How to Manage Side Effects During Breast Cancer Treatment

When you or a loved one is diagnosed with breast cancer, it can feel like your world has been turned upside down. Luckily, the grand majority of breast cancer diagnoses are not metastatic, meaning that the cancer has not spread beyond the breast. Of the new cases of invasive breast cancer that are diagnosed in women in the United States each year, more than 90% of them are considered “early stage.”

Still, even early-stage breast cancer can be intimidating, and the treatment can cause both physical and mental changes. Read on to learn about how breast cancer is classified, what happens to your body during treatment for early-stage breast cancer, how to manage side effects, and how to cope.

What is Early Stage Breast Cancer?

Cancer of any sort is caused by unregulated growth of abnormal cells. Breast cancer starts in the breast tissue and can be unique because of its relationship to hormones such as estrogen and progesterone, and certain types of proteins.

Cancer doctors (also known as oncologists) use a specific categorization system to classify breast cancers based on the size of the tumor, the number lymph nodes that are involved (if any), and where (if anywhere) the cancer has spread. This is known as the TNM system — tumor, nodes, metastasis— and it dictates how breast cancer is labeled, for example, “stage IA” or “stage IIB.”

For early-stage breast cancers, treatment generally involves surgical removal of the tumor and potentially radiation therapy. There may or may not be chemotherapy or other systemic therapy involved before or after these treatments. Below is a primer on what to expect with all different types of treatment.

What to Expect with Breast Cancer Surgery

When a surgical oncologist discusses surgery with you, she will take into account all of the information about your personal situation. You may have two surgical options available to you, a “lumpectomy,” or a “mastectomy.”

A lumpectomy only removes the breast tumor and the surrounding tissue. This means that the remaining breast is left in place, which may or may not be important to you from a cosmetic standpoint.

A mastectomy removes the entire breast on one side (a “double mastectomy” removes both breasts), not just the area immediately around the tumor. Depending on your medical history and your preferences, you may have the option to have a procedure to reconstruct your breasts at the time of the surgery or during a later surgery.

Typically lymph nodes will be removed from under the arm as well, in order to establish the “N” part of the “TNM” classification.

Regardless, you can expect certain side effects, such as pain at the incision site and some scarring. You may also experience pain in the area of your armpit where the lymph nodes were removed, and arm swelling called lymphedema. Talk to your surgeon about how to minimize these side effects and how to reduce the potential for infection at the surgical site.

What to Expect with Radiation for Breast Cancer

You may have radiation therapy in addition to your surgery. Radiation introduces consistent disruption of the cancer process by shooting energy waves, x-rays, at the targeted area.

You will have a radiation dose to the same site each day for a certain period of time, usually several weeks. The immediate side effects will be similar to a sunburn—redness at the target area and some skin peeling. You may also experience arm swelling, changes in sensation, tiredness, nausea, and soreness. These symptoms will typically go away after the treatment ends.

What to Expect with Chemotherapy for Breast Cancer

Sometimes your oncologist will recommend chemotherapy before surgery and radiation in order to shrink the tumor cells. This type of chemotherapy is called “neoadjuvant” chemotherapy. Sometimes chemotherapy is offered after surgery and radiation—this is known as “adjuvant therapy.”

Regardless of when chemotherapy occurs, the goal is to kill the rapidly growing cancer cells and to reduce the chance of cancer coming back. Unfortunately, most chemotherapies are not specific to just the cancer cells; they will also disrupt all of the rapidly growing cells in the body, even when they are your own healthy cells, such as hair, mouth, blood, and digestive cells.

Common symptoms of chemotherapy include hair loss, taste changes, mouth dryness, nausea, vomiting, and diarrhea. Chemotherapy can also cause anemia, bone pain, nerve pain, memory problems, and fertility problems.

The grand majority of these side effects will resolve after the chemotherapy treatment stops. However, in the meantime, there are many good medications that your oncologist can prescribe, such as Zofran or Reglan for nausea and vomiting. If you are having nerve pain, you may also be a candidate for a medication called Gabapentin, which can help relieve pain. These medications can be rather pricey, so make sure to use RxSaver to possibly save up to 85% at the pharmacy.

Other Systemic Therapy for Breast Cancer

Chemotherapy is not the only type of whole-body therapy that can be used for early breast cancer. Another way to attack cancer cells is to target their specific identities. This can be with hormonal therapy (if your breast cancer is found to be estrogen or progesterone receptor-positive) or immunotherapy. Both treatments reduce the chance of the cancer coming back after surgery and radiation.

Other Changes with Breast Cancer Treatment

Breast cancer treatment can completely disrupt your physical well-being, daily routine, and sense of normalcy. Because your body can undergo dramatic physical changes, you can also have changes to your self-concept and struggle with your identity. It is common to feel down or depressed.

If you are struggling with anxiety or depression, you are not alone—depression and decreased quality life are particularly common within the first year of a breast cancer diagnosis. Make sure to talk to your oncologist about how you are feeling because she can help connect you with specific resources, including medication, therapy, and breast cancer support groups.