During breast cancer treatment, patients, their family and friends, and medical staff will make it their duty and joint effort to strive for the best possible outcome in order to have the best chance of survival. They will spare the maximum investment in terms of time, energy and finance. However, when the patient has undergone surgery, chemotherapy and radiotherapy, and endocrine therapy, everyone’s concern for the patient often remains on the disease itself, without paying good attention to the issue of how the patient adapts to family life, social life and building a healthy and confident self-image.
Advances in breast cancer treatment have allowed a significant number of patients to enjoy a long, even regular life expectancy. During this long post-treatment journey, the quality of the patient’s recovery, including the psychological state, determines to a considerable extent the value of the treatment. A long and painful life is to a large extent a departure from our ultimate therapeutic goal.
But unfortunately, whether from the perspective of medical personnel, or from the perspective of family and society, people pay much less attention to health than to the treatment itself, so that few people can do something practical and beneficial for their recovery on the long road to recovery after breast cancer treatment as much as they pay attention to treatment.
1. Take up family and social work as early as possible
After surgery, chemotherapy and radiotherapy, many patients are able to take up certain jobs, sometimes not very different from their normal ones, including the application of targeted therapy and endocrine therapy. Taking up appropriate family and social work as early as possible within the limits of one’s ability is irreplaceable for restoring strength and regulating the mind. Family members and other surrounding persons can also easily establish their relatively normal image of health from the patient’s relatively normal behavior and accept her participation in normal social activities as a normal individual.
Those patients who are clinically more normal minded are often the ones who resume their former family and social life soon after treatment. Those patients who are more privileged and have been recuperating at home for a long time tend to be in the shadow of the tumor for a long time, with high psychological stress and poor quality of life. Helping these patients to come out of the shadow is a very important part of work in this period. Family and friends should spend as much time and energy as possible as they did when they were first treated, but instead of taking too much care and substitution, they should try to let the patients actively participate and gradually adapt themselves.
If necessary, it is worthwhile to invest a certain amount of energy, time and money in changing the living environment, working environment, and traveling and sightseeing.
2. Daily life should be in line with general health care principles
For most of the patients, the overall life after breast cancer treatment does not need to be much different from normal people, including diet, daily activities and sexual life. Hypertension, coronary heart disease, diabetes, fatty liver and hypercholesterolemia are quite common among tumor patients, and some of these conditions appear after breast cancer treatment. Dietary habits, life like, especially low physical exertion, inappropriate diet and medication supplementation that do not conform to general health care principles after breast cancer treatment may trigger or aggravate these conditions, and eventually lead to serious consequences.
The various damages caused to patients by daily behaviors that do not conform to general health care principles far exceed the toxic damages of treatments such as triamcinolone. The benefits are certainly great if people can pay a little more attention to these areas and develop good habits. Keep your weight normal, not to mention not allowing too much weight gain!
It has also not been reported in breast cancer that the lower the physical exertion the lower the risk of recurrence. On the contrary, it has been reported that obesity may increase the risk of recurrence of breast cancer, and that low physical exertion is the main reason for obesity. In fact, many breast cancer patients who have undergone surgery, chemotherapy and radiation therapy can have very normal and sometimes surprising physical strength, which can only be recovered with gradual physical activity.
The gradual return to normal pre-treatment activities in the process of physical recovery is important for building a healthy self-image, restoring family and social relationships, and enjoying a high quality of life, as well as being of irreplaceable value for general health care. Therefore physical activity within the limits of one’s ability should be encouraged. For vaginal dryness and itching caused by estrogen deficiency topical estrogenic drugs can be applied if necessary, which is generally much safer than systemic medication.
After treatment, breast cancer patients should try to normalize their daily and social life as much as possible within their capacity, and in this way promote physical and psychological recovery. Do not neglect the prevention and treatment of other serious diseases because of breast cancer, and conform your daily life to general health care principles. There will be some long-term discomfort after breast cancer treatment, so patients and family members should be fully prepared.
3. Know and understand the long-term adverse effects after treatment
People pay more attention to the recent adverse reactions after social chemotherapy, but those long-term ones, especially the not very drastic ones, rarely attract enough attention. For example, cosmetic problems after total mastectomy, upper limb edema after surgery and radiotherapy, and estrogen deficiency symptoms after chemotherapy and endocrine therapy are all issues that should be understood and appropriately addressed. Unfortunately, there are some problems for which there is no good way to solve.
For example, estrogen deficiency problems are relatively common after chemotherapy and endocrine therapy and can plague fellow women for a long time. Patients may feel discomfort such as panic attacks, fatigue, excessive sweating, abnormal sleep, and vaginal dryness or itching. These symptoms can sometimes be so severe that it is difficult for patients to tolerate them for a long time. However, we also know that estrogen has a stimulating effect on the development and progression of breast cancer, so reducing or fighting estrogen stimulation is exactly what is needed to treat and prevent breast cancer.
Abandoning ongoing endocrine therapy or applying estrogen-like drugs to relieve these symptoms is likely to compromise the effectiveness of treatment. Small doses of progestins have been used to counteract these symptoms, but the limited research available suggests that progestins also have the potential to stimulate the development of breast cancer and affect the effectiveness of endocrine therapy. There is no definitive information on whether estrogens contained in plants such as soy can be used to counteract these symptoms, but it may be a promising measure.
Studies on the application of antidepressants to counteract estrogen deficiency symptoms have also been reported, and preliminary results are encouraging, but it may affect triamcinolone metabolism. Osteoporosis may also be a problem after chemotherapy and endocrine therapy, which may be alleviated to some extent by increasing physical activity and calcium supplementation. Certain bisphosphonates also have definite value in the management of osteoporosis.
Rehabilitation after breast cancer treatment is rich in elements, some of which are psychological, others are physical, and still others are pathological. Some of them are related to breast cancer itself and some are related to our treatment. How to make patients face up to breast cancer in their long-term family and social activities, and to properly perform self-examination and review without excessive psychological burden is really a problem that is difficult to solve satisfactorily and can have different standards for different people.
In fact, in foreign countries, many people suffering from such a serious disease as breast cancer seek help from psychologists, but few patients and family members do so in China.
As the number of breast cancer patients increases, the issue of rehabilitation after breast cancer treatment is also attracting more and more attention. Currently, some international studies are being conducted on the rehabilitation of breast cancer patients after treatment, with the goal of alleviating or even eliminating the long-term discomfort caused by the breast cancer disease itself and its treatment without affecting the effectiveness of the treatment. It is believed that in the near future, our breast cancer patients will be able to live a more relaxed and elegant life and return to society earlier than now.