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Though your breast cancer treatment might be over, life might not feel like it’s back to “normal” just yet. Even if your cancer is in remission, you might worry about it coming back.

For some women with advanced breast cancer, the cancer may never completely go away, and you’ll be in a phase of maintenance to help keep it under control.

What you just went through was an incredible challenge, and it will take a little time to get your life back on track.

Breast cancer treatment can cause some aftereffects, which may be dependent upon the type of treatment you received. You should take all the time you need to manage and adjust to them.

But there are a few ways to make this process go a little more smoothly, including medications and lifestyle changes. Sticking to the follow-up schedule outlined by your care team can also greatly help with this process.

Most breast cancer treatments will cause physical or psychological side effects. And some of these side effects can linger for months or even years after treatment ends.

Depending on the treatment you received, you might experience one or more of the following aftereffects:

  • pain
  • arm swelling due to lymph node removal
  • scarring
  • hot flashes
  • joint pain
  • swelling
  • hair loss, which starts to regrow after treatment
  • numbness (neuropathy)
  • fatigue
  • bone thinning
  • digestive issues, like diarrhea or constipation
  • changes in how the breasts look or feel
  • early menopause
  • problems with memory or concentration
  • weight gain
  • skin irritation
  • skin darkening
  • depression
  • vaginal dryness
  • sleep problems

Most post-treatment effects can be managed or treated after breast cancer treatment is completed. You can work with your doctor or care team to develop a post-treatment plan.

Coping with fatigue

Many breast cancer survivors will feel tired or worn out after treatment and sleeping or resting may not help. It’s not fully understood why this happens, but the fatigue should improve over time.

One study found that women with breast cancer were most affected by fatigue in the first 6 months after diagnosis followed by a slow decrease over time. Until then, it’s important to work with your doctor to find ways to cope. This may include:

  • getting treatment for any medical problems that could affect your energy levels, like anemia or poor nutrition
  • drinking more fluids
  • taking naps and breaks between activities
  • getting help with household chores or cooking
  • eating a healthy, balanced diet and getting the right amount of calories

Managing pain

Pain isn’t a sign of weakness or failure. Tell your doctor if you’re in pain. They can assess your pain level and recommend treatment.

Your doctor may recommend starting with a non-pharmacologic approach or over-the-counter pain relievers. They may put you on mild pain medications and move up to stronger medications, but only if you need them.

It’s important to note that some stronger medications may put you at risk of dependence or addiction, so be sure to take the correct dose and see your doctor for regular checkups.

Other ways to manage pain include:

  • physical therapy
  • massage
  • acupuncture
  • ice packs or heating pads
  • meditation
  • yoga
  • relaxation skills

For persistent pain, discuss with your doctor if nerve blocks or surgery are right for you.

Coping with other physical effects

Weight changes, digestive issues, and other aftereffects of breast cancer treatment can all be managed with medications or lifestyle changes. It may take time and some trial and error to figure out how to get them under control.

It’s important to talk with your doctor about these side effects and what can be done about them.

It may be a good idea to also join a breast cancer survivors support group. Once connected, you all can share tips about how to manage the physical effects of cancer treatment.

Another option is the Bezzy Breast Cancer app. This free app provides a platform to share experiences and ask questions to a community of breast cancer survivors. You can download the app for iPhone or Android.

Your main treatment might be over, but monitoring will still be a part of your life. It’s important to keep your follow-up appointments. Your doctors will want to watch you carefully for any new problems or symptoms.

Depending on your stage of breast cancer, lab and imaging tests might not be needed during follow-up meetings. But if you’re having new symptoms, these tests could be necessary to see if they result from treatment-related side effects or the cancer returning.

For later-stage breast cancer, regular follow-up testing is important to test for recurrence.

Other tests may also be needed depending on which treatment you received and if you’re still taking any medications.

Mammograms

Unless you’ve had both breasts removed during a mastectomy surgery, you still need to have yearly mammograms on the remaining breast. If you had a lumpectomy or partial mastectomy, you will likely have a mammogram 6 months after surgery and every year after that.

