A journey with breast cancer is often as emotionally and socially taxing as it is physically taxing. In addition to harsh treatments, breast cancer patients may also face financial struggles and psychological hardships, on top of navigating their everyday jobs, families, and prior commitments. Finding a balance between these roles and responsibilities can be very challenging and overwhelming. In an attempt to provide breast cancer survivors support during this time, I Will Survive, Inc. offers breast cancer patients in metro-Atlanta a variety of services, including financial assistance, mentorship programs, and access to healthcare and wellness workshops. (Visit http://www.iwillsurviveinc.org for more information). Furthermore, IWS, in alignment with medical professionals, advises all breast cancer patients to make use of the following ten tips to live at their very best while undergoing treatment.
Stay active (with care). It is critical to keep your body moving during treatment while you can. Gentle movement is encouraged, and helps to improve circulation and reduce inflammation. Moreover, exercise has been shown to reduce one’s experience of nausea, pain, and stress. Listen to your body. Yoga, walking, stretching, swimming, and other low-impact, non-strenuous activities are typically recommended by physicians. Check with your own doctor before proceeding.
Prioritize your nutrition and hydration. Make sure your body is properly hydrated at all times. Carry a water bottle with you and use electrolytes as needed. Since chemotherapy often causes nausea, breast cancer patients are advised to eat smaller, more frequent meals with milder foods (like toast, crackers, rice, eggs, and soft potatoes). Avoid fried, very processed, heavily salted, or spicy foods. Do not take additional supplements or vitamins unless directed to do so by your doctor—these can interfere with certain medications. If you need financial assistance to secure the nutrition you need, a number of nonprofits (including IWS) can assist you with this.
Maintain your dental hygiene. Certain medications, as well as side effects like vomiting, may make your teeth and gums more sensitive than normal. Be sure to brush your teeth at least twice a day (more as needed), and use a soft toothbrush and mild toothpaste. Try to stay away from very acidic foods, and do not smoke.
Take care of your mental health. This is a tumultuous time, and it is completely okay to feel exhausted, overwhelmed, angry, or sad, among other things. The breast cancer journey is unique, especially as it affects a very intimate part of a woman’s body. Use support groups to talk to other patients who can relate to your experiences, and seek out professional help or therapy as needed. Lean on your friends and loved ones.
Remember: You are NEVER alone.
Put yourself and what you love first. Continue to do what hobbies make you happy. Engage in mindfulness practices and activities that can help take your focus away from your treatment. Reconnect with your passions and explore new activities as you desire. Try expressing and grounding yourself through art and journaling.
Get your sleep. A side effect of many medications is partial insomnia, so it is very important to establish a regular sleep schedule. Try to go to bed and rise at the same time everyday, and sleep in a dark and cool room. Only if advised by your physician, consider taking melatonin supplements as needed, as long as they don’t interfere with any drugs you’ve been prescribed.
Keep your brain active. Chemotherapy patients occasionally report temporary cognitive impairment after treatment. To counteract this, keep your mind sharp by reading, engaging in small puzzles, or participating in yoga or mediation.
Limit skin irritation. Dry or cracking skin can be a side effect of many medications. To prevent and treat this, apply thick, fragrance-free lotions to your skin, multiple times a day if needed. Use sunscreen and avoid intensive sun and heat exposure.
Prepare for hair loss. If you are expected to experience temporary hair loss as a result of your chemotherapy, explore wigs, scarves, or cryotherapy options. Talk with your physician about what they recommend and what companies other patients have liked. If you need financial assistance for this, a variety of nonprofits (including IWS) can support you.
Communicate with your doctors and healthcare team. It is essential that you stay open and honest with your healthcare providers in order to receive the best care possible. Update your nurses and doctors about each side-effect and symptom you may experience during your treatment so that they can do their best to help you. Consult your doctor before taking any additional supplements, or before trying any alternative therapies. These may interfere with your treatment. Ask your healthcare provider any questions you may have as they come up, and use the support of a healthcare advocate if you want more help understanding or communicating with your doctor.
Breast cancer, accounting for 30% of all new cancer cases among U.S. women annually, is not only a prevalent but also a pressing public health issue. Globally, it constitutes 12.5% of all new cancer cases, making it the most commonly diagnosed cancer worldwide. These statistics underscore the urgent need for effective health policies that encompass prevention, early detection, and treatment. Despite being mainly a women’s disease, breast cancer also affects men at a significantly lower rate. With approximately one in eight U.S. women facing the risk of invasive breast cancer in their lifetime, and millions currently living with or recovering from the disease, targeted policies are crucial to address disparities influenced by age, genetics, lifestyle, and healthcare access. (Breastcancer.org) Health policies crafted by legislatures should strive not only to enhance screening accessibility and treatment outcomes but also to mitigate factors such as age that can impact breast cancer outcomes, including delayed diagnosis among older women due to lower perceived risk and less frequent screenings. Genetics also significantly impact risk, as evidenced by mutations in genes like BRCA1 and BRCA2, which increase susceptibility to early-onset breast cancer. Lifestyle factors such as diet, exercise, and alcohol consumption further influence risk levels, highlighting the importance of promoting education, healthy behaviors, and preventive measures. ( Castaldi et al. 2022) Additionally, disparities in healthcare access can exacerbate inequalities in breast cancer outcomes, particularly for underserved populations who may experience barriers to timely diagnosis and quality treatment. Addressing these multifaceted challenges requires policies that not only expand access to affordable screenings and genetic testing but also prioritize comprehensive healthcare services that cater to diverse demographic needs. By addressing these factors holistically, policymakers can strive towards equitable outcomes in breast cancer prevention, detection, and treatment across all communities. Breast cancer’s prevalence and the disparities in incidence and outcomes among demographic groups highlight the critical need for targeted health policies. Legislation like the Find It Early Act (H.R. 3086) shows the efforts made to enhance access to health care by providing no-cost additional screenings for high-risk individuals. These initiatives, alongside flexible workplace policies for screening, aim to reduce structural barriers and promote early detection. By advocating for comprehensive strategies such as incorporating education, screening access, genetic counseling, and equitable healthcare delivery, policymakers can effectively address disparities in breast cancer care. These policies not only improve treatment outcomes but also create a supportive environment essential for the well-being of those navigating breast cancer diagnoses and treatments. (NIH- Cancer Institute) Moreover, workplace policies promoting flexible scheduling for screenings, as outlined in legislation like the Breast Cancer Patient Equity Act (H.R. 4779), contribute to a supportive environment for employees undergoing cancer treatment. By ensuring coverage for custom fabricated breast prostheses post-mastectomy, this legislation not only promotes physical recovery but also supports psychological well-being. Additionally, legislation such as the Medicare Patient Access to Cancer Treatment (MPACT) Act of 2023 (H.R. 4473) plays a crucial role in expanding Medicare coverage to include site-neutral payments for cancer care services under Medicare Part B. This initiative aims to ensure equitable access to treatment options regardless of where patients receive care, thereby addressing disparities in healthcare delivery. (NIH- Cancer Institute) Public Health programs like Georgia CORE and I Will Survive Inc. exemplify how community-based initiatives can complement these legislative efforts. Georgia CORE provides access to breast and cervical cancer screenings for uninsured women or those with limited insurance, meeting specific income guidelines. I Will Survive Inc. offers valuable economic support, prevention education, and health & wellness services to those at higher risk and affected by breast cancer. Integrating such programs with broader health policies can enhance their reach and effectiveness, further reducing disparities and improving outcomes for all affected individuals. By aligning these diverse policies with current breast cancer initiatives, policymakers can effectively address disparities, enhance patient outcomes, and strengthen community support networks for individuals affected by breast cancer. These efforts collectively contribute to advancing public health goals and promoting equity in cancer care across diverse populations. Sources Breast cancer facts and statistics 2024. (n.d.). https://www.breastcancer.org/facts- statistics?gad_source=1&gclid=Cj0KCQjwvb- zBhCmARIsAAfUI2tJTxPYyGyspV51bCPi0e- 5Fo3YgvbRvkKgXox0AjrAZOYR6HCm7tcaAtdcEALw_wcB National Institute of Health – National Cancer Institute. (n.d.). https://www.cancer.gov/about- nci/legislative/current-congress/federal-health Coughlin, S. S., & Smith, S. A. (2015). The impact of the natural, social, built, and policy environments on breast cancer. Journal of environment and health sciences. