Controlling the symptoms and effects of secondary breast cancer
The best way of controlling the symptoms of secondary breast cancer is to treat the cancer itself.
People with secondary breast cancer may experience different types of pain. There is a wide range of pain-relieving medications (analgesics).Pain relief works best if taken regularly. Tell your cancer treatment team if your prescribed medications are not easing your pain, as there are likely to be other pain-relieving medications that you can try.
Morphine for cancer pain
Morphine is a commonly used medication for severe pain. The dose can be changed to suit each person. When morphine is used in its proper role as a pain reliever it is given in controlled doses and people do not become addicted.
Ko te morphine tētahi o ngā rongoā e whakamahia ai mō ngā mamae tino kino. Ka taea te whakarite i te horopeta mō ia tangata. Ki te āta whakamahi te morphine hei whakaiti ake i te mamae, ka āta hoatu ngā horopeta ā-tautāwhi, kia kore ai e warawara te tangata.
Radiation treatment for cancer pain
Radiation treatment can be very good at relieving pain caused by secondary cancer in the bone, and can be given as either a single treatment or a number of treatments that are given daily. Radiation treatment used in this way usually causes very few side effects. You will need to keep taking your usual pain-relieving medication as it can take several weeks for radiation treatment to be fully effective.
As your pain begins to improve, you may want to talk to your doctor or nurse about reducing the dose of your pain medications.
Cancer fatigue has come to be recognised as one of the most common symptoms of secondary cancer. It has many causes, from psychological factors such as the stress of coping with the diagnosis, to physical ones such as the side effects of treatment or the progression of the cancer.
"I save my energy for work. No-one knows at work so at work suddenly I'm not Pat with cancer I'm just me." Pat
Each person’s experience of cancer fatigue is unique but the following suggestions may help you cope better:
- Tell your doctor about the fatigue, as its cause may be treatable.
- Plan your days so you have a balance of activity and rest.
- Try to have short, achievable periods of exercise each day.
- If you are having a bad day try to accept it and enjoy the good days.
- Take short naps throughout the day.
- Prepare yourself for a special occasion by resting beforehand.
- Try to eat well. If your appetite is poor choose high-calorie foods for energy.
- Choose relaxing activities such as watching TV or listening to music or a talking book.
- Accept offers of help from other people to save your energy for things you enjoy.
One of the common causes of breathing problems in people with secondary breast cancer is a pleural effusion (a build-up of fluid around a lung). This fluid can press on the lung, making it harder for you to breathe and causing a feeling of breathlessness. This is managed by removing the fluid.There may be other reasons for breathlessness, such as anaemia or a chest infection.
Always seek medical attention if breathing becomes difficult.
The Cancer Society has an information sheet, Breathlessness (being short of breath), that offers suggestions for when you are having difficulty breathing. You can find it on our downloads page.
There is a range of anti-sickness drugs that work in different ways. Let your doctor know if you feel sick, or if the drug is not working. Most anti-sickness drugs take about 20 to 30 minutes to work.
Some women have also found the following suggestions helpful:
- Eat small meals at frequent intervals.
- Avoid fatty or fried foods.
- Rest before and after eating.
- Don’t lie flat during or after eating.
- Drink plenty of fluids.
- See a dietitian or nurse for dietary advice.
- Try relaxation exercises.
- Do something enjoyable as a distraction from feeling sick
Dealing with constipation
If you are taking pain relievers containing morphine, if treatment has affected your appetite, or if there is too much calcium in your blood, you may experience constipation.Some ideas that could help are:
• increasing the fibre in your diet by eating fresh fruit (such as kiwifruit, vegetables and grains)35
• increasing the amount of water you drink. Drink at least eight glasses (1500 millilitres) of fluid each day• following a gentle exercise programme.
People with secondary breast cancer may feel tired but find it hard to sleep. Insomnia can be caused by the side effects of some drugs, anxiety, or pain.