Pelvic exams

Hormone treatments like tamoxifen can increase your risk of endometrial (uterine) cancer, especially if you’re postmenopausal. It’s important to continue your routine gynecological cancer screening, including an annual pelvic exam. Let your doctor know if you experience any unusual vaginal bleeding, especially if it’s postmenopausal.

Bone density tests

Drugs known as aromatase inhibitors such as anastrozole or letrozole used to treat breast cancer can reduce bone density and lead to osteoporosis. Bone density scans should be performed every 2 years due to the risk of reduced bone density and osteoporosis.

Your doctor may want to monitor your bone density and overall health. You may consider increasing calcium intake and weight-bearing exercises to preserve bone health.

Adjuvant therapies are additional treatments that help treat cancer after a primary therapy like surgery.

If your breast cancer is considered hormone-receptor positive (about two out of three breast cancers are), adjuvant hormone therapy can help stop estrogen from fueling the cancer cells.

Drugs that block estrogen receptors or lower estrogen levels include:

  • tamoxifen
  • toremifene
  • fulvestrant
  • aromatase inhibitors such as letrozole, anastrozole, and exemestane

Treatment with oral hormone therapy typically lasts about 5 to 10 years, depending on the tumor size, any lymph node involvement, and other factors. Your doctor may prescribe these medications if they think your cancer has a higher chance of returning.

Changes to your diet and physical activity level can help improve your outlook and your well-being post-treatment for breast cancer.

Diet changes

It may not be possible to do everything suggested in diet guidelines. Mouth sores, pain, and digestive issues could make it difficult to eat certain foods. If possible, try to incorporate the following changes to your diet:

  • Avoid alcohol as it can irritate mouth sores or interfere with certain medications.
  • Eat more vegetables and fruits since they are rich sources of antioxidants. Antioxidants are thought to lower your risk of cancer. Fruits and vegetables are also rich sources of vitamins and minerals.
  • Avoid foods high in fats especially trans fats, like baked goods and margarine. Though the link between a high fat diet and breast cancer isn’t fully understood, foods high in fat often contain excess calories that can lead to weight gain. Excess weight is linked to having a higher risk of cancer.
  • Avoid red and processed meats, sugary foods and beverages, and highly processed foods.
  • Eat foods high in dietary fiber, such as beans, whole grains, nuts, and fruits to help digestion. These foods are also associated with a lower risk of death for breast cancer survivors.
  • Drink plenty of water to help with fatigue and digestive problems.

Exercise

Even if you’re experiencing fatigue, you’ll want to stay active. Research suggests that exercise can help improve quality of life and cancer-related side effects such as fatigue, depression, anxiety, and sleep issues. Exercise can also help you maintain a healthy weight.

It might be a challenge at first to get up and start exercising. But it’s okay to start small. The key is to be consistent. Start with just 10 minutes of exercise a day. Then, slowly increase your activity level over time as your strength returns.

The American Cancer Society recommends getting at least 150 total minutes of moderate-intensity or 75 minutes of vigorous-intensity activity each week.

Research suggests that breast cancer survivors who are physically active have a lower risk of death than those who are less active.

Keeping open lines of communication with your doctor is key to successful aftercare following breast cancer treatment. You should let your doctor know if you notice any changes, new symptoms, or side effects. This includes your mental health.

You can also ask your doctor or care team for:

  • a summary of all diagnostic and follow-up tests and your past treatments
  • a schedule for follow-up exams and tests
  • a list of what to expect in terms of long-term side effects from your treatment
  • a list of symptoms to look out for and when you should alert your doctor
  • diet and exercise recommendations
  • referrals to mental health counselors, physical therapists, nutritionists, dentists, and other professionals who can help address post-treatment effects

You should also meet with your primary care doctor for regular checkups for other health problems unrelated to breast cancer, like diabetes, heart disease, and routine vaccinations.

You’ll want to pass along your medical history to your primary care doctor and inform them of which medications you’re currently taking.

An open line of communication with your cancer care team is essential to navigating life after breast cancer treatment. Your care team and doctors can help you understand what can be done to improve your overall quality of life post-treatment.

It’s vital to take your medications on time and make exercise and healthy eating part of your new routine. Sticking to follow-up appointments can make life more manageable and prevent problems from escalating.