Tag Archive | breast cancer treatments

Breast Cancer Treatment and Bone Loss

Bone_lossExtracted from Breastcancer.org.

Certain breast cancer treatments can speed up bone loss or cause you to lose more bone than you normally would:

Chemotherapy: Some chemotherapy medicines can have a direct effect on your bone health. In other situations, some women who are close to menopause and get chemotherapy may have significant bone loss because the chemotherapy causes early menopause. If chemotherapy pushes your body into menopause, bone loss may begin while you’re still having treatment and continue after treatment is done.

Aromatase inhibitors (hormonal therapy):

  • Arimidex (chemical name: anastrozole)
  • Aromasin (chemical name: exemestane)
  • Femara (chemical name: letrozole)

Aromatase inhibitors work by preventing the formation of estrogen. The loss of estrogen can lead to bone loss during treatment. Aromatase inhibitors are used most often in postmenopausal women diagnosed with hormone-receptor-positive early breast cancer.

Ovarian shutdown using medication or surgically removing the ovaries: Ovarian removal causes irreversible menopause. Your bone density may drop suddenly after ovaries are removed. Ovarian shutdown using medicine temporarily stops your ovaries from producing estrogen.

Other hormonal therapy medicines known as SERMs (selective estrogen receptor modulators) can actually help protect your bones by slowing bone loss. SERMs are:

  • tamoxifen
  • Evista (chemical name: raloxifene)
  • Fareston (chemical name: toremifene)

If an aromatase inhibitor or chemotherapy would have benefits for you, talk to your doctor about ways to protect your bones during treatment. This is especially important if you have any of the risk factors for bone loss:

  • being older
  • being postmenopausal
  • being small and thin
  • a family history of osteoporosis or broken bones
  • having low bone mass (osteopenia)
  • smoking
  • not getting enough calcium or vitamin D
  • not exercising
  • having more than 2 alcoholic drinks several times a week
  • having one of the following medical conditions:
    • hyperthyroidism or hyperparathyroidism
    • chronic lung disease
    • inflammatory bowel disease
    • Cushing’s disease
    • multiple sclerosis
    • arthritis

Different hormonal therapy and chemotherapy medicines can be used in your treatment plan, depending on your unique situation. And your treatment plan can change over time based on your needs, the benefits you’re getting, and any side effects you may have. If you’re worried about the effects of treatment on your bones, ask if you can change your treatment plan.

You’ll probably have a baseline DEXA scan before you start treatment with hormonal therapy or chemotherapy. If you don’t, talk to your doctor to see if having one makes sense for you. During follow-up visits during treatment, ask your doctor about your bone health and whether protective measures are right for you.

More Side Effects – Anemia and Dizziness

 

Anemia means you have a low red blood cell count or your red blood cells don’t have enough hemoglobin. Hemoglobin is an iron-rich protein found in red blood cells that carries oxygen from your lungs to the rest of your body. If you’re anemic, you might experience the following:

You may bruise easily and may bleed more or longer than normal. You also might have frequent nosebleeds.

Anemia can be caused by breast cancer treatments:

Managing anemia

Medications like Epogen (chemical name: epoetin alfa),Aranesp (chemical name: darbepoetin alfa), and Procrit (chemical name: epoetin alfa) can help your body make more red blood cells. Talk to your doctor to see if a medicine like that might be right for you. You can also ask your doctor if an iron supplement would help you.

To help increase your body’s iron levels and ease anemia, try to eat foods that are rich in iron:

  • spinach
  • peanuts, peanut butter, or almonds
  • lean beef
  • eggs
  • fortified cereal
  • lentils

Also try to eat foods that are rich in vitamin B12:

  • liver (cooked)
  • clams (cooked)
  • vitamin-fortified cold cereal
  • wild caught rainbow trout (cooked)
  • sockeye salmon (cooked)

Dizziness

If you’re dizzy, you may feel lightheaded or lose your balance. If you feel that the room is spinning, technically you have vertigo, a related condition.

Dizziness can be caused by a sudden drop in blood pressure or from being dehydrated. If you get up too quickly from a sitting- or lying-down position, you might feel lightheaded. Some women feel dizzy while they’re having a hot flash.

Several breast cancer treatments can cause dizziness:

In addition, some antihistamines, antiseizure medications, antidepressants, and tranquilizers can cause dizziness. Many pain medications can also make you dizzy.

Managing dizziness

In most cases, dizziness caused by medicine to treat breast cancer usually goes away by itself after you’ve received the medicine a few times. If it doesn’t, talk to your doctor. You may be able to take another medicine. If your dizziness is caused by something else, you may be able to do exercises or change your diet to help.

Other tips to manage dizziness:

  • Sit or lie down immediately when you feel dizzy.
  • Ask for help if you need to be somewhere and feel dizzy.
  • Avoid rapid changes in position, especially from lying down to standing up or turning around from one side to the other.
  • Avoid moving your head quickly, especially from side to side, or moving it as far as it will go up or down or from side to side.
  • Remove clutter from areas where you spend the most time.
  • Avoid driving a car or operating heavy machinerywhen you feel dizzy.
  • Keep areas well-lit so you can see clearly. It’s especially good to have a bright lamp near your bed in case you have to get up at night.
  • Use a cane or walker for stability.
  • Wear sturdy shoes to avoid tripping and slipping.
  • Avoid using caffeine, salt, alcohol, and tobacco. These substances all can restrict your blood vessels and worsen any feelings of dizziness you may have.
  • Carry a cell phone or cordless phone with you in the house in case you fall and need help.

