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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.

Is Heartburn Troubling you?


Heartburn, also known as gastric reflux or indigestion, happens after you eat and food is in your stomach. In the stomach, food is broken down by acids. Usually these acids stay in your stomach because a valve blocks the acids from going up the esophagus. Sometimes this valve doesn’t work properly because the muscle weakens. When this happens, gastric acids can travel up the esophagus and cause a burning sensation — this is heartburn. When these acids travel up into the mouth and then down into the lungs, they can cause gastroesophageal reflux disease (GERD).

Symptoms of heartburn and GERD include:

  • irritating burning sensation in the chest or throat
  • middle back pain
  • coughing spells
  • bitter, acidic taste in the mouth
  • an increase in the burning sensation while lying down

Breast cancer treatments that can cause heartburn and GERD are:

Bisphosphonates, medicines that are used to protect bones during breast cancer treatment, also may cause heartburn and GERD.

Heartburn also can be caused by some pain medications you may be taking during breast cancer treatment, including NSAIDs (non-steroidal anti-inflammatory drugs) such as aspirin and ibuprofen (one brand name: Advil).

Managing heartburn and GERD

Symptoms of heartburn and GERD can be the same as some symptoms of serious medical conditions such as a heart attack, stomach ulcer, and gall bladder and pancreatic problems. Talk to your doctor right away if you’re heartburn or GERG symptoms.

To reduce your risk of heartburn and GERD, you also can:

  • Avoid highly acidic and caffeinated foods and drinkssuch as citrus fruits, fatty and fried foods, garlic, onions, mint, spicy foods, tomato-based foods, carbonated drinks, and vinegar.
  • Lose weight. Being overweight can increase the risk of heartburn.
  • Limit alcohol use. Alcohol can upset your stomach and cause heartburn.
  • Reduce stress through exercise, meditation, or massage.
  • Quit smoking.
  • Prop up your head while sleeping. Sleep with your head on two or more pillows. Or, try putting wooden blocks under the two feet of the bed closest to the headboard to slant your bed down. This will help keep the gastric acids from traveling up the esophagus.
  • Don’t wear tight clothes or belts. Looser clothing can help alleviate some heartburn symptoms.
  • Avoid unnecessary bending. Bending at the waist can send stomach acids into the esophagus.
  • Slowly eat small amounts of food, to better let your stomach digest.
  • Don’t lie down after a meal. And don’t eat 2 to 3 hours before you go to bed.
  • Talk to your doctor about prescription or over-the-counter medications that can help your heartburn.

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.

Other Side Effects – Neuropathy

Extracted from Breast Cancer.org

Neuropathy is the general term for pain or discomfort caused by damage to the nerves of the peripheral nervous system. Your peripheral nervous system is made up of the many nerves that bring signals from the brain and spinal cord to other—or peripheral—parts of the body, such as the hands and feet. Damage to those nerves can affect the way the body sends signals to muscles, joints, skin, and internal organs. This can cause pain, numbness, loss of sensation, and other symptoms.

For people with breast cancer, the most common cause of uncomfortable or even painful neuropathy that limits activity is chemotherapy—often referred to as chemotherapy-associated peripheral neuropathy. Chemotherapy medications travel throughout the body, where they can cause damage to the nerves.

Chemotherapy medications that can cause neuropathy include:

Chemotherapy-associated neuropathy can start any time after treatment begins, and it may worsen as treatment continues. Usually it begins in the toes, but it can expand to include the legs, arms, and hands. The most common symptoms include:

  • pain, tingling, burning, weakness, tickling, or numbness in arms, hands, legs, and feet
  • sudden, sharp, stabbing, or shocking pain sensations
  • loss of touch sensation
  • clumsiness
  • trouble using hands to pick up objects or fasten clothing

Other possible symptoms are:

  • balance problems and difficulty walking
  • hearing loss
  • jaw pain
  • constipation
  • changes in sensitivity to temperature
  • decreased reflexes
  • trouble swallowing
  • trouble passing urine
  • blood pressure changes

Managing neuropathy

If you suspect you have neuropathy, talk to your doctor as soon as possible. Your doctor might be able to switch your medication to ease your nerve problems. Your doctor also may prescribe medicines, pain patches, or topical creams that can help. If neuropathy isn’t treated, it can become a long-term problem.