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4597477/#:~:text=incidence%20and%20s urvival.-,Effective%20health%20care%20policies%20can%20encourage%20the%20provis ion%20of%20high,control%2C%20screening%2C%20and%20treatment. Castaldi, M., Smiley, A., Kechejian, K., Butler, J., & Latifi, R. (2022, June 22). Disparate access to breast cancer screening and treatment. BMC women’s health. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9219222/
The Basics: Eating Well, Staying Active, and Managing your Weight
During Treatment: Managing Side Effects and Other Tips
After Treatment: Stay Strong in Recovery
Easy Tips to Get Started
In Closing
To Learn More Introduction: Nutrition Through Breast Cancer A breast cancer diagnosis changes many things in your life. Some of those changes are how you think about the food you eat and your physical activity. Good nutrition and staying active are important during this time. Nutrition during cancer treatment helps your body: Respond better to medications Manage treatment side effects Keep your energy when you need it most After your treatment ends, continuing to eat healthy and doing regular activity may help reduce your risk of cancer returning. These same habits also protect your overall health as you age. Your body may need different things during treatment, but the goal stays the same: eat to keep your body strong and stay as physically active as you can. Because nourishing your body is very important during this time, your healthcare team may include a dietitian or nutritionist (experts in food and nutrition). They will talk to you about what is best for you to eat. Here are some of the things they might share. The Basics: Eating Well, Staying Active, and Managing Your Weight Eating different healthy foods gives your body the nutrients it needs to heal and stay strong. Most experts recommend:
Eat mostly plant foods: Go for colorful vegetables, fruits, whole grains (oats or brown rice), and plant-based proteins like beans and lentils. Add healthy fats from nuts, seeds, and olive oil. If you eat meat, choose lean options like skinless chicken or fish.
Cut back on certain foods: Try to limit processed foods, red and processed meats, sugary drinks, and foods high in added sugar or salt. If you drink alcohol, talk to your doctor. Even small amounts can raise the risk of breast cancer returning, especially for women who’ve already had it.
Stay active: Movement can lift your mood and lower your risk of other health problems. Your goal is to move your body most days. Physical activity includes walking, stretching, dancing, or any activity you like. You don’t have to do it all at once. Even a few minutes at a time adds up.
Keep a healthy weight: Some people gain weight during or after treatment, and others might lose it. Try not to stress about it too much. Focus on eating balanced meals and staying active when you can. If you’re not sure what a healthy weight looks like for you, ask your doctor or a registered dietitian who can help. These healthy habits are a great start, but cancer treatment can bring some ups and downs that may change how you feel and eat. Let’s look at some ways to adjust when you’re going through treatment. During Treatment: Managing Side Effects and Other Tips Cancer treatment can affect how you feel about food. Some days, you may feel too tired to eat. Other days, food might not taste right, or you may have an upset stomach. These changes are common, and they may come and go. Here are some ways to make eating a little easier while you’re going through treatment: If you feel sick to your stomach (nausea): Try eating bland foods like crackers, toast, noodles, or rice. Sipping ginger tea or sucking ginger chews may also help calm nausea. If food doesn’t taste right: Add lemon juice, herbs, or mild seasoning for better flavor. Sometimes, room-temperature foods may go down easier than very cold or hot foods. If your mouth is sore: Go for soft foods like smoothies, oatmeal, yogurt, or mashed potatoes. Skip salty or crunchy foods that might hurt your mouth. If you’re not very hungry: Try eating small meals every couple of hours instead of large meals. Don’t wait until you feel very hungry. It is better to set a schedule that helps you stay nourished. If you’re losing weight: Add healthy calories to meals (nut butters, avocado, or olive oil). A registered dietitian can help you find healthy food options. Also, keep this in mind: Stay hydrated: Drink plenty of fluids throughout the day, especially water. Some people need electrolyte drinks if they’re losing fluids from vomiting or diarrhea. If you’re not sure about how to stay hydrated, check with your doctor. Food safety is important: Some cancer treatments weaken the immune system, which makes it easier to get sick from food. Wash fruits and vegetables well, stay away from raw or undercooked meats and eggs, and make sure leftovers are refrigerated. If eating gets hard or you’re losing too much weight, don’t wait — ask your doctor for a referral to see a dietitian who works with cancer patients. You don’t have to figure it out alone. Once you’ve completed your treatment, your focus will shift to healing and staying well for the long haul. Let’s talk about what that looks like. After Treatment: Stay Strong in Recovery When treatment ends, your body continues to heal. What you eat and how you take care of yourself still matters. Many survivors find that staying with healthy habits helps them feel more in control of their recovery. Experts suggest doing this: Stick to a plant-based diet. Eat vegetables, fruits, whole grains, beans, and healthy fats to reduce inflammation and help your immune system. Try to limit eating highly processed foods and added sugars. What about eating soy products? Whole soy foods like tofu, soy milk, and edamame are safe for most patients. If you’re not sure that eating soy products is best for you, talk with your doctor. Also, keep moving your body. Physical activity helps your heart, bones, and mental health. It can also help with fatigue, sleep, and mood. Choose something you enjoy and make it part of your routine. Activities you can try are:
Short daily walks
Gentle stretching or yoga
Gardening or light housework
Dancing to music you like Weight gain is common after treatment, especially if you had early menopause or hormone therapy. If this is a concern:
Talk with your doctor care team.
Balance diet and physical activity
Be patient with your body as it recovers At first, making these changes might feel overwhelming, but healthy habits can be more manageable with simple steps. Easy Tips to Get Started Here are some simple ways to begin eating better and moving more: Eat a vegetable or fruit at every meal and snack. Choose whole grains like brown rice, oatmeal, or whole-wheat bread. Include protein from beans, eggs, poultry, or nuts. Drink water throughout the day. Take short walks or daily stretches to build movement into your routine. If your appetite is low, eat small meals every few hours. Add calorie-rich foods like avocado, olive oil, or smoothies if you’re losing weight. Ask your doctor for a referral to a dietitian if you need help with meals, side effects, or weight changes. Remember, you’re not alone. Your journey can be easier and more successful with support from others. In Closing Taking care of your health is a lifelong journey, and you don’t have to do it alone. Talk to your doctor if you have questions or concerns about nutrition during your breast cancer diagnosis, treatment, and recovery. They can help you find good information. Whether you’re just starting treatment or if you have been in recovery for years, small changes can make a big difference. Choose foods that nourish your body, move your body in ways that feel good, and ask for help when you need it. Your health matters, and support is always available to help you feel your best— one step at a time. To Learn More
1. American Cancer Society
Nutrition and Physical Activity Guidelines for Cancer Survivors
Can I Lower My Risk of Breast Cancer Progressing or Coming Back?
