Side Effects

Long-term and late side effects of breast cancer treatment may include:

  • Lymphedema 
  • Memory loss and cognitive function (“chemo brain”)
  • Pain and numbness (peripheral neuropathy)
  • Fatigue
  • Menopausal symptoms
  • Dental issues 
  • Bone loss and osteoporosis
  • Heart problems
  • Vision Problems
  • Headaches
  • Blood clots

Lymphedema

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Following treatment, some breast cancer survivors may suffer from lymphedema, a chronic condition caused by lymphatic fluid accumulating in the tissues. It affects the limbs and can also cause swelling in other parts of the body. 


Doctors do not fully understand why some breast cancer survivors  suffer from lymphedema after treatment while others remain unaffected.


Management

  • Do not get needle sticks or blood pressure in the arm where the lymph nodes were removed
  • Be vigilant in treating injuries and cuts that happen in that arm
  • Learn about preventative measures before your surgery and request that it be part of your preoperative teaching

The risk of developing lymphedema continues for the rest of your life so it is critical to be aware of the risks. 


Treatment

Decongestive therapy by a certified lyphedema specialist is the best prescription for lymphedema. 

  • Massaging the affected areas (by therapist) to help move excess fluid to healthy tissue
  • Completing exercises (by you) to help ease swelling
  • Wearing compression garments (by you) to increase tissue pressure and keep fluid moving


Please consult your physician or other health care provider to learn more about lymphedema treatment.

Chemo Brain

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Chemo brain is mental cloudiness during and after cancer treatment. The exact cause is unknown, but it can last a short time or for years, and can make you unable to go back to school, work, or participate in social activities.


There are  things that you can do to help you manage chemo brain:


  • Use a detailed daily planner or your smart phone 
  • Exercise your brain
  • Get enough rest and sleep
  • Move your body
  • Eat veggies 
  • Try to keep the same daily schedule
  • Don’t try to multi-task
  • Track your memory problems
  • Try not to focus on how much these symptoms bother you

Please consult your physician or other health care provider to learn more about chemo brain.

peripheral neuropathy

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Some chemotherapy drugs can cause peripheral neuropathy, a set of symptoms caused by damage to nerves that control the sensations and movements of your arms and legs. 


According to the American Cancer Society, the most common symptoms are:

  • Pain (which may be there all the time or come and go, like shooting or stabbing pain)
  • Burning/Tingling (“pins and needles” feeling) or electric/shock-like pain
  • Loss of feeling (which can be numbness or just less ability to sense pressure, touch, heat, or cold)
  • Trouble using your fingers to pick up or hold things; dropping things
  • Balance problems
  • Trouble with tripping or stumbling while walking
  • Being more sensitive to cold or heat
  • Being more sensitive to touch or pressure
  • Shrinking muscles
  • Muscle weakness
  • Trouble swallowing
  • Constipation
  • Trouble passing urine
  • Blood pressure changes
  • Decreased or no reflexes

Please consult your physician or other health care provider to learn more about chemo-induced peripheral neuropathy.

fatigue

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Fatigue is the most common side effect of breast cancer treatment. An estimated 9 out of 10 people experience some fatigue during treatment. Fatigue can last for months or even years after treatment ends.


Symptoms

  • Lack of energy
  • Sleeping more
  • Not wanting to do normal activities or being unable to do them
  • Paying less attention to personal appearance
  • Feeling tired even after sleeping
  • Trouble thinking or concentrating
  • Trouble finding words or speaking

Treatment Causes

  • Surgery
  • Chemotherapy
  • Radiation therapy
  • Hormonal therapy


Management

Because there are so many causes, there is no one solution to relieve fatigue. Here is a list of practices that many women have used:

  • Acupuncture
  • Massage
  • Meditation
  • Reiki
  • Tai chi
  • Yoga

The American Cancer Society recommends that people who have been diagnosed with breast cancer exercise regularly to improve their quality of life (and reduce fatigue).


Please consult your physician or other health care provider to learn more about breast cancer-related fatigue.

menopause

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Most women go through menopause (cessation of monthly menstrual cycle) as a natural part of the aging process, right around age 51 on average — some sooner, some later. But if you’ve been diagnosed with breast cancer before menopause, some of your treatments could bring on menopause more quickly and more abruptly than expected. This is called medical menopause.  


Medical menopause causes a sudden and dramatic shift within the body —lowering hormone levels within days or weeks instead of years. Symptoms often come on more abruptly than they would with a natural menopause. Although these symptoms can be uncomfortable for anyone, they can be particularly hard to deal with during or after breast cancer treatment.     


Symptoms 

  • Hot flashes 
  • Vaginal changes 
  • Weight gain 
  • Sleep problems 
  • Grieving, depression, and mood changes 
  • Memory problems 
  • Skin changes 
  • Hair changes    


Management   

There are ways to manage symptoms and live more comfortably with menopause. Lifestyle changes (diet, exercise, smoking cessation, emotional support) may be just as important and effective as medications in helping you feel better and live well.  See our lifestyle tips on the SISTAAH Talk Cancer Prevention page.


Please consult your physician or other health care provider to learn more about surgical menopause.

dental issues

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One out of every 3 people treated for breast cancer can develop complications that affect the mouth. Chemotherapy can effect saliva production, leading to dry mouth, and serious dental implications. 


