Living with breast cancer

Friday 1 August, 2014

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On this page: Nerve pain | Lymphoedema | Cording | Menopause and fertility | Using a breast prosthesis | Wigs | Key points


Side effects of treatment can vary. Some people will experience a few side effects, others will have more.

Nerve pain

Some people have long term nerve pain after surgery, particularly mastectomy and axillary dissection. This pain may feel like pins and needles. Nerve pain usually settles within a few weeks. If it’s ongoing, speak to your doctor about ways to manage the pain.

Lymphoedema

Lymphoedema is a swelling of part of the body, usually a limb such as the arm. When lymph nodes have been damaged or removed, lymph fluid may not be able to drain properly. This causes fluid build-up resulting in swelling.

Lymphoedema can occur as a result of some cancer treatments such as after radiotherapy to the armpit or surgery to remove axillary lymph nodes. People who have had surgery followed by radiotherapy to the armpit are more at risk.

Signs of lymphoedema include swelling, heaviness or fullness in the arm; redness and skin warmth. These signs may begin gradually, and may come and go. Some people experience pain or fever, which may mean an infection in the arm with lymphoedema. If you have swelling, see your doctor as soon as possible. Symptoms are easier to manage if lymphoedema is picked up and treated early.

Preventing and treating lymphoedema

Lymphoedema can develop months or years after treatment – some people who are at risk never develop it.

In many hospitals, a lymphoedema specialist will assess you before you have surgery. Some hospitals have specialist physiotherapists who can work with you to reduce your risk of developing lymphoedema. You can do simple exercises such as shoulder rolls, elbow bends and hand clenching.

Reducing your risk of lymphoedema 
What to do
  • use a gentle moisturiser to keep skin healthy
  • wear shoes, gloves or long sleeves when gardening or washing dishes
  • wear loose clothing and jewellery
  • clean any cuts (on the affected side of your body) straightaway and see a doctor if the area becomes hot, red or swollen
  • be as physically active as you can
  • eat a healthy diet and maintain a healthy body weight
What to avoid
  • sunburn
  • cuts, burns and insect bites
  • tattoos or piercings
  • repetitive tasks and heavy lifting for long periods of time
  • blood pressure cuffs and having injections on the affected side
  • saunas, hot baths and spas

Swelling can be reduced by wearing a professionally-fitted elastic sleeve or by massage from a trained lymphoedema drainage therapist, physiotherapist, nurse or occupational therapist.

Long periods of physical inactivity, such as travelling, may contribute to lymphoedema. Talk to your doctor or specialist about wearing a compression sleeve during air, rail or car travel. You can download a fact sheet about lymphoedema and travel from Breast Cancer Network Australia.

To find out more, contact Cancer Australia for a copy of the Lymphoedema – what you need to know booklet. The Australasian Lymphology Association website has a directory of lymphoedema practitioners.

Cording

This feels like a tight cord running from your armpit down the inner arm, sometimes to the palm of your hand. Cording, also known as axillary web syndrome, can happen weeks or months after surgery or lymph node dissection. It is due to hardened lymph vessels. Some people are able to see and feel raised cord-like structures across their arm, and this can restrict arm movement.

Cording usually gets better over a few months. Gentle stretching during the first couple of weeks after surgery can help. If the cording doesn’t seem to be improving or is getting worse, try physiotherapy or massage. Laser treatment from a lymphoedema specialist may also help. 

Menopause and fertility

Some treatments for early breast cancer cause your periods to stop (menopause) and can affect your ability to become pregnant (fertility). Chemotherapy drugs usually cause an interruption to a woman’s periods. This may be temporary or permanent. If your periods stop permanently, this is known as early menopause.

Some of the symptoms of menopause include hot flushes and sweats, trouble sleeping, vaginal dryness, lower sex drive, tiredness, dry skin, aches and pains, mood swings, poor concentration, weight gain and osteoporosis. Symptoms can range from mild to severe. Talk to your doctor or breast care nurse about ways to manage any symptoms.

If preserving your fertility is important to you, talk to your doctor before treatment starts about your options and ask for a referral to a fertility clinic. If you learn you may be permanently infertile, you may feel a great sense of loss. You might be devastated that you won’t have your own children or additional children, and you might worry about the impact of this on your relationship. It’s normal to feel this way even if your family is complete. To find out more, call 13 11 20 for see our Fertility and Cancer section. 

Permanent menopause means you will not be able to become pregnant. If the interruption to your periods is temporary, you might still be able to have children. 
Preventing osteoporosis

Women who experience menopause, especially if it is earlier than usual, are at an increased risk of developing osteoporosis. This is the thinning of the bones. Bone weakness can lead to fractures and pain.

To prevent osteoporosis:

  • do regular weight-bearing or resistance exercise with weights
  • make healthy eating choices, which include low-fat dairy and high-calcium foods
  • talk to your doctor about medication.

For more information, see the Osteoporosis Australia website or call the toll free information line on 1800 242 141.

Using a breast prosthesis

A breast prosthesis (breast form) is a synthetic breast or part of a breast that appears real when worn in a bra or under clothing. It can be used after a mastectomy or after breast conserving surgery.

In the first couple of months after surgery, you may choose to wear a temporary soft breast form. This will be more comfortable next to your scar. A free bra and temporary soft breast form is available through Breast Cancer Network Australia. To order a My Care Kit, visit the Breast Cancer Network Australia website or talk to your breast care nurse or treatment team.

Once your scar has healed (usually by six weeks), it should be comfortable to be fitted for a permanent breast prosthesis.

This is usually made from silicone and has the shape, feel and weight of a natural breast. A prosthesis can help you maintain good posture and prevent neck and back problems.

The cost of a permanent prosthesis ranges from about $250–$450. Financial assistance towards the cost of a breast prosthesis is available from Medicare. Women with private health insurance may be able to get a further rebate for a prosthesis depending on their cover.

More information on how to buy a breast form and what to expect at a fitting is available from Cancer Council. Call 13 11 20 or see the Breast Prostheses and Reconstruction section. 

Wigs

If you lose your hair during chemotherapy treatment, you may want to wear a wig, scarf or hat while it’s growing back.

You can borrow a wig – some hospitals and cancer care units have wig libraries where wigs are free or available for a small fee. You can also buy a wig, though some types can be expensive. Ask your treating hospital or call Cancer Council 13 11 20 to find out more.

Some private health funds cover part of the cost of purchasing wigs – check with your health fund.

Key points

  • Side effects vary, depending on the treatment you have.
  • Lymphoedema is a swelling of part of the body, such as the arm. It can happen if the lymph nodes are damaged or removed and the fluid is unable to drain properly.
  • There are ways to prevent or treat lymphoedema. For example, exercises, massage or wearing a compression sleeve may reduce or prevent swelling.
  • Cording, also known as axillary web syndrome, feels like a tight cord running from the armpit to the palm of the hand. It usually gets better over several months but gentle stretching can help.
  • Some treatments, such as chemotherapy, can cause a woman’s periods to stop. This may be temporary or permanent. This can cause symptoms of menopause such as hot flushes, vaginal dryness and tiredness. Talk to your doctor about how to manage any symptoms.
  • If you would like to have children, talk to your doctor before treatment begins about ways to reduce the risk of infertility, and ask for a referral to a fertility clinic.
  • Following menopause, bones may become weaker. This is called osteoporosis. Doing regular weightbearing exercises, eating high-calcium foods and taking medication can help.
  • After a mastectomy, the breast can be replaced with a temporary soft breast form or you can be fitted for a permanent breast prosthesis. This has the shape and feel of a natural breast, and helps prevent back and neck pain. 

Reviewed by: Dr Carolyn Cho, Breast and General Surgeon, Surgical Oncology, Deakin, ACT; Lynn Buglar, Breast Physician, BreastScreen, NSW; Mena Crew, Consumer; Elizabeth Jacobson, Consumer; Jane Marsh, Clinical Manager, Breast Centre, Brian Fricker Oncology Centre and Burnside War Memorial Hospital, SA; Marie Murdoch, Breast Care Nurse, Cancer Council Queensland, QLD; and Marion Strong, Clinical Nurse Consultant Breast Care Nurse and Cancer Care Coordinator, Toowoomba Hospital, QLD.

Updated: 01 Aug, 2014