Some side effects from breast cancer treatment are easily noticed by those around the patient and can cause some discomfort for the patient. However, there are many ways that patients can overcome these side effects and improve how they feel.
Breast changes
The first side effect of breast cancer treatment that affects appearance should be a partial or complete mastectomy. Patients who undergo mastectomy have the option of using an external prosthesis instead of breast reconstruction or prior to breast reconstruction.
When wearing a prosthesis, it can be placed in a bra or attached to the skin with double-sided tape.
If you choose to wear a prosthetic breast:
Refer to your oncologist for specialty stores that sell prosthetic breasts, and patients may also be able to find them in some places that sell underwear.
Make an appointment with a prosthetic breast consultant to find the right one.
Try on multiple prostheses to see which one feels and looks best for you.
Hair loss
Some chemotherapy can kill fast-growing cells whether they are cancerous or not, such as hair follicles. Hair loss is different in each person and also depends on the type of chemotherapy the patient is receiving.
Radiotherapy and endocrine therapy may also cause hair loss.
Expectations: If a patient is losing hair because of chemotherapy, the hair may fall out within 1 to 2 weeks of the start of treatment, and may become thinner or fall out almost simultaneously. It is also common for patients to lose hair all over their body, not just their hair, which means they will lose eyelashes and eyebrows, as well as axillary, leg, and pubic hair.
Ice caps or other measures do not prevent hair loss, but with a mild shampoo, soft comb, or cool blow dryer, you may be able to slightly reduce hair loss.
Sometimes hair grows back even before the treatment is complete. The new hair that grows back may be thinner, or have a different color or texture.
Coping: Patients can prepare for hair loss episodes to make them easier to cope with. For example, many women who cut their hair short before they notice it starting to fall out can avoid shedding large amounts of hair in the shower or leaving a lot of hair on their pillow. Here are other practices that may help:
- Consider acquiring scarves, bandanas, and hats before your hair falls out.
- Learn about the wig products available.
- Before starting chemotherapy, select and customize a wig based on the color and texture of your hair. If a wig is chosen too early, it may fit slightly when you need to wear it after hair loss.
- Prepare those close to you, especially children, for how they will look after hair loss by involving them in the selection of scarves and other products.
- If you choose to leave your head uncovered, remember to use sunscreen on your head when in the sun and to keep it warm during the colder months.
Swollen arm
Doctors call this lymphedema, which is swelling on the side of the arm that received breast or lymph node surgery, and may also occur after radiation therapy. This is often a temporary side effect, but it can also be permanent. If it is permanent, it can affect the patient’s quality of life.
Early detection of symptoms can lessen their impact.
Tips:
- Don’t ignore any swelling that occurs in your arm.
- Avoid damaging the skin of the affected arm.
- Wear gloves when working or doing housework.
- Avoid excessive changes in water temperature.
- Protect your arms from sunburn.
- Avoid injecting medications or intravenous fluids into the affected arm.
- Do not use the affected side to carry heavy bags or wear heavy hand jewelry.
Swelling may affect the type of clothing the patient can wear, and may require elastic compression sleeves to control swelling and looser fitting clothing.
Patients can ask their doctor for a referral to a therapist to learn safe exercises to help avoid or reduce swelling and other techniques.
Weight change
Both weight gain and weight loss may occur during treatment. Weight loss may be due to nausea, vomiting, or changes in appetite. Weight gain is sometimes caused by chemotherapy or endocrine therapy, both of which can lead to early menopause, but weight gain may also be caused by other medications the patient takes that change the patient’s diet and make him or her less active.
Tips: Dieting is not appropriate for cancer patients. A nutritious, balanced diet can help maintain a healthy weight, sustain energy, and promote healing. The following suggestions may be helpful:
- Eat plenty of protein, but limit your intake of saturated fat, sugar, alcohol, and salt.
- Eat small, frequent meals, especially if you feel nauseous.
- Exercise to help control your weight and keep your appetite in check. Exercise can also help with other side effects, such as fatigue and depression. Consult your doctor about the amount of exercise that is right for you.
- Find an exercise partner to help keep yourself going over time, even a few minutes a day can have a positive impact on patients.
Skin changes
Patients may experience skin changes after chemotherapy, radiation, or endocrine therapy that may appear:
- Redness
- Rash
- Dryness
- Inflammation
- Darkening of blood vessels
Redness from radiation therapy and some chemotherapy may worsen if the skin is exposed to the sun. Although rare, skin damage may also occur if chemotherapy drugs administered through an IV leak into the skin.
Patients who notice any cracks or cuts in their skin should tell their doctor that they may be infected.
Tips:
- Consult your doctor before using any skin products. These products include emulsions, powders, perfumes, creams, deodorants, body oils, or home remedies, and the additives in some products may aggravate skin reactions.
- Avoid detergents with dyes and fragrances.
- Keep your skin clean and dry. Use a mild soap and dry your skin after bathing.
- Use a strong moisturizer several times a day as recommended by your doctor to prevent dry skin.
- Use sunscreen when you are in the sun.
- Wear loose, natural fabrics, such as cotton and silk.
Nail changes
Patients may experience nail changes after receiving chemotherapy, radiation, or endocrine therapy. The nail bed may become darker or discolored, the nail may crack, split, or become stiff, and sometimes the nail may even fall out of the nail bed. Tell your doctor if any of these things happen, as this can increase the risk of infection.
Tips:
- Cut your nails short to reduce splitting.
- Avoid artificial nails, which can increase the risk of infection. You can use nail polish, but use an acetone-free nail shampoo that is less likely to cause dryness when removing.
- Use a fingernail remover cream or gel and rub it into your own nails.
- Do not bite or tear your nails or fingernails.
- Wear gloves when working or doing housework.
- Avoid professional manicures, or bring your own sterilized utensils.
- Control the amount of time your hands are submerged in water to reduce the risk of fungal infections.
Skin and nail changes often disappear by the end of a patient’s treatment.