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What to expect after breast cancer treatment

After you’ve completed your breast cancer treatment, you may struggle with the lingering physical and emotional effects. It’s common to have difficulty moving on from cancer – you are not alone.

What to expect: the physiological things

A woman with a headscarf smiles at her doctorSome side effects may linger after treatment is over, including neuropathy, fatigue and “chemobrain,” which refers to trouble with memory and focusing caused by chemotherapy. Breast cancer patients taking endocrine therapy such as Tamoxifen, an estrogen-blocker prescribed to prevent recurrence, may also experience some side effects like hot flashes and night sweats. “Physically, my patients typically get back to where they were at pre-diagnosis in about three to six months, but everyone is different” says Dr. Carol Townsley, medical director at the After Cancer Treatment Transition Clinic (ACTT) at Women’s College Hospital. Listen to your body, and talk to your doctor about solutions for ongoing side effects.

You might feel pressure to immediately dive back into work. “Typically, you may need up to six months after chemotherapy and radiation before you’re ready to return to work,” says Dr. Townsley. “Some will return sooner and others may have worked while undergoing treatment.” Don’t hesitate to ask for some extra time off, if needed, or to start out part-time, especially if your job is physically demanding. Be open with your supervisor and co-workers about any physical or mental limitations that come up.

You can, and should, also return to being physically active, which, according to Dr. Townsley, is crucial to your recovery. If you’re still experiencing side effects like fatigue, take your time and temper your expectations. “If you were running, say, five kilometers pre-diagnosis, you may not be able to get there right away, but the distance may gradually come back if you work on it,” she says. Listen to your body and go slow when you need to.

What to expect: the mental and emotional things
Fears of recurrence coupled with not being constantly seen by your health-care team may induce increased anxiety during this time. While this worry can lessen as time goes by, certain events can be more triggering, such as follow-up visits and medical tests or learning that someone you know has cancer.

The first step is to acknowledge and normalize your fears. “It’s common to worry about your cancer coming back,” says Dr. Townsley. “You are not alone.” The next step is to educate and get informed. Learn what you can do for your health now and stay on top of ongoing screenings. “I’ll reassure patients worried about a headache that lasted a few hours, for example, is unlikely a cancer recurrence. I’ll teach them what signs to look for.” There are ways of dealing with worrying, including relaxation techniques and cognitive behavioural therapy aimed at shifting your thought process. “And if someone is taking longer than usual to cope, we can also refer them to a psychiatrist.” Bounce Back (bouncebackontario.ca) is a great resource, offering therapies for low mood, worrying and anxiety.

What to expect: your new normal

“When patients ask when they’ll ‘feel normal’ again, I like to say there’s a new normal after diagnosis,” says Dr. Townsley. “Going through cancer will have a long-term effect on your life. It will change your perspective and, unfortunately, that fear of recurrence may not go away.” In general, being involved in your health care and making healthy lifestyle changes are among the things you can control. “Eating a wide range of healthy foods and being active, both physically and socially, will help you feel confident that you’re taking charge of your health,” she adds. In addition, follow your doctor’s recommendations for screening and, if you’re fearing cancer recurrence, express these feelings to your health-care provider, close friend, relative or counsellor.

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  • A publication of:
  • Women's College Hospital