Nutrition for People with Cancer
Benefits of Good Nutrition During Cancer Treatment
2. Breastcancer.org
Healthy Eating During Treatment
Healthy Eating After Treatment
Diet and Nutrition
Nutrition and Breast Cancer Risk Reduction
3. Cleveland Clinic
The Best Foods To Eat When You Have Breast Cancer
Cancer Patient Diet Tips and Recommendations
Nutrition Tips for Cancer Survivors
4. Johns Hopkins Medicine
Cancer Diet: Foods to Add and Avoid During Cancer Treatment
General Nutrition Guidelines During Cancer Treatment
Nutrition and Cancer Survivorship
5. Mayo Clinic
Diet Tips During Cancer Treatment
No appetite? How to get nutrition during cancer treatment
Mayo Clinic Minute: Plant-based diet is encouraged for patients with cancer
Introduction Breast cancer affects many parts of your life. Whether you’ve just given a new cancer diagnosis, you are already in treatment, or if you are in recovery, you may go through powerful emotions that affect your life. Your emotional health plays a big role in helping you heal through breast cancer. Understanding Your Emotions After diagnosis, you might have a wide range of feelings: Anxiety about the future Sadness about changes in your life Anger about your situation Fear of treatment Changes in how you see yourself Wondering, “Why me?” These reactions are all normal. You are going through a major life change. Your feeling may also change from day to day. One moment you might be ready to fight the cancer; the next, you may feel overwhelmed with uncertainty, distress, and emotional ups and downs. You may be stressed about the medical appointments, deciding on the treatment options, or the changes in your routine. Some people worry that showing emotion means they’re not “strong enough” to face cancer. The truth is exactly opposite: Getting in touch with your feelings and getting help is real courage. All your emotions are valid and deserve attention just like the physical symptoms. Two of the most common emotions that you may experience during this time are anxiety and depression. Coping with Anxiety and Depression Many people with breast cancer feel anxiety and depression. These mental health challenges are common emotions for many living with breast cancer. These feelings can show up in different ways, depending on the person and their unique situation. Spotting and addressing anxiety and depression is an important part of the breast cancer journey, as these feelings can impact your well-being and quality of life. Symptoms of Depression Your doctor may diagnose you with depression if these symptoms happen almost every day for more than two weeks: Constant worry Racing thoughts Feeling hopeless, depressed, or down Little interest in activities you liked Changes in how you sleep Eating too much or too little Trouble focusing Moving so slow that others notice Feeling disconnected from others Thinking about hurting yourself Symptoms of Anxiety Anxiety can show in a variety of ways, including: Nonstop worry Feeling on edge or nervous Restlessness Difficulty relaxing Easily frustrated, annoyed with others or angry Feeling afraid like something bad is going to happen Anxiety and depression symptoms often overlap, so it’s important to remember that only a doctor can diagnose anxiety or depression. Experts suggest several ways to manage these symptoms: Therapy: Talking with a therapist that knows oncology can help improve your emotions. Counselors may use different types of talk therapy. Therapist often use cognitive-behavioral therapy to help managing negative thoughts. Some cancer centers offer counseling services specifically for patients. Ask your doctor if you want to see a therapist. Support Groups: Meeting others going through cancer reduces the feeling of loneliness and isolation you may have. Support groups offer tips and validation people who understand you. Most cancer centers can connect you with organizations like Cancer Support Community that offer face-to-face or online meetings. Communication: Sharing your feelings with family and friends you trust. Being open about your emotions can make the emotional load lighter for you. Share how they can help you, either through practical help or just listening. There is no need to try to “fix” everything, but just listening can make a positive difference in how you feel. Medication: Your doctor may suggest drugs special to help with anxiety and depression, if your symptoms make it hard to live your life. Ask for help soon if you feel persistent sadness that doesn’t go away, hopelessness, thoughts of harming yourself, or if you are feeling so emotional distress that you can’t follow your treatment. Your doctor can put you in touch with a mental health expert who understand cancer. Beyond the emotional and mental impact, cancer treatment can also bring about changes to your body, impacting how you see yourself and your body image. Navigating Body Image Changes Cancer treatment can cause obvious changes like losing your hair, surgery scars, or weight changes that can affect how you see yourself. Talk to your doctor about ways to manage these changes. If you are losing your hair during chemotherapy, your doctor may recommend some of these options: Cold caps and scalp cooling to reduce hair loss if you are getting chemotherapy Wigs, scarves, bandanas, turbans, or hats that match your style If you had a mastectomy the doctor may talk to you about some of these options: Breast prosthetics or reconstruction information if appropriate Mastectomy clothing Self-compassion during this time is important. Your body is working hard to heal. Programs like “Look Good Feel Better” or breast cancer survivor groups may help you connect with others who have gone through the same. You can share tips and encouragement. Talk about how treatment can affect appearance and self-image (hair loss, scars, weight changes). Offer tips for coping with the disease Talking to your doctors about options (wigs, prosthetics, reconstruction) Being compassionate and patience with yourself Connecting with others who share similar experiences With all the changes you may be going through, being kind to yourself will be important. So, what are some practical ways to nurture your emotional well- being during this time? Let’s explore some self-care ideas that can help. Self-Care Ideas Small daily ways to care for yourself through breast cancer can strengthen you emotionally and improve your overall well-being. Taking to care for yourself, can be of big support during this challenging journey. These simple activities can help boost your mood and bring a greater sense of resilience as you navigate the physical and emotional impacts of your breast cancer diagnosis and treatment. Mindfulness and Relaxation: Mindful exercises is when you are relaxing your body and your mind to help reduce stress. Special breathing methods can lower hormones that produce stress. Here are a few mindful breathing exercise link . Journaling: Writing about your experiences helps getting difficult emotions out of your mind and into paper. You don’t need to share what you write, but the act of writing itself brings clarity to how you are feeling. Try writing about your feelings, questions, or moments of gratitude. Creative Expression: You don’t have to be a creative person to try any artistic activity. When you do art, or crafts you use different parts of your brain that help with express emotions. You can try art therapy as a creative distraction and to help you relax. Some cancer centers offer creative arts therapy programs. If you are interested in trying art therapy, ask your doctor. Gentle Movement: Moving your body can help improve your mood. Perform activities that are okay with your level of energy (short walks or stretching). Talk to your doctor to see what’s safe for you. Nature Time: Spending time outside can lower stress. You can sit in a quiet place, notice the colors in nature, listen to the birds, and feel the sun on your skin. Setting Boundaries: Save your energy for when you need it the most. It’s okay to say no to activities that drain you and feel hard. You may have to limit your time away from stressful people or difficult situations during treatment. Another way to take care of yourself as to get the right and helpful people around you. Building Your Support Network Having strong social connections can help you feel better during cancer. Your support team might include: Family and friends who provide emotional support and practical help Healthcare team members including nurses and social workers Fellow patients who understand firsthand what you’re experiencing Online communities that offer 24/7 support Many cancer centers have people specially trained to connect you with resources tailored to your