Tag Archive | breast cancer treatment

Loss of Libido

loss-libido-symptoms
Extracted from Breastcancer.org
Perhaps the most frustrating change in your sexual life is the loss of libido, of “those urges.” You’ve lost your hair, your breast is altered or gone, you’ve put on weight, you have no energy, you’re tired, you’re nauseated, and you hurt in new places. No wonder you’re not feeling sexy.

 Your sex life may be altered by vaginal pain resulting from breast cancer treatment, especially after bone marrow transplantation. Certain chemotherapies can cause short-term ulcers in the body’s mucous membranes (mouth, throat, vagina, and rectum). Physical changes may result from treatment-induced menopausetamoxifen therapy, or the end of hormone replacement therapy. Add the psychological stress, and pleasure from sex may seem like ancient history.

Advice from your doctors, or from friends who’ve been down the same road, may help, but some impairment of sexual function is generally unavoidable. Over time, however, things do get better.

Depression and libido

Depression is a common result of both the diagnosis and the treatment of breast cancer, and it directly affects your interest in sex. If you’re depressed, sex may be the last thing you want to deal with. (You may even develop a real aversion to sex.) A sensitive partner picks up on this and holds back. But then, when you’ve recovered, your partner may continue to show no interest in sex, and you may assume it’s because you’re no longer desirable, which is most likely not the case.  Being sensitive to your feelings, your partner may be waiting for you to make the first move, safeguarding that you are ready to begin intimacy again.

If you are depressed and unable to turn the corner, you need help. Try to consider therapists or group support. You’ve undoubtedly heard of the success of new medications, but you’ll have to be careful. Some therapies for depression may cause loss of libido, including Prozac (chemical name: fluoxetine) and Zoloft (chemical name: sertraline). Medications must be carefully administered and monitored by a qualified medical professional (usually a psychiatrist). Effective dose levels are important and not always appropriately prescribed, and for many medications it takes three weeks or more for you to feel the benefit.  Discuss with you doctor the side effects of anti-depression medications available and select one that will best benefit you.

Depression, however, is too debilitating a condition to ignore, so be sure to seek help. There are some things that time alone doesn’t heal.

If you are taking tamoxifen, talk to your doctor about which antidepressants are safe for you to take. Some antidepressants — including Paxil (chemical name: paroxetine), Wellbutrin (chemical name: bupropion), Prozac, Cymbalta (chemical name: duloxetine), and Zoloft — interfere with the body’s ability to convert tamoxifen into its active form, preventing you from getting the full benefit of tamoxifen. For more information, please visit the Tamoxifen page.

Hormones and libido

You may find that it has become harder to get aroused, and even harder to experience orgasm. “It takes so long to make it happen,” said one woman. This dullness of response—if you can call it a response—is a consistent complaint. You must be open with your doctor, so that he or she can suggest appropriate medical solutions. Loss of desire and drive may be directly related to your lower estrogen, progesterone, or testosterone levels, brought on by your breast cancer treatment.

If you’re having problems with sex, you might want to try downplaying the importance of orgasm, at least for a while. While you’re recovering, try concentrating on pleasure from touching, kissing, and imagery, rather than penis-in-vagina orgasm. De-emphasizing vaginal orgasm may actually allow it to happen again sooner than you expected.

For some women who’ve had minimal interest in or opportunity for sex before all this happened, loss of libido may not be much of a problem. But if it is for you, talk to your doctor about the possibility of a hormone evaluation. A woman’s sex drive is somewhat dependent on the hormone testosterone (the primary hormone in men), produced in the ovaries and the adrenal glands. A little goes a long way, and an adjustment may help restore sexual interest.

But if your testosterone level is within normal range, more testosterone probably won’t help. In fact, too much testosterone can produce acne, irritability, and male characteristics such as facial hair or a deepened voice. In addition, it’s not known if “testosterone replacement therapy” is safe for women with a personal history of breast cancer.

