A practical guide to tests and treatments bReAST › Downloads › CancerInformation › ... · 2016-05-05 · Breast swelling A few women will develop swelling of the breast area

A practical guide to tests and treatments

bReASTside effects

radiotheRApy –possible Long-term

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Breastradiotherapy–possiblelong-termsideeffects

Contents

AboutBreast radiotherapy – possible long-term side effects 3

Radiotherapy 4

Sideeffectsofradiotherapyforbreastcancer 6

Possibledelayedsideeffects 8

Breastchanges 8

Restrictedarmandshouldermovement 11

Changesinthewayyourheartworks 12

Lungproblems 14

Effectonthebones 15

Lymphoedemainthearm 16

Numbness,painandweaknessinthearm 18

Radiation-inducedsecondcancers 20

Yourfeelings 21

Howwecanhelpyou 23

Otherusefulorganisations 27

Furtherresources 30

Questionsyoumightliketoaskyourdoctorornurse 33

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AboutBreast radiotherapy – possible long-term side effects

About Breast radiotherapy –possible long-term side effectsThis booklet gives information about the possible long-term (delayed) side effects of radiotherapy to the breast. Thesesideeffectsarerareandhavebecomelesscommonasradiotherapyplanningtechniqueshaveimproved.We’veincludedallofthepossibledelayedsideeffectssothatyoucanbeawareofthem.Butit’simportanttorememberthatyou’reunlikelytogetallofthesideeffectsmentionedhere.Manywomenonlyhavemild,short-termsideeffects.

Wehopethisbookletanswerssomeofyourquestionsaboutdealingwithlong-termsideeffectsofradiotherapy.Itmayhelptoreadthisinformationalongsideourinformationaboutbreastcancerandradiotherapy.

Asthemainaudienceforthisinformationiswomenweusethetermwomenthroughoutthetext,butit’salsoappropriateformenwhohavebeentreatedforbreastcancer.

Wecan’tadviseyouaboutthebesttreatmentforyourself.Thisinformationcanonlycomefromyourowndoctor,whoknowsyourfullmedicalhistory.

Ifyou’dliketodiscussthisinformation,calltheMacmillanSupportLinefreeon0808 808 00 00,Monday–Friday,9am–8pm.Ifyou’rehardofhearingyoucanusetextphone08088080121,orTextRelay.FornonEnglishspeakers,interpretersareavailable.Alternatively,visitmacmillan.org.uk

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Turntopages27–32forsomeusefuladdressesandwebsites,andpage33towritedownquestionsforyourdoctororbreastcarenurse.

Ifyoufindthisbooklethelpful,youcouldpassitontoyourfamilyandfriends.Theymayalsowantinformationtohelpthemsupportyou.

Radiotherapy

Radiotherapytreatscancerbyusingtargetedhigh-energyraystodestroycancercells,whiledoingaslittleharmaspossibletonormalcells.Radiotherapyisacommonpartofthetreatmentofmanycancersandcancuresomecancersorhelpreducetheriskofthemcomingbackaftersurgery.Radiotherapymayalsobegiventohelprelievesymptoms.

Radiotherapyisoftenusedaspartofyourtreatmentforbreastcancer.It’sgiven:

• After surgery:It’scommonlygivenaftersurgerythatremovesthebreastlumpandsomeofthebreasttissuesurroundingit(lumpectomyorawidelocalexcision),andsometimesafterremovalofthewholebreast(mastectomy).

• Before surgery:Occasionallyradiotherapyisgivenbefore,orinsteadof,anoperation.

• To the lymph nodes:Sometimesradiotherapyisgiventothelymphnodesintheunderarm(axilla).

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Radiotherapy

• To the lymph nodes behind and above the collarbone (the supra clavicular nodes):Radiotherapymayalsobegiventothelymphnodesinthisareaifit’sthoughtthereisarisktheymightcontaincancercells.

Externalradiotherapyisthemaintypeofradiotherapyusedtotreatbreastcancer.Lesscommonlyatypeofinternalradiotherapy(alsocalledbrachytherapy)isused.Thisplacesaradioactivesourceclosetothetumour.Ourcancersupportspecialistscangiveyoumoreinformationaboutthis.

Externalradiotherapyisnormallygivenasaseriesofshortdailytreatmentsintheradiotherapydepartmentatthehospital,usingamachinecalleda Linear Acceleratorwhichproduceshigh-energyx-rays.Treatmentisusuallygivenover3–6weeks,onceadayMonday–Friday,witharestatweekends.Treatmenttakesseveralminuteseachdayandispainless.Itwon’tmakeyouradioactiveanditissafeforyoutobearoundotherpeople,includingchildren.Treatmentisusuallygivenasanoutpatient.

Somewomenarealsogivena‘boost’doseofradiotherapytothepartofthebreastwherethecancerwaslocated(knownasthetumour bed).Thisisusuallygivenafterthemaincourseofradiotherapyhasfinished.