needs. Survivorship programs provide guidance for life during and after treatment. If your natural support system is limited, organizations like Cancer Support Community and Living Beyond Breast Cancer can link you with trained volunteers and peer support. Mental Health Resources and Hotlines There are several mental health resources available to provide support through your breast cancer journey Immediate Help: National Suicide Prevention Lifeline: 988 or 1-800-273-8255 Crisis Text Line: Text HOME to 741741 Ongoing Support: American Cancer Society: 1-800-227-2345 (24/7 cancer information) Living Beyond Breast Cancer Helpline: 1-888-753-5222 Cancer Support Helpline: 1-888-793-9355 NAMI Helpline: 1-800-950-6264 (mental health support) Conclusion Your emotional wellness matters throughout your cancer journey. Some days will be harder than others, but support is always available. Give yourself permission to feel your emotions, reach out when you need help, and practice self-care that works for you. Each small step you take to support your emotional health contributes to your overall healing process. To Learn More https://pmc.ncbi.nlm.nih.gov/articles/PMC8125471/ American Cancer Society Adjusting to Life with Cancer Attitudes and Feelings About Cancer Breast Reconstruction Alternatives Cold Caps and Scalp Cooling Coping with Distress Emotional and Mood Changes Hair Loss (Alopecia) Hair Loss: Choosing and Wearing a Wig Physical Activity and the Cancer Patient Practice Mindfulness and Relaxation Providing Support Psychosocial Support Options for People with Cancer Save Complementary Methods Wearing a Hat Wearing a Scarf Wearing a Wig Breastcancer.org How Breast Cancer Affects Mental Health How to Find Mental Health Support Services Journaling Scarves, Hats, and Turbans Taking Care of Mental Health Talking to Family and Friends Types of Mental Health Support Understanding Your Breast Forms Cancer Support Community Cancers Support Community Cleveland Clinic Wellness & Survivorship Guide (PDF) Look Good Feel Better Look Good Feel Better Mayo Clinic Cancer Support Center NAMI NAMI HelpLine National Library of Medicine Associations between Nature Exposure and Health: A Review of the Evidence 988 Lifeline 988 Suicide and Crisis Lifeline
Loneliness. When you read or hear this word, what comes to your mind? That single word likely creates a strong picture in your mind and probably has a negative connotation. Many people experience loneliness at some point in their life. It is a transient condition that can wax and wane depending on many factors and anyone can experience it. A critical or chronic illness can exacerbate social isolation and loneliness. Being diagnosed with breast cancer or any other serious illness can produce a wide array of negative emotions that may be difficult to understand and navigate. “It has been suggested that ½ of adult cancer patient[s] are experiencing loneliness…” (Fanakidou et al., 2018, 539), which highlights the importance of discussing the significance of social isolation and loneliness and how it affects a person’s quality of life as well as interventions to lessen it. This article aims to provide simple, practical, and actionable tools for someone to implement to combat loneliness and reduce social isolation. To begin, let’s explore what loneliness is and the impact it has on one’s health.
What is loneliness?
The words social isolation and loneliness may seem to convey the same meaning or definition. However, they are not the same thing. Social isolation is described as “the objective physical separation from other people, while loneliness is the subjective perception [or perspective] of being isolated or alone” (Ross et al., 2022, 2). The two are similar but are two different concepts. While it is possible to feel lonely or disconnected while in a group with other people, it is also possible to be alone but not feel lonely” (Ross et al., 2022, 2). An individual may experience solitude, but depending on how the time alone is perceived, it can be a negative or positive experience. On the other hand, having a large social network of family, friends, and acquaintances online or offline, a person can still encounter “perceived isolation and dissatisfaction with the quality of relationships” (Adams et al., 2018, 1902).
Side effects of loneliness?
Research shows that “the effects of perceived isolation on [how the immune system functions] and inflammation…are extensive, [revealing] that adults with increased loneliness have [increased] pro-inflammatory [activity] and [decreased] anti-inflammatory [activity]” (Hinzey et al., 2016, 4).
Possible Reasons for Loneliness
Loneliness is a common emotion that occurs when facing breast cancer. As mentioned at the beginning of the article, it has been suggested that ½ of cancer patients face loneliness. These feelings can also be experienced after completing cancer treatment. An article, discussing how having a chronic illness can contribute to loneliness states, “Chronic illness interrupts connection by removing opportunities for interaction. Symptoms and treatment often require withdrawal from the world at large. Pain and fatigue cause chronically ill people to miss out on school, work, and social life—all areas where connection is made and built upon…Many people with chronic illness who do manage to work or go to school find that social life is non-existent due to the demands placed upon their bodies” (Virant, 2022). These observations also hold true when facing an illness like breast cancer or any other type of cancer. The side effects of cancer treatment may mean you’re not able to do as much as before and lessen social activities. There can also be the fear of “of other people observing one’s symptoms [related to cancer and treatment which] can lead to self-isolation” (Virant, 2022).
Below are possible additional reasons for experiencing loneliness. Each person is unique and may have various experiences or perceptions that contribute to feelings of loneliness, therefore this list is not exhaustive. Reading this list and identifying if you have similar thoughts or feelings may be the first step to understanding that you are facing loneliness and that will allow you to look at actionable steps you can take to alleviate loneliness.
Seems like no one understands what you are going through (Loneliness and Isolation, 2018)
You might feel you have to be brave (Loneliness and Isolation, 2018)
You do not want to upset your family and friends by talking about your feelings (Loneliness and Isolation, 2018)
Family and friends may live far away, be busy, or feel uncomfortable talking about the cancer. (Loneliness and Isolation, 2018)
You feel like no one cares (Emotions and Cancer – NCI, 2023)
You may feel too sick to take part in the hobbies and activities once enjoyed.
You don’t feel like reaching out (Emotions and Cancer – NCI, 2023)
Even when you’re with people you care about, you may feel that no one understands (Emotions and Cancer – NCI, 2023)what you’re going through (Emotions and Cancer – NCI, 2023)
Tools to Combat Loneliness
Ease into how you implement the following suggestions to lessen loneliness or social isolation. You choose how much or little you’d like to socialize based on your symptoms from treatment, your mood, and your energy levels. Go at a pace that works for you to prevent feelings of overwhelm. Below are tips that may be helpful. Some you have likely heard of before but may not have fully utilized to your benefit until now.
Phone Calls or Videoconference Calls: Contact friends or family. It is beneficial to have such social interactions scheduled into one’s routine and keep it consistent. A study showed that there is an enhanced connection via video calls compared to other forms of communication with technology (Hwang et al., 2020, 1218). You can keep these conversations brief or as long as you would like. If a video or phone call seems to be energy-draining, you can try sending recorded audio messages or a simple text message. You can schedule these communications to keep consistency.
Support Groups: Participating in a support group is a form of connecting with others who are facing the same challenges you are, helping to reduce feelings of isolation and loneliness. These support groups can be in person or online. You can choose whichever you feel comfortable with. Below are some local and national breast cancer support groups.
Emory Winship Cancer Institute: Provides monthly support groups that are facilitated by a social worker, nurse, or other healthcare professionals. These resources are for patients, survivors, caregivers, family, and friends. At this time, many of the support groups are held virtually. You can visit their website for more information.