Pain, nausea, and libido

Painful intercourse can destroy your interest in sex faster than anything else. Vaginal ulcers that arise during certain chemotherapies (such as 5-fluorouracil) are a major source of such pain. The ulcers may be particularly severe in women who have had bone marrow transplantation, but they do go away when treatment ends. Women with genital herpes may have an outbreak of the disease brought on by stress and a weakened immune system. Steroids and antibiotics can cause yeast infections in the mouth and vagina. Pain medications, narcotics in particular, can also reduce libido.

Menopause, whether natural or treatment-induced, can cause thinning and shortening of the vaginal walls. Vaginal dryness (lack of natural lubrication) is another menopausal side effect. These conditions can contribute to pain during sex.

Nausea, a side effect of chemotherapy, can kill your interest in anything, particularly sex. And some anti-nausea medications depress libido.

Skin Care Tips

Extracted from Breastcancer.org

Here are a few things you can do to make the skin less sensitive during radiation treatment and to help it return to normal after radiation treatment is over.

Prevent irritation before and after daily treatments

  • Wear loose-fitting shirts, preferably cotton.
  • Use warm rather than hot water while showering.
  • Try to not let shower water fall directly on your breast.
  • Avoid harsh soaps that have a lot of fragrance; instead use fragrance-free soaps with moisturizers (such as Dove).
  • To help prevent redness and skin irritation, avoid having skin-on-skin contact. This most often happens:
    • where your arm presses against your armpit and the outer portion of your breast
    • along the bottom crease of your breast, where your breast might droop a bit and lie up against your upper belly wall
    • along your cleavage where the breasts snuggle up against each other

    To avoid skin-on-skin contact:

    • Try to keep your arm away from your body whenever possible.
    • Wear a strong bra without an underwire to keep your breasts separated and lifted.
    • If you have large breasts, when you’re not wearing a bra, stick a soft washcloth or piece of flannel or soft cotton under your breast.
  • Regularly dust the breast area and inside skin folds with cornstarch to absorb moisture, reduce friction, and keep you smelling fresh. You can use baby powder made from cornstarch (don’t use talc) or sifted kitchen cornstarch. Apply it with a clean makeup brush or put some cornstarch into a single knee-high nylon or thin sock and knot it at the top. Gently tap the sock against the skin to dust the surface. If your doctor has recommended using creams or salves, apply those first, then dust the area with the cornstarch.
  • With or without radiation, yeast infections are common in the skin fold under each breast — particularly during warm weather in women with large breasts. Signs of yeast infections are redness, itchiness, and sometimes a faint white substance on the skin. If you have a yeast infection, take care of it before radiation starts so it gets better, not worse. An anti-fungal cream (such as athlete’s foot medicine) usually works well.

Manage irritation during and after your course of radiation

  • At the beginning of treatment, before you have any side effects, moisturize the skin after your daily treatment with an ointment such as A&D, Eucerin, Aquaphor, Biafene, or Radiacare. You also can put it on at night — wear an old T-shirt so the ointment doesn’t get on your bed clothes.
  • For mild pinkness, itching, and burning, apply an aloe vera preparation. Or try 1% hydrocortisone cream (available without a prescription at any drugstore). Spread the cream thinly over the affected area 3 times a day.
  • If areas become red, itchy, sore, and start to burn, and low-potency cream no longer relieves your symptoms, ask your doctor for a stronger steroid cream available by prescription. Examples include 2.5% hydrocortisone cream and bethamethasone.
  • Some people get some relief by blowing air on the area with a hair dryer set to “cool” or “air” (no heat).
  • Don’t wear a bra if there are raw areas.
  • If your skin becomes dry and flakey during the course of your treatment, moisturize frequently and cleanse skin gently.
  • If your skin forms a blister or peels in a wet way, leave the top of the blister alone! The bubble keeps the area clean while the new skin grows back underneath. If the blister opens, the exposed raw area can be painful and weepy. Keep the area relatively dry and wash it with warm water only. Blot the area dry and then apply a NON–ADHERENT dressing, such as Xeroform dressings (laden with soothing petroleum jelly) or “second skin” dressings made by several companies. To relieve discomfort from blistering or peeling, take an over-the-counter pain reliever, or ask your doctor for a prescription if you need it.

