“Treatment options for breast cancer are dependent upon the type of cancer and the size of the tumour. I was diagnosed with a grade 2, invasive ductal carcinoma, tumour size 30mm. It was suspected and confirmed after surgery, that 3 out of 21 lymph nodes under my arm were infected. These were subsequently removed.
Aside from surgery, the main forms of Western medicine’s attack on cancer are chemotherapy and radiation. The two methods are based on a single principle: generally, cancer cells are extremely fast growing. They divide much more rapidly than any of the body’s normal cells. Therefore if you administer cell-poisoning drugs to the body that kill cells when they divide, then you will kill some normal, healthy cells but many cancer cells. This is what both chemotherapy and radiation do. Chemotherapy is administered intravenously and travels through the bloodstream to every part of the body. The normal cells in the body that grow more rapidly than others, such as hair, stomach lining, mouth tissue, nose, nails, will also be killed more rapidly, hence accounting for hair loss, stomach nausea etc. At the end of a successful course of chemotherapy, the tumour is dead and the patient only half dead.
I chose (how much choice did I have? – I wanted the cancer cut out, eradicated, gone), a mastectomy and six sessions of chemotherapy because the cancer had spread to my lymph nodes and possibly to somewhere else in my body – cancer cells use the lymph nodes for travelling. After chemo I now follow a drug regime to reduce the possibility of the cancer returning.”
How to Manage Chemotherapy Symptoms Through Food
You know that foggy feeling that comes after you’ve had chemo? The fumbling for the right words, the memory loss and the super-short attention span?
And multitasking? You can forget all about that!
If you are one of the lucky 30% of cancer patients who don’t experience chemo brain, then this blog is not for you. Otherwise, read on.
The good news is that for most people the symptoms are what the doctors describe as mild to moderate (even if they may not feel that way). Usually things get better gradually, and within nine months of your last treatment, the fog would usually have cleared.
For some people, though, the symptoms can last for years…
If that is what you are experiencing, the good news is that chemo brain is not a progressive dementing condition. In other words, it is unlikely to get worse. And the really excellent news is that chemotherapy may be associated with a lower risk of developing Alzheimer’s and other types of dementia.
The best advice we can give if you are experiencing chemo brain is to allow yourself a little time. Try not to get anxious. Let people know what you are experiencing so they can help you. And most of all, take a deep breath and try to relax.
This too shall pass.
There are various types of reconstructions that can be offered to a patient after a mastectomy. There are many factors that need to be considered before one can decide on a reconstruction and this needs to be discussed between the patient and the surgeon. Each person is different and the type of reconstruction is based on many various factors including:
- The choice of the patient as discussed with the surgeon and multidisciplinary team
- The type of cancer
- The location of the cancer
- The build of the patient
- Involvement of the nipple
- Whether the patient will still need radiotherapy or not
There are many types of reconstruction, most of which are available in South Africa. Reconstruction can be done as an immediate reconstruction or a delayed reconstruction.
- A flat chest: many people will request a flat chest. Women will often choose this procedure as it is a fairly quick operation with minimal pain post operatively and has a low risk of complications. A prosthesis with a special mastectomy bra can be fitted a few months after the operation. The patient can also have a reconstruction a few years after having a flat chest mastectomy, this is known as a delayed reconstruction.
- A reconstruction using expanders: this is where an expander is placed beneath the muscle in the chest wall. It is then inflated every few weeks until it reaches the appropriate size. An operation to remove the expander and replace it with a prosthesis will follow.
- An immediate reconstruction using prosthesis: this is done in certain cases where a skin sparing mastectomy is performed and the tissue is immediately replaced with a prosthesis.
- Reconstruction using body tissue:
- A flap from your back (latissimus dorsi flap) – the surgeon will make a new breast by using the muscle, skin and fat from your back.
- A flap from your abdomen (a TRAM flap) – the surgeon uses part of the muscle with its skin, fat and blood vessels to make a new breast.
- A flap from your abdomen (a DIEP flap) – the surgeon takes only the fat and skin from the abdomen to make a new breast. This procedure often has a very good outcome as the breast looks and feels natural as it consists of fatty tissue.
- A flap from the thigh (TMG or TUG) – the surgeon will use the fat, skin and muscle from the thigh, either making use of the outer or inner thigh.
Once a mastectomy with reconstruction has been performed, a nipple can also be made. This would be done only once the reconstruction has entirely healed and would involve small procedures. A tattoo can be done to give the nipple areolar its colour.
Reconstruction is a very personal decision and the patient should not be rushed into something that they do not feel comfortable with having. It is important as a patient to look into the various options that are offered before making a decision.
Sr Lieske Wegelin
Surgery for breast cancer includes surgery to the breast and surgery to the axilla (armpit).
Surgery to the breast.
Although there are many operations that we do, they fall into two groups: breast conservation surgery (wide local excision, lumpectomy) and mastectomy.
Breast conservation means removal of the cancer and some surrounding tissue. It is important that there is no cancer or precancer in the surrounding tissue. (We refer to the normal tissue around the cancer as the margin. A negative margin means all the cancer has been removed and normal tissue surrounds the tumour). Breast conservation surgery is generally followed by radiotherapy. If it is not possible to have radiotherapy, breast conservation is not generally advisable.
Mastectomy means removal of the breast. It may be done with or without reconstruction.
