The outcome can also be!
Breast cancer is the most common type among women in Brazil. And it demands the appropriate attention. But it does not mean it’s the end of the line for a long time now. Treatments have increasingly been improved and the chances of cure are bigger and bigger.
But, for this to happen, remember that the mastologist is your best friend,the specialist who diagnoses, treats and rehabilitates any breast disease. So, don’t go looking for miraculous treatments on “Doctor Internet”, with or without other specialists.
BREAST CANCER IS NOT ALL THE SAME
One of the most used categories nowadays separates the disease into 4 groups:
Luminal A
Hormone-sensitive, low-risk tumors
Luminal B
Hormone-sensitive and more aggressive tumors
Triple-Negative
Negative for estrogen and progesterone, and negative for the oncogene HER2
HER2-Positive
Are those containing an oncogene called HER2
NEITHER IS THE TREATMENT
Besides depending on the type of cancer, the treatment varies according to the phase of the disease. Besides the surgery, in which the tumor is removed, there is:
Chemotherapy
Here is where the medication comes into the picture to destroy the cells forming the tumor, preventing that they multiply.
The chemo may be administered in 8 different ways: oral, intravenous, intramuscular, subcutaneous, intracranial, intra-arterial, intraperitoneal and topical (exception).
Hormonal Therapy
This treatment is frequently used after the surgery, to reduce the risk of the disease coming back. This is because this therapy attacks cancer cells in any part of the body. Remember that, in spite of the name, it is a hormonal blockade.
Radiotherapy
It is a treatment where ionizing radiations are used in the tumor. The aim is also to destroy or prevent the tumor cells from growing. Many times, the patient feels nothing at all.
HOW IT IS GOING TO WORK
Is the cancer accurately diagnosed? Your medical team will recommend the ideal treatment. In most cases, more than one treatment is used.
WHAT ABOUT THE SIDE EFFECTS?
Don’t panic. Each human body is unique, so each person responds in a specific way in relation to each treatment. This means that not every side effect is felt by every patient during the same phases of the treatment. So, do not suffer in advance! =]
However, possible side effects according to each treatment are:
Surgery
• Neck and back discomfort
• Short-term pain
• Changes in skin sensitivity
• Accumulation of lymphatic fluid in the adipose tissue
• Lymphedema
Radiotherapy
• Tiredness
• Loss of appetite and difficulty in swallowing food
• Skin reaction (it may itch, become red, irritated, burnt, becoming dry and scaly)
Hormonal Therapy
• Fatigue
• Mood swings
• Hot flashes
• Vaginal dryness
• Changes on sex drive
• Mood changes
Chemotherapy
• Changes on skin and nails
• Changes on sex drive
• Changes on mood
• Anemia
• Diarrhea or constipation
• Fatigue
• Bruises and hemorrhages
• Infection
• Infertility
• Inflamações na boca
• Mouth inflammations
• Nausea and vomit
• Loss of appetite
• Hair loss
• Weight loss
• Concentration problems
• Neurological and muscular problems, such as numbness, tingling and pain
• Renal problems
LIVING (WELL) WITH THE TREATMENT
“Nowadays, it is possible to keep a good quality of life during the breast cancer treatment phase. Surgeries are increasingly less radical and, even when chemotherapy is necessary, we have better control of the side effects!”
Dr. Gilberto Amorim
In addition to the treatments mentioned above, some other professional care may help you go through this phase the best way possible:
PALLIATIVE CARE
Palliative medicine is a specialty that treats patients who have a serious disease, with the main objective of mitigating the suffering, reducing the risks and improving the quality of life.
Palliative medicine is provided by a multiprofessional team that gives support not only to the patient, but also to the patient’s family members and caretakers.
In addition to working on physical symptoms, it treats psychological, social and spiritual symptoms. And it is even able to assist in decision-making.?
PSYCHOLOGICAL COUNSELING
Breast cancer diagnosis is scary, and so are the treatments that normally come after that. In addition, there are many questions concerning the possible causes of the disease, from openly admitting the situation or not, to receiving a torrent of suggestions.
For this reason, the possibility of psychological counseling is extremely valuable, helping to cope with painful aspects involving the stigma of the disease, the fears raised, and the changes, even if temporary.
With a healthy mind, everything gets easier! ?
NUTRITIONAL FOLLOW-UP
Focus on the diet! A healthy diet is decisive to reduce symptoms and potentialize the treatment.
These are simple recommendations, but they are effective: do not drink alcoholic beverages; do not forget about the vegetables, greens and fruits; avoid industrialized and ultra-processed foods, besides keeping away from foods that are rich in refined sugar and saturated fats.
