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Article / Updated 11-13-2023
When linking the term side effects with cancer, horrific visions pop into most people’s heads. If you haven’t started the treatment leg of your journey yet, you may be imagining yourself bald, frail, and tired, with your face glued to the toilet bowl. But while some treatment-related side effects may be serious or debilitating, many of them are minor and only minimally impact a person’s quality of life. In addition, very few side effects persist for long periods of time, like months or years. Most last only days or weeks. Putting side effects of cancer treatments in perspective The goal of cancer treatment is to remove or kill cancer cells while sparing the healthy organs and tissues throughout the body. To achieve this, you may receive any number of treatments, from surgery, to radiation, to chemotherapy, to an array of different medications. All these treatments are associated with their own set of side effects, some major and some minor. Although the list of related side effects can be scary, you’re unlikely to experience the vast majority of them, and you may even experience none of them. Everyone is different. Also, keep in mind that when clinical trials are conducted to test new drugs and treatment regimens, medical professionals are required to report all adverse effects attributable to the treatment being evaluated. In some cases, however, it can be very difficult to determine if a correlation may actually exist between an adverse event and the drug being evaluated. But to err on the side of caution, the adverse event will still be included in the drug labeling information when the drug gets approved. Therefore, despite the list of side effects looking long and scary, you really should just think of them as potential effects, not definitive ones. Focusing on factors that may increase the risk of cancer treatment side effects Numerous factors can increase your risk of experiencing certain side effects during treatment. By understanding what these risk factors are, you can take steps to mitigate them and prevent complications. For example, one of the potential side effects of many chemotherapy drugs is a reduction in a type of bone marrow cells known as platelets. These cells are responsible for preventing and stopping bleeding. Certain medications, including aspirin, are known to interfere with platelet function. This effect may be favorable in certain non-cancer settings, such as for various cardiovascular problems, but it can lead to major bleeding and other serious consequences when receiving chemotherapy. As a result, your doctor will likely advise you to avoid taking aspirin and similar medications while you’re receiving chemo. Be sure to closely follow your oncologist’s recommendations. Also, avoid drinking alcohol while receiving treatment. Alcohol can cause many adverse reaction, depending on which medications it’s paired with. For example, drinking alcohol at the same time that you’re taking antiemetics (medications to prevent nausea and vomiting) may cause short-term drowsiness and lead to dry mouth and dry eyes. Whatever you do, be honest with your doctor about your history and what medications and dietary and herbal supplements you’re taking. Because numerous factors can increase the risk of certain side effects, only your doctor and cancer-care team will be able to properly assess your risk and explain in detail what you can do to reduce your specific risks. But they can only do this if they have a clear picture of your history and situation. How side effects can affect nutrition Cancer treatments often come with a long list of potential side effects. These effects may make it challenging to eat, alter your body’s ability to digest and use nutrients properly, and/or affect your body’s nutrient needs. Difficulty taking in nutrients is the most prevalent problem, because almost all symptoms can make it hard to consume nutrients. When you have an upset stomach or a sore mouth or throat, or when food doesn’t taste right, eating is no longer enjoyable and you may not feel like eating. There are also the potential digestive challenges caused by treatments. Chemotherapy and radiation treatments, for instance, can cause lactose intolerance, temporarily impairing your ability to digest milk products. This can lead to various gastrointestinal issues, including gas, bloating, and diarrhea. If you experience diarrhea, there’s a good chance you’ll absorb less water, electrolytes like sodium and potassium, and other nutrients like zinc. This can lead to dehydration and electrolyte imbalances; proper electrolyte levels are essential for maintaining normal cellular function, muscle action, and blood chemistry. So, as you can see, there’s a cascade of effects. How food can ease certain side effects Some foods will aggravate many of the side effects that can be experienced during cancer treatment, while others can ease many of the side effects. For example, foods containing or prepared with a high amount of fat can be difficult to digest or absorb, making an upset stomach, nausea, and diarrhea worse. On the other hand, low-fat, high-protein foods can help alleviate nausea and enable you to maintain lean muscle mass and strength. You should come to appreciate that food can be used as medicine to help relieve side effects. For example, ginger can be used to settle an upset stomach. Honey may help heal a sore mouth or throat. Glutamine (an amino acid found in high-protein foods) and probiotics (the healthy bacteria in yogurt and kefir) may help nourish the body and reduce side effects that affect the digestive tract. These are just a few examples of how food can help ease side effects.
