Finding out you have Breast Cancer Many of us are not prepared to face cancer. When told that we have cancer, we refuse to believe it. We think a mistake has been made, The reality however is that each year the number of Sri Lankan women who learn they have breast cancer is growing. Breast cancer strikes women of all ages, all communities, rich or poor — women who thought they were healthy, women like you and me. This disease is frightening because it is potentially life threatening. It brings with it fear, confusion, pain, depression and even isolation. It forces us to make difficult choices at a time when we are confused and in shock. We fear for ourselves — whether the disease would be cured, whether it would spread to other parts of our body. We are also frightened for our families. Would the other female members of our family — mother, sisters, daughters get the disease? We fear the treatment and the after effects it may cause. If you have learned that you have cancer, it is natural to fear, to feel anger and resentment, to cry and grieve. 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UMA uaoue9 908} 01 pasedaid you axe sno KUCH Toouwy Ieaag sey NOX jno Buiputyvel ne ee e Breese ane chat 7ON er pelptest O Sacvive important Oe are not Pe peip yous Meme, ane 7 sae enat cary a cancer pee ne a Let us ner wledge. Let us begin Deen ores teens ee eating the * page brochure tells YOu about some of these The ore healing, the "Eaten OPtiong oo poss pave to face and their side effec, what are the treatments available to me? qtreapment of baeasts cancer highly advanced today and there are you can use, either alone number of options orin combinati will: adepeneumopmmezocn Individel circumstances: Given below are the procedures usually employed. on. The option/s you choose Partial Mastectomy/Lumpectomy In this surgical procedure, only the cancerous section of the breast and a margin of breast .e that surround this section is removed tissu ¢ anywhere from The surgeon may remov: 1.2596 of the breast tissue. Fat and lymph ies from the armpit area could also be nodi cancer cells had removed to find out if any spread beyond the breast tissue. After partial mastectomy, the patient may also need to follow a course of radiation treatment (See page 8). Modified Radical Mesto con aaa In this type of surgery, all the breast tissue including the nipple will be removed. Lymph tissue will also be removed from the armpit to see if the cancer has spread: You will be left with a scar across the flat chest wall What will surgery be like? @ i Dene: Depending on the type of surgery and how soon you recover ; our stay in hospital may last from one to seven days.You will be asked to check into the hospital a day or two before the surgery: You chould tell your surgeon (or the snesthets*) lergies or have had any if you have any all previous problems with an anzestiss You will not be allowed to eat OF drink (no solids, +o liquids, and no water) from the evening efore the surgery until YOu have been Iprought back from the recovery room Depending on the procedure, your surgery may take from two to four hours. Following surgery, your breast will be bandaged and a tube placed to drain fluid from the wound You may feel nauseous, and tired. Your chest shoulder, orarm may feel numb or you may bein pain, Ifyou are in pain, you should ask After surgery it is important that you rest and regain your strength IFyour lymph nodes were removed You ak. You will be provided » strength These arm may be we apy exercises to regain physiothe in your arm, and to maintain mobility. jses arean important part ol Y y, You jour recovery should practise doing them as ths will cand frozen arm and shoulder from becoming stl Coping after surgery Many women experience numbness or in the area around this scar change of fe« This is caused by nerves which have been cut during surgery, and are healing. The numbness may take a year or even longer to diminish. You may find it helpful to use a soft pillow to support the arm when sitting or lying down. Avoid carrying a heavy handbag or heavy weights on the side on which you had surgery, You will feel more comfortable if you wear solt, loose clothing as the sear heals You should avoid creams or deodorants and avoid shaving in the a F ea surrounding If you drive ‘drive and are used to wearing a alety belt, yor Xu can prevent irritation and discomfort by ae rt by putting a soft cloth between elt and your shoulder Onee the se your besa Scat has healed, you ca wear as usual by ins eat erting a prosthesis inform of treatment is 3 eraysto kill cancer Radiation therapy which uses high eneray 7 Cells or to shrink tumors: Rae onserving sure turning i fiotherapy (used ry) reduces the with — c ‘ erst chances of cane rire Radiation treatment 15 done by machines hich direct che 7275 t© the precise area of the breast treatment is given usually every day © This You are then given a for four to six weeks. Lreak, This break allows normal cells to recover | amounts of daily radiation, doses, helps to protect being treated © Using smal rather than a few large normal body tissues 17 the area @ Radiation treatment is painless although the skin around the area in some cases, peel or become red