Suggested remedies include:
- gentle exercise such as walking or a simple exercise programme
- developing a schedule of gentle activities or visits from friends so you maintain a normal daily rhythm
- avoiding coffee, tea, and caffeine drinks later in the day
- having a herbal tea, especially before going to bed
- doing deep breathing and relaxation exercises
- taking a warm bath
- having a gentle massage for relaxation
- talking to friends, family/whānau or a counsellor.
If difficulty sleeping is affecting your ability to cope day to day, talk to your doctor for further guidance. Sometimes a short course of medication to help you sleep will help.
"I listen to music and I read a lot – reading is an escape – I go to bed early to read." Alexandria
Feelings of anxiety and depression are often described by people diagnosed with secondary breast cancer. These feelings can happen at any time. You may have trouble sleeping, concentrating, eating and/or getting up in the morning. You may also be irritable or find yourself crying at the slightest thing.
If you are feeling this way, you do not have to ignore it. It can sometimes be hard to acknowledge that you are having difficulty coping. Friends and family/whānau can offer empathy and support, but you may prefer to talk to someone who is specially trained in helping people to deal with emotional distress.
One techniques that may help you include:
Relaxation techniques may enable you to relax your body and your mind. You can practise relaxation using tapes at home or by going to a class. Try to get into the habit of noticing the tension in your body and letting it go.
Visualisation means using your mind to create pictures. It is often linked to relaxation. For example, you may simply use it to help you relax by imagining yourself in a favourite place where you feel happy, peaceful, and strong.
You may become infertile, either temporarily or permanently, during treatment. Talk to your doctor about this before you start treatment.Despite the possibility of infertility, contraception should be used (if the woman has not gone through menopause) to avoid pregnancy. This is because there is a risk of miscarriage or birth defects for children conceived during treatment. If you are pregnant now, talk to your cancer treatment team about it straight away.
Muscular tension, exhaustion or increased levels of calcium in the blood (hypercalcaemia) may cause headaches. It is important to let your cancer treatment team know if you are having regular headaches, as sometimes they are a sign that cancer has spread. Symptoms caused by cancer that has spread to the brain can be helped by radiation treatment and/or steroid medication.
Lymphoedema is swelling in an area of the body due to the lymphatic vessels being blocked. In people with breast cancer, the arm and chest wall on the side of treatment may be affected. Causes include the cancer itself, or previous surgery or radiation treatment to the area.
The best treatment for lymphoedema is a programme of exercise, massage, skin care, and a properly fitted compression sleeve or bandaging. Damage to the lymph nodes means it is not usually possible to reverse the swelling and, therefore, the aim of treatment is to control the swelling on a long-term basis.
A specialist breast care nurse or lymphoedema therapist will work closely with you to treat your lymphoedema. Contact your local Cancer Society for details of lymphoedema therapists available in your area. Lymphoedema therapists work in private practices and have a range of charges.
Hypercalcaemia (high levels of calcium in the blood) which occurs due to secondary breast cancer in the bone can make you feel very tired and sick. Other symptoms include headache, increased urination, excessive thirst, dehydration, constipation, feeling disorientated, and drowsiness. You may be admitted to hospital for short-term treatment with bisphosphonates (see bisphosphonates). This quick treatment should make you feel much better within a couple of days. Treatment can be repeated as often as necessary.
If your bones have been weakened by the spread of cancer, you may need regular medication (bisphosphonates) to help maintain their strength. If your bones are at increased risk of breaking, it may be necessary to have an operation to protect the bones from further damage. This is sometimes done before radiation treatment begins to treat secondary breast cancer that has spread to the bones.
Report any of the following symptoms to your doctor as soon as they occur:
- tingling or numbness in arm(s), hand(s), or leg(s)
- difficulty walking
- trouble passing urine
- constipation or diarrhoea.
Early treatment – usually steroids, radiation treatment, or surgery or a combination of these – offers the best chance of avoiding permanent damage to the spinal cord.