View ArticleArticle / Updated 10-10-2023
Chicken soup is just the tip of the iceberg when it comes to the health benefits of incorporating soups into your diet when you’re undergoing treatment for cancer. Soups are a great way to get whole grains, vegetables, fruits, and beans into one dish, particularly if you’re short on time or energy. You can’t get more wholesome than that! Vegetable Stock Preparation time: 5 minutes Cook time: 45 minutes Yield: 8 cups 1 tablespoon olive oil 2 large onions, quartered 1 medium leek (white and green parts), chopped 2 celery stalks with leaves intact, chopped 2 large carrots, quartered 8 cloves garlic, crushed 8 sprigs fresh parsley or 4 teaspoons dried parsley 6 sprigs fresh thyme or 3 teaspoons dried thyme 2 quarts water 1 teaspoon sea salt 2 bay leaves Heat the oil in a soup pot over medium heat, and add the onions, leek, celery, carrots, garlic, parsley, and thyme. Cook for 5 to 10 minutes, stirring frequently so the vegetables don’t brown. Add the water, sea salt, and bay leaves, and bring to a boil. Then lower the heat and simmer for at least 35 minutes. Remove the broth from the heat, strain the liquid, and discard the vegetables. Per cup: Calories 18 (From Fat 15); Fat 2g (Saturated 0g); Cholesterol 0mg; Sodium 290mg; Carbohydrate 1g (Dietary Fiber 0g); Protein 0g. Instead of following this recipe, you can save all the trimmings from the vegetables you eat during the week and add them to a pot of water with some garlic, onion, parsley, bay leaves, and other desired herbs and simmer them for 35 minutes to a few hours. Then strain them out and toss them. Use the stock within a week or freeze it for up to six months for later use. Apple Carrot Ginger Soup Preparation time: 10 minutes Cook time: 40 minutes Yield: 4 servings 1-1/2 teaspoons olive oil 1/4 cup diced celery 1 cup shredded carrot 1/4 cup onion, peeled and chopped 1-1/2 teaspoons minced garlic 1 tablespoon minced fresh ginger root or 1 teaspoon ground ginger 1 teaspoon fresh thyme or 1/4 teaspoon dried thyme 1/4 teaspoon curry powder 2 teaspoon whole-wheat flour 2 cups skim milk 2 cups vegetable broth 1/2 cup unsweetened applesauce Heat the oil in a large pot, and then add the celery, carrot, onion, garlic, ginger, thyme, and curry. Sauté lightly for 2 to 3 minutes. Stir in the flour and cook while stirring for about two minutes. Add the milk, broth, and applesauce. Cook for 30 minutes, stirring occasionally. Remove the soup from the heat, place in a blender, and puree until smooth. Return the soup to the stove and simmer for 10 more minutes. Per serving: Calories 128 (From Fat 47); Fat 5g (Saturated 1g); Cholesterol 2mg; Sodium 546mg; Carbohydrate 16g (Dietary Fiber 2g); Protein 5g. Creamy Potato Soup Preparation time: 15 minutes Cook time: 30 minutes Yield: 6 servings 4 medium potatoes, peeled and cubed 3/4 cup onion, peeled and chopped 1 medium carrot, peeled and chopped 2 stalks celery, chopped 1-1/2 cups chicken broth 3 tablespoons canola oil 3 tablespoons all-purpose flour 2-1/2 cups milk 1 tablespoon minced fresh parsley or 1 teaspoon dried parsley 3/4 teaspoon salt 1/2 teaspoon pepper 1 cup shredded low-fat Swiss cheese In a large saucepan, combine the potatoes, onions, carrots, celery, and chicken broth and bring to a boil. Reduce the heat; cover and simmer for 12 to 15 minutes or until the vegetables are tender. Using a potato masher, lightly mash the vegetables. Alternatively, for a smoother consistency, place the vegetable mixture in a blender and blend until smooth; then return to the saucepan. In a small saucepan, heat the canola oil. Stir in the flour until smooth. Gradually stir in the milk. Heat milk without boiling and cook, stirring for about 2 minutes or until thickened. Stir the milk-and-flour mixture into the vegetable mixture. Cook and stir until thickened and bubbly. 