Recurrent Breast Cancer, Nutrition and Physical Activity, Follow-up Care

by National Cancer Institute

(Page 8 of 8)

Recurrent Breast Cancer

Recurrent cancer is cancer that has come back after it could not be detected. Treatment for the recurrent disease depends mainly on the location and extent of the cancer. Another main factor is the type of treatment the woman had before.

If breast cancer comes back only in the breast after breast-sparing surgery, the woman may have a mastectomy. Chances are good that the disease will not come back again.

If breast cancer recurs in other parts of the body, treatment may involve chemotherapy, hormone therapy, or biological therapy. Radiation therapy may help control cancer that recurs in the chest muscles or in certain other areas of the body.

Treatment can seldom cure cancer that recurs outside the breast. Supportive care is often an important part of the treatment plan. Many patients have supportive care to ease their symptoms and anticancer treatments to slow the progress of the disease. Some receive only supportive care to improve their quality of life. Breast Reconstruction

Some women who plan to have a mastectomy decide to have breast reconstruction. Other women prefer to wear a breast form (prosthesis). Others decide to do nothing. All of these options have pros and cons. What is right for one woman may not be right for another. What is important is that nearly every woman treated for breast cancer has choices.

Breast reconstruction may be done at the same time as the mastectomy, or later on. If you are thinking about breast reconstruction, you should talk to a plastic surgeon before the mastectomy, even if you plan to have your reconstruction later on.

There are many ways to reconstruct the breast. Some women choose to have implants. Implants may be made of saline or silicone. The safety of silicone breast implants has been under review by the Food and Drug Administration (FDA) for several years. If you are thinking about having silicone implants, you may want to talk with your doctor about the FDA findings. Your doctor can tell you if silicone implants are an option.

You also may have breast reconstruction with tissue that the plastic surgeon moves from another part of your body. Skin, muscle, and fat can come from your lower abdomen, back, or buttocks. The surgeon uses this tissue to create a breast shape.

Which type of reconstruction is best depends on your age, body type, and the type of surgery you had. The plastic surgeon can explain the risks and benefits of each type of reconstruction.

You may want to ask your doctor these questions about breast reconstruction:

• What is the latest information about the safety of silicone breast implants?
• Which type of surgery would give me the best results? How will I look afterwa
• When can my reconstruction begin?
• How many surgeries will I need?
• What are the risks at the time of surgery? Later?
• Will I have scars? Where? What will they look like?
• If tissue from another part of my body is used, will there be any permanent changes where the tissue was removed?
• What activities should I avoid? When can I return to my normal activities?
• Will I need follow-up care?
• How much will reconstruction cost? Will my health insurance pay for it?

Complementary and Alternative Medicine

Some women with breast cancer use complementary and alternative medicine (CAM):

• An approach is generally called complementary medicine when it is used along with standard treatment.
• An approach is called alternative medicine when it is used instead of standard treatment.

You may want to ask the doctor these questions before you decide to use CAM:

• What benefits can I expect from this approach?
• What are its risks?
• Do the expected benefits outweigh the risks?
• What side effects should I watch for?
• Will the approach change the way my cancer treatment works? Could this be harmful?
• Is this approach under study in a clinical trial? If so, who sponsors the trial?
• Will my health insurance pay for this approach?

Acupuncture, massage therapy, herbal products, vitamins or special diets, visualization, meditation, and spiritual healing are types of CAM.

Many women say that CAM helps them feel better. However, some types of CAM may change the way standard treatment works. These changes could be harmful. And some types of CAM could be harmful even if used alone.

Some types of CAM are expensive. Health insurance may not cover the cost.

Nutrition and Physical Activity

It is important for women with breast cancer to take care of themselves. Taking care of yourself includes eating well and staying as active as you can.

You need the right amount of calories to maintain a good weight. You also need enough protein to keep up your strength. Eating well may help you feel better and have more energy.

Sometimes, especially during or soon after treatment, you may not feel like eating. You may be uncomfortable or tired. You may find that foods do not taste as good as they used to. In addition, the side effects of treatment (such as poor appetite, nausea, vomiting, or mouth sores) can make it hard to eat well. Your doctor, dietitian, or other health care provider can suggest ways to deal with these problems. Also, the NCI booklet Eating Hints for Cancer Patients 8 has many useful ideas and recipes.

Many women find they feel better when they stay active. Walking, yoga, swimming, and other activities can keep you strong and increase your energy. Exercise may reduce nausea and pain and make treatment easier to handle. It also can help relieve stress. Whatever physical activity you choose, be sure to talk to your doctor before you start. Also, if your activity causes you pain or other problems, be sure to let your doctor or nurse know about it.

Follow-up Care

Follow-up care after treatment for breast cancer is important. Recovery is different for each woman. Your recovery depends on your treatment, whether the disease has spread, and other factors.

Even when the cancer seems to have been completely removed or destroyed, the disease sometimes returns because undetected cancer cells remained somewhere in the body after treatment. Your doctor will monitor your recovery and check for recurrence of the cancer.

You should report any changes in the treated area or in your other breast to the doctor right away. Tell your doctor about any health problems, such as pain, loss of appetite or weight, changes in menstrual cycles, unusual vaginal bleeding, or blurred vision. Also talk to your doctor about headaches, dizziness, shortness of breath, coughing or hoarseness, backaches, or digestive problems that seem unusual or that don't go away. Such problems may arise months or years after treatment. They may suggest that the cancer has returned, but they can also be symptoms of other health problems. It is important to share your concerns with your doctor so problems can be diagnosed and treated as soon as possible.

Follow-up exams usually include the breasts, chest, neck, and underarm areas. Since you are at risk of getting cancer again, you should have mammograms of your preserved breast and your other breast. You probably will not need a mammogram of a reconstructed breast or if you had a mastectomy without reconstruction. Your doctor may order other imaging procedures or lab tests.

Facing Forward Series: Life After Cancer Treatment 13 is an NCI booklet for people who have completed their treatment. It answers questions about follow-up care and other concerns. It has tips for making the best use of medical visits. It also suggests ways to talk with the doctor about creating a plan of action for recovery and future health.

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