Breast Cancer Survivors: Managing Treatment Side Effects
Sometimes the cure feels worse than the disease. But new drugs and therapies help reduce the ill effects of chemotherapy and radiation.
Sick and Tired: Tackling Fatigue
Almost everyone undergoing breast cancer treatment feels some fatigue. It often builds up over the course of treatment, so while you start out thinking "This isn't so bad; I still have plenty of energy," by the end of chemotherapy and radiation you may feel lucky if you can get out of bed.
Some treatment-related fatigue, doctors say, is almost inevitable. "Chemotherapy does cause collateral damage to normal tissues, and the broad tissue damage is one source of this fatigue," says Mark Pegram, MD, director of the Women's Cancer Program at the Jonsson Comprehensive Cancer Center at UCLA. "Until we have more targeted therapies that don't damage normal tissues as much as chemotherapy does, we will have to try to manage fatigue as best we can."
Longer-lasting drugs to treat chemotherapy-induced anemia, which can leave patients drained and dragging, are now available, says Pegram. These red blood cell boosters were once only available as weekly injections, but a newer drug in this category, Aranesp, requires fewer injections and office visits.
According to a study presented at the San Antonio Breast Cancer Symposium in 2004, 94% of patients treated with Aranesp reported a significant improvement in their quality of life. "I don't think that anybody has a magic bullet for fatigue, but maintaining an adequate hemoglobin level is definitely an important goal," says Pegram.
Aiming to Protect Bones, Prevent Osteoporosis
Women diagnosed with breast cancer before going through menopause often endure "chemopause." This short-term or permanent menopause is a result of chemotherapy, which interferes with the production of ovarian cells. Research shows this early and harder-hitting form of menopause (which happens all at once, instead of the slower slide of natural menopause) can lead to an increased risk of osteoporosis.
Medications called bisphosphonates, like Fosamax and Actonel, slow the rate of bone breakdown and are commonly prescribed to improve bone density in people who have already developed osteoporosis. But what about women who are at higher risk for bone loss due to "chemopause" but haven't developed osteoporosis yet? Should they take a drug like Fosamax to help prevent bone loss?