5Add the parsley, salt, and pepper. Remove from the heat and stir in the cheese until melted. Per serving: Calories 282 (From Fat 113); Fat 13g (Saturated 4g); Cholesterol 22mg; Sodium 889mg; Carbohydrate 32g (Dietary Fiber 3g); Protein 11g. Wild Salmon Soup Preparation time: 15 minutes Cook time: 40 minutes Yield: 5 servings 2 cups water 4 ounces carrots, peeled and diced small 1 small onion, peeled and diced small 1 bay leaf 14 ounces (about 4 medium) Yukon gold potatoes, peeled and cubed small 4 ounces raw wild salmon, cubed and fine pin bones and skin removed 1 tablespoon fresh dill weed or 1 teaspoon dried dill 5 whole peppercorns 2 cups milk 1 tablespoon butter 1 teaspoon sea salt 1 tablespoon fresh parsley or 1 teaspoon dried parsley Add the water to a large pot, and bring to a boil. Add the carrots, onion, bay leaf, and peppercorns. Reduce the heat to low, and cook for 15 minutes. Add the potatoes, salmon, and dill, and cook for 15 to 20 minutes. Check the potatoes for doneness. When soft, add the milk, butter, salt, and parsley. Cook for an additional 5 minutes. Remove bay leaf and peppercorns before serving. Per serving: Calories 194 (From Fat 64); Fat 7g (Saturated 4g); Cholesterol 30mg; Sodium 540mg; Carbohydrate 22g (Dietary Fiber 2g); Protein 11g.
View ArticleStep by Step / Updated 04-15-2021
Cancer and its treatments can contribute to loss of appetite. Because the calories you get from food are energy, if a poor appetite results in not enough food intake, you may experience fatigue. Poor food intake may also result in weight or muscle loss, which can impair your immune function and make it more difficult to recover in between treatments. Fortunately, there are several strategies you can use to prevent a poor appetite from causing you to lose weight and become malnourished. Following are ten tried-and-true tips to help you meet your nutritional needs when you lose your appetite.
View Step by StepStep by Step / Updated 10-15-2020
Following are ten inspiration stories from breast cancer survivors — some of them in their own personal words. Survivorship is broken into three categories: Acute survivorship: This is just after getting the diagnosis of breast cancer. Women often experience "the shock" and immediately start thinking about life decisions. Transitional survivorship: This comes just after initial treatment for breast cancer (whether surgery, chemotherapy, or radiation). You may be taking endocrine therapy for 5–10 years after treatment to reduce your recurrence risk. This is also the time when most women feel uneasy because their medical visits are not as frequent and they are taking less medication. Sometimes women may even equate not getting active treatment to increasing the chance of breast cancer coming back. You may also see a reduction in social support while you are struggling to get control over your symptoms or lifestyle. This transition into a "new normal" is not one that happens instantly; it's a process that comes with time, self-perseverance, objectivity, and self-discovery. The best therapy for this stage of survivorship is to engage in exercise (Zumba, sporting activities, and so forth), eat healthy, and focus on the renewed you. Extended survivorship: You will continue to have follow-up visits for 5–10 years with your cancer doctor depending on whether you're on endocrine therapy. If you're not on endocrine therapy, you will continue your regular follow-up with your primary care or general practitioner. During this period you may have unresolved issues that are important to you, such as managing lingering side effects of breast cancer treatment and any perceived psychosocial stress.