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Side effects of radiotherapy for breast cancer

Althoughradiotherapycandestroycancercells,itcanalsoaffectsomeofthenormalcellsinthetreatmentarea.Yourdoctorswilldecidewhetherornottorecommendaparticularradiotherapytreatmentbyweighingupthelikelybenefitsoftreatingthecanceragainstthepossiblerisksandsideeffects.

The benefits of the treatment usually outweigh the risk of developing delayed side effects.

Youshouldbegiventhechancetodiscussanypossiblesideeffectswithyourdoctor.Asthere’softenalotofinformationtotakein,itmayhelptotakearelativeorfriendwithyouwhenyouseethedoctor.

Radiotherapyaffectspeopleindifferentways,soitcanbedifficulttopredictwhetheryouwilldevelopanylong-termproblems.Mostsideeffectsofradiotherapytothebreastaretemporaryanddisappearoverafewweeksormonthsoncetheradiotherapyhasfinished.Forasmallnumberofwomenthesideeffectscanbecomelong-termproblemsthatmaydevelopmonths,orevenyears,later.

Developmentsinthewaythatradiotherapyisgivenhavereducedtheriskofsideeffects,andseriouslong-termproblemsarenowveryrare.However,becausebreastcancerisbecomingmorecommon,andtreatmentisnowverysuccessful,morewomenarelivinglongeraftertreatment.Asaresult,thenumberofwomenwithalong-termproblemhasslightlyincreased.

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Sideeffectsofradiotherapyforbreastcancer

Mostwomenwillonlyneedtohaveradiotherapytothebreastarea,whichmakestheriskofdevelopingseriousdelayedsideeffectsverysmallindeed.However,somewomenwillalsoneedtohaveradiotherapytotheareaunderthearm(axilla)whichcanincreasetheriskoflong-termproblems.Long-termproblemsaremorelikelyifradiotherapyiscombinedwiththeremovalofall,oralargenumberof,thelymphnodesfromunderthearm.

Thisinformationisaboutthepossibledelayedsideeffectsthatmayoccurmonths,oryears,aftertreatment.

Radiotherapy can also cause some general side effects during treatment, such as tiredness or redness of the skin. These are discussed in our booklet Understanding breast cancer.

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Possible delayed side effects

Ifyoudevelopanynewsymptomsafteryourtreatmentisover,orifyou’reconcernedthatthesideeffectsyoudevelopedduringyourtreatmentaren’tgettingbetter,youshouldcontactyourdoctor,radiographerorbreastcarenurseatthehospitalforadvice.Thereisoftenasimpleexplanationforthesesymptomsandtheydon’tnecessarilymeanthatyouaredevelopinglong-termsideeffects.

Yourdoctorwillprobablywanttodoteststofindthepossiblecauseofyoursymptoms.Thesemayincludex-rays,scansandspecialistinvestigations,dependinguponyourparticularsymptoms.Youmaybereferredtoadoctorwhospecialisesintreatinglong-termsideeffectsofradiotherapy.Thesespecialistdoctorsaren’tavailableineveryhospital,soyoumayneedtotraveltoseeone.

Themainlong-termsideeffectsarecoveredonthefollowingpages(8–20).

Breast changes

Mostwomenwilldevelopchangesinthelookandfeeloftheirtreatedbreastafterradiotherapy,althoughformanythesechangesareveryslight.

Changes to the skinDuringtreatmentsomewomendevelopaskinreactionsimilartosunburn,knownaserythema.Theskinmaybecomeredanditchy,andifyouhavedarkskinitmayappeardarkerwithablueorblacktinge.Usuallythissideeffectwillsettledown2–4weeksafterradiotherapy,butsometimesitcancontinue.

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Possibledelayedsideeffects

Afewwomenfindthattheiroperationscarremainstenderorsensitiveforsometimeafterradiotherapy.

Somewomenmaydevelopchangeswhichcanincludesmallredblotchesonthebreastcausedbydilatedbloodvesselsundertheskin.Thisconditionisknownastelangiectasia.Althoughthisaffectshowthebreastlooks,itshouldn’tcauseanyotherproblems.

Skin careIfyouhaveaskinreaction,yourdoctor,nurseortheradiographerwillgiveyouadviceonhowtolookafteryourskin.Thefollowingtipsmaybehelpful:

• Avoidusingperfumedsoaps,talcumpowderanddeodorants/antiperspirantsuntilthereactionhassettled.

• Avoidshavingunderyourarmontheaffectedside.

• Showersarebetterthanbaths,andyoushouldavoidsoakingtheaffectedareafortoolongifyouhaveabath.

• Afterwashing,pattheareadryratherthanrubbingitwithatowel,ordryitwithahairdryeronacoolsetting.

• Looseclothingmaybemorecomfortabletowear.

• Avoidexposingtheareatostrongsunlightforatleastayear,asyourskinwillcontinuetobemoresensitive.Ifyoudogooutinthesun,applysunblocktotheskinwhichhasbeentreatedbyradiotherapy.