as 2 receiving it may result of the burn. © Radiation treatment it II be asked to wear a utes. You wil ae atment t gown and lie on 4 tre a © You will not see, hear or feel the radiation A radiation therapist will be watching you during the treatment. During the treatment, family members or friends will not be permitted in the room with you What are the Side Effects of Radiation Treatment? © Radiotherapy does not cause nausea vomiting or hair loss. There are no dietary restrictions to follow while undergoing the treatment © You can lead a normal life during radiotherapy, © Iryou get very tired, try to limit what you do. Get more rest by sleeping during the day and going to bed early. Ask family members or friends to help you with shopping, cooking and childcare Coping with Radiation treatment PAs san you have to travel daily to the hospital this very tiring or stressful. You 8 much as possible and. You should not apply creams or powser a which is receiving radiet ts burnt, you Jhould do, ion How is Chemotherapy given? to the treatment. If your skin 8¢' doctor what yous! should ask your reams that can Chemotherapy drugs used to treat breast about it. There are special © cancer are usually given by injection into a be used in such cases: vein (intravenously). Some drugs may also © Wear loose cotton clothing, asthis would ue a i be taken as tablets. Sometimes both forms 11 feel comfortable Avoid irritating BQ of chemotherapy are used. make yo Use non-perfumed the skin by rubbing it soap when bathing. - What is the \¢ sore So, treat it treatment procedure? © Your skin may becom: gently. Skin reactions generally heal within a few weeks Generally chemotherapy drugs are given i CHEMOTHERAPY oe eee. teycles'- There isa break between one evcle and the next. This rest time allows normal cells to recover before the next treatment Chemotherapy is the use of drugs to treat cancer by killing or preventing the growth In the past, Chemotherapy ‘Treatment programmes vary but generally treatment was quite “aa a e four to si the treatment 3S about th ix cycles. This can take about three to 5 much more six months to be completed of cancer cells. was feared because the Today, howeve' ved significantly and i ~~ harsh. impro’ bearable Chemotherapy works by destroying er with cells that grow rapidly, such as cance! cells. emotherapy side effects shown flit search studies have 5 Re. ne ves survival 3 actions to chemotherapy often vary ming ‘on the individual and the drugs chemotherapy impro he chance of t he cancer ©° reduces ¢ have no side effects or only back.Or you may have side These effects The most common side effects are discussed below a few mild ones effects that cause you concer. can be prevented or managed. or being tired, is the most If you get very tired sually do. © Fatigu common side effect try to limit what you If you are working, you may need to take leave from your work, or work part-time. Ask members of your family and/or friends to help with cooking, shopping or childcare. as much rest as you can. Try to get Gentle exercise such as walking also helps to reduce fatigue. © Nausea and vomiting You may feel sick or nauseous. There are drugs that can prevent There are tablets that you have to Your nausea swallow or dissolve in your mouth. doctor may prescribe such drugs If you do develop nausea and vomiting, you may not feel like eating food that is oily or greasy, and you may wish to avoid exting meat. Eating fruits and vegetables will help Remember it is important to keep up you Drink plenty of your fluid and food intake water. 7 2s los © Hair loss Chemotherapy often causes|o hair on the head. However loss of body hair. TS and pubic of hair, especially some drugs also caus can include eyebrows © hair, When hair loss happens: ryelashes, + three weeks after treatment begins two o1 yy lose all their hair starts, Some people = ‘Often the hair comes out in very quickly. a bath or shower, Others may clumps during lose hair only everal treatments. after s Ifyou lose the hair on Yous head, you may find it comfortable tam scarf. In Lanka, chisis Ver see PP slo a few places that sell wigs, Tf YoU t= buying a wig, i Donte a before ail_your hair falls Out soles aa buy one that matches your natural hair and its colour, You may find that the less of eyebrows and eyelashes make you look quite different. Using a pencil to draw eyebrows ‘or as a liner usually helps to restore your normal appearance Remember that hair loss is not permanent ‘The hair will grow back either during the treatment period itself or after it is over. ‘Sometimes it grows back differently. People who have had straight hair may find that they develop curly hair, ® Infection Sometimes chemotherapy may lower your white blood cell count making you more prone to infections. Itis therefore saler to avoid crowded places (such as Pi mas) or travelling in crowded buses as _Much as you can,pod tests are taken before each cycle of Benoiieniyioinieswddanter cs counts are normal before your next treatment © Mouth sores and problems Some people dugeigpitblin ores darmechemolcisny Others may even develop teeth and gum. ater and f baking problems. Drinking plenty of rinsing your mouth with a solution © coda and water often