View Step by StepArticle / Updated 03-13-2018
Your body makes great efforts to fight off many diseases on its own, but it must have the right resources on its side to be able to do that. Poor nutrition reduces mental function and productivity as well as diminishes your body's immunity against diseases such as cancers. When you are getting sufficient calories for energy and sufficient nutrients to support body function and growth, you can say you have good nutrition. Maintaining good nutrition and normal body function is a kind of balancing act. Your food must include a variety of fruits and vegetables, grains, fiber, protein with small amounts of fats, and lots of water to maintain good nutrition. The best health outcomes occur when good nutrition is combined with regular physical activity. One hundred and fifty minutes of moderate exercise per week can lower your risk of breast cancer. No vigorous or intense exercises are needed to reduce your risk — if you walk for 30 minutes daily, your risk for breast cancer can reduce by 3 percent. Exercise can keep you at your ideal weight. When you're overweight, you have more fat cells or adipose tissue, which can release high levels of estrogen into your body. In general, obesity increases women's risk for any hormone-related cancer such as breast and endometrial cancer. Men who are overweight have an increased risk of prostate cancer. Exercise is great for lowering insulin levels, hormones, and proteins (known as growth factors). Growth factors must be present for any cancer to grow. Exercise reduces stress by releasing the brain's feel-good neurotransmitters, the endorphins. More endorphins reduce the urges to smoke and drink alcohol, which reduces your overall risk of breast cancer. Researchers have found that high levels of stress can damage your immune system, which can increase your risk of developing cancer.
View ArticleArticle / Updated 11-07-2017
Sometimes the option to remove both breasts is based on the disease, and sometimes it's based on the disease plus a patient's anxiety. The guidelines do state that if you have left breast cancer, you can have a lumpectomy with radiation or a mastectomy. Yet often women choose to remove both breasts to reduce the risk of getting another breast cancer. Breast reconstruction options for the non-breast cancer side are the same for a breast cancer side. Here are some possible reasons for removing the other breast when there is no cancer: Breast cancer gene mutation carriers (BRCA1, BRCA2, and so on) Strong family history of breast cancer The original cancer was not found by mammograms or other tests Personal choice of a woman after considering her breast cancer risk Advantages Easier to have both breasts look the same or symmetric One surgery and one hospital stay Reduced chance of getting breast cancer No need for future mammograms (if all tissue from both breasts is removed) Disadvantages If abdominal flaps are being used, only half the abdominal tissue can be used for each breast (which limits the size of the reconstructed breasts). Implants, tissue expanders, or back tissue may be needed to make the breasts the right size. Lengthy surgery compared to reconstructing one breast Increased risk for complications
View ArticleArticle / Updated 11-07-2017
Breast reconstruction can be done at the same time as the breast cancer surgery (called immediate reconstruction). It can also be done in a two-stage process where tissue expander (a temporary placeholder) is placed at the time of breast cancer surgery. For the final breast reconstruction, a synthetic implant or tissue from another part of your body is used to complete the procedure at a later date. You can also have breast reconstruction after breast cancer surgery, called delayed reconstruction. Your breast plastic surgeon will consider the following before making a recommendation for your breast reconstruction surgery. Type and stage of your breast cancer Additional treatments that you might need for your breast cancer Your body shape Your feelings Your personal preferences and lifestyle When you meet with your breast plastic surgeon, she will discuss your reconstructive options, including the risks, benefits, and options available for each procedure. You'll also discuss the expected cosmetic outcomes from the reconstruction. Immediate breast reconstruction An immediate reconstruction is typically recommended when you have no known breast cancer in the breast, and it gives you a new breast straight away. For example, when women have pre-cancerous lesions removed or when women with positive BRCA mutation who have not yet developed cancer have their breast removed (called a prophylactic mastectomy), they may have immediate reconstructive surgery reconstruction. Even though the breast is not identical to the one