Breast swellingAfewwomenwilldevelopswellingofthebreastareaduring,orshortlyaftertreatment.Thisswellingisknownasoedema,andusuallygoesawayacoupleofmonthsaftertreatmenthas

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finished,althoughinsomewomenitmaypersistformonthsoryears.

Sometimes,adifferenttypeofswellingcalledlymphoedemacandevelop.Thiscanoccurifthelymphnodeshavebeenremovedoraredamagedbyradiotherapy,causingabuild-upoflymphfluid.Itmorecommonlyaffectsthearm(seepage16),butcanalsocauseswellingofthebreast.

Lymphoedemacandevelopmanymonthsoryearsaftertreatmenthasfinished.Talktoyourbreastcarenurseordoctorifyouthinkyouhavelymphoedema.Ifnecessarytheycanreferyoutoalymphoedemaspecialist.

There is more information about lymphoedema in our booklet Understanding lymphoedema, which includes tips to help you avoid it and advice on how to reduce its effects.

Soreness or painManywomenfindthattheareainthebreastthathasbeentreatedfeelsuncomfortableorsore.Thistendstobecomelessofaproblemyearafteryear.Ifthishappensandiscausingyouaproblem,yourdoctorcanprescribepainkillerstohelprelieveanypain.Somewomenfindthatthepaincanberelievedbywearingasupportbra.Itcanalsohelptowearasoftbraatnight,butmakesurethebrahasnounderwire.

Shrinking of the breastIt’sfairlycommonforthebreasttoshrinkslightlyovertime,butforittofeelthesame.Afewwomendevelopahardeningorthickeningofthebreasttissue(fibrosis).Thiscancausethebreasttobecomeharderandsmallerthanitwas,althoughtheeffectismostlyverymild.Inseverecasesthiscanmakethebreastslookdifferenttoeachother.

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Somewomenfindthatastheygetoldertheirbreaststendtogetbigger.Breastscanalsogetbiggerasaresultofgainingweight.Abreastthathasbeentreatedwithradiotherapymaynotincreaseinsizeasmuchastheuntreatedbreast.Ifthisisaproblemforyou,talktoyourdoctororbreastcarenurse,asasiliconeshell(partialprosthesis)canbefittedtoyourbra.Surgerycanalsosometimesbedonetocorrectanimbalanceinsize.

Restricted arm and shoulder movement

Radiotherapycanaffecthowwellyoucanmoveyourarmandshoulder.It’sfairlycommonforwomenwhohaveradiotherapytotheareaunderthearmtoexperiencesomerestrictioninmovement,especiallyifthey’vehadsurgerytotheirunderarmareaaswell.Thismaymakeitdifficulttocarryheavybagsanddohouseholdchoresorsometypesofexercise,suchasswimming.

Beforesurgery,aphysiotherapistshouldshowyouexercisestohelpimprovethemovementofthearmandshoulder.It’sagoodideatocontinuetheexercisesforacoupleofyears–yourphysiotherapistcantellyouhowfrequentlytodothem.Anyrestrictionsinmovementshouldgraduallyimproveaftertreatment,butsomewomencontinuetohaveproblems.Ifyouhaveproblems,asktoseeaphysiotherapistagainforadvice.

Ifthearmandshoulderarepainful,itcanhelptotakepainkillersbeforedoinganyexercises.Somewomenfindthatcomplementarytherapiesarehelpful.There’smoreinformationinourbookletUnderstanding complementary therapies.

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Changes in the way your heart works (cardiac complications)

Thereisaverysmallriskofdamagetotheheartmuscleorthemajorbloodvesselsaroundtheheart.Thisisonlyapotentialproblemifyouhavehadcancerinyourleftbreast,astheheartisontheleftsideofthechest.Radiotherapyisnowverycarefullyplanned,sothattheheartiseithernotwithintheradiationareaoronlyasmallamountoftheheartwillreceiveanyradiation.Asaresult,theriskofdevelopinganyheartproblemsisnowverylow.

Ifyourhearthasbeendamagedbyradiotherapyyoumayfindthatyougettiredveryeasilyorgetbreathlessonexertion,forexamplewhenclimbingthestairs.Youmayalsonoticethatyousometimesfeeldizzyorgetchestpains.It’simportanttorememberthatthesesymptomscanbecausedbymanythingsandtheyaren’talwaysaresultofdamagetotheheart.

Treatment for heart changesThetreatmentwilldependuponthepartoftheheartthathasbeendamagedandhowit’saffectingyou.Youmayjustbeadvisedtoavoidthingsthatcouldcausefurtherdamage,suchasalcohol,smokingandstress,ortoimproveyourdiet.

Treatmentmayincludemedicinestoimprovetheheartrhythm(anti-arrhythmics),orimprovethebloodflowaroundthehearttohelpreducechestpain(anti-anginals).

Yourdoctorornursewillexplainmoreaboutthetreatmentthatyouneedandcanansweranyquestionsyouhave.

