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Surviving Breast Cancer — What Happens Next?

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Somewhere in the middle of breast cancer treatment, a woman might begin to ask herself: Is there life after breast cancer? What does that life look like? In fact, about 2.6 million women in the United States who have been treated for breast cancer are learning the answers to these questions every day.

The Five-Year Mark

Today nearly nine out of ten women with breast cancer live more than five years after their breast cancer diagnosis. Research published in the Journal of the National Cancer Institute in August 2008 found that 89 percent of women who survive for five years will survive for the decade, and 81 percent will see 15 years. Thirty years ago, only half of breast cancer patients could expect that outcome. Medical technology, research and the dedicated efforts of breast cancer survivors continue to make it possible for women to live long, high-quality lives after diagnosis and treatment.

But when a woman reaches the moment that a doctor tells her that her treatment has been successful and her cancer is in remission, she might be surprised at what she is hearing. Remission means that the cancer is gone for now, but the unpleasant reality is that it has the potential to return. Women who have been treated for breast cancer are three times more likely than their peers to have breast cancer in the breast that was not affected initially.

For many women, the risk of a recurrence is slim. Nonetheless, a woman who has just successfully beaten her cancer through months of grueling treatment and surgery might be surprised by this fact and the new goal: Surviving for five years.

Breast cancer survivors must continue to visit their doctors regularly and participate in regular screenings for cancer. Women who are going to be taking medication to help prevent a recurrence should ask about its side effects and monitor their body's reaction to the drugs. In addition, they should be aware of the following factors than can affect their quality of life after cancer:

  • Post-treatment aches and pains

    Breast cancer survivors might notice new aches and pains in their joints and the muscles and tissues of the arm and chest where they received treatment. Women should let their doctors know about changes in their comfort and physical abilities. Physical therapy and lifestyle changes, such as getting more sleep or adopting a new exercise program, can help ease some symptoms.

  • Staying active and involved

    Breast cancer survivors are a crucial source of information and support for newly diagnosed women. Getting involved with support groups and fundraisers is a valuable way in which breast cancer survivors can further research and awareness, as well as offer other women a sense of community.

  • Sexuality

    Breast cancer survivors face a number of challenges as they learn how to be sensual and comfortable in their bodies after treatment. Women who have had surgery have to adjust to the new shape and feel of their body. Chemotherapy can alter a woman's sex drive and cause vaginal dryness. Although many women are reluctant to discuss sexuality with their doctors — and many doctors are reluctant to ask — it is important to talk to a primary care provider, therapist or gynecologist about any problems, such as reduced interest or pleasure in sex, that arise after treatment.

  • Difficulty concentrating

    Many women report difficulty concentrating, multi-tasking and remembering details in the months after their treatment ends. This condition is called “chemo brain” or “chemo fog” and clears up within a year for most people. However, women who find that the symptoms interfere with work and daily living should talk to their medical oncologist about ways to cope, including medication and rehabilitative therapies, until the fog clears.

  • Lymphedema

    Women whose treatment included surgery or radiation of the lymph nodes are more likely than other to develop a buildup of fluid in the arm closest to the surgery. This is called lymphedema. Breast cancer survivors should know the signs of lymphedema and contact their doctor if they notice swelling or water retention in the arm. Gentle stretching, physical activity, yoga and pilates may be recommended to help prevent lymphedema.

  • Infection

    In women who have undergone removal of lymph nodes, there is an increased risk of infection in the affected area. Infection risk is also increased in women with lymphedema. Being alert to signs and symptoms of infection is important. These signs and symptoms include warmth, redness, pain and fever. Prompt treatment of an infection can hasten resolution and help avoid further complications.

    FOR MORE INFORMATION: The National Cancer Institute offers a list of organizations that provide support and information to breast cancer survivors. Go to www.cancer.gov and type "national organizations" in the search field.

    SOURCES: "Risk of Relapse Low After Surviving Five Years," Aug. 13, 2008, USA TODAY; National Cancer Institute (www.nci.nih.gov); American Cancer Society (www.cancer.org)


    Written by Madeline Roberts Vann, MPH

    Reviewed by Susan L. Luedke, MD
    St. Louis Cancer & Breast Institute
    St. Louis University Medical Center

    Last updated September 2008
 
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