that was removed, most women find that immediate reconstruction helps them cope better with the loss of a breast. When you do have breast cancer, you will have delayed reconstruction because it gives time for the final surgery pathology to determine whether you have clear margins (that is, no cancer cells are seen at the outer edge of the tissue that was removed). If you are found to have positive margins, or cancer cells are seen at the outer edge of the tissue, then an additional surgery may be indicated to remove the cancer cells. Having had immediate reconstruction would interfere with the surgery in this case. Advantages You will have your newly reconstructed breast after waking up from your lumpectomy or mastectomy. Immediate breast reconstruction may also have a psychological benefit, as you won't have a period of time with "no breasts." You will have fewer surgeries and fewer anesthetics. Your reconstructed breasts may form better because the plastic surgeon can use the extra skin that's already there, leading to improved cosmetic outcome. You may have less scarring on the reconstructed breast itself. It involves lower healthcare costs. Disadvantages You may not have as much time to decide on the type of breast reconstruction that you want. If you're having radiation therapy after surgery, it may cause injury to the reconstructed breast. Difficulty in detecting mastectomy skin problems. Your doctor may advise you not to have implant reconstruction if you're having radiation therapy afterwards. However, you may have a temporary implant during radiation with another breast reconstruction surgery after radiation has completed. You will have longer hospitalization and recovery times than if you had mastectomy alone. Complications from breast reconstruction surgery may delay chemotherapy that you need. Chemotherapy stops the body from being able to heal well, so if you have any problems with wound healing after your breast reconstruction, you won't be able to start chemotherapy until the problems have been resolved. If you were given chemotherapy at this time, it would stop the wound healing and cause a serious infection. Research has shown that the most benefit received from chemotherapy is when it is given within six weeks of breast cancer surgery. And if your breast reconstruction surgery causes delayed wound healing, then chemotherapy could be delayed beyond those six weeks. Immediate breast reconstruction requires a lot of coordination between the breast surgeon and plastic surgeon operating room (OR) schedules, because they both will have to be in the OR at the same time, along with other members of the team to ensure the success of the procedure. Immediate breast reconstruction may be a good option if you have the following: Smaller tumor size (less than 2 cm) Low chance of needing radiation therapy after surgery Diagnosis of a non invasive cancer or pre-cancer (such as ADH or DCIS) Auxiliary lymph nodes under your armpit don't have cancer Clear margins from surgery You're healthy to undergo general anesthetic Prophylactic (preventive) mastectomy due to having a genetic mutation (such as BRCA 1 or 2) Delayed breast reconstruction Some women prefer to get over the mastectomy and breast cancer treatment first, before they think about reconstruction. Delayed reconstruction is typically done after the mastectomy site has healed. Healing can take six months or even several years after the mastectomy. Advantages You have more time to look at all types of reconstruction options and discuss them with your plastic surgeon. If you're having additional cancer treatment after mastectomy (such as radiation), it won't cause problems at the reconstruction site. You schedule the surgery at your leisure or at the time you elected. Disadvantages You have a period after the mastectomy during which you have no breast tissue, but you can choose to wear a false breast. You will have a mastectomy scar on the chest wall, which is a larger scar on the reconstructed breast than after immediate reconstruction. Delayed reconstruction requires additional surgery and recovery time. The breast is sometimes difficult to reconstruct after scarring occurs. Delayed reconstruction may be a good option if you have the following: Larger breast tumor (over 2 cm) Tumor-free from breast cancer (all cancer was successfully removed in your first surgery) and have completed chemotherapy/radiation therapy Healthy to undergo general anesthesia Radiation therapy completed at least six months prior to surgery
View ArticleArticle / Updated 11-07-2017