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Lung problems

Asmallnumberofwomen(around1in50)developsymptomssuchasbreathlessness,adrycoughorchestpain.Thesemayoccurbecausetheradiotherapycandamagethecellsliningthelungs,causinginflammationorahardeningandthickening(fibrosis).Thisproblemappearstobeslightlymorelikelyifyou’vehadcertainchemotherapydrugsatthesametime.

Thesesymptomscandevelop2–3monthsaftertheradiotherapyhasfinished,orsometimesuptoayearlater.Thechangesareusuallytemporary,lastingamonthortwo,butoccasionallycanbecomealong-termsideeffect.

Yourriskofdevelopinglungproblemsisslightlyhigherif:

• radiotherapyisalsogiventothelymphnodesinthechestarea

• you’vehadchemotherapy.

Thesesymptomsmaybemadeworseifyoualreadyhavealungproblemsuchasasthma,orifyousmoke.

Treatment for lung problemsMostlungproblemsaretreatableandit’sunusualforthemtocontinueovertime.Treatmentdependsonexactlywhatiswrongwithyourlungsandmaysimplyinvolveadviceoncuttingdownorgivingupsmoking,andmaintainingahealthyweight.

Youmaybegiveninhalersthatcontaindrugstohelpopenuptheairways(bronchodilators).Steroidscanbegivenastabletsorinhalerstoreduceinflammation.Youmaybegivenantibioticsifyouhaveaninfectioninthelung.

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Yourdoctorornursewillexplainmoreaboutthetreatmentyouneedandwillteachyouhowtouseaninhalerifnecessary.

Effect on the bones

Ararelatesideeffectofradiotherapytothebreastisdamagetothebones,especiallytheribs.Thisaffectsfewerthan1in100womenandisslightlymorelikelyifyou’vehadcertainchemotherapydrugsatthesametime.Thebonescanbecomethinnerandmorebrittle.Ifthishappens,itcancausepainandmakeithardforyoutoliftheavyobjectsortoexercise.

It’simportanttobeawarethatthisproblemcanhappen,sothatifyouhaveanysymptomsyoucangetthemcheckedbyyourdoctor.Radiotherapydamagetothebonesisveryuncommonsoit’slikelythatifyouhaveanysymptomstherewillbeanothercause.

Treatment for bone damageTreatmentrelievesanysymptomsthatoccur.Thismayinvolvetakingpainkillersoranti-inflammatorydrugs.Sometimescalciumsupplements,vitaminD,ordrugscalledbisphosphonates,whichcanhelptostrengthenthebones,maybehelpful.

Ifyouhavepain,thiscanusuallybecontrolledwithpainkillers.Youmayalsoneedtoseeaphysiotherapistoroccupationaltherapist(OT)ifthedamagedboneismakingitdifficulttocarryoutdailyactivities.Veryoccasionally,surgerymaybesuggestedtoremovethedamagedribs.

Veryrarely,ifthebonehasbeenseverelydamaged,atreatmentknownashyperbaric oxygen therapy mayhelptopreventfurtherweakeningoftheboneandimprovesymptoms.

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Thisisanewertypeoftreatmentandtheexactbenefitsarestillbeingresearched.It’snotavailableinmanyplacesintheUK.

We can send you information about controlling cancer pain and hyperbaric oxygen therapy.

Lymphoedema in the arm

Lymphoedemaisatypeofswelling.Itcanoccuriflymphnodesinthearmpithavebeenremovedoraredamagedbyradiotherapy.Lymphfluidnormallyflowsalongthelymphvesselsandthroughthelymphnodes.Ifthelymphvesselsaredamaged,excessfluidmaybuildupinthearmcausingittoswell.

Lymphoedemacanoccurinwomenwhohadradiotherapytothearmpitaspartoftheirtreatmentforbreastcancer.It’smorecommoninwomenwho’vehadsurgerytoremovemost,orall,ofthelymphglandsintheareaunderthearmaswellasradiotherapytotheunderarm.

Lymphoedemainthearmcanalsooccurafterradiotherapytothebreastandchestwall,butthisisveryrare.

Ifyourarmisswollenbecauseoflymphoedemaitmaybecomestiff,uncomfortableandawkwardtomove.Thiscanmakedailyactivitieslikedressingdifficult.Theskinofyourarmmaybecometightandstretched.Oncelymphoedemaoccursitcanneverbecompletelycured.However,manythingscanbedonetohelpreducetheswellinganddiscomfortandallowwomentousetheirarmnormally.

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Preventing lymphoedemaIfyou’reatriskofdevelopinglymphoedema,itmayhelpnottoputtoomuchstrainonyourlymphaticsystem.Thismeanstryingtoavoidanyinfectionorinflammation,asthesecancausemorelymphfluidtobeproducedandincreasetheriskoflymphoedema.It’simportanttoavoidgettinganycutsorgrazesonyourarm.Ifyoudogetthem,useantisepticandplastersstraightawayandusemoisturisertokeepyourskinsupple.

