to speak for yourself. For more information, see the topic Care at the End of Life.
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| Author: | Kathe Gallagher, MSW Ralph Poore | Last Updated: October 19, 2007 |
| Medical Review: | Joy Melnikow, MD, MPH - Family Medicine Donald Sproule, MD, CM, CCFP, FCFP - Family Medicine Douglas A. Stewart, MD - Medical Oncology | |
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