Symptoms

  • Inflamed oral tissues
  • Cavities 
  • Bleeding gums
  • Difficulty swallowing
  • Lack of taste
  • Loss of appetite
  • Speech problems
  • Difficulty sleeping

Management

  • Brush with a soft toothbrush or sponge brush to clean your teeth and gum
  • Floss gently and regularly 
  • Use alcohol-free mouthwash containing xylitol
  • Avoid dental treatment for about a week after chemotherapy
  • Use toothpaste and chewing gum with xylitol
  • Make sure you keep denture clean and that they fit well
  • Take dentures out at night
  • Report all mouth changes to your physician
  • Seek regular dental care (especially at the beginning of treatment) or as recommended by an oncologist

Practice good oral hygiene to decrease bacteria levels in the mouth to relieve some of the side effects of breast cancer treatment. 


Please consult your physician, dentist, or other health care provider to learn more about dental issues for breast cancer survivors.

osteoporosis

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Women who have been treated for breast may be at greater risk for osteoporosis and fracture.  The drop in estrogen (which has a protective effect on bone) is reduced due to chemotherapy. Women who were premenopausal before breast cancer treatment go through menopause earlier than those who have not had the disease. Because of chemotherapy or surgery, reduced levels of estrogen trigger bone loss. Studies also suggest that chemotherapy may have a direct negative effect on bone. Breast cancer itself may also stimulate the production of osteoclasts, the cells that break down bone.


Management

For women diagnosed with breast cancer, there are strategies to reduce the risk or lessen the effects of osteoporosis:

  • Diet rich in calcium (low-fat dairy products; dark green, leafy vegetables; and calcium-fortified foods and beverages)
  • Vitamin D (400 to 800 IU International Units)
  • Weight-bearing exercises (walking, climbing stairs, lifting weights, and dancing)
  • Bone density test
  • Medications for prevention and treatment

Please consult your physician or other health care provider to learn more about osteoporosis or bone loss for breast cancer survivors.

heart problems

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Many things can cause heart problems, including stress, being overweight, and smoking. But for breast cancer survivors, several treatments can also cause heart problems. Most doctors believe that if heart problems occur during treatment, your heart will probably regain full function after treatment ends. To make sure, your doctor may test your heart before you start treatment for breast cancer and several times during treatment.  


Symptoms 

  • Breathing problems
  • Rapid or irregular heartbeat 
  • Coughing 
  • Swelling of feet and lower legs 
  • Feeling weak or dizzy 
  • Fatigue   

Management 

  • Control your blood pressure   
  • Stop smoking 
  • Exercise regularly 
  • Reduce stress levels  
  • Manage your cholesterol levels  
  • Eat a healthy diet 
  • Loose weight and maintain a healthy weight      

Please consult your physician or other health care provider to learn more about health problems for breast cancer survivors.

Vision Problems

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Though not a common side effect, breast cancer treatment may affect your eyes, including your vision. Chemotherapy, radiation, and hormone therapy medications may cause ocular side effects. During breast cancer treatment, you can experience many side effects. 


Symptoms

  • Red, itchy, or dry eyes
  • Watery eyes
  • Conjunctivitis (pink eye)
  • Blurry or double vision
  • Seeing dark spots

Management

  • Baseline eye exam within the first year of treatment
  • Blink frequently to lubricate your eyes
  • Artificial tears or eye drops 
  • Wearing your glasses instead of contact lenses 
  • Avoid rubbing your eyes
  • Wash your hands before you touch your eyes


Please consult your physician or other health provider to learn more about vision problems during breast cancer treatment.

Headaches

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Breast cancer treatments (chemotherapy, hormonal therapy, and targeted therapy) can cause headaches.  


Symptoms include throbbing, sharp, steady, or dull pain in the head


Prevention

  • Relaxation techniques (deep breathing, meditation, progressive muscle relaxation)
  • Regular exercise
  • Adequate sleep
  • Avoid caffeine
  • Avoid cigarette smoke
  • Regular meals

Management 

  • Ice packs
  • Quiet, dimly lit room
  • Warm bath or shower

Please consult upper physician or other health care provider to learn more about headaches during breast cancer treatment.

blood clots

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Breast cancer and its treatment places survivors at a higher risk of blood clots. A blood clot develops in a vein, is called venous thromboembolism (VTE); a blood clot in the legs, thighs or pelvis, is called deep vein thrombosis (DVT). 


Causes

  • People with cancer have higher than normal amounts of platelets and clotting factors in the body and their blood is more likely to clot
  • Some treatments for breast cancer (surgery, chemotherapy, hormone therapy, and targeted therapy) may increase the risk of blood clots
  • Heart disease, diabetes, smoking, personal or family history of VTE or DVT, fractures, being sedentary, overweight and/or obesity can also increase your chances of developing blood clots 

Symptoms

  • Pain, redness/discoloration, heat and swelling of the calf, leg or thigh
  • Swelling, redness or tenderness where a central line is inserted to give chemotherapy (arm, chest area, or neck)
  • Shortness of breath
  • Tightness in the chest
  • Unexplained cough

Management

  • Anticoagulants (blood thinners)
  • Regular blood tests
  • Leg exercises
  • Regular, short walks
  • Drinking plenty of water

Please consult your physician or other health care provider to learn more about preventing blood clots during and following breast cancer treatment.