Side effects of treatments

Managing side effects

Breast cancer treatment can affect your physical, cognitive, emotional and psychological well-being. No side effects should be ignored. If you notice any changes that worry you after treatment or if you’re unsure, connect with your healthcare team right away. They will be able to provide you with advice tailored to your situation to help you feel better.

You can also check out our resources directory to find services geared toward your needs in your area.

Lymphedema

Lymphedema is swelling due to a buildup of lymph fluid in the soft tissues near the organ where the lymph nodes have been removed or damaged by treatment. It is characterized by swelling of the arm and hand and difficulty moving the limb. Lymphedema can be caused by sentinel biopsy, axillary dissection, breast surgery and radiation therapy, and can lead to certain complications in people being treated for breast cancer.

Here are some precautions to take to reduce the risk of arm lymphedema appearing or worsening after surgery:

• Wear sunscreen to avoid sunburn.
• Protect your hands and arms from trauma such as insect bites, cuts, pet scratches, burns, etc.
• Avoid substances that irritate your skin.
• If you have an open wound, wash the area, apply an antibacterial ointment and cover it to avoid infection.
• Consult a healthcare professional as soon as symptoms of infection appear (skin rash, redness, itching, pain, inflammation, increased temperature or fever and general discomfort).
• Ideally, have your blood pressure taken on the arm that hasn’t been affected by the operation.
• If possible, don’t receive injections or infusions, and don’t have blood drawn from the arm that’s been affected by the operation (due to the risk of infection).
• As much as possible, avoid exposure to high temperatures (hot baths, saunas, spas and sun), as heat can cause swelling.
• Regularly engage in appropriate physical activity to promote lymphatic circulation; for example, arm strengthening exercises (with weights or elastic bands) and cardiovascular exercises. Our My Active Health program can help you maintain an active lifestyle.
• Return to normal physical activities gradually. Set short-term goals—the important thing is to move daily.

Research has also shown that lymphedema is more common in people who are overweight or who have gained weight since surgery. It is therefore recommended to adopt as wholesome a lifestyle as possible to help maintain a healthy weight.

For more information, see the leaflet on lymphedema produced by the Centre hospitalier de l’Université de Montréal (in French), the Lymphedema Association of Québec website, and the educational video on the prevention and treatment of lymphedema developed by the CISSS de la Montérégie-Centre (in French).

Peripheral neuropathy

Certain chemotherapy drugs can cause damage to the nervous system (neuropathy) and lead to symptoms that occur mainly in the extremities, including:

• Numbness or tingling in the hands or feet;
• Itching or burning in the hands or feet;
• Pain or discomfort;
• Muscle weakness or cramps;
• Loss of sensation or unusual sensations on contact with objects;
• Change in sensitivity to heat or cold; and
• Loss of balance, clumsiness or coordination problems.

The type and intensity of symptoms vary greatly from person to person, depending largely on the type of chemotherapy and the dose received. These symptoms are often temporary but can sometimes last longer or appear months or years after treatment.

No symptoms should be ignored. If any changes appear or worsen, or if they don’t go away after stopping treatment, contact your healthcare team right away. They will be able to advise you on how to find relief or may decide to adjust your treatment until the symptoms subside.

While there is no treatment for peripheral neuropathy, certain medications and strategies can be used to prevent or relieve symptoms to help you better cope with it. Your healthcare team will be able to advise you on the most appropriate strategies for your situation. These may include:

• A change in your treatment;
• Medication for pain and discomfort;
• Certain supplements;
• Physiotherapy or occupational therapy;
• Complementary therapies such as mindfulness meditation, yoga, reiki, massage, acupuncture and transcutaneous nerve stimulation. The Foundation provides free access to oncological yoga.
• Preventive measures:
  • Handling sharp objects or other dangerous instruments carefully.
  • Not walking barefoot and wearing shoes that provide good support.
  • Protecting hands and feet from heat and cold.
  • If balance is affected, moving around carefully and creating a safe environment.

To learn more about peripheral neuropathy, see the leaflet on nerve problems associated with cancer treatment produced by the Centre hospitalier de l’Université de Montréal (in French), the Canadian Breast Cancer Network’s blog post titled Helping you live better with Chemo Induced Neuropathy, and the educational video on the prevention and relief of chemotherapy-induced peripheral neuropathy developed by the CISSS de la Montérégie-Centre (in French only).

Cognitive changes

Breast cancer and its treatments can affect cognitive abilities (thinking, reasoning, judgment, learning, attention, memory, etc.). For example, people with breast cancer may:

• Feel confused and disoriented;
• Feel frustrated and powerless;
• Feel overwhelmed by events;
• Have difficulty remembering or memory lapses;
• Have trouble multitasking;
• Have trouble concentrating;
• Feel like they’re functioning in slow motion;
• Have difficulty structuring their ideas; and
• Have difficulty carrying out daily tasks.

Possible causes of cognitive impairment include chemotherapy and hormone therapy, certain supportive medications, as well as brain metastasis and its treatment. Cognitive changes can also be caused by secondary factors such as fatigue, anemia, sleep disorders, pain, malnutrition, dehydration, advanced age, stress and anxiety.

The type, intensity and duration of symptoms vary greatly from person to person. No symptom should be ignored. If you or your loved ones notice any changes that affect your quality of life, connect with your healthcare team right away. They will be able to advise you on strategies tailored to your needs or refer you to a specialist if necessary.

Here are a few strategies for taking care of yourself:

• Be physically active and eat a healthy, appropriate diet. Our My Active Health program can help you move every day and eat a healthy diet according to your needs.
• Rest and take time for yourself.
• Lower your stress with relaxing activities such as yoga or meditation. The Foundation provides free access to oncological yoga.
• Take your mind off stressful things with activities that you enjoy and that recharge your batteries.
• If you have the energy, stimulate your brain by reading, playing games, listening to music, drawing or trying new hobbies.
• Tell your loved ones how you feel. Clearly communicate your limitations and your needs.
• Speak to your employer about helping you complete tasks that have become more difficult.
• Reassess your priorities, set realistic goals and try to let go of the things that seem less important.
• Use tools to help you reduce your mental load and organize your daily life (notepad, agenda, calendar, reminders and alarms, etc.).
• As much as possible, be kind to and compassionate with yourself.
• Our psychosocial support service can help you develop coping strategies to deal with the many challenges of being diagnosed with breast cancer.

Other resources

• Educational videos on preventing musculoskeletal complications following breast cancer treatment, developed by the CISSS de la Montérégie-Centre (in French only): Capsules éducatives sur le cancer du sein | Portail Santé Montérégie (santemonteregie.qc.ca) 
• For more information on caring for scars, see our blog post titled Everything you need to know about scars after surgery.