Visible Side Effects of Breast Cancer Treatments

The side effects of breast cancer treatment that people around you might notice can take an emotional toll on you.

But there’s a lot you can do to overcome them, and that can help you feel better.

Breast Changes

The first visible side effect is having part or all of your breast removed. If you've had a mastectomy, you can choose to use an external prosthesis instead of, or before, breast reconstruction surgery.

When you wear a breast prosthesis, you tuck it into a bra or attach it to your skin with double-sided tape.

If you chose to get one:

  • Ask your doctor for a prescription for an external prosthesis -- then usually it can be covered by insurance.
  • Ask your oncologist for referral to a specialized store that sells external prostheses. You may also find them in some lingerie departments.
  • Make an appointment with a breast prosthesis consultant and allow yourself about an hour to get fitted.
  • Try a variety of them to see which feels and looks the best on you.

Hair Loss

Some chemotherapy kills fast-growing cells -- like hair follicles -- whether those cells are cancer or not. Hair loss is different for everyone, and it depends on the type of chemo you're taking.

Radiation and hormonal treatments may also cause this side effect.

What to expect:

If you lose hair from chemo, it's likely to fall out within 1 to 2 weeks of starting treatment. It may thin or fall out almost all at once. It's common to lose hair over your whole body, not just on your head. This means you may lose eyelashes and eyebrows, as well as arm, leg, and pubic hair.

You can't prevent hair loss with ice caps or other measures. But if you use a mild shampoo, soft hairbrush, or cool blow-drying, that may slightly lessen your hair loss.

Sometimes hair begins to grow back even before your treatment is done. It may be thinner or a different color or texture.

Tips:

You can prepare for hair loss and make it easier to deal with. For example, many women find it helpful to cut their hair short before it starts falling out. This way you can avoid losing large clumps of it in the shower or waking to large amounts on the pillow.

Here are some other tips that may help:

  • Consider buying scarves, turbans, caps, or hats before your hair falls out.
  • Ask your oncologist for a "cranial prosthesis" prescription to help ensure insurance coverage for a wig.
  • Check with wig retailers and makers, your hair stylist, or the American Cancer Society to learn about wig and hair product options.
  • Before you begin chemotherapy, match your hair texture or color to wigs. This is also a good time to have a wig styled. But if you get fitted with a wig early, know that it may fit slightly different once you lose your hair.
  • Prepare loved ones, especially children, for how you'll look with your hair gone. It may help to involve them in choosing scarves and other products.
  • If you choose to go bald, remember to use sunscreen on your head when in the sun. Keep your head warm in cold climates, too.

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Arm Swelling

Doctors call this lymphedema. It's swelling in the arm on the side where you've had breast or lymph node surgery. It can also happen after you get radiation. It’s often a temporary side effect, but it can be permanent. If so, it can affect your quality of life.

You can lessen its impact if you spot the symptoms of it early.

Tips:

  • Don't ignore any swelling you have in your arm.
  • Avoid injury to the skin of an affected arm.
  • Wear gloves when you garden or do housework.
  • Avoid extreme water-temperature changes.
  • Keep your arm protected from the sun.
  • Avoid getting shots or IVs on your affected arm.
  • Don't carry heavy handbags or wear heavy jewelry on the affected side.

The swelling may affect the type of clothing you can wear. You may need an elastic compression sleeve to control swelling, along with more loose-fitting clothes.

Ask your doctor for a referral to a certified lymphedema therapist. She can show you safe exercises and other techniques to help avoid or reduce swelling.

Weight Gain or Loss

You might have either during your treatment.

Weight loss might be due to nausea, vomiting, or appetite changes.

Weight gain is sometimes brought on by chemotherapy, or hormone therapy, which can both cause early menopause. But some other medications you may take can also cause you to put on extra pounds, as can changes in your diet and being less active.

Tips:

Now is not the time to diet. Eat nutritious, balanced meals to help yourself stay at a healthy weight, keep up your energy, and heal.

These recommendations may help:

  • Eat plenty of protein, but limit saturated fat, sugar, alcohol, and salt.
  • Eat smaller meals more often throughout the day, especially if you're nauseous.
  • Find an exercise partner to help you stick with a routine. Even a few minutes a day can make a positive difference in how you feel.

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Skin and Nail Changes

You might notice these after chemotherapy, radiation, or endocrine treatment.

What to expect with skin changes:

You may have:

Redness from radiation and certain types of chemo may get worse if you expose your skin to the sun.

Though rare, skin damage can happen if chemo drugs given through a vein (IV) leak onto the skin.

Let your doctor know about any breaks or cuts in your skin, which can become infected.

Tips:

  • Check first with your medical team before you use any skin products. This includes lotions, powders, perfumes, creams, deodorants, body oils, or home remedies. Additives in some products can worsen skin reactions.
  • Avoid detergents with dyes and perfumes.
  • Keep your skin clean and dry. Use a mild soap, and pat your skin dry after bathing.
  • Use a rich moisturizer as recommended by your doctor several times a day to help with dry skin.
  • Wear loose-fitting, natural fabrics like cotton and silk.

What to expect with nail changes:

Nail beds may become darkened or discolored. Your nails may crack, split, or become rigid. Sometimes they may even lift off the nail bed. Tell your doctor if this happens. It increases the risk of infection.

Tips:

  • Cut them short to minimize splitting.
  • Avoid artificial nails, which may increase the risk of an infection. It's OK to use nail polish, but remove it with a non-acetone-based remover, which is less drying.
  • Use a cuticle remover cream or gel, massaging it into your nails.
  • Don't bite or tear at your nails or cuticles.
  • Wear gloves when you garden or do housework.
  • Avoid professional manicures, or bring your own sanitized instruments.
  • Limit the time you have your hands in water to lower the risk of fungal infections.

Skin and nail changes usually go away when your treatment ends.

The 'Look Good Feel Better' Program

The American Cancer Society has teamed up with the Personal Care Products Council and the National Cosmetology Association to create "Look Good Feel Better." This program teaches beauty techniques that can boost your appearance and how you feel about yourself after your cancer treatment.

For more information, call 1-800-395-LOOK, or click here.

WebMD Medical Reference Reviewed by Nayana Ambardekar, MD on September 20, 2017

Sources

SOURCES:

Susan Brown, Director of Education, Susan G. Komen for the Cure.

Terri Ades, RN, Director of Cancer Information, American Cancer Society.

American Cancer Society: "Detailed Guide: Breast Cancer."

Breast Cancer Network of Strength: "Losing your hair."

Breast Cancer Network of Strength: "Weight Gain."

Breast Cancer Network of Strength: "Lymphedema."

Breastcancer.org: "Treatment Side Effects."

Look good feel better.org: “Contact Us.”

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