Can I drink alcohol now my treatment is over?
Yes, and in fact you may have been told you could have a drink during treatment if you wished. There is no reason why you shouldn’t have a drink, but avoid having too much alcohol for the good of your general health.
Is it OK to go swimming after treatment?
Yes, although until your skin has healed from radiotherapy, it will remain sensitive and your doctor may advise against it just in the short term, in case chlorine in a pool irritates the area. Once everything is healed, it is safe to swim. If you have had a mastectomy, you may feel less confident about going swimming. Your breast care nurse can offer advice on how to adapt swimming costumes and where to buy special swimwear. You can also get information about this from organisations such as Breast Cancer Care.
After my operation I was given special exercises to do by the physiotherapist. How long do I need to continue these?
Check with your breast care nurse or physiotherapist when to stop any special exercises. These will have been given to you to help you heal and to increase your range of movement. You need to carry on with them for the right length of time or you may not gain the full benefit from them and problems, such as stiffness, may occur later. Some people choose to carry on doing the exercises for years because they have got into a routine and it helps reassure them that they are reducing the chances of any arm problems in the future.
I haven’t been able to do very much around the house. When can I begin doing shopping and housework?
Generally, whenever you feel able to. Housework is a more energetic activity than we tend to think so start slowly with dusting, washing-up and cooking light meals. Gradually add in other activities such as vacuuming, ironing and going out shopping. Remember your strength and range of movement will be less on the side of the surgery and you may well have lower energy levels after treatment. You will usually be given specific advice by the doctor or physiotherapist about what you can and cannot do in the weeks after surgery. In most cases, very energetic activities and heavy lifting are best avoided for a few weeks but don’t worry if it takes longer before you feel back to normal. Everyone recovers at their own pace.
I can’t wait to get out in the garden. Is gardening a good kind of exercise?
Yes, and it gets you out into the fresh air. However, you should start with light jobs like weeding and not try to dig the vegetable patch or mow the lawn in one go. And remember to take care to avoid cuts and infections if you have had surgery to your lymph nodes under the arm because of the risk of developing lymphoedema. Wear gloves when you garden and wash any cuts and apply an antiseptic cream.
The nurse mentioned lympheodema. What is it exactly?
Lymph is a colorless liquid that is formed by the tissues of the body. It is normally taken back into the bloodstream through the small tubes and glands which make up the lymphatic system. Lymphoedema occurs when this liquid builds up in the tissues under the skin. It causes swelling (oedema) in a limb or another part of the body. The tubes and glands of the lymphatic system may be damaged by treatment for cancer and so the lymph can’t drain away, resulting in swelling.
Can I do anything to prevent getting lymphoedema?
It is not usually possible to prevent lymphoedema. However, your doctor can tell you if there is a chance that you may develop it because of the type of surgery or radiotherapy you have had. The doctor, physiotherapist and nursing staff can suggest ways to reduce the likelihood of developing lymphoedema.
• Use your ‘at risk’ arm normally. Gentle non-repetitive exercise, such as swimming, will keep your joints supple and assist lymph drainage.
• Don’t use your arm for sudden or strenuous movements like pushing objects or carrying heavy shopping or a heavy shoulder bag on this side.
• Take care of your skin – wear gloves when gardening or doing housework, as an infection in a cut or scratch can trigger a swelling. Use an insect repellent to reduce the risk of bites or stings.
• Don’t have blood taken from, or injections given into, the treated side. Ask the doctors or nurses to use your other arm. If you have had both sides treated, it is best to alternate sides.
• Don’t wear tight clothing, like tight-fitting bras or sleeves that can cause constriction, or have your blood pressure measured on the treated side.
If I get lymphoedema, can it be treated?
Yes. More is now known about why lymphoedema develops and how it can be treated. Several methods are used to control swelling including special massage techniques called manual lymph drainage (MLD) and elastic support sleeves. Treatment will be more effective if it is started as soon as you notice any swelling. Even if swelling is mild or comes and goes, report it to your doctor.
During my treatment I have put on a lot of weight. Will I get back to my normal weight again?
It is possible to lose the extra weight but it will take time. Try to set yourself realistic goals and plan to take regular exercise, for example, a daily walk. You can ask a dietitian at the hospital or your doctor for advice about a healthy eating plan.
I am getting some pretty terrible menopause-like effects. Are these because of the hormone therapy?
If you were still having periods before you had chemotherapy, and your periods have stopped as a result – either temporarily or permanently – then this could be causing these symptoms. Hormone therapies can also cause side effects like menopausal symptoms. These can include hot flushes, night sweats, vaginal dryness, dry skin and hair, mood changes and difficulty concentrating.
Will the menopausal problems get better over time?
Yes, they should do. Most women notice they get better over a few months, whatever the cause. However, some find they don’t improve and on rare occasions decide not to continue with their hormone treatment because of the side effects.