Treating lymphoedemaIfyoudeveloplymphoedema,youwillusuallybereferredtoalymphoedemaspecialistfortreatmentandadvice.Thismaybeanurse,physiotherapistordoctor.Thetreatmentwilldependuponhowmuchlymphoedemayouhave,andaimstohelpreducetheswelling,preventfurtherswellingandrelieveanydiscomfort.Therearefourmaintypesoftreatment:

• skincare

• supportingthearmusingcompressionstockingsorbandages

• positioningandmovement,orexercisingthearm

• aparticulartypeofmassagecalledmanuallymphaticdrainage(MLD)orsimplelymphaticdrainage(SLD).

Our booklet Understanding lymphoedema has more detailed information about preventing and treating lymphoedema.

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Numbness, pain and weakness in the arm

About1in100womenwhohaveradiotherapytotheunderarmwilldevelopsomenumbnessandtinglinginthehand,weaknessinthehand,orpainaroundtheshoulder,armorhand.Thesesymptomswillusuallybemildbutveryoccasionallymaybemoresevereandtroublesome.

Thesymptomsareduetodamagetothenervesgoingintothearm,whichcansometimesoccurafterradiotherapytothearmpit.Thesenervesareknownasthebrachialplexusandthelong-termsideeffectisoftencalled radiation-induced brachial plexus neuropathy or brachial plexopathy.

Treating brachial plexopathyUsuallythisisamildsymptom.But,ifseverebrachialplexopathydevelopsitcan’tbereversed.However,treatmentscanhelptocontrolsymptomssuchaspain,andmakethepracticalaspectsoflifeeasier.

Oneoftheprioritiesoftreatmentistofindthebestwayofcontrollingthepain.Peopleoftendescribethepainas‘shooting’or‘burning’,butyoumayalsohavepinsandneedles,numbnessortightness.Therearevariouspainkillersthatmaybehelpful,dependinguponhowseverethepainis,andyourdoctorcanadviseyouaboutthese.Theymayprescribelow-doseantidepressantsorantiepilepticdrugs,asthesecanbeeffectiveincontrollingnervepain.Youmaybereferredtoaspecialistpainclinicforfurtheradvice.

Yourdoctorsmayalsosuggestothertreatments,suchasmassageorapplyingheatandcoldtothepainfulareas.AnotherpossibilityisusingaTENS(transcutaneouselectricalnervestimulation)machine.Thiscanbeveryeffectiveat

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relievingpain.Itinvolvesplacingstickypadsthatcontainelectrodesontoyourskin.Aweakelectricalcurrentispassedthroughthepads.Theelectricalcurrentcanmakethebodyreleaseitsownnaturalpainkillers(endorphins),whichcanhelpcontrolpain.

Somewomenfindacupuncturehelpful,andsomeGPorhospitalclinicsnowofferthis.Othercomplementarytherapiesmayalsobeuseful,butyoushouldalwaysdiscussthesewithyourdoctorfirst.

We can send you a booklet about cancer and complementary therapies.

Youmaybereferredtoaphysiotherapistandanoccupationaltherapist(OT).Aphysiotherapistwillhelpyoukeepyourarmasmobileandstrongaspossible.Thiswillinvolveexercisestostrengthenthemusclesandkeepthemsupple.Theywillalsobeabletoshowyouhowtouseslingsorsplintstosupportyourarm.TheOTwillassesshowthenervedamagehasaffectedtheuseofyourarm,andlookathowthisinterfereswithyourdailylife.ThephysiotherapistandOTcanthensuggestpracticalwaystohelpyoucarryonasnormallyaspossible.

Ifyouaren’tabletoworkbecauseofthedamagetoyourarm,youmaybeentitledtosomebenefits.Asocialworker,eitheratthehospitalorinthecommunity,oryourlocalJobcentrePlusofficecanadviseyouaboutthis.YoucanfinddetailsofyourlocalJobcentrePlusofficeandgetmoreinformationaboutbenefitsontheDepartmentforWorkandPensionspublicserviceswebsitedirect.gov.uk

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Our booklets, Work and cancer and Self-employment and cancer have helpful information about work, disability and financial issues. We can also send you a copy of Help with the cost of cancer.

Radiation-induced second cancers

Thisisaveryrarelong-termproblemfollowingradiotherapyforsometypesofcancer,includingcancerofthebreast.Lessthan1in1,000womenwilldevelopasecondcancer,suchasasarcoma,withinthetreatmentarea.Thiscanoccurmanyyearslater.Secondcancersareveryrarebutanynewsymptomsshouldalwaysbecheckedwithyourdoctor.

