It is normal for women to be concerned about how physical and emotional symptoms and side effects of secondary breast cancer will affect their quality of life.
Pain
Pain levels vary for women living with secondary breast cancer -- from none, to considerable. Pain can usually be well controlled and managed in many ways with different types of medications and treatments.
Analgesics
Analgesics (pain killers) are best given before the pain starts, and are taken as tablets, liquids, suppositories, skin patches or injections. Sometimes low-strength drugs are given with stronger drugs as they complement each other, working in different ways.
Morphine is given at any stage when mild pain killers are not working -- it doesn't necessarily mean cancer is getting worse. Some people resist taking pain killers fearing they will become addicted. However there is no risk of addiction if they are used to control pain.
Other medications
- Anti-inflammatories can be very effective in controlling bone pain.
- Bisphosphonates can also treat bone pain and strengthen bones.
- Steroids can help reduce pain related to nerve compression, bone, brain and liver tumours.
- Muscle relaxants relieve muscle spasm and pain. They can also reduce anxiety and sleeplessness which often increase pain.
Non-medical pain relief
- Some women find acupuncture, relaxation techniques and yoga reduce their pain. The article on complementary therapies in Issue 17 of The Inside Story (supplement to The Beacon Issue 51) provides more information.
- Massage can reduce pain and provide comfort, but avoid inflamed or swollen areas.
- Cold packs can reduce inflammation, muscle aches and spasms or joint pain, but should be avoided if circulation is poor. Warm packs help pain caused by stiffness or muscle tightness. Avoid any packs to areas being treated with radiotherapy.
If your pain is not well controlled, you can ask your doctor to refer you to a palliative care physician or a pain clinic as they specialise in pain management. Physiotherapists and occupational therapists can assist with exercises and aids that help reduce pain. The your treatment and care page has more information.
"I exercise on a treadmill which is kinder on my body than uneven ground. My muscles feel stronger, I feel good and have less pain." --Inka
The Australian Pain Management Association website has useful information on pain management options, including how to seek help for persistent (chronic) pain and how to choose a pain management team.There is also advice on things you can try yourself to help manage your pain.
Pain issues from a woman's perspective
In her speech to the National Pain Summit in Canberra in March 2010, BCNA member Helen Owens told the story of her personal experiences of managing pain associated with secondary breast cancer. Her speech included recommendations for improvements to the Australian health system for better access to adequate pain management (Helen's speech is available as a downloadable PDF file below).
Hair loss
Because it's visible to others, hair loss can be one of the more distressing side effects of chemotherapy. The hair loss page contains information and tips for dealing with hair loss.
"As soon as I knew I was going to lose my hair I got a wig that was matched to my own hair colour" --Bree
Nausea and vomiting
Nausea is sometimes caused by the secondary breast cancer itself, especially in the liver or if bone cancer is causing high levels of calcium in the blood. It could also be a symptom of constipation, a side effect of radiotherapy, chemotherapy or strong pain killers.
- Anti-nausea drugs work in different ways and can be taken as tablets, suppositories or injections.
- Some women find that meditation and relaxation can also help their nausea.
- Eating small, frequent meals, resting before and after eating and drinking plenty of fluids can help prevent nausea.
Constipation
This very common symptom of secondary breast cancer can make you feel miserable. It may be due to the cancer, or a side effect of pain killers, reduced mobility and changes in eating and drinking habits.
- Fibre supplements are usually not a good idea if constipation
- Increasing the amount of fresh fruit, vegetables and high-fibre breads can help.
Sore mouth
A sore mouth and ulcers can occur with chemotherapy, which can be helped by:
- mild pain killers
- local anaesthetic gel
- rinsing with bicarbonate of soda in water
- cleaning teeth with a soft toothbrush improves oral hygiene and can reduce the risk of getting ulcers.
Poor appetite
Poor appetite can result from the illness, treatment or a side effect such as a sore mouth, constipation or anxiety.
- Seeing a dietitian is an option.
- Try to choose foods you enjoy or eat soft foods if your mouth is sore.
- If you are losing weight your doctor may prescribe medication to stimulate your appetite.
Early menopause
Chemotherapy and ovarian suppression can cause early menopause, when periods stop. This can cause hot flushes, dry vagina and night sweats. Your doctor will be able to help you manage these symptoms. The chemotherapy page provides more information.
Fatigue
Fatigue is common and can be distressing for women with secondary breast cancer. It is often described as relentless tiredness, with a feeling that everything seems much more of an effort. Activities such as yoga or swimming can revitalise your mind and spirit and help reduce fatigue.
The page on fatigue and the section on physical wellbeing contain more information, in particular about how exercise can boost your energy levels.
Issue 17 of The Inside Story (supplement to The Beacon Issue 51) includes an article on Managing Sleep and Fatigue.
Difficulty sleeping
You may feel exhausted, yet still have trouble sleeping. Try warm baths, massages, warm drinks and if nothing is working, you may want to consider sleeping tablets.
Breathing problems
Shortness of breath can be both frustrating and frightening. It doesn't mean the cancer is getting worse, it may simply be a build up of fluid on the lungs or an infection, both of which are easily treated. Ask your doctor whether a physiotherapist could help if the feeling persists.
'Chemo brain'
A less common side effect of chemotherapy is a condition known as 'chemo brain' or 'chemo fog'. It is described as feeling vague. Some women say they have trouble remembering things and find they aren't as organised as they used to be. The Chemo brain page has some suggestions on how to manage the effects.
"I really began to worry when I noticed I was forgetting things. I started doing crosswords, which helped me to focus and reassured me that I was okay. I also found that my diary became my best friend." --Anna
Depression
Depression is common for women with secondary breast cancer, due to pain, medication, lack of support or a history of the illness. There are many effective treatments available, the depression and breast cancer fact sheet offers more information.
More information
- The Hope & Hurdles Pack has more information on managing symptoms and side effects.
- Issue 17 of The Inside Story (supplement to The Beacon Issue 51) includes an article on Managing Sleep and Fatigue.
Downloads
- Helen Owens speech to the National Pain Conference 2010 (PDF, 54.91 KB)