There are ways of minimizing menopausal symptoms without drugs and you could contact organisations, for suggestions about these, which include diet, vaginal lubricants and complementary therapies.
Sometimes I sit down to read a book or write a letter and find I can’t concentrate. Is this normal after treatment?
Lack of concentration is not uncommon. It may be due to the effects of treatment or simply because you have not fully adjusted to having had a serious illness. Usually when we are ill, even if it’s just a bout of flu, we feel mentally less alert and less able to concentrate. Studies have shown that chemotherapy can result in poor concentration and memory and this can take many months to improve. If you don’t feel you are recovering as quickly as you should, it may be useful to talk to someone about this. It may help to set your mind at rest that you are not unusual.
How soon after treatment can I start driving again?
You should discuss this with your doctor. Your physical movements may be restricted or a seat belt may cause discomfort to your chest after surgery. However, you can usually drive about four to six weeks after your operation. If you drive when your doctor has advised you not to, your insurance may be invalid if you have an accident.
I feel pretty well, all things considered. Is there anything I shouldn’t do?
Not really, but check with your doctor if you are in any doubt. Occasionally, a person will be given specific advice which may only need to be followed for a short time or which may be relevant in the longer term. For example, if you have had chemotherapy, or any other treatment which has affected your blood count, you may be advised to avoid crowded places for a while immediately after treatment because you might still be at risk of picking up an infection more easily. But this sort of advice will only need to be followed in the short term.
When will I feel able to get out and about more with my friends and family?
Whenever you feel ready to do so. The time you choose will depend on how you feel physically, how confident you are about mixing with other people and what you want to do. The important thing is not to overtire you by doing too much too soon.
I don’t have the energy to go out with friends or do the things I did before treatment. I don’t feel I’m achieving anything. What can I do?
Any illness unsettles your normal routine and if you are used to being busy it is very frustrating when you don’t feel able to take part in your usual activities. Recovery, both physical and emotional, is gradual. You may have up days and down days. Try to take advantage of the days when you have more energy and have a few activities lined up in preparation for such a day. Even if you don’t feel like going out, family and friends can visit or you might like to take up a new hobby, something you always wanted to do but never had time for before. Fatigue after treatment for breast cancer is very common so you may feel reassured to know you are not alone and that reduced energy levels are very unlikely to be related to the cancer coming back.
I really miss my job. When can I go back to work?
This will depend to a large extent what your job entails. You may have continued working, full-time or part-time, during your treatment. If you were unable to work, discuss the possibility of returning on a part-time basis with your employer. If you have been working part-time during treatment you may be able to go back fulltime quite soon.
If your job is mentally stressful or involves heavy manual work you may need a longer interval between finishing therapy and returning to work. Depending on how you feel, you might wish to discuss this with your doctor, the occupational health department at your work or your employer to help you come to a decision.
What I really need is a break. Is there any reason why I can’t go on holiday?
No, it’s a good idea to plan a holiday or short break as soon as you feel well enough but you may have to take some extra factors into consideration. For example, you may need to check you have enough medicine for the time you are away. If you have only just finished treatment you may need to take a doctor’s letter containing details of your illness, in case you need care while on holiday.
Sometimes holiday insurance may be more expensive after treatment for breast cancer, so you may have to shop around. Some organisations will be able to provide you more information.
We are taking this opportunity to have a good holiday. Is it all right to go sunbathing?
As a general rule anyone who sunbathes should protect exposed skin with a sun block cream and wear a hat and avoid the hottest time of the day. If you have had radiotherapy, the part of the body that was treated should be protected as the skin will be more sensitive.
Some chemotherapy agents, for example fluorouracil and methotrexate, can also make your skin more sensitive and may cause an unusual darkening of the skin. If you have had these drugs you should be particularly careful to avoid bright sunlight.
Check with your doctor and follow all the rules about protecting your skin from the sun.
How soon can I resume sexual activity?
This varies from individual to individual and it is up to you to decide when, and if, you wish to start having sex again. If you have lost interest in sex during your illness and treatment, you will probably find your feelings return once you are well again and have got used to the physical and emotional changes caused by your treatment. You may find sexual activity more tiring or difficult at first, but this will improve with time.
You may find that changes in the way your body looks and feels make you worry about loss of attractiveness, femininity or masculinity. Talking to your partner about these feelings may help to dispel them. You may wish to discuss your thoughts and fears with
others, such as a specialist nurse or a counselor. Don’t be embarrassed about this; it is an important aspect of your recovery and adjustment.
Practical problems may result from your treatment, for example, chemotherapy causing an early menopause or side effects of hormone treatments may mean you have vaginal dryness which can make sexual intercourse uncomfortable. You may wish to try some of the range of vaginal lubricants available from the chemist.
Patience may be required and your sexual relationship may resume slowly. There are many ways of meaningful love-making and pleasurable sexual contact. You may find that this is the time to explore them.
