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Ways to Manage the Typical Side Effects of Breast Cancer Treatment

Here we describe common problems associated with breast cancer treatments and ways to manage them.

All medical treatments have unwanted consequences. Here are the most common breast cancer treatment side effects and ways to manage them.


  • Mastectomy: If a breast needs to be removed entirely, perhaps because the tumor is very large, breast prostheses are designed to restore your natural body shape.
  • Breast-Conserving Surgery (BCS): Most women with breast cancer today undergo breast-conserving surgery, also known as a lumpectomy or wide local excision. Surgeons use this procedure to keep as much of the breast tissue as possible. It can still change the appearance of the breast. In many cases, the shape and size of the breast may be irregular or look different than the other breast (asymmetry). Partial breast shapers can help.
  • Lymphedema: Lymphedema is an unpleasant, often painful swelling caused by protein-containing fluid that collects in tissue. In women with breast cancer, it usually occurs after surgery on the arm or armpit or in the operated chest or hand. Exercise helps prevent lymphedema by stimulating the lymphatic drainage to stop fluid from accumulating. Exercise, ideally in combination with manual lymphatic drainage (MLD), is effective  if you have lymphedema. You can find more suggestions in our article, "What helps if you have lymphedema ”.
  • Limited movement: Poor mobility and stiff shoulders are common side effects during the first few weeks after surgery. Some women develop "cording," also known as axillary web syndrome. It is a tight cord of tissue starting in the armpit that can, in some cases, stretch as far as the wrist, restricting movement. Both symptoms improve with physiotherapy and stretching exercises. 
  • Scars: Once the wound has healed, the remaining scar can be gently massaged. Massaging stimulates the blood supply and makes the connective tissue more supple. Non-perfumed creams or ointments can also help moisturize dry scar tissue. 


Chemotherapy side effects

  • Hair Loss (including eyelashes): Doctors recommend chemotherapy for many types of breast cancer. However, chemotherapy has side effects. The reason is that chemotherapy drugs are non-specific. That is, they act on both healthy and diseased cells. As a consequence, chemotherapy not only interrupts the division of the cancer cells. It also affects the healthy cells in hair roots, nails and mucous membranes.
    Many women like to wear a wig or headscarf while their hair is growing back. If you choose to wear a wig, it can be useful to establish a routine from the start of your treatment. 
  • Dry mucous membranes: The lining in the mouth often also feels more sensitive than usual. When eating, it can be helpful to avoid acidic foods such as citrus fruits. Vaginal lubricants and moisturizers can be used during sex  to enhance comfort. 
  • Weak immune system: Chemotherapy often attacks healthy immune cells as well as cancer cells. The body's immune system can be weakened and become more susceptible to infection among women undergoing chemotherapy. It's best to avoid large crowds, especially during cold and flu season, wash your hands frequently and prevent cuts and scrapes.
  • Fatigue: Many women suffer from chronic fatigue (tiredness) while receiving chemotherapy. Exercise helps. For mild fatigue, moderate to intense training is recommended. In case of severe fatigue, light activities are good enough. If you are very tired, start with gentle movements and build your training up as you gain strength. You could start with five to ten minutes of easy walking, take a pause, and then repeat with another five to ten minutes of walking. A rule of thumb: the more exhausted you feel, the lower the intensity of exercise. Doing too much too quickly can lead to a rebound and increase tiredness. 
  • Nerve damage: Chemotherapy can damage the myelin sheath of the nerves, which causes a tingling sensation and numbness in the fingers and toes (peripheral neuropathy). Coordination training such as balancing exercises and drumming can help. Acupuncture and TENS (Transcutaneous electrical nerve stimulation) have also been found to reduce symptoms. 


Radiotherapy (Radiation) for Breast Cancer Side Effects

  • Red or sensitive skin: The extent of the change in color and sensitivity of the skin depends not only on the length of treatment and strength of the radiation but also on your skin type and sensitivity. Typically, women with a light complexion and hair often react more strongly to radiation than those with darker skin. If the skin reddens and feels like mild sunburn, extra care should be taken to avoid irritation. It is recommended that direct sunlight, chlorinated water and heat should be avoided, and underwear and clothing should not rub or pinch. If you can, don’t wear a bra during the first few weeks of treatment. Ask your radiation team for advice on ways to care for your skin during treatment. 
  • Skin feels thicker and looks darker: Again, the change in your skin depends not only on the strength of the radiation but also on your skin type. These changes usually disappear after treatment, but if your skin becomes inflamed, talk to your doctor or breast care nurse.
  • Lymphedema: Like chemotherapy, radiation is also non-specific. That means that when it reaches the skin, it destroys all the cells that are dividing at that moment. This can result in side-effects that cause local inflammation and lead to lymphedema  forming at the site being treated.