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Yourfeelings

Your feelings

Youmayhaveallkindsofemotionsifyouarediagnosedashavingdamagecausedbyyourradiotherapytreatment.Radiotherapydamageisuncommonanditcantakealongtimetofindoutthattheproblemisrelatedtoradiotherapy.Youmayfeelangryaboutthis.Youmayberelievedthatyounowknowthereasonsforyoursymptoms,orfeelcheatedthatyouhavesurvivedcanceronlytobedamagedbythetreatment.Youmaybeworriedabouthowyouwillcopewithanydisability,orworriedaboutmoneyproblemsifyouhavetogiveupwork.

Theseareallnormalreactionsandpartoftheprocessthatmanywomengothrough.Everyonehastheirownwayofcoping.Somewomenfindithelpfultotalktofriendsorfamilymembers,whileothersprefertoseekhelpfrompeopleoutsidetheirsituation,suchascounsellors.Manypeoplefindsupportthroughonlineforumswheretheycanshareexperienceswithothersinasimilarsituation.Othersprefertokeeptheirfeelingstothemselves.Thereisnorightorwrongwaytocope,buthelpisthereifyouneedit.

Anumberoforganisationsandsupportgroupscanhelpandsupportyou.Ourcancersupportspecialistscangiveyoudetailsofthosethatarelocaltoyou.

Our booklet The emotional effects of cancer discusses the feelings you may experience and has advice on how to cope with them.

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Howwecanhelpyou

Canceristhetoughestfightmostofuswilleverface.Butyoudon’thavetogothroughitalone.TheMacmillanteamiswithyoueverystepoftheway.

Get in touch

Macmillan Cancer Support 89AlbertEmbankment,LondonSE17UQQuestions about cancer? Callfreeon0808 808 00 00 (Mon–Fri,9am–8pm)www.macmillan.org.ukHard of hearing?Usetextphone08088080121orTextRelay.Non-English speaker? Interpretersareavailable.

Clear, reliable information about cancer

Wecanhelpyoubyphone,email,viaourwebsiteandpublicationsorinperson.Andourinformationisfreetoeveryoneaffectedbycancer.

Macmillan Support Line Ourfree,confidentialphonelineisopenMonday–Friday,9am–8pm.Ourcancersupportspecialistsprovideclinical,financial,emotionalandpracticalinformationandsupporttoanyoneaffectedbycancer.Calluson0808 808 00 00 oremailusviaourwebsite,macmillan.org.uk/talktous

Information centresOurinformationandsupportcentresarebasedinhospitals,librariesandmobilecentres,andofferyoutheopportunitytospeakwithsomeoneface-to-face.Findyournearestoneatmacmillan.org.uk/informationcentres

How we can help you

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PublicationsWeprovideexpert,up-to-dateinformationaboutdifferenttypesofcancer,testsandtreatments,andinformationaboutlivingwithandaftercancer.Wecansendyoufreeinformationinavarietyofformats,includingbooklets,leaflets,factsheets,andaudioCDs.WecanalsoprovideourinformationinBrailleandlargeprint.

Youcanfindallofourinformation,alongwithseveralvideos,onlineatmacmillan.org.uk/cancerinformation

Review our informationHelpusmakeourresourcesevenbetterforpeopleaffectedbycancer.Beingoneofourreviewersgivesyouthechancetocommentonavarietyofinformationincludingbooklets,factsheets,leaflets,videos,illustrationsandwebsitetext.

Need out-of-hours support? Youcanfindalotofinformationonourwebsite,macmillan.org.ukFormedicalattentionoutofhours,pleasecontactyourGPfortheirout-of-hoursservice.

Someone to talk to

Whenyouorsomeoneyouknowhascancer,itcanbedifficulttotalkabouthowyou’refeeling.Youcancallourcancersupportspecialiststotalkabouthowyoufeelandwhat’sworryingyou.

Wecanalsohelpyoufindsupportinyourlocalarea,soyoucanspeakface-to-facewithpeoplewhounderstandwhatyou’regoingthrough.

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Howwecanhelpyou

Professional help

OurMacmillannurses,doctorsandotherhealthcareandsocialcareprofessionalsofferexperttreatmentandcare.Theyhelpindividualsandfamiliesdealwithcancerfromdiagnosisonwards,untiltheynolongerneedthishelp.

YoucanaskyourGP,hospitalconsultant,districtnurseorhospitalwardsisterifthereareanyMacmillanprofessionalsavailableinyourarea,orcallus.

Support for each other

Nooneknowsmoreabouttheimpactcancerhasonaperson’slifethanthosewhohavebeenaffectedbyitthemselves.That’swhywehelptobringpeoplewithcancerandcarerstogetherintheircommunitiesandonline.

Support groupsYoucanfindoutaboutsupportgroupsinyourareabycallingusorbyvisitingmacmillan.org.uk/selfhelpandsupport

Online communityYoucanalsoshareyourexperiences,askquestions,getandgivesupporttoothersinouronlinecommunityatmacmillan.org.uk/community

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Financial and work-related support

Havingcancercanbringextracostssuchashospitalparking,travelfaresandhigherheatingbills.Somepeoplemayhavetostopworking.