Targeted therapy is also called biological therapy. It affects specific protein-receptor targets (called biomarkers) found only on cancer cells. These protein-receptor targets are responsible for the growth and spread of cancer cells. Targeted therapy medicines block the growth and spread of cancer because they interfere with processes in the cells that cause cancer to grow. Targeted therapy causes less harsh or toxic side effects because it does not affect healthy rapidly dividing cells. The most well-known targeted therapy is trastuzumab (marketed as Herceptin), a medicine that kills specific cancer cells that are HER2+ (HER2-positive). A protein called human epidermal growth factor receptor 2 (HER2), which is found on the surface of the cancer cell, in large quantities can promote the rapid growth of cancer cells. Approximately 20–25 out of every 100 patients with breast cancer are HER2+ and are most likely to respond well to Herceptin treatment. This figure illustrates HER2 receptors. It's difficult to predict how any one person will respond to a treatment. Therefore, targeted therapies were developed based on a particular group of factors that may be found on a tumor. Herceptin treatment was made possible through the results from clinical trials that show specific therapies to be more effective on certain types of breast cancer cells. Clinical trials have shown that Herceptin reduces the risk of HER2-positive breast cancers from coming back. In other words, individuals with HER2+ breast cancer get personalized treatment, which is as a result of precision medicine. This figure illustrates how Herceptin works on HER2+ breast cancer cells. Other targeted therapies besides Herceptin include the following: Bevacizumab (marketed as Avastin): Used to treat colon cancer and ovarian cancer. Lapatinib: Used to treat HER2+ metastatic breast cancer. Everolimus (marketed as Afinitor): Used to treat kidney cancer, breast cancer, and brain cancer. Pertuzumab (marketed as Perjeta): Used in combination with Herceptin and/or Taxotere to treat metastatic breast cancer. T-DM1 (marketed as Kadcyla): Used to treat HER2+ metastatic breast cancer. Denosumab (marketed as Xgeva): Used for treatment of secondary breast cancer in the bone.
View ArticleArticle / Updated 11-07-2017
Radiation, or radiotherapy, involves the use of a beam of high-energy rays to kill cancer cells in your breast or lymph nodes under your armpit or chest wall. Radiation therapy is usually recommended after a lumpectomy, when the breast cancer has spread to the lymph nodes under the armpit, or after a mastectomy and the surgical margins are still positive for cancer. Side effects Side effects from radiation can be immediate (also called acute or early side effects) or long-term, occurring after six months of radiation treatment. Immediate side effects are typically related to skin reactions that may occur during radiation and may last for up to six months. If you are exposed to the sun a lot without wearing sunscreen, for example, you are more likely to get sunburn. Similarly, radiation will increase your risk of skin damage and other side effects that include the following: Sunburn. Darkening. Tenderness and/or itching of the skin in the treatment area. Peeling or flaking of the skin as treatment goes on, and this may result in a red, blistering, weepy skin reaction. Note that many individuals do not experience this symptom, and your radiation oncologist may provide you with special topical creams to use during radiation to reduce the risk of peeling and blisters from developing. Side effects that may occur immediately and long-term Pain in the breast or chest area in the form of aches, twinges, or sharp shooting pain Swelling of the breast or chest Stiffness or discomfort around the breast/chest or shoulder Fatigue or tiredness Hair loss under the armpit or chest area Sore throat Hardening of the tissue, known as fibrosis, caused by the accumulation of scar tissue Dry cough or shortness of breath because of inflamed treatment area Serious side effects that can occur later Weakening of the bones under the treated area, which can lead to rib and collarbone fractures Injury to the nerves in the arm, which may cause numbness, tingling, weakness, pain, and possible loss of movement Immediate side effects usually occur around 10–14 days after starting radiation treatment, but can happen later in treatment or after it has finished. The severity of your skin reactions depends on a few factors: Dose of radiation given Your skin type Existing skin conditions, such as eczema, psoriasis, and so on If you have existing skin conditions, let your radiation oncologist/doctor know before starting treatment because it may be useful for you to meet with a dermatologist (skin specialist) for advice. Skincare during radiation therapy You must take special care of your skin that is being treated with radiation. Your radiation oncologist or radiation technologist (who administers the radiation therapy treatments) will provide you with specific skincare instructions