Cancer Support Community Atlanta: Offers support, education, nutrition and cooking classes, exercise classes, and stress reduction classes in a group setting with other cancer patients and cancer survivors at no cost. This is a wonderful opportunity to connect with others while learning new skills and strategies to improve overall well-being.
My Life Line: A digital community that provides support and inspiration to those impacted by cancer. The goal of My Life Line is for you to “connect to your community to reduce stress, anxiety, and isolation — and to transform your cancer experience. [Their] online community includes patients, survivors, caregivers, and loved ones impacted by cancer.” You can keep family and friends updated about the course of your medical appointments, treatments, or anything else. You can share as much or as little as you would like. The purpose is to stay in communication with your support system and for your support system to know how best to help you, based on your preferences. Go to their website below to learn more about their service and create a free account.
Living Beyond Breast Cancer: Provides a helpline that connects individuals to trained volunteers who have also been diagnosed with breast cancer to provide emotional support, encouragement, and guidance. Speaking to someone who has gone through or is going through a similar experience to yours can help you not feel so alone.
Caring for a Pet: Research studies have shown the emotional benefits of having a pet. They can provide a form of companionship and provide an effective coping mechanism that can lessen feelings of loneliness (Gardiner et al., 2016, 152). Depending on your circumstances and where you are in your cancer treatment, getting a pet may be a good addition to your life and your family’s life.
Counseling: Feelings of loneliness may become too overwhelming for you to handle or address on your own or with the suggestions mentioned above. If that is the case, pursuing therapy from a pain or health psychologist will “help you feel less lonely and develop the tools to build a supportive environment in a way that works for you” (Lucette, 2022).
As noted in the introduction, loneliness is something anyone can experience. It can be exacerbated or start with a chronic illness. However, it doesn’t have to be a debilitating situation in your life. It can be managed and controlled. Is there one tool or suggested action mentioned above that you can implement today or sometime this week? After trying one of the tools, observe how you are feeling to notice if there are improvements over time. Awareness of even a small improvement in lessening feelings of loneliness will motivate you to keep trying.
References
Adams, R. N., Mosher, C. E., Rand, K. L., Hirsh, A. T., Monahan, P. O., Abonour, R., & Kroenke, K. (2018, July 01). The Cancer Loneliness Scale and Cancer-related Negative Social Expectations Scale: Development and Validation. Quality of Life Research, 26(7), 1901-1913. National Library of Medicine. 10.1007/s11136-017-1518-4
Fanakidou, I., Zyga, S., Alikari, V., Tsironi, M., Stathoulis, J., & Theofilou, P. (2018, February). Mental health, loneliness, and illness perception outcomes in quality of life among young breast cancer patients after mastectomy: the role of breast reconstruction. Quality of Life Research, 27(2), 539-543. Fanakidou, I., Zyga, S., Alikari, V., Tsironi, M., Stathoulis, J., & Theofilou, P. (2018). Mental health, loneliness, and illness perception outcomes in quality of life among young breast cancer patients after mastectomy: the role of breast reconstruction.
Gardiner, C., Geldenhuys, G., & Gott, M. (2016, June 6). Interventions to reduce social isolation and loneliness among older people: an integrative review. Health and Social Care in the Community, 26(2), 147-157. Wiley Online Library. 10.1111/hsc.12367
Hinzey, A., Gaudier-Diaz, M. M., Lustberg, M. B., & DeVries, A. C. (2016, May 26). Breast cancer and social environment: getting by with a little help from our friends. Breast Cancer Research, 18(54), 1-9. 10.1186/s13058-016-0700-x
Hwang, T.-J., Rabheru, K., Peisah, C., Reichman, W., & Ikeda, M. (2020, May 26). Loneliness and social isolation during the COVID-19 pandemic. International Psychogeriatrics, 32(10), 1217-1220. Cambridge University Press. 10.1017/S1041610220000988
Ross, A., Perez, A., Wehrlen, L., Lee, L. J., Yang, L., Cox, R., Bevans, M., Alice Ding, Wiener, L., & Wallen, G. R. (2022, April 4). Factors influencing loneliness in cancer caregivers: A longitudinal study. Psychooncology, 29(11), 1-14. 10.1002/pon.5477.
Breast cancer is a significant public health concern that affects millions of women. 1 in 8 women in the United States will be diagnosed with breast cancer in their lifetime. In 2023, an estimated 297,790 women and 2800 men will be diagnosed with invasive breast cancer.[1] The survival rate amongst cancer patients continues to improve due to early detection and advances in treatment options. There are currently 3.8 million breast cancer survivors in the United States.2 The journey to battling breast cancer and achieving remission is multifaceted. A critical aspect of managing breast cancer, both during treatment and in remission, is adopting a healthy lifestyle. Having a healthy lifestyle involves maintaining a nutritious diet and engaging in regular exercise. According to the American Institute for Cancer Research, both of these lifestyle factors play a pivotal role in not only improving the overall quality of life but also in enhancing the outcomes of breast cancer treatment and minimizing the risk of recurrence.3
The Importance of Healthy Eating
1. Nutrient-Dense Diet
A nutrient-dense diet rich in fruits, vegetables, whole grains, lean proteins, and healthy fats provides the body with essential vitamins, minerals, and antioxidants. These nutrients support the immune system, aid in tissue repair, and help mitigate side effects of cancer treatments such as chemotherapy and radiation therapy.4 Nutrient-dense foods are vital for breast cancer patients aiding in their recovery and survival rate. Researchers analyzed 108 studies from around the world comprising more than 151,000 women with breast cancer. Research showed some evidence that eating more dietary fiber from whole grains, pulses, vegetables, and fruits could improve the survival rate of women who had breast cancer. 5
2. Weight Management
Maintaining a healthy weight is crucial for breast cancer patients and survivors. A balanced diet plays a pivotal role in achieving and sustaining a healthy weight. Balanced diets prevent weight gain during treatment and support gradual weight loss when needed. According to the American Institute for Cancer Research, maintaining a healthy body weight can help prevent breast cancer and help improve the chances of survival after a diagnosis.6 Researchers analyzed 226 studies from around the world, comprising more than 456,000 women with breast cancer. The extensive research found strong evidence that having a higher body weight after diagnosis increases the risk of death.7
When looking at weight management, the Body Mass Index (BMI) should be considered. The BMI is a measurement tool that is used to measure an individual’s weight with respect to their height. The BMI is an indicator of total body fat. The CDC considers the following guidelines in terms of BMI:8
BMI is less than 18.5, it falls within the underweight range.
BMI is 18.5 to 24.9, it falls within the healthy weight range.
BMI is 25.0 to 29.9, it falls within the overweight range.
BMI is 30.0 or higher, it falls within the obese range.