Ifyou’vebeenaffectedinthisway,wecanhelp.CalltheMacmillanSupportLineandoneofourcancersupportspecialistswilltellyouaboutthebenefitsandotherfinancialhelpyoumaybeentitledto.

Wecanalsogiveyouinformationaboutyourrightsatworkasanemployee,andhelpyoufindfurthersupport.Macmillan Grants Moneyworriesarethelastthingyouneedwhenyouhavecancer.AMacmillanGrantisaone-offpaymentforpeoplewithcancer,tocoveravarietyofpracticalneedsincludingheatingbills,extraclothing,oramuchneededbreak.

Findoutmoreaboutthefinancialandwork-relatedsupportwecanofferatmacmillan.org.uk/financialsupport

Learning about cancer

Youmayfinditusefultolearnmoreaboutcancerandhowtomanagetheimpactitcanhaveonyourlife.

YoucandothisonlineonourLearnZone–macmillan.org.uk/learnzone–whichoffersavarietyofe-learningcoursesandworkshops.There’salsoasectiondedicatedtosupportingpeoplewithcancer–idealforpeoplewhowanttolearnmoreaboutwhattheirrelativeorfriendisgoingthrough.

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Otherusefulorganisations

Breast Cancer Care5–13GreatSuffolkStreet,Southwark,LondonSE10NSHelpline08088006000(Mon–Fri,9am–5pm,Sat,9am–2pm)Tel (admin)08450920800Tel (text)08088006001Emailinfo@breastcancercare.org.ukwww.breastcancercare.org.ukProvidesinformation,practicalhelpandemotionalsupporttoanyoneaffectedbybreastcancer.Specialistbreastcarenursesrunthehelpline.TheLavenderTrustalsorunsfromBreastCancerCare,offeringinformationandsupportspecificallyforyoungerwomenwithbreastcancer.

Lymphoedema Support NetworkStLuke’sCrypt,SydneyStreet,LondonSW36NHInfo and support line 02073514480Email [email protected]

www.lymphoedema.orgAnationalcharitythatprovidesinformationandsupporttopeopleaffectedbylymphoedema.

RAGE (Radiotherapy Action Group Exposure)Tel01892557804Email janice.millington@btinternet.comwww.rage.webeden.co.ukForwomenwhohavesurvivedbreastcancerbuthavebeendamagedbyradiotherapytreatment.

General cancer and support organisations

Cancer Black Care 79ActonLane,LondonNW108UTTel02089614151(Mon–Fri,9.30am–4.30pm)Email [email protected] Offersarangeofinformationandsupportforpeoplewithcancerfromethnic

Other useful organisations

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communities,theirfriends,carersandfamilies.WelcomespeoplefromdifferentethnicgroupsincludingAfrican,Asian,TurkishandWestIndiancommunities.

Irish Cancer Society43–45NorthumberlandRoad,Dublin4,IrelandCancer Helpline1800200700(Mon–Thurs,9am–7pm,Fri,9am–5pm)[email protected] OperatesIreland’sonlyfreephonecancerhelpline,whichisstaffedbyqualifiednursestrainedincancercare

Maggie’s Centres 8NewtonPlace,GlasgowG37PRTel03001231801Emailenquiries@maggiescentres.orgwww.maggiescentres.org Locatedthroughoutthecountry,Maggie’sCentresareplacestoturntoforanyoneaffectedbycancer.Youcanaccessinformation,benefitsadvice,andemotionalorpsychologicalsupportfree

ofchargeandunderoneroof.Youdon’thavetomakeanappointmentorbereferred.

Tak Tent Cancer Support – Scotland Flat5,30ShelleyCourt,GartnavelComplex,GlasgowG120YNTel01412110122Emailtaktent4u@gmail.comwww.taktent.org Offersinformationandsupportforcancerpatients,families,friendsandhealthprofessionals.RunsanetworkofmonthlysupportgroupsacrossScotland.Alsoprovidescounsellingandcomplementarytherapies.Tenovus9thFloor,GleiderHouse,TyGlasRoad,Llanishen,CardiffCF145BDFreephone helpline [email protected] BasedinWales,Tenovusprovidesarangeofservicestopeoplewithcancerandtheirfamilies,including

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Otherusefulorganisations

counsellingandafreephonecancerhelpline.

The Ulster Cancer Foundation 40–44EglantineAvenue,BelfastBT96DXFreephone helpline08007833339Helpline [email protected]@ulstercancer.orgwww.ulstercancer.org Providesarangeofservicestopeoplewithcancerandtheirfamilies,includingafreetelephonehelpline,whichisstaffedbyspeciallytrainednurseswithexperienceincancercare.