during the day will help Peete curmouth, Useasotstoothbrichs to brush your teeth Many people find that that food does not taste the same during treatment. Meat especially may have a bitter taste, Ik also helps to reduce or stop your intake of coffee and tea. © Forgetfulness and Mood Swings Chemotherapy seems to make some women forgetful and prone to mood swings. These changes are temporary but it can last for Jong as two years after chemotherapy It might help to talk to a friend or another woman with breast cancer © Menopausal symptoms If you are menstruating, your periods will BecOms irregular or may stop altogether. For may women, their period returns when the treatment is over. However, for some chemotherapy may also lead tOIBs earlier menoy cnet a 'er menopausal symptoms such as body aches, hot s, hot flushes an desire thes and loss of sexual © Lymphoedema Lymphoedema a persistent «Well SF alana eee can be quite mild or severe. Lymphoedema may occurany time after surgery (even after many years) and may be temporary or permanent. Lymphoedema may even occur ster radiation treatment. Surgery and vadiation can stop the flow of lymph from the arm back into the circulation. Because the fluid does notleave thearm, through the iymph vessels, the arm may swell Lymphoedema may be prevented by avoiding infection, limiting heavy lifting with the arm and avoiding cuts. For example do not permit blood tests on the affected arm. The growth of breast cancer seems to be aa oy A female hormone oestrogen sou Sa stops oestrogen from stmt ve e growth of breast cancer ‘ © FeMoves oestrogen that is Present in the bodym a lood tests are taken before each cycle of chemotherapy to make sure that the blood counts are normal before your next treatment starts. © Mouth sores and problems Some people develop mouth sores during chemotherapy Others may even develop teeth and gum problems. Drinking plenty of water and rinsing your mouth with asolution of baking soda and water often during the day will help Merman: Uerachrcotbrsh to brush your teeth. Many people find that that food does not taste the same during treatment. Meat especially may have a bitter taste. lt also helps to reduce orstop your intake of coffee and tea, © Forgetfulness and Mood Swings Chemotherapy seems to make some women prone to mood swings. These last for as forgetful and changes are temporary but it can I Jong as two years after chemotherapy, Ie might help to talk to a friend or another woman with breast cancer. eiNichopausal symptoms |i /aiaais menstruating, your periods will become ieregular or may stop altogether: For many 4 returns when the women, their perio for some However, treatment is over Iso lead to 8 chemotherapy may al women, earlier meno} ieuermenonaus. Ifthis happens YOuTRY ’er menopausal symptoms stich as body aches, hot dane * flushes and loss of sexual © Lymphoedema | ymphoedema a persistent swelling of the armor breast. k can be quite mild or se piles _ yr severe. Lymphoedema may occur any time after surgery (even af even after vnany years) and may be temporary permanent. Lyme eee eats after radiation treatment. Surgery and vadiation can stop the Flow of lymph from rhe arm back into the circulation, Because the fluid does not leave thearm, through the Iymph vessels, the arm may swell Lymphoedema may be prevented by avoiding infection, limiting heavy lifting with the arm and avoiding cuts. For example do not permit blood tests on the affected arm. RMON wa The growth of breast cancer seems to be enhanced by the female hormone oestrogen Hormone therapy stops oestrogen from se the growth of breast cancer an also Femoves oestroxen that is Present in the bodyrered as taken once daily Tamoxifen 16 21° » form of Tamoxifen m of hormone therapy e usually prescribed for five years*© PS taken ee nodifying t group of hormone recent group ¢ nhibitors are also drugs called aromatase used, especially to treat advanced breast cancer or breast cancer that has spread to other parts of the body metastatized) Arimidex, Femara and Aromasin are examples of aromatase inhibitors which anterfere with the production of oestrogen. The side effects of these drugs include © Being very tired © Hot flushes © Feeling sick © Headaches. amoxifen may also cause blood clots and Having breast cancer can be frightening and stressful. The periods of treatment can be lonely, tiring, and difficult. It is also not easy to put aside the demands of others family, friends, colleagues, and work mates But if you are to become well again YOM eed to need to take control of your life and treatment ee You need to look after yourself Some tips to help yourself © Learn to ask forhelp. You will be surprised at how many people do want to help you recover: © Try to hand over your work to others at well. Even though you may have loss of appetite, it is important that you get all the nutrition your body needs. Try eating small portions frequently — rather than one or two large meals © Take time to rest. Sleep as much as possible . Drink plenty of water and liquids . lg yourself emotional support. Cry orlaugh, Be R gh. Be angry. Many people have found hat me meditation and turning to a religious phik 7 losophy helps immensely during these ifficult times,