Life After Breast Cancer :: Health and Disease :: Cancer

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Life After Breast Cancer
by author Lorna Vanderhaeghe, BSc

Congratulations, you’ve beaten cancer! Now that you’re free from surgery and radiation, with a clean bill of health, you may be pleased (or not) with the results of reconstructive surgery (if you had it). You may be wondering about the long-term effects of the treatments you’ve endured.

Although you should be jumping for joy at this point, many women reflect on the experience and wonder, “What now?” Many fear that the cancer will recur, and little things, like a pain in the chest, a bruise, or cough, things you used to ignore, now raise alarm bells. Around you people keep saying, “It’s time to get on with your life.” The fact is, though, breast cancer changes us on many levels.

Some women feel abandoned by their physicians even though they may still be attending follow-up visits for several years. Others have difficulty sharing their experience and end up emotionally isolated and alone. To minimize the risks of cancer recurring, follow these special recommendations.

Black Cohosh and Hot Flashes

Some survivors may still be taking chemotherapy drugs like tamoxifen for an additional five years. The sudden onset of menopause is a side-effect of long-term tamoxifen therapy, with symptoms of severe hot flashes, mood swings, vaginal dryness, and night sweats. Until recently, women were told to just deal with these symptoms because treatments to stop hot flashes may also increase estrogen, definitely something we do not want to encourage in women with estrogen-receptor-positive cancers or those preventing the recurrence of this cancer.

Now very well-designed studies are showing tamoxifen-induced hot flashes can be treated non-hormonally. Two new studies on black cohosh, which confirm what some of the older studies have shown, have found that not only is black cohosh not estrogenic but also has an effect on inhibiting breast cancer cells. Breast Cancer Research and Treatment published a study in February 2004 showing that the triterpene glycoside deoxyacteine found in the standardized extract of black cohosh, inhibited the growth of human breast cancer cells.

Another study published in Maturitas in March 2003 examined the effects of black cohosh on hot flashes caused by tamoxifen in 136 young premenopausal breast cancer survivors age 35 to 52 years. After treatment with segmental or total mastectomy, radiation therapy, and chemotherapy, participants were open-label randomly assigned to receive tamoxifen 20 mg per day orally or tamoxifen plus black cohosh. Duration of treatment was five years for tamoxifen, according to international standards for adjuvant therapies, and 12 months for black cohosh plus tamoxifen. Follow-up included clinical assessment every two months; the primary endpoint was to record the number and intensity of hot flashes. Almost half of patients receiving the combination of tamoxifen and black cohosh were free of hot flashes, while severe hot flashes were reported by 73.9 percent of the tamoxifen-only group.

Researchers found that hot flashes were the most frequent adverse reaction to tamoxifen in breast cancer survivors. The combined administration of tamoxifen plus black cohosh for a period of 12 months allowed satisfactory reduction in the number and severity of hot flashes.

Hot flashes are not the only side-effect of tamoxifen. It is important that if you have any bleeding that you follow up with your physician immediately as endometrial cancer is a side-effect of the drug.

Coenzyme Q₁₀ for Heart Health

During radiation therapy it is not uncommon for the heart to be irradiated as well, even though more sophisticated low-dose radiation is employed today. Cardiovascular complications can occur, including pericarditis, myocardial fibrosis, muscular dysfunction, and valvular abnormalities or conduction disturbances. Those who were treated with mastectomy (removal of the breast) along with radiation and younger women appear to be at highest risk of cardiovascular side-effects. As well, certain chemotherapeutic drugs can contribute to heart complications.

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Lorna Vanderhaeghe, BSc, has researched nutritional medicine for more than 20 years and has written several books, including the best-selling No More HRT: Menopause Treat the Cause (Fitzhenry, 2002).

Source: alive #261, July 2004

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