It is also important to reduce the consumption of red meat, drink lots of water and not smoke. ?
PHYSICAL FOLLOW-UP
You already know that physical activity is good for you, but maybe you hadn’t realized that it is also excellent during an oncological treatment. And it is excellent because physical exercise regimes, mainly of medium and high intensity, can prevent and control the adverse effects associated with the treatment.
According a recent publication in The Oncologist (2019), exercises of physical resistance and high intensity interval training reduce hospitalizations during chemotherapy in breast cancer patients. This is one more proof that physically active patients during the oncological treatment endure it better.
Believe it: physical exercise is also a medication for cancer!
To live well during the treatment, it is also important to talk about two of the main fears: mastectomy and hair loss.
Mastectomy consists of removing the entire breast in order to treat the cancer. Many times, it is carried out when the patient cannot be treated with lumpectomy, a surgery that keeps most part of the breast.
During or after mastectomy, the patient may opt for breast reconstruction, which restores the appearance of the breast.
There is also the preventive mastectomy, which is rare and recommended in cases of a strong family background of breast and ovary cancer. How is this background assessed? Preferably, after genetic counseling and tests that monitor mutations. It is the famous case of Angelina Jolie, remember?
Hair loss occurs because chemo mainly affects the cells that frequently multiply, such as hair cells.
Keep in mind that not every kind of chemo causes hair loss. But, if this is your case, you should know that 2 or 3 months after the end of the sessions, your hair will grow back again. During this phase, many women take this opportunity to change their appearance by wearing headscarves, wigs, hats… All it matters is to protect the scalp against the sun and, of course, to feel good!
Some Oncology D’Or units offer the Scalp Cooling service, which is a cooling cap that helps preserving the hair during the treatment.
FACT OR FAKE?
Pass the mouse, if you are using a computer, or click on the cards below, on your cell phone, to visualize the answer.
Every breast cancer must be operated on as soon as it is found out
FAKE!
The pillar of the breast cancer treatment is surgery, but there are cases where the oncological treatment can be inverted, with the chemo coming first and, consequently, going through surgery under better conditions.
You can’t remove your cuticles during the treatment
FACT!
But it depends! Women who have had the total removal of underarm lymph nodes have this restriction. This is because it can favor the entrance of bacteria and cause infection.
A “positive” attitude is essential for the cure
FACT!
It is natural to feel sad, but a positive attitude can help you keep social and family connections, which are fundamental for you to remain active, besides mitigating the side effects of the treatment. During the sad moments, find someone who will understand you, without any judgment. And if you are the patient’s friend/family member, remember: you are very important in helping the patient to regain the mood during a difficult moment, but if you are too picky, it will not help at all. Sometimes comforting the patient gives her the strength to move forward!
Hair dying is not recommended during the treatment
FAKE!
Although… it is suggested to avoid ammonia or, at most, a concentration of up to 2%. In addition, if the patient has been using the cool cap technique and has been maintaining her hair, hair dying is not recommended.
The immunity of those who go through treatment does not change
FACT!
At least in most patients, immunity is preserved. And even those patients going through chemo, the decrease in immunity is specific and transitional. However, occasionally, infections may occur.
Can the cancer return?
UNFORTUNATELY,
FACT!
But it is important to keep in mind that treatments are getting better and better. For this reason, even when the tumor returns in the breast or other parts of the body, we still expect the treatment result to be increasingly better.
SOME GOOD TIPS
Books:
• Você é mais Forte do que o Câncer (You are Stronger Than Cancer)
• Paciente com câncer: um guia para quem acabou de receber o diagnóstico (Patient With Cancer: A Guide for Those Who Have Just Received the Diagnosis)
• A História dos Seios (The Story of Breasts)
• Cadê seu Peito, Mamãe? (Where is Your Breast, Mom?)
• Por uma Vida Inteira (For an Entire Life)
• Mastectomia: Mantendo a Qualidade de Vida Após o Câncer de Mama (Mastectomy: Keeping the Quality of Life After Breast Cancer)
• O que as Mulheres querem saber sobre o Câncer de Mama (What Women Want to Know About Breast Cancer)
Movies:
• Ice Bound (2003)
• Decoding Annie Parker (2014)
• Cristina (2016)
• Lipstick: Why I Wore Lipstick to My Mastectomy (2006)
• Stepmom (1998)
Series:
• Sex and the City – Samantha Jones [Kim Cattrall] receives the breast cancer diagnosis in the last season of the series.
• Parenthood – Kristina Braverman [Monica Potter] finds out she has breast cancer right after she and her husband are dismissed from work, and after the highly-anticipated birth of their daughter.
