Tag Archive | health

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.

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.

Bathing Suit Tips and Breast Forms for Swimming

As we head into the winter months, be thinking about summertime and the small alterations that need to be made to your swim suit.  Swimming is a good form of exercise — any time of the year — is a terrific way to strengthen your body before, during, and after breast cancer treatment.  There’s nothing like a cool swim on a hot day to relax your mind and refresh your spirit — just be sure to check with your doctor before starting any new exercise program.Before you start thinking about bathing suits, remember this comforting thought: most women are self-conscious in a bathing suit, whether they’ve been through breast cancer treatment or not. Still, we put up with them because they’re part of the summer package that also includes swimming; a warm, relaxing environment; and outdoor fun.

Sure, there are some women who are completely at-ease in a bathing suit. But if you’re having any feelings of insecurity, look up and down the beach or around the poolside. You’ll see all kinds of bodies: small, medium, large, extra-large. They’re all okay; remember perfection doesn’t exist, well maybe after they have been airbrushed in a magazine, which are not real women. So don’t waste your precious energy on feeling insecure. Instead, use it for pleasant and interesting thoughts, fun, and sharing time with friends and family.

If you’ve recently had surgery for breast cancer, you may be wondering what your options are for buying a bathing suit that’s comfortable for you.

Several bathing suit brands are designed for women who have had breast cancer surgery (mastectomy or lumpectomy). These suits have higher necklines and armholes, to conceal scars. They also have built-in bra pockets for securing breast forms (prostheses) if you have not had reconstruction.

Amoena and It Figures are companies that make bathing suits designed for women who have had breast cancer surgery. Lands’ End offers built-in pockets in many of their swimsuit styles.  You may not need a specially designed bathing suit. If you find standard swimwear that you like, the retailer might be able to add a breast form bra pocket to the inside of the suit. Some stores charge for this service, others don’t. 

For those who want a do it yourself and can sew a straight seem; buy a remnant of Lycra type material used for lingerie (ensure it has stretch capabilities).  Measure the breast area of your suite, cut the material approximately ¼ of an inch larger, to make a pocket once sewn.  Line up the seams of material to the breast area of your suite and pin on the sides and bottom, insert the prosthesis to measure, make adjustments if needed, then sew the seams.  Leave the opening at the top to enable your prosthesis to fit snugly into the pocket, and “ta da” you are done.

If you have not had reconstruction and do use breast forms, you may consider getting a swim form, which is like a conventional breast form but much lighter. Although weighted forms are good for everyday use — to maintain balance and protect against back and neck pain — they may be uncomfortable or just downright heavy when swimming.

Swim forms are less dense and float better than weighted forms. Made from clear silicone, they’re designed to allow water to flow naturally across the chest. Some attach into the bathing suit with fabric tabs, to prevent unexpected “pop-up” moments. Built-in pockets also hold them in successfully.  Whichever suite or prosthesis you choose to wear, remember, summer is about having fun with friends and family.  Enjoy yourself and laugh!  As my friend, Sandy always said, “laughter is the best medicine”.

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

Heart Problems and High Blood Pressure Associated with Breast Cancer – Side Effects

Extracted from breastcancer.org

If you’re having heart problems you may feel that your heart is beating irregularly, very fast, or forcefully in your chest. You may have chest pains or experience a heart attack.

Symptoms of heart problems include:

  • breathing problems
  • rapid or irregular heartbeat
  • coughing
  • swelling of feet and lower legs
  • feeling weak or dizzy
  • fatigue

Many things can cause heart problems, including stress, being overweight, and smoking. Several breast cancer treatments may cause heart problems:

Avoiding heart problems

If you have chest pain or trouble breathing, talk to your doctor right away. Since heart problems can be caused by so many things, it’s important to figure out exactly what’s happening. Your doctor may test your heart before you start treatment for breast cancer and several times while you’re having treatment. If you do happen to have any treatment-related problems, your heart will probably regain its strength and full function after treatment ends.