at the center. Most instructions will include the following actions and precautions: Have a shower instead of a bath. Wash the treated area gently with warm water using a mild soap and pat the skin dry with a soft towel. Use a fragrance-free deodorant. Use a mild moisturizer or recommended topical cream to keep skin soft. If you want to use anything else on the skin in the treatment area, you must discuss this with your radiation doctor. Avoid exposing the treated area to extremes of temperature such as heat pads, saunas, or ice packs during radiation treatment. Avoid exposing the treated area to sun while having radiation and afterwards, until all skin changes at the treatment site have healed. Avoid getting sunburn after treatment. Always use a sunscreen with a high sun protection factor (SPF) of 50 and above. You should also apply sunscreen under clothes because, thought it isn't widely known, it is possible to contract sunburn through clothing. Avoid swimming during treatment and afterwards until all skin reactions have healed. Chemicals in the swimming pool may cause skin irritation, and a swimsuit can cause friction and discomfort at the treatment site. Wear a soft cotton bra or vest during treatments to avoid rubbing or friction that can worsen skin reactions. Avoid wearing underwire bras until your skin is healed. Your radiation technologist will monitor your skin during treatments. When a skin reaction develops, they will advise you on caring for your skin. If you develop a skin reaction during radiation, it should heal within four weeks from the date of your last treatment. If your skin is taking longer than four weeks to heal, or you have severe blisters and skin peeling, you must contact your radiation treatment team or breast care nurse for advice.
View ArticleArticle / Updated 11-07-2017
There are several surgical options for treating breast cancer, but it is your stage of breast cancer that determines which surgical options are best for you. Breast reconstruction is when a surgeon rebuilds the breast using one of two main types of breast reconstruction: implant or your own tissue (tissue from belly, back, thigh, or buttock). The figure illustrates sources of breast construction. Sometimes, based on the size of your tumor, your doctor may recommend a lumpectomy with or without a sentinel lymph node biopsy followed by several weeks of radiation with minimal change in the size of your breasts. But you may prefer to have the whole breast removed (mastectomy) and perhaps have a breast reconstruction. Regardless of what your doctor recommends and your preferences, here are some things you may find it helpful to consider as you decide among options: How do you feel about having your whole breast removed? How do you feel about having part of your breast removed? How do you feel about having radiation therapy? How quickly do you want your treatment to be completed? How will you cope with travelling daily to get radiation therapy for several weeks? Will you want to have immediate breast reconstruction or wait some months after surgery? There are no right or wrong answers to these questions — it is based on your values and preferences. Each woman is different and will approach their treatment decisions differently in a way that may be personal, social, financial, religious, or cultural. Some women may feel compelled to keep their breast and choose a lumpectomy even though that wasn't recommended by their surgeon because of the stage of their breast cancer. If you are that person, you should speak to your doctor or psychologist to help you determine why you are willing to put your life at risk by not getting the recommended type of surgery. In this case, a mastectomy would better ensure that all your cancer is removed and your risk of cancer coming back will be minimal. If you feel strongly about not getting radiation, then lumpectomy should not be an option for you because you will not be receiving the standard treatment for your breast cancer. Mastectomy and possible breast reconstruction may be your only option in such a case, according to standard NCCN guidelines. The type and timing of breast reconstruction may depend on your need for further treatment post–breast surgery, such as chemotherapy or radiotherapy. Breast reconstruction is optional — it's not required and won't change the outcome of the cancer. Take the time you need to make the right decision after hearing all the options available to you for your treatment. Every decision you make may impact your survival positively or negatively. You can discuss your concerns with your doctor, family, and friends. Feel free to contact your breast specialist or nurse if you have additional questions before you make your treatment decision.
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