Supportive care for breast cancer

Supportive care helps people meet the physical, practical, emotional and spiritual challenges of breast cancer. It is an important part of cancer care. There are many programs and services available to help meet the needs and improve the quality of life of people living with cancer and their loved ones, especially after treatment has ended.

Recovering from breast cancer and adjusting to life after treatment is different for each woman, depending on the stage of the cancer and the treatments you had. You may need to take hormonal therapy or biological therapy after other treatments are finished. The end of cancer treatment may bring mixed emotions. Even though treatment has ended, there may be other issues to deal with, such as coping with long-term side effects. A woman who has been treated for breast cancer may have the following concerns.

Both surgery and radiation therapy can affect your arm and shoulder on the side of the body where the breast cancer was treated. Your arm and shoulder may become stiff and sore. You may have trouble moving them. Sometimes tender or painful rope-like structures develop below the skin a few weeks after surgery. They may run down the arm from the underarm to the wrist. This is called axillary web syndrome, or cording.

Physical rehabilitation exercises can help reduce stiffness and pain in your arm and shoulder. They can improve your range of motion and help you get back to your normal day-to-day activities.

Find out more about exercises after breast surgery.

Lymphedema is swelling that occurs when lymph fluid can't flow normally and builds up in the soft tissues of a limb. It can develop in your arm if the lymph nodes under the arm are removed or damaged.

Tell your healthcare team if you have any swelling or puffiness in your hand or arm. They can suggest ways to treat or manage lymphedema.

Find out more about lymphedema.

Many women have pain after breast cancer surgery. In most cases, this pain goes away over time.

PMPS is pain that occurs when nerves in the breast or underarm area are damaged during surgery or when scar tissue develops in these nerves after surgery. You may feel pain in the chest, armpit and arm on the side of the surgery. It can get worse when you move your arm or shoulder. The pain may be dull or aching, or it can be sharp and stabbing. Some women may feel burning or numbness in the area.

PMPS is most common in women who have a mastectomy. Some women have pain after an axillary lymph node dissection (ALND) or breast-conserving surgery (BCS). Younger women and overweight women have a higher risk of developing PMPS.

A small number of women may have phantom breast pain after a mastectomy. Phantom breast pain is when you feel pain in the breast that was removed. It happens because the brain keeps sending signals to nerves in the breast area that were cut during surgery, even though the breast is no longer there. The symptoms of phantom breast pain may include itching, tingling or pins and needles, throbbing or a sense of pressure on the chest.

Tell your healthcare team if you have breast pain after treatment and how it affects your life. They will suggest treatments based on your needs and work with you to develop a treatment plan if phantom breast pain doesn't go away on its own.

Treatment for pain may include:

• drugs for managing pain
• transcutaneous electrical nerve stimulation (TENS)
• a cream made from red chilli peppers (called capsaicin cream)
• massage
• injections with botulinum toxin A (Botox)

How a person feels about themselves is called self-esteem. Body image is how a person sees their own body. Breast cancer and its treatments can affect your self-esteem and body image. You may feel differently about your body because you no longer have a breast or you lost your hair during treatment.

Talk to your healthcare team. They can help you cope and find support to deal with your feelings.

Find out more about how to cope with problems of self-esteem and body image.

Breast cancer and its treatments can affect your sexuality and sexual function. It can also affect your sexual partner and your relationship. For many people, sexuality is a very personal subject. It can be hard to talk openly about it. But talking honestly about sex with your partner and getting help from your healthcare team offer you the best chance of coping with any sexual changes that breast cancer treatment brings.

Find out more about sexuality and cancer.

Surgery and radiation therapy to the breast area don't cause problems getting pregnant. But some chemotherapy drugs and hormonal therapy may make it difficult for you to become pregnant after these treatments are finished. Some women may not be able to become pregnant.

If you think you might want to have children in the future, talk to your healthcare team before your breast cancer treatments start. They will work with you to develop a treatment plan based on your needs.

Find out more about fertility problems.

Research shows that exercise can help reduce side effects during chemotherapy and hormonal therapy for breast cancer. It can also help you cope with fatigue, anxiety and stress.

Some research studies found that being physically active after treatment can help lower the risk of breast cancer coming back (recurring) and lead to longer survival. Other studies didn't show these effects. More research is needed to find out what role physical activity may have in breast cancer survival.

A physically active lifestyle includes light to moderate exercise, such as walking, biking or swimming, every day. It has many health benefits. It can improve your quality of life and generally help you feel better. It also helps you maintain a healthy body weight after cancer treatment.

Find out more about physical activity after treatment.

To make the decisions that are right for you, ask your healthcare team questions about supportive care.