Coping with recovery after cancer treatments
A loved one of mine had a double mastectomy due to a rapid growing breast cancer, chemotherapy, and radiation. She is in her early 30s. She is a year out from treatment/surgery and suffers daily with aches and pains. She also has lymphedema in her right arm, which doesn't help with her discomfort. She feels pain in her joints, sometimes her back, she gets headaches, she is often fatigued, and she feels sick a lot. She's forgotten what it feels like to have her body feel good. Is this normal? She definitely has depression due to this and often thinks she will get cancer back somewhere else. It's been two years since her diagnosis and she has not felt a day of no pain and or sickness. I want to give her some good feedback, some light at the end of the tunnel so to speak (without using that phrase) to help her get through it. The doctors aren't too helpful. Mostly they want her to take more pills, which are becoming the size of a meal. She refuses to take the pills that are anti hormonal. I don't blame her; she can't handle the menopausal symptoms they give her on top of everything else. She is active and often just pretends to feel ok for others sake. She also eats well with a low salt diet to help the fluid in her arm. Should there, or will there be relief after undergoing so much stress on ones body?
Watching a loved one go through a serious illness is emotionally trying, and it’s commendable that you’re seeking out ways to help her see a “light at the end of the tunnel.” You mention that your loved one is experiencing a range of conditions: general aches and pains, lymphedema, joint pain, headaches, fatigue, and depression. If it’s any consolation, these symptoms actually seem to be quite common among breast cancer patients in recovery and can sometimes last for several years after treatment ends. Up to 30 percent of people recovering from breast cancer experience persistent pain, and 20 to 30 percent experience major depressive disorder symptoms during recovery. While it can be disheartening to learn that so many go through this, the high rate also means that there is research investigating ways to alleviate pain and discomfort during recovery. Here’s some information on the symptoms and conditions you described, and what’s currently known about strategies to mitigate the suffering (though it's recommended that your friend talk to a health care provider to identify strategies that work best for her):
- General aches and pains: Discomfort after breast surgery is very common with somewhere between 25 and 60 percent of people reporting some sort of pain during recovery. It’s possible that what your loved one is experiencing is “post-mastectomy pain syndrome.” The condition is a result of damage to nerves in the chest wall after mastectomies, biopsies, or lumpectomies. The type and degree of pain depends on the person and may feel burning, stabbing, constricting, or numb. Though the use of pain relief medication (both prescription and over-the-counter) is an option to manage general pain, some alternative treatments may also help, such as acupuncture, acupressure, or yoga. Other people also find options such as skin creams and physical therapy to be effective in reducing pain.
- Lymphedema: This condition is characterized by chronic swelling of the arms or legs that occurs when the lymphatic system is blocked, sometimes a result of cancer surgeries. It can cause a dull ache and limit movement, which can be both physically and emotionally challenging. Some options for decreasing the effects of lymphedema include range-of-motion exercises, compression garments, and maintaining a weight that meets your body's needs. As your loved one has already been diagnosed with lymphedema, it's also recommended that she contact her health care provider if she experiences sudden swelling in her affected limb.
- Joint pain: Your loved one’s joint pain could be the result of a number of different things, including post-mastectomy pain syndrome. If she did take any anti-hormonal pills at any point in her treatment, this could be the reason for joint pain, as it's a known side effect of anti-hormonal treatments like aromatase inhibitors. Over-the-counter nonsteroidal anti-inflammatory medications (NSAIDs) might be one avenue to decrease the pain. She might also benefit from exploring with a health care provider whether other rare but possible causes of joint pain may be related to her treatment, such as carpal tunnel syndrome.
- Headaches: There are many potential culprits for headaches, but they could be related to the stress or fatigue she’s experiencing in recovery. Perhaps taking note of when the headaches occur or if there are specific triggers could help unravel why they’re happening and how they might be treated. Reading What to do for headaches? might be one place to start. Research also indicates that acupuncture may provide pain relief, as it does for general aches and pains.
- Fatigue and depression: Fatigue can occur even if someone seems like they're getting enough sleep. Some possible causes include excessive work, interrupted or inconsistent sleep, stress, a lack of regular physical activity, and treatment for an illness. Fatigue is very common in those recovering from breast cancer, and there’s even a syndrome known as cancer-related fatigue (CRF), which is sometimes a predictor of depression down the road. One of the most powerful buffers against fatigue and depression is actually you: her social network. The positive impact of social support on cancer patients’ health outcomes has been widely seen, and low social support has even been correlated with a poorer immune system and increased inflammation. This, in turn, can worsen depression or fatigue. Physical activity has also been shown to stave off depression and fatigue for breast cancer survivors, and there’s no particular type of activity or exercise that’s better than others. Just being active for a few hours a week may grant benefits. Thankfully, fatigue is generally expected to lessen as people continue to recover from cancer.
In addition to these strategies, further exploration of other complementary and alternative medicines is another option she could consider. For example, researchers are currently looking into the potential effect of acupuncture in helping with fatigue in breast cancer survivors. While there’s not a lot of definitive evidence for these types of therapies yet, as long as an alternative or complementary therapy doesn’t interfere with current treatments, they may be worth investigating with the help of her health care provider. The National Cancer Institutes has some resources about these complementary methods, as well as more information about the “new normal” for those recovering from cancer.
Everyone’s journey to recovery is unique, and it sounds like you’re a great source of support. It may further assist you in encouraging your loved one throughout her recovery if you ask what action or feedback she finds most helpful. Does she want to be distracted from her pain with humor or fun activities? Would it be comforting to hear recommendations on how to manage discomfort from other people recovering from breast cancer? The most beneficial option may change depending on the day or even the moment, so checking in with your loved one and respecting her feelings can be an effective way to be supportive.
Interview-based research with people recovering from breast cancer — especially younger people — shows that they often undergo remarkably similar emotional experiences, including anxiety, uncertainty, and fear. Finding a support group of people who share a similar experience might also help your loved one cope. Through all of this, a small silver lining might even be identified: the people in this study all reported that recovering from breast cancer made them emotionally stronger and wiser. While recovery may feel like an uphill battle, the support of people like you in your loved one’s life may help her cultivate a renewed hope for a brighter, healthier future.
Originally published Jan 30, 2015
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