Navigating Breast Cancer Treatment Side Effects and Long-Term Care

Breast cancer treatment, including the long-term use of anti-estrogen therapy, can bring about various side effects that patients should be aware of, especially since they can play a role in treatment decision-making for some.

As part of its Speaking Out video series, CURE® spoke with Marla Sustin, a nurse practitioner at University Hospitals Seidman Cancer Center in Cleveland, about side effect management and how survivorship care plans can play a role in the long-term care of patients with breast cancer.

For example, aromatase inhibitors may be associated with side effects, such as arthralgia or bone pain, that can be debilitating or affect everyday life.

Patients undergoing tamoxifen treatment should be aware of effects such as an increased risk of endometrial thickening, a potential sign of endometrial cancer; blood clots; and sudden shortness of breath. However, Sustin noted that patients may transition to other medications and treatments, each with its unique set of potential side effects.

In the long term, certain evaluations and tests become essential for monitoring a patient’s health. For those on aromatase inhibitors, a baseline bone density scan or DEXA scan is needed, followed by regular monitoring every two to three years. In addition, patients who received cardiotoxic medications during chemotherapy may need to see a specialized cardiologist.

As a result of these side effects, survivorship care plans play a pivotal role in guiding patients through post-treatment life. These plans detail the patient’s cancer journey, including tumor grade, stage and treatment specifics, and they provide valuable information about potential side effects and their management to help patients understand their cancer history comprehensively.

Lastly, Sustin suggested that patients can track their side effects effectively by paying close attention to their body and reporting any changes or discomfort to their health care provider. Mental notes or written records of symptoms, their timing, and any possible contributing factors can be helpful to make note of and mention during consultations with providers. Meanwhile, she concluded, engaging with health care providers, nurse navigators or nurse partners can help patients discover available resources to better navigate the challenges of breast cancer treatment and side effects.

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