Extracted from BreastCancer.Org

Questions to Ask My Doctor About Breast Cancer

Extracted from www.cancer.org

Being told you have breast cancer can be scary and stressful. You probably have many questions and concerns. Learning about the disease, how it is treated, and how this information might apply to you is a lot to do on your own. You might need some help.  American Cancer Society can give you general information about this disease and its treatment, but your doctor is the best source of information about your situation.

It is important for you to be able to talk frankly and openly with your cancer care team.  They want to answer all of your questions, no matter how minor they might seem to you.  But it helps if you know what to ask. Here are some questions that you can use to help you better understand this cancer and your options. Don’t be afraid to take notes and tell the doctors or nurses when you don’t understand what they’re saying.  The questions are grouped by how far along you are in the cancer experience. Not all of these questions will apply to you, but they should help get you started.

For more information on breast cancer please contact the American Cancer Society toll free at 1-800-227-2345 or online at www.cancer.org.

When you’re told you have breast cancer

1. Exactly what type of breast cancer do I have?

2. How do I get a copy of my pathology report?

3. Has the cancer spread to my lymph nodes or other organs?

4. What is the cancer’s stage? What does that mean?

5. How does this affect my treatment options and long-term outcome (prognosis)?

6. What are my chances of survival, based on my cancer as you see it?

7. How much experience do you have treating this type of cancer?

8. Will I need other tests before we can decide on treatment?

9. What are my treatment choices?

10. What treatment do you recommend and why?

11. What is the goal of my treatment?

12. Should I think about genetic testing?

13. Should I get a second opinion? How do I do that?

14. Should I think about taking part in a clinical trial?

 When deciding on a treatment plan

1. What are the chances the cancer will come back after this treatment?

2. What would we do if the treatment doesn’t work or if the cancer comes back?

3. Will I go through menopause as a result of the treatment?

4. Will I be able to have children after treatment? How about breast feeding?

5. How much will I have to pay for treatment? Will my insurance cover any of it?

6. How long will treatment last? What will it involve? Where will it be done?

7. What risks and side effects should I expect?

8. What can I do to reduce the side effects of the treatment?

9. How will treatment affect my daily activities?

10. Will I lose my hair? If so, what can I do about it?

11. If treatment includes surgery:

  • · Tell me about breast reconstruction. Is breast reconstruction surgery an option if I want it?  What would it involve in my case?
  • · Can I have reconstruction at the same time as the surgery to remove the cancer? What are the pros and cons of having it done right away or waiting until later?
  • · Will you have to take out lymph nodes?

12. What will my breasts look and feel like after my treatment? Will I have normal feeling in them?

13. Will the treatment hurt? Will I have any scars?

 Before treatment

1. Will I need a breast form (prosthesis), and if so, where can I get one?

2. What should I do to get ready for treatment?

3. Will I need blood transfusions?

4. Should I change what I eat or make other lifestyle changes?

 During treatment

Once you have decided on treatment, you will need to know what to expect and what to look for. All of these questions may not apply to you, but asking the ones that do may be helpful.

1. How will we know if the treatment is working?

2. Is there anything I can do to manage side effects?

3. What symptoms or side effects should I tell you about right away?

4. How can I reach you on nights, holidays, or weekends?

5. Do I need to change what I eat during treatment?

6. Are there any limits on what I can do? Will I be able to work during treatment?

7. What kind of exercise should I do, and how often?

8. Can you suggest a mental health professional I can see if I start to feel overwhelmed, depressed, or distressed?

9. Will I need special tests, such as imaging scans or blood tests, and how often?

 After treatment

1. Do I need a special diet after treatment?

2. Are there any limits on what I can do?

3. What kind of exercise should I do now?

4. What type of follow-up will I need after treatment?

5. How often will I need to have follow-up exams and imaging tests?

6. What blood tests will I need?

7. How will I know if the cancer has come back? What should I watch for?

8. What are my options if the cancer comes back?

 

Find Financial Help When You have Cancer

Extracted from CancerCare.org

Cancer is an expensive illness. Many of the people who contact cancer agencies  each year cite financial need as a major source of difficulty. Some have no health insurance, some are insured but don’t have coverage for parts of their treatment such as prescription drug co-pays, and many do not have extra income to meet new costs such as child care or transportation to treatment. People with cancer and their caregivers often have to cut back on time spent at work, which means their income decreases at the same time that their bills pile up.

Financial stress often causes emotional stress. For example, when a family is under new financial pressures, it can create feelings of worry, sadness, and anxiety. Because cancer treatment often means years of medical care, financial concerns can influence major life decisions about work, housing, and school. There is assistance available, and CancerCare can help you navigate the maze of government, nonprofit, and pharmaceutical programs, as well as other sources of financial help. Here are some of the things you can do:

Talk to your insurance company. Many companies will assign a case manager to help you work through insurance concerns, clarify benefits, and suggest ways to get other health services.

Talk to your health care providers about your needs. Many treatment centers have social workers who help you sort through financial concerns. CancerCare social workers can also help you.

Find out which government programs (entitlements) you are eligible for, and apply promptly. To contact the Social Security Administration, call 1-800-772-1213 or visit www.ssa.gov. To contact the Centers for Medicare & Medicaid Services, call 1-800-633-4227 or visit www.cms.gov. For Medicaid information, contact local listings for a Medicaid office in your state.

Learn how private organizations can help you. There are nonprofit programs for co-pay relief, as well as pharmaceutical patient assistance programs to help those who do not qualify for other aid. See our listing of financial assistance resources.

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