On some occasions, the outcome for an individual is better if a mastectomy is performed. Indications for a mastectomy include:
- Patient preference
- Widespread pre cancer (DCIS)
- More than one cancer in the breast
- A strong family history of breast cancer
- If the cancer is large/the breast small, the cosmetic result may be better after a mastectomy with reconstruction than after breast conservation.
Axillary surgery refers to the management of the lymph nodes. The reasons to do axillary lymph node surgery are:
- To see if the cancer has spread. This is very important as we generally base our adjuvant treatment of breast cancer on the behavior of the cancer rather than only on the size or grade. The commonest way to do this is with a sentinel node biopsy. Before surgery, the breast is injected with a dye. At the time of surgery, the lymph node containing dye is removed and is tested.
There are several variations on the techniques used
- The dye used may be blue dye or radioactive dye or both
- There may or not be a preoperative scan
- The lymph nodes may or not be tested at the time of surgery.
- To remove the lymph nodes if they are involved with disease.
Commonly used terms:
Simple mastectomy: removal of the breast
Modified radical mastectomy: removal of the breast and the axillary lymph nodes
(Radical mastectomy is rarely done any more: it involves removal of the underlying muscle).
by Jenny Edge
What are the implications of losing a breast or both breasts? Will it be painful? How long will I take to recover? When I get back to my normal day to day activities? Will I have scars? These are the questions that follow once a patient knows that they will need a mastectomy. People respond to the news of needing a mastectomy in many various ways. Some people want it as soon as possible, others delay as they are not sure that it is the right thing to do or they may be anxious or nervous about it. Everyone is different.
What are the implications of losing a breast or both breasts?
When you research a mastectomy it is very easy to become anxious. Whether about the operation, recovery or what you will look like after the surgery. Many people, organisations, doctors and surgeons will write about the topic but unfortunately what you read is not always accurate and can cause mixed emotions. The best way to understand the process is to listen to your options from your surgeon and to meet and talk with a person that has been through a similar experience or had a similar operation.
Will it be painful?
Very often there is more emotional than physical pain after a mastectomy. It is something new that one has to get used to. It takes time and everyone will go through their own recovery at their own rate. You may be happy, sad, teary or relieved. A whole wave of emotions may follow after having a mastectomy.
How long will I take to recover?
This will depend on the person, the type of operation and the circumstances that surround the patient. It takes a good few weeks to recover from a breast operation but again the emotional side may take longer than the physical side. Getting back to day to day activities will gradually increase and become easier with time. It is important to take time to recover and to not do too much too soon. If you rest in the beginning your recovery tends to be quicker. If you are very busy straight after your surgery and do not give yourself time to recover, the patient will tend to have a lot more aches and pains that may continue for a lot longer than usual.
Will I have scars? The answer is yes. If you have an operation, you will have a scar. Scars however, do not have to be associated with something bad. There are ways to minimise scars and each surgeon will have their own way of looking after wounds and scars. The emotional scars on the other hand may remain for quite some time. As we are all different, we will all heal in different ways. It is very important to ask for help if you need it. Whether speaking to a fellow patient, a psychologist, your GP or your medical team, it is important to communicate. It is a natural feeling to be anxious regarding a pending operation and even after the operation it remains important to communicate. Therefore speak to someone before your operation and have that person as a support during your operation and after your operation as you recover. Recovering mentally is a process that starts from the time that you are diagnosed.
Most importantly, try to stay positive! Surround yourself with positive, happy and supportive people that make you feel good. Do not be afraid to ask for help when you need it! A little bit of support goes a long way when needed.
Sr Lieske Wegelin
2015’s Breast Cancer Awareness Month saw us vlogging instead of blogging, giving South African breast cancer survivors a stage from which to state their survivorship on their own terms, in their own words and in their very own way! Meet these #lifers at our Youtube channel in the series we called Walk With Me. The response has been nothing less than extraordinary – to the point where we’ve decided to continue creating Walk With Me video interviews! Leave a comment below or Facebook us if you’re keen to have your #survivorsay!
This month we are focusing on breast cancer treatment, with each kind of treatment receiving it’s own blog post where we’ll cover everything about each particular treatment from what the treatment is, why it has been chosen, its side-effects and ways to deal with the side-effects.
BREAST CANCER TREATMENTS:
- SURGERY: breast-conserving surgery (lumpectomy), lymph node dissection and mastectomy.
- CHEMOTHERAPY: a ‘systemic’ treatment (i.e. affects the entire body because the medicine is carried in the bloodstream) which destroys or weakens cancer cells at both the original cancer site, as well as where they may have spread.
- RADIATION THERAPY: (or ‘radiotherapy’) destroys cancer cells in the breast that may linger after surgery.
- HORMONAL THERAPY: treats hormone-receptor-positive breast cancers.
- TARGETED THERAPIES: these treatments target specific characteristics of cancer cells.
- HOLISTIC & COMPLEMENTARY MEDICINE: there are many available options, but we are unable to endorse anyof these options and strongly advise that patients always discuss these options with their medical team.
***NB: we will also be looking at treatments that can and can’t be used during pregnancy.
We discovered this AMAZINGINCREDIBLEWOW!WOW!WOW! video by a #lifer that cuts straight to the chase!
(Would you like to do your own version? Let us know! We’d love to have you walk your #lifer talk on our Walk With Me vlogging series!)
Click here to read all of our previous posts where we’ve explored the topic of treatment!