What about sun exposure during radiation therapy?

  • During radiation, it’s best to keep the treated area completely out of the sun.
  • Wear a bathing suit with a high neckline.
  • Wear a cover-up when you’re not in the water.
  • Wear an oversized cotton shirt to cover the treated area and allow it to breathe.
  • Avoid chlorine. Chlorine is very drying and can make your skin reaction worse.
  • If you do swim in a pool, you might want to spread petroleum jelly (a product like Vaseline) on the treated area to keep chlorinated water away from your skin.

After your radiation treatment is done, the skin that has been exposed to radiation may be more sensitive to the sun than it was in the past. You can go out in the sun and have fun, but continue to protect your skin:

  • Use a sunblock that is rated SPF 30 or higher on the area that was treated. (A strong sunblock is a very good policy for every inch of your body.)
  • Apply the sunblock 30 minutes before you go out in the sun.
  • Reapply the sunblock every few hours, as well as when you get out of the water.

Appetite Changes During Treatment

Extracted from  Breastcancer.org

Page last modified on 09/17/2012 10:59 PM

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You and your doctor can’t predict exactly how your treatment will affect your appetite. You may continue to enjoy cooking and eating and have a normal appetite. Or you might have days when you don’t feel like eating anything, days when you want to eat everything, and times when only some things taste good. Your sense of smell and sense of taste may change. It’s best to have a flexible, healthy eating plan to help you deal with your body’s changing needs and wants.

Appetite changes can be caused by all breast cancer treatments:

As you move through your treatment, listen to your body and give it what it needs. If you continue to have problems eating, make sure your doctor and registered dietitian know. Not getting enough fluids, protein, and calories can contribute to feelings of tiredness or fatigue, which is one of the most frequent side effects of breast cancer treatment.

Managing appetite loss

  • Try new foods. If you start to dislike your favorite foods, try foods that are different from what you normally eat. Be sure to try new foods when you’re feeling good so you don’t develop more food dislikes.
  • Eat lightly and several hours before you receive a treatment. This helps prevent food aversions caused by nausea or vomiting after chemotherapy, targeted therapy, or radiation.
  • Ask another person to cook for you, or rely on prepared foods from a store if you can’t stand cooking smells. You can also order take-out.
  • Try eating cold foods such as yogurt, cottage cheese, or a sandwich because there will be fewer smells.
  • Try eating with plastic utensils if your food tastes like metal.
  • Rinse your mouth with tea, ginger ale, salted water, or baking soda dissolved in water before you eat to help clear your taste buds. Some people say that sucking on ice chips in between bites of food helps numb their taste buds so they can eat.
  • Don’t force yourself to eat foods that taste bad to you. Find substitutes that you can tolerate.
  • Eat small, frequent meals. It may be easier to eat more that way.
  • Keep snacks close at hand so you can eat when you feel like it. Cheese and crackers, muffins, peanut better, and fruit work well.
  • Don’t wait until you feel hungry to eat. If you have no appetite, think of eating as a necessary part of your treatment. Try to eat at least a little something at regularly scheduled times during the day.
  • Consider a liquid protein supplement if you’re having trouble getting enough protein. Commercial products are available. Ask your doctor or registered dietitian for product recommendations and other eating tips.

Managing increased appetite

  • Make healthy food choices. Eat lots of fruits, veggies, beans, and whole grains. You’ll feel full longer and be less tempted by high-calorie, low-nutrient junk food.
  • Drink water or low-calorie drinks if you’re hungry between meals, or eat sugarless candy or fruit. Avoid lemonade, sweetened ice tea, and juices.
  • Keep low-calorie snacks on hand, such as:
    • carrot and celery sticks
    • bite-sized pieces of broccoli, cauliflower, or other vegetables
    • low-fat cottage cheese
    • apple slices
    • raisins
    • orange sections
    • rice cakes
    • low-fat frozen treats
    • pretzels
    • air-popped popcorn
    • sugarless hard candy
    • flavored decaffeinated coffee
    • fruit tea or herbal tea
    • water flavored with lemon or lime
    • broth or bouillon
    • low-fat gelatin