Other tips to keep your heart as healthy during treatment:

  • Manage high blood pressure, if you’ve been diagnosed with it.
  • Stop smoking.
  • Exercise. Regular exercise can help you maintain a healthy weight, reduce stress, and keep your heart (a muscle) fit.
  • Use relaxation techniques such as meditation and visualization to help reduce your stress levels.
  • Manage your cholesterol levels. Lower your “bad” cholesterol (low-density lipoproteins) and raise your “good” cholesterol (high-density lipoproteins).
  • Eat a healthy diet full of fruits, vegetables, whole grains, and low-fat dairy products. Reduce the amount of fatty meat and sugar you eat.
  • Maintain a healthy weight. If you’re overweight, your heart has to work harder. Excess weight also raises your risk of high blood pressure, diabetes, and high cholesterol, all of which can harm your heart.

High Blood Pressure (Hypertension)

Your blood pressure is the force of your blood against the walls of your arteries as your heart pumps. Every time your heart beats (this is the heart contracting), it pumps blood into the arteries. Your blood pressure is highest when your heart beats and lowest when the heart rests between beats. Blood pressure readings use two numbers, read one over the other. The top number (systolic pressure) measures blood pressure when the heart beats. The bottom number (diastolic pressure) measures blood pressure in between heartbeats. A normal blood pressure reading is 120/80 or slightly lower. If you have a blood pressure reading of 140/90 or higher, you’re considered to have high blood pressure (also known as hypertension).

High blood pressure usually doesn’t have any symptoms, so you may not realize you have it.

Several breast cancer treatments can cause high blood pressure:

Some pain medicines you may be taking during breast cancer treatment also can cause high blood pressure.

Managing high blood pressure

High blood pressure increases your risk of heart problems, stroke, and kidney problems. If you have chest pains, a severe headache, nausea, dizziness, or lose your sight, call your doctor immediately

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?

 

Side Effects – Swallowing, Smell and Taste Changes

Extracted from Breastcancer.org

Problems swallowing, also called dysphagia, can make eating an uncomfortable process. During meals, you may experience gagging, choking, coughing, spitting, or pain when trying to swallow. The sensation that food is stuck in your throat, upper chest, or behind the breastbone can cause feelings of chest pain, heaviness, or pressure.

The following breast cancer treatments can affect your ability to swallow:

Some pain medications also can cause swallowing problems.

Managing swallowing problems

  • Eat slowly and chew food thoroughly to make it as soft and manageable as possible.
  • Try thicker liquids such as milkshakes, yogurt, pudding, and gelatin. Thicker liquids may be easier to swallow.
  • Eat pureed food such as blended meats, cereals, and fruits. You may need to add some liquid.
  • Stay away from dry foods such as crackers, nuts, and chips.
  • Avoid very hot foods, as these could cause more swallowing pain or difficulty.
  • Don’t eat spicy and acidic foods that can irritate your mouth and throat.
  • Ask your doctor if you can crush medicines that are in pill or tablet form and mix with juice or applesauce. Make sure to check with your doctor or pharmacist first — some medicines can be dangerous if crushed. Other medicines react badly with certain foods and others must be taken on an empty stomach.
  • Avoid alcohol — it can burn your mouth or throat if you have sores.
  • Sit up and stay seated while eating to ease the swallowing process.

 


Certain medications can change the way the receptors in your mouth and nose tell your brain what you’re tasting or smelling. Some foods may taste bitter, rancid, or metallic. Foods that used to be your favorites may taste different while you’re getting treatment. This condition usually only lasts as long as treatment does — in most cases, your will senses will return to normal a couple months after you’re done.

The following breast cancer treatments can affect your sense of taste and smell:

Some pain medications also can affect your sense of taste and smell.

Managing taste and smell changes

  • Try new foods. If you find yourself disliking 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 chemotherapy. This helps prevent food aversions caused by nausea or vomiting after chemotherapy.
  • Ask another person to cook for you, or rely on prepared foods from a store if you can’t stand the smell of food. 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.
  • Suck on ice chips in between bites to help numb taste buds.
  • Try other sources of protein such as chicken, turkey, fish, or soy foods if red meat doesn’t taste right. Eggs also have a lot of protein.
  • Eat fresh vegetables. They may be more appealing to you than canned or frozen ones. Canned soups and vegetables may have a metallic taste.
  • Try peeled, sweet baby carrots instead of large unpeeled carrots, which often taste extremely bitter.
  • Don’t force yourself to eat foods that taste bad to you. Find substitutes that you can tolerate.