Depending on what symptoms you’re experiencing, you may find the following tips helpful in managing the effects of neuropathy:

  • Handle sharp objects carefully to avoid cutting yourself accidentally.
  • Be careful when moving. Walk slowly and use handrails if they’re available.
  • Put no-slip bath mats in your tub or shower to avoid falling.
  • Clear areas where you frequently walk of objects such area rugs, cords, toys, and other clutter, to reduce your risk of tripping and falling.
  • Consider using a cane to steady yourself.
  • Protect your feet from injury by wearing shoes or slippers as often as possible.
  • Check water temperature with a thermometer or wear gloves to avoid burning yourself when you’re bathing or cleaning.
  • Get plenty of rest.
  • Find a physical therapy or exercise program designed for people with neuropathic pain.
  • Consider complementary medicine techniques such asacupuncture and massage to help stimulate and restore feeling in your nerves.
  • Ask your doctor about seeing a pain specialist if your symptoms are severe and/or long-lasting.

Fertility and Breast Cancer

Extracted from Breastcancer.org

 

Most doctors define infertility as not being able to become pregnant after 1 year of trying or not being able to maintain a pregnancy.

At some point in their lives, most people think about having children. While not everyone decides to have kids, most people want the option. Some treatments for breast cancer can cause temporary infertility or make it harder for you to get pregnant after treatment ends. Other treatments cause permanent and irreversible menopause, which means you are permanently infertile.

There are 3 hormonal therapies approved for treating pre-menopausal women: tamoxifenEvista (chemical name: raloxifene), and Fareston (chemical name: toremifene). These hormonal therapies can cause your periods to become irregular or stop and make your ovaries stop producing eggs. Many women are still fertile and start their periods again after hormonal therapy treatment is done. But it’s important to know that some women have problems getting pregnant after hormonal therapy.

Ovarian shutdown (which is done with medication and surgical removal of the ovaries) causes your body to stop releasing eggs each month so you are no longer fertile. This infertility is permanent.

Chemotherapy may damage some of the eggs in your ovaries and may cause your periods to become irregular or stop. If you are premenopausal before starting chemotherapy, your periods may come back after treatment ends. Even if your periods don’t come back, you may still be fertile. If you’re close to menopause when you start chemotherapy, your periods may never come back and you are permanently infertile.

Managing fertility issues

Most doctors consider treating breast cancer more important than fertility issues. But you may not have to choose one or the other. Many women successfully go through treatment and then have a healthy baby.

Talk to your doctor about your fertility options:

  • What’s your prognosis? How serious is your condition? Is your prognosis good? Are you encouraged to become a parent in the future? Or does your prognosis make you not want to take added risks?
  • How safe is it for you to become pregnant? Talk to your doctor about the safety of pregnancy as it relates to your particular kind of cancer. There isn’t definitive evidence that pregnancy affects the prognosis of women diagnosed with breast cancer. But every situation is unique and needs to be evaluated.

If your prognosis is good and pregnancy would be relatively safe, talk to your doctor and a fertility expert about your options for preserving fertility. Do this before you start treatment. You’ll probably want to consider these questions:

  • Can you bank fertilized eggs now, in case you can’t produce eggs later?
  • Is ovarian stimulation (with in vitro fertilization) the only realistic option for getting enough eggs?
  • Is there another type of fertility treatment that might be less risky for you?
  • Should some of your ovarian tissue be frozen instead of, or in addition to, your eggs?
  • Should you consider taking drugs to suppress your ovaries during chemotherapy?
  • What are the demands and costs involved — medically, financially, and time-wise — with each approach?
  • Can you postpone treatment? Would it be safe for you to postpone treatment for 6 weeks to allow time for ovulation stimulation and in vitro fertilization?
  • Are fertility drugs safe for you? Are the hormones that will be used to stimulate ovulation safe for you or are the estrogen levels risky?
  • Whose sperm will you use? If you’re in a committed relationship with a man, you need to be sure both you and your partner are equally committed to having children. If you’re single or in a committed relationship with a woman, you, or you and your partner, have to consider whether you’re willing to pursue sperm donation.
  • Can you afford fertility procedures? Find out if your health insurance covers fertility procedures and think about what you’ll do if the procedures aren’t completely covered.

If your ovaries permanently stop producing eggs after treatment, you can still be a parent if you are open to the idea of having a child without using your eggs. There are several options:

  • Egg donation: Donated eggs come from women who volunteer to go through a cycle of hormone stimulation and have their eggs collected. After the eggs are retrieved from the donor and fertilized with your partner’s (or donated) sperm, the embryo is transferred to your uterus.
  • Embryo donation: A fertilized egg from another couple is transferred to your uterus.
  • Surrogacy: A woman becomes pregnant through artificial insemination with your partner’s sperm and carries the baby through birth.
  • Adoption: Adoption is available to just about anyone who would like to become a parent. While some agencies prefer a two-parent household, many others are happy to place a child in a loving-single parent home. It’s helpful to talk to an experienced adoption counselor who can help guide you through the process.