“Treatment for breast cancer is scary,” says Amy Tiersten, MD, oncologist and hematologist at Dubin Breast Center, Mount Sinai Hospital in New York City. “The role of the medical oncology team is really to demystify it, and carefully explain what will be happening and what can be done to ameliorate certain side effects.”
Open dialogue between the patient and the team is critical. In an ideal situation, patients should feel like they can reach out to their team whenever necessary to voice their concerns or ask questions.
Another benefit of open dialogue between the medical team and the patient is alerting the patient of all potential side effects during treatment. When the patient knows what possible side effects to expect, it can make the process less scary and can empower them to take steps to manage them.
For example, certain types of chemotherapy drugs can cause damage to small nerves in the fingers and toes (a condition known as peripheral neuropathy). This results in numbness and tingling. “Acupuncture has shown to be helpful for the treatment of neuropathy,” says Dr. Tiersten.
Women undergoing breast cancer treatment should also be aware of the potential for menopausal symptoms. Since anti-estrogen therapy is a common treatment for some types of breast cancer, that can affect hormone levels and put patients in a temporary state of early menopause. This can cause unpleasant symptoms—like hot flashes and vaginal dryness—as well as affect fertility, pregnancy, and even sex life. (Learn more about sex during breast cancer treatment here.)
“Thankfully, there [are] new drugs that have been studied that have been shown to be effective to minimize hot flashes or vaginal dryness,” says Dr. Tiersten.
Vaginal dryness is a side effect that Dr. Tiersten actively brings up with her patients. “It’s not something that someone might offer on their own,” she says. “To know that it’s a normal side effect of the drug they’re on, and [that] there are things that can be offered that might help, is really important.”
It’s not just medications that can help: Regular exercise has been shown to improve outlook of breast cancer treatment and reduce the risk of cancer recurrence. It can even relieve some of the side effects associated with chemotherapy.
“As much as people feel up to it, I recommend at least 30 minutes of walking, five days a week,” says Dr. Tiersten. “I find that that really helps with fatigue and other symptoms associated with treatment.”
One major part of dealing with breast cancer treatment that often gets overlooked is prioritizing your mental health. “It’s important to be in a place where psychological support can be offered, such as psychiatrists, psychologists, social workers who can help with plugging patients into support groups,” says Dr. Tiersten.
If you’re in a situation where your doctor is not being upfront and direct about side effects to expect, or how to manage them, that’s the time to advocate for yourself and ask those questions directly—or find a new medical oncology team.