The Importance of Exercise
1. Physical and Emotional Well-Being
Exercise has been shown to improve the overall physical and emotional well-being of breast cancer patients and survivors. Engaging in regular physical activity reduces symptoms of fatigue, anxiety, and depression, thereby enhancing the overall quality of life. Exercise also contributes to improved mood, self-esteem, and body image, which are essential for coping with the emotional challenges of cancer.9 Researchers analyzed 23 studies from around the world comprising more than 39,000 women with breast cancer. Most of the studies looked at aerobics, walking, and running, with limited studies on other types of physical activity. The review found some evidence that physical activity for breast cancer patients could reduce the risk of death after a breast cancer diagnosis. There was also some evidence that physical activity could reduce the risk of getting breast cancer again.10
2. Weight Control
Exercise is a great tool for weight control which is critical for reducing the risk of breast cancer recurrence.11 It promotes weight loss while preserving lean muscle mass, leading to a healthier body composition. Excessive weight gain and obesity are side effects of having cancer with an increased risk of breast cancer recurrence and poorer survival rates.12 According to research, while obesity at diagnosis correlates with poor prognosis, weight gain after diagnosis is also concerning. Individuals who gain 10% or more weight since diagnosis have higher risk of all-cause mortality and breast cancer mortality compared to individuals who maintain (within 5%) or lose weight.13
Limitations and Opportunities
While the benefits of healthy eating and exercise for breast cancer patients and survivors are evident, several limitations must be considered. Fatigue, physical limitations, dietary restrictions, and other treatment-related side effects may hinder diet and exercise participation. Researchers note that most women who perceived eating less healthy and being less active before diagnosis continued to do so during chemotherapy. Active women usually managed to stay active because exercise was very important to them and made them feel good, although they also suffered from the side-effects of chemotherapy.14
Recommendations
It is recommended that individuals managing breast cancer or in remission follow the AICR Cancer Prevention Recommendations.15
These recommendations are:
Maintain a healthy weight
Be physically active
Eat a diet rich in whole grains, vegetables, fruits, and beans
Limit consumption of “fast foods” and other processed foods that are high in fat, starches and sugars
Limit consumption of red and processed meat
Limit consumption of sugar-sweetened drinks
Limit alcohol
Do not use supplements for cancer prevention
For mothers, breastfeed your baby if you can
After cancer, follow AICR recommendations if you can
In addition, individuals managing breast cancer or in remission should talk to their healthcare provider about the recommended exercise guidelines. If no guidelines are provided, individuals should follow national guidelines for physical activity. The CDC recommends the following guidelines:16
At least 150 minutes per week of moderate-intensity physical activity such as brisk walking, cycling, and swimming.
Two days of muscle-strengthening activity such as using free weights or resistance
Research states that women who participated in any moderate-intensity recreational physical activity, such as brisk walking after diagnosis had an approximately 64% lower risk of death than inactive women.17
Examples of moderate and vigorous intensity physical activities18
Soccer, basketball, field or ice hockey, lacrosse, singles tennis, racquetball, cross-country skiing
Home activities
Mowing the lawn, general yard, and garden maintenance
Digging, carrying, and hauling, masonry, carpentry
Workplace activity
Walking and lifting as part of the job (custodial work, farming, auto or machine repair)
Summary
Adopting a healthy lifestyle that includes nutritious eating and regular exercise is important for individuals battling breast cancer or in remission. These lifestyle choices not only enhance the overall quality of life but also improve treatment outcomes and reduce the risk of recurrence or even death. While challenges and limitations exist, collaboration between healthcare providers and patients is key to developing personalized strategies that empower individuals to embrace a healthier way of life.
4. Kushi, L. H., Doyle, C., McCullough, M., Rock, C. L., Demark-Wahnefried, W., Bandera, E. V., … & Gansler, T. (2012). American Cancer Society guidelines on nutrition and physical activity for cancer prevention: reducing the risk of cancer with healthy food choices and physical activity. CA: A Cancer Journal for Clinicians, 62(1), 30-67.
5. Becerra-Tomás, N, Balducci, K, Abar, L, et al. Postdiagnosis dietary factors, supplement use and breast cancer prognosis: Global Cancer Update Programme (CUP Global) systematic literature review and meta-analysis. Int J Cancer. 2023; 152(4): 616-634. doi:10.1002/ijc.34321
7. Chan, DSM, Vieira, R, Abar, L, et al. Postdiagnosis body fatness, weight change and breast cancer prognosis: Global Cancer Update Program (CUP global) systematic literature review and meta-analysis. Int J Cancer. 2023; 152(4): 572-599. doi:10.1002/ijc.34322
9. Courneya, K. S., Friedenreich, C. M., Quinney, H. A., Fields, A. L., & Jones, L. W. (2019). Fostering physical activity and exercise in oncology. American Journal of Lifestyle Medicine, 13(4), 348-356.
10. Cariolou, M, Abar, L, Aune, D, et al. Postdiagnosis recreational physical activity and breast cancer prognosis: Global Cancer Update Programme (CUP Global) systematic literature review and meta-analysis. Int J Cancer. 2023; 152(4): 600-615. doi:10.1002/ijc.34324
11. Schmitz, K. H., Campbell, A. M., Stuiver, M. M., Pinto, B. M., Schwartz, A. L., Morris, G. S., … & Hayes, S. C. (2019). Exercise is medicine in oncology: engaging clinicians to help patients move through cancer. CA: A Cancer Journal for Clinicians, 69(6), 468
12 . Chan, D. S., Vieira, A. R., Aune, D., Bandera, E. V., Greenwood, D. C., McTiernan, A., … & Norat, T. (2014). Body mass index and survival in women with breast cancer—systematic literature review and meta-analysis of 82 follow-up studies. Annals of Oncology, 25(10), 1901-1914.
13. Jung, A.Y.; Hüsing, A.; Behrens, S.; Krzykalla, J.; Obi, N.; Becher, H.; Chang-Claude, J. Postdiagnosis weight change is associated with poorer survival in breast cancer survivors: A prospective population-based patient cohort study. Int. J. Cancer 2021, 148, 18–27
14. de Kruif, A.J., Westerman, M.J., Winkels, R.M., Koster, M.S., van der Staaij, I.M., van den Berg, M.M.G.A., de Vries, J.H.M., de Boer, M.R., Kampman, E. and Visser, M. (2021), Exploring changes in dietary intake, physical activity and body weight during chemotherapy in women with breast cancer: A Mixed-Methods Study. J Hum Nutr Diet, 34: 550-561. https://doi.org/10.1111/jhn.12843
17. Irwin ML, Smith AW, McTiernan A, Ballard-Barbash R, Cronin K, Gilliland FD, Baumgartner RN, Baumgartner KB, Bernstein L. Influence of pre- and postdiagnosis physical activity on mortality in breast cancer survivors: the health, eating, activity, and lifestyle study. J Clin Oncol. 2008 Aug 20;26(24):3958-64. doi: 10.1200/JCO.2007.15.9822. PMID: 18711185; PMCID: PMC2654316.
Being diagnosed with breast cancer is never easy. Treatment options can vary based on the stage of cancer, health insurance, personal preferences, and much more. Radiotherapy is a common treatment form, so it is important to know and understand what it is, as well as the potential advantages and disadvantages.
Types of Radiotherapy
Radiotherapy is a method to kill cancer cells using high-energy X-rays, protons, or other particles.¹ Radiation can kill healthy, normal cells, but cancer cells are more susceptible as they are fast-growing.² The x-rays, protons, and other particles are painless and invisible.² For breast cancer patients, this is usually done with an external beam (radiation) from a machine, which is known as external radiation.¹ However, internal radiation is a possibility for patients who have had surgery to remove the cancer.² This method consists of the provider temporarily placing a radiation-delivery device in the area where the breast cancer once was, with the purpose being to prevent recurrence.² The exact dose of radiation will vary based on a patient’s specific circumstances, considering factors such as where the cancer is located and how severe the case is.¹
Who should undergo Radiotherapy?