Support for carers

Carers UK 20GreatDoverStreet,LondonSE14LXTel02073784999Carers line 08088087777(WedandThurs,10am–12pmand2–[email protected]

Offersinformationandsupporttocarers.Canputpeopleincontactwithsupportgroupsforcarersintheirarea.HasnationalofficesforScotland,WalesandNorthernIreland:

Carers Scotland TheCottage,21PearceStreet,GlasgowG513UTTel01414453070Emailinfo@carerscotland.orgwww.carerscotland.org

Carers Wales RiverHouse,YnsbridgeCourt,Gwaelod-y-Garth,CardiffCF159SSTel02920811370Emailinfo@carerswales.orgwww.carerswales.org

Carers Northern Ireland 58HowardStreet,BelfastBT16PJTel02890439843Emailinfo@carersni.orgwww.carersni.org

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Financial and legal advice

Benefit Enquiry Line2ndFloor,RedRoseHouse,LancasterRoad,Preston,LancsPR11HBTel0800882200Textphone0800243355EmailBEL-Customer-Services@dwp.gsi.gov.ukwww.direct.gov.uk/en/Dl1/Directories/DG_10011165 Providesadviceaboutbenefits,andcanalsoprovidehelptocompletesomedisabilityrelatedclaimpacks.

Citizens Advice Bureau Findcontactdetailsforyourlocalofficeinthephonebookoratcitizensadvice.org.uk FindadvicefortheUKonline,inarangeoflanguages,atadviceguide.org.ukCitizensAdviceBureausprovidefree,confidential,independentadviceonavarietyofissuesincludingfinancial,legal,housingandemployment.Citizens Advice Scotlandwww.cas.org.uk

Further resources

Audiotapes and CDs

Ourhigh-qualityaudiomaterials,basedonourrangeofbooklets,includeinformationaboutcancertypesanddifferenttreatments.Theyalsogiveadviceaboutlivingwithcancer.

ToorderyourfreeCDortapevisit be.macmillan.org.ukorcall0808 808 00 00.

Useful websites

Alotofinformationaboutcancerisavailableontheinternet.Somewebsitesareexcellent,othershavemisleadingorout-of-dateinformation.Thesiteslistedonthefollowingpagesareconsideredbynursesanddoctorstocontainaccurateinformationandareregularlyupdated.

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Furtherresources

Macmillan Cancer Support www.macmillan.org.uk Findoutmoreaboutlivingwiththepractical,emotionalandfinancialeffectsofcancer.Ourwebsitecontainsexpert,accurateandup-to-dateinformationoncanceranditstreatments,including:

• our100+booklets,300+factsheets,andcancerQ&As

• howMacmillancanhelp,theservicesweofferandwheretogetsupport

• howtocontactourcancersupportspecialists,includinganemailformforsendingyourquestions

• localsupportgroupssearch,linkstoothercancerorganisationsandadirectoryofinformationmaterials

• ahugeonlinecommunityofpeopleaffectedbycancersharingtheirexperiences,adviceandsupport.

www.cancer.gov (National Cancer Institute – National Institute of Health – USA)Givescomprehensiveinformationoncancerandtreatments.

www.cancer.org (American Cancer Society)Nationwidecommunity-basedvoluntaryhealthorganisationdedicatedtoeliminatingcancerasamajorhealthproblem.Itaimstodothisthroughresearch,education,advocacyandservice.

www.cancerhelp.org.uk (Cancer Research UK)Containspatientinformationonalltypesofcancerandhasaclinicaltrialsdatabase.

www.healthtalkonline.org www.youthhealthtalk.org (site for teens and young adults) Bothwebsitescontaininformationaboutsomecancersandhavevideoandaudioclipsofpeopletalkingabouttheirexperiencesofcanceranditstreatments.

32


www.nhs.uk (NHS Choices)NHSChoicesistheonline‘frontdoor’totheNHS.Itisthecountry’sbiggesthealthwebsiteandgivesalltheinformationyouneedtomakechoicesaboutyourhealth.

www.nhsdirect.nhs.uk (NHS Direct Online)NHShealthinformationsiteforEngland–coversallaspectsofhealth,illnessandtreatments.

www.nhsdirect.wales.nhs.uk (NHS Direct Wales)

www.nhs24.com (NHS 24 in Scotland)

www.patient.co.uk (Patient UK)Aimstoprovidenon-medicalpeopleintheUKwithgood-qualityinformationabouthealthanddisease.Includesevidence-basedinformationleafletsonawiderangeofmedicalandhealthtopics.Alsoreviewsandlinkstomanyhealthandillnessrelatedwebsites,someofwhichareoverseas.

www.riprap.org.uk (Riprap) Developedespeciallyforteenagerswhohaveaparentwithcancer.

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Questions you might like to ask your doctor or nurse

Youcanfillthisinbeforeyouseethedoctorornurse,andthenuseittoremindyourselfofthequestionsyouwanttoask,andtheanswersyoureceive.

1.

Answer

2.

Answer

3.

Answer

4.

Answer

5.

Answer

6.

Answer

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Disclaimer

Wemakeeveryefforttoensurethattheinformationweprovideisaccuratebutitshouldnot

bereliedupontoreflectthecurrentstateofmedicalresearch,whichisconstantlychