June 25th, 2012 by Hasham
Side Effects of Breast Cancer Surgery
Less invasive diagnostic and treatment techniques, such as sentinel lymph node biopsy and lumpectomy, together with innovative approaches to managing pain, mean that more people are finding relief from the side effects of breast cancer surgery. In fact, many large hospitals and cancer facilities now have pain clinics devoted exclusively to helping people with cancer feel better.
While many of surgery’s side effects are short-lived, others may linger longer or even be permanent. The good news is that physical therapy, cosmetic surgery, and other treatment approaches can help you overcome many of the long-term side effects of breast cancer surgery.
We examined the impact of surgical treatments (breast-conserving surgery [BCS], mastectomy alone, mastectomy with reconstruction) and surgical side-effects severity on early stage (0-IIA) breast cancer patients’ body image over time. We interviewed patients at 4-6 weeks (T1), six (T2), 12 (T3), and 24 months (T4) following definitive surgical treatment. We examined longitudinal relationships among body image problems, surgery type, and surgical side-effects severity using the Generalized Estimating Equation approach, controlling for demographic, clinical, and psychosocial factors. We compared regression coefficients of surgery type from two models, one with and one without surgical side-effects severity. Of 549 patients enrolled (mean age 58; 75% White; 65% BCS, 12% mastectomy, 23% mastectomy with reconstruction), 514 (94%) completed all four interviews. In the model without surgical side-effects severity, patients who underwent mastectomy with reconstruction reported poorer body image than patients who underwent BCS at T1-T3 (each P < 0.02), but not at T4. At T2, patients who underwent mastectomy with reconstruction also reported poorer body image than patients who underwent mastectomy alone (P = 0.0106). Adjusting for surgical side-effects severity, body image scores did not differ significantly between patients with BCS and mastectomy with reconstruction at any interview; however, patients who underwent mastectomy alone had better body image at T2 than patients who underwent mastectomy with reconstruction (P = 0.011). The impact of surgery type on body image within the first year of definitive surgical treatment was explained by surgical side-effects severity. After 2 years, body image problems did not differ significantly by surgery type.
Exercises After Breast Surgery
Breast surgery can affect your arm
Women with breast cancer may have many different kinds of treatments. Many women with breast cancer have some kind of surgery. You may have had a:
* Breast biopsy
* Lymph node biopsy or removal
* Breast conservation surgery (lumpectomy)
* Breast reconstruction
Any of these can affect how well you can move your shoulder and arm, take a deep breath, or do your daily activities, like dressing, bathing, and combing your hair.
Exercises can help
No matter what type of surgery you had, it is important to do exercises afterwards. Exercises help to decrease any side effects of your surgery and make you able to go back to your normal daily activities.
If you have radiation therapy, exercises are important to help keep your arm and shoulder flexible. Radiation therapy may affect your arm and shoulder for up to 6 to 9 months after it is finished.
It is very important to talk with your doctor before starting any exercises so that you can decide on a program that is right for you. Your doctor may suggest that you talk with a physical therapist or occupational therapist. This therapist has special training to help design an exercise program just for you. You may need this kind of help if you do not have full use of your arm within 3 to 4 weeks of surgery.
Some exercises should not be done until drains and sutures (stitches) are removed. But some exercises can be done soon after surgery. The exercises that increase shoulder and arm motion can usually be started in a few days. The exercises to help make your arm stronger are added later.
We will review some of the more common exercises that women do after breast surgery. Talk to your doctor or therapist about which of these are right for you and when you should start doing them. Do not start any of these exercises without talking to your doctor first.
The week after surgery
These tips and exercises listed below should be done for the first 3 to 7 days after surgery. Do not do them until you get the OK from your doctor.
* Use your affected arm (on the side where your surgery was) as you normally would when you comb your hair, bathe, get dressed, and eat.
* Lie down and raise your affected arm above the level of your heart for 45 minutes. Do this 2 or 3 times a day. Put your arm on pillows so that your hand is higher than your wrist and your elbow is a little higher than your shoulder. This will help decrease the swelling that may happen after surgery.
* Exercise your affected arm while it is raised above the level of your heart by opening and closing your hand 15 to 25 times. Next, bend and straighten your elbow. Repeat this 3 to 4 times a day. This exercise helps reduce swelling by pumping lymph fluid out of your arm.
* Practice deep breathing exercises (using your diaphragm) at least 6 times a day. Lie down on your back and take a slow, deep breath. Breathe in as much air as you can while trying to expand your chest and abdomen (push your belly button away from your spine). Relax and breathe out. Repeat this 4 or 5 times. This exercise will help maintain normal movement of your chest, making it easier for your lungs to work. Do deep breathing exercises often.
* Do not sleep on your affected arm or lie on that side.
Getting started — general guidelines
The exercises described here can be done as soon as your doctor says it’s OK. Be sure to talk to your doctor before trying any of them. Here are some things to keep in mind after breast surgery:
* You will feel some tightness in your chest and armpit after surgery. This is normal and the tightness will decrease as you do your exercises.
* Many women have burning, tingling, numbness, or soreness on the back of the arm and/or chest wall. This is because the surgery can irritate some of your nerves. These feelings may increase a few weeks after surgery. But keep doing your exercises unless you notice unusual swelling or tenderness. (If this happens, let your doctor know about it right away.) Sometimes rubbing or stroking the area with your hand or a soft cloth can help make the area less sensitive.
* It may be helpful to do exercises after a warm shower when muscles are warm and relaxed.
* Wear comfortable, loose clothing when doing the exercises.
* Do the exercises until you feel a slow stretch. Hold each stretch at the end of the motion and slowly count to 5. It is normal to feel some pulling as you stretch the skin and muscles that have been shortened because of the surgery. Do not bounce or make any jerky movements when doing any of the exercises. You should not feel pain as you do the exercises, only gentle stretching.
* Do each exercise 5 to 7 times. Try to do each exercise correctly. If you have trouble with the exercises, talk to your doctor. You may need to be referred to a physical or occupational therapist.
* Do the exercises twice a day until you get back your normal flexibility and strength.
* Be sure to take deep breaths, in and out, as you do each exercise.
* The exercises are set up so that you start them lying down, move to sitting, and finish them standing up.
Side Effects of Breast Cancer Treatment
The side effects you experience will depend on the type, location, and extent of your breast cancer and the treatment you receive. Side effects are very individual and may not be the same for two people with similar diagnoses that are receiving the same treatment. They may even vary for the same individual from one treatment session to the next. It’s important to discuss the possible side effects you may experience with your doctor and have a plan in place for managing them before you begin treatment.