For almost every stage of breast cancer, radiotherapy can be an effective treatment option.² For those with locally advanced cancer that can’t be removed with surgery, radiation is an effective option.² Radiotherapy can be useful for those with metastatic cancer, which is when cancer has spread to other parts of the body, because the treatment can greatly help ease symptoms such as pain.² For those with inflammatory breast cancer, which is when it spreads to the lymph channels of the skin covering breasts, radiation often follows the chemotherapy and mastectomy treatment options to prevent recurrence.² Radiation is often used following lumpectomies, and sometimes used following mastectomies.³ There is a common misconception that you will be radioactive after this treatment, however, that is not true and you are safe to be around other people and children.² Radiation is not safe for pregnant women.⁴
Radiation after Lumpectomy and Mastectomy
As mentioned above, patients who undergo surgical removal of the cancer can benefit from radiotherapy as it can effectively reduce the risk of breast cancer recurring.² In a lumpectomy, the tumor (cancerous cells) and a small amount of surrounding tissue is removed, while the breast is mostly left intact.³ This is different from a mastectomy, which is when the breasts are completely removed.³ Because most of the breast tissue remains intact with the lumpectomy procedure, providers may recommend pairing it with radiotherapy to prevent cancer from returning to the breast.²Though all breast tissue is removed with a mastectomy, oncologists may recommend radiotherapy to prevent cancerous cells from occurring in remaining tissues of the chest or lymph nodes. If the tumor is larger than two inches or if cancer is already present in surrounding lymph nodes or skin tissues, oncologists also may recommend radiation after a mastectomy.⁴ However, this is less common than radiation after a lumpectomy.⁴
Cost and Insurance Coverage
It is well known that treatment for breast cancer can get very costly very quickly. It is important to know and understand the payment options with and without insurance. For radiation as a treatment, many individuals have health insurance to help mitigate the cost, but it does not cover everything. For eligible enrollees, Medicaid (requirements vary by state) will cover radiation therapy, though some states may charge a copayment.⁵ For Medicare, individuals who wish to receive radiation as treatment are covered under Part A for inpatients and Part B for outpatients.⁵ For private insurance enrollees, radiation as a cancer treatment is required to be covered, but some insurers may limit the type of radiation therapy covered.⁵ For individuals without insurance, radiation can range anywhere from $10,000-$50,000 out-of-pocket.⁵ Overall costs for radiation treatment vary depending on each case, considering factors such as the type and location of the tumor, the number of radiation sessions, and the amount of radiation used. You may be able to receive help from cancer funds and foundations to help cover expenses, such as the Patient Access Network Foundation.⁶
Advantages and Disadvantages
Advantages⁷
Disadvantages⁷
Highly effective at killing cancerous cells and can kill isolated cells undetectable by surgery, great for small tumors
Can cause damage to surrounding organs/tissues
Can shrink tumors in preparation for surgery
Only useful for tumors visible on a CT image
High level of safety for the patient
Lower effectiveness in larger tumors
Painless treatment
Less effective in areas with low blood supply
Highly effective at killing cancerous cells and can kill isolated cells undetectable by surgery, it great for small tumors
Can reduce the chance of recurrence and can make other treatments such as chemotherapy and surgery more successful
Can reduce symptoms and relieve pain
Can be costly
Discuss with your Provider
To determine if radiotherapy is the right treatment option for you, you and your provider will consider a multitude of factors. Before radiation treatment, you may meet with a radiation oncologist, radiation therapist, radiation oncology nurse, nurse practitioner, physician assistant, or dosimetrist.² Your oncologist will perform physical exams to predict the potential efficacy of radiation, and will also ask an array of questions pertaining to your medical history.² Additionally, they should run through the risks, side effects, and benefits of radiation.² When discussing any treatment option with a provider, be sure to ask plenty of questions and pose all of your concerns. Understand the pros and cons. Ask questions regarding insurance and coverage for the treatment option. Also, be sure to gauge a timeline for the process. Always remember that your needs are very important and you are not alone in choosing the right treatment option for you!
When it comes to being diagnosed with breast cancer, effects on sexual health usually aren’t the first thing that comes to mind. The reality is, that your sexual health can be affected both during and after cancer. Individual physical changes, as well as side effects from the disease and treatments all play a role. Understanding the possible changes and knowing what you can do to proactively mitigate the effects can enhance your sexual health and overall well-being.¹
What is Sexual Health?
Defined by the Centers for Disease Control and Prevention (CDC), sexual health is having a complete state of physical, emotional, mental, and social well-being as it relates to sexuality.² The absence of disease, dysfunction, or infirmity is not equivalent to having sexual health. An important aspect is having a positive and respectful approach to sexuality and sexual relationships.² Lastly, sexual experiences should be safe and free from coercion, discrimination, and violence.²
Effects on Sexual Health
When diagnosed with breast cancer, both the natural side effects and treatment side effects can change the way an individual physically looks. In addition, the treatment and overall feelings toward the diagnosis may cause changes in mood, emotional health, mental health, self-confidence, and desire to have sex. Breast cancer may also lead to discomfort during and after sexual activity.
Changes in Physical Appearance
Changes to physical appearances can occur with lumpectomies and mastectomies, which are when one or both breasts are surgically removed to mitigate the cancer.³ Breast removal can result in pain that may make sex feel physically uncomfortable. In addition, physical changes may include surgical scars, hair loss, and changes in weight, either loss or gain. These changes can impact sexual health by affecting body image and self-esteem, making it more difficult to enjoy sexual activity.
Loss of Libido and Vaginal Dryness
Libido is essentially your sex drive, which often decreases as a result of a breast cancer diagnosis. Sex may be the last thing on your mind after attending doctor appointments, undergoing treatment, consulting with insurance companies, etc. Therefore, it is normal for you to have a lower libido. A breast cancer diagnosis is scary, and experiencing fear, anxiety, depression, and stress can all contribute to a lower libido. Certain medications and hormonal therapies can also affect your libido as well as cause vaginal dryness. It’s important to remember that you are in control of your body and being patient with yourself is key when enduring loss of libido or vaginal dryness.
What You Can Do
Caring for your sexual well-being both during and post-breast cancer treatment is important, and remember that you’re not alone in facing changes.¹ Changes in sexual desire or comfortability can arise due to various factors, all of which are normal when dealing with a breast cancer diagnosis. Seeking assistance and advice from experts, starting with your cancer care team, can help you understand and navigate your sexual health.¹ Discussing concerns with trusted providers such as oncologists, nurses, and social workers can help you identify issues, help you work through them, and also suggest additional relevant specialists.¹ In addition to providers, open dialogue with your partner, friends, and family members can also help alleviate stress and tension pertaining to your sexual health.¹ Remember, how much you are willing to share is always up to you!
Participating in support groups can provide you valuable insight from women in similar situations.¹ Whether through in-person or virtual gatherings, support groups can offer a safe, secure, and confidential space for sharing your experiences.¹
As mentioned earlier, emotional changes can lead to lower libido. A great way to boost your mood is through physical activity.¹ Exercising triggers the release of endorphins and can improve sexual arousal as well as enhance sexual satisfaction by improving heart health and mood.¹
Lastly, you must practice patience with yourself.¹ Sexuality and intimacy are unique to each person and desires can greatly differ.¹ Remember that it is your choice whether you engage in sexual activity during treatment or prefer to wait.¹ Remember that you are not alone and treatments and resources are out there to address anxiety, stress, and changes in your overall sexual experience.¹
According to the National Cancer Institute and the American Cancer Society, 68 to 73% of breast cancers are hormone-receptor positive (HR+).[1] This means cancer cells receive messages from the hormones estrogen and/or progesterone telling them to grow. Identifying the type of hormone can help physicians know how to best treat it. The majority of HR+ breast cancers, around 80%, are estrogen-receptor positive (ER+) or estrogen and progesterone receptor positive (ER/PR+).[2] As a result, new cancer treatment research has focused on addressing these hormones.
Moreover, HER2- is another breast cancer subtype which means that cancer does not have HER2 proteins and therefore cannot be treated by drugs that target these proteins. Patients with HER2- cancer require different treatment than those with HER2+ cancer because the differing cancer cells use distinct mechanisms to survive and spread across the body which demand specialized treatment.
New Drug, New Findings
Researchers have been working on a new oral medication called “amcenestrant.” This drug binds to estrogen receptors, where it acts to break down the receptors and inhibits the growth and survival of cancer cells.[3] Dr. Sara M. Tolaney and her team recently completed a phase II clinical trial on the new drug. Phase II means that amcenestrant passed phase I, wherein the safety of the drug is tested and ensured, and is now being tested for effectiveness.[4]
290 people from all over the world participated in the phase II trial.[5] They were randomly assigned to the treatment group (to receive amcenestrant) or the control group (to receive single-agent endocrine therapy determined by the individual’s physician).[6] In this way, the researchers could compare the new drug’s effectiveness against standard treatment for ER+ HER- breast cancer. 143 people took amcenestrant, while 147 received the control treatment.[7] 82% of the participants had received one type of endocrine treatment previously.[8]
The researchers measured “progression-free survival.” In other words, they wanted to know how many months the treatment would inhibit cancer growth. They followed up with the patients after a median of 11.2 months (this varied slightly across patients).
They found that patients who received amcenestrant had a higher median progression-free survival time, 3.7 months, than those in the control group, 2.0 months. Despite the difference in these outcomes, the researchers’ data was not found to be statistically significant. This means there is not enough evidence to show that this difference between the treatment and control group is not due to chance.
Group
Median progression-free survival time (months)
Treatment
3.7
Control
2.0
However, this does not mean that Tolaney’s research is useless – we just cannot definitively state that the treatment is more effective than the control or vis-a-versa. Researchers would need to complete more research, possibly with more participants and more control of extraneous variables, in order to demonstrate their conclusions from this study are valid and reliable. Nonetheless, Tolaney’s findings demonstrate potential benefits and risks associated with amcenestrant and changes that could be made to further amcenestrant trials.
Insights for Next Time
Most cancer treatments have intense side effects, and amcenestrant is no different. Tolaney et al’s research allow us to understand the potential side effects and their severities. This information will be essential if amcenestrant eventually becomes available on the market, as patients will need to know what to expect when taking the medication.
Patients of different ages, races, ethnicities, and socioeconomic backgrounds all have different physical dispositions and may react differently when exposed to amcenestrant. In other words, side effects may vary greatly in type and severity based on an individual’s identity. However, the trial demographics reveal several racial and ethnic groups did not have representative inclusion. Most importantly, Black, Latina, and indigenous women were not adequately (if at all) represented in the treatment and control groups.[9] If this study were repeated to try and demonstrate statistical significance, researchers should make a concerted effort to include women of more diverse backgrounds. Only one man was enrolled in the study, so no conclusions could be drawn on the effectiveness of the treatment in men (as a result, this patient was not included in the demographics table, but was mentioned in the research article).[10] This could also be addressed in future studies.
The reported side effects included nausea, vomiting, joint pain (arthralgia), back pain, headache, fatigue, and diarrhea.[11] Most of these side effects afflicted a higher percentage of patients who took amcenestrant than those patients who had classic endocrine therapy (described as TPC in the graphic above).[12] This information informs future patients who are considering joining an amcenestrant trial. They can weigh the pros and cons, knowing the potential effects the medication may have on their body.
Tolaney et al’s study demonstrates how clinical trials, even those with inconclusive data, can inform researchers and patients about new treatments. Further, Tolaney et al’s limited demographic diversity allow us to see who should seek out clinical trials, and suggest changes for next time. The more diverse the participants, the more applicable the findings will be to global citizens.
If you look at Tolaney’s findings and notice people like you (similar age, race, sex, etc.) are absent or underrepresented, consider finding a clinical trial you could join. Your contribution
This article was written by Lucy R Yates with I Will Survive, Inc.
Tolaney, S. M., Chan, A., Petrakova, K., Delaloge, S., Campone, M., Iwata, H., Peddi, P. F., Kaufman, P. A., De Kermadec, E., Liu, Q., Cohen, P., Paux, G., Wang, L., Ternès, N., Boitier, E., & Im, S.-A. (2023). Ameera-3: Randomized phase II study of Amcenestrant (oral selective estrogen receptor degrader) versus standard endocrine monotherapy in estrogen receptor–positive, human epidermal growth factor receptor 2–negative advanced breast cancer. Journal of Clinical Oncology. https://doi.org/10.1200/jco.22.02746
[1]Tolaney, S. M., Chan, A., Petrakova, K., Delaloge, S., Campone, M., Iwata, H., Peddi, P. F., Kaufman, P. A., De Kermadec, E., Liu, Q., Cohen, P., Paux, G., Wang, L., Ternès, N., Boitier, E., & Im, S.-A. (2023). Ameera-3: Randomized phase II study of Amcenestrant (oral selective estrogen receptor degrader) versus standard endocrine monotherapy in estrogen receptor–positive, human epidermal growth factor receptor 2–negative advanced breast cancer. Journal of Clinical Oncology. https://doi.org/10.1200/jco.22.02746
[6]Tolaney, S. M., Chan, A., Petrakova, K., Delaloge, S., Campone, M., Iwata, H., Peddi, P. F., Kaufman, P. A., De Kermadec, E., Liu, Q., Cohen, P., Paux, G., Wang, L., Ternès, N., Boitier, E., & Im, S.-A. (2023). Ameera-3: Randomized phase II study of Amcenestrant (oral selective estrogen receptor degrader) versus standard endocrine monotherapy in estrogen receptor–positive, human epidermal growth factor receptor 2–negative advanced breast cancer. Journal of Clinical Oncology. https://doi.org/10.1200/jco.22.02746
[9]Tolaney, S. M., Chan, A., Petrakova, K., Delaloge, S., Campone, M., Iwata, H., Peddi, P. F., Kaufman, P. A., De Kermadec, E., Liu, Q., Cohen, P., Paux, G., Wang, L., Ternès, N., Boitier, E., & Im, S.-A. (2023). Ameera-3: Randomized phase II study of Amcenestrant (oral selective estrogen receptor degrader) versus standard endocrine monotherapy in estrogen receptor–positive, human epidermal growth factor receptor 2–negative advanced breast cancer. Journal of Clinical Oncology. https://doi.org/10.1200/jco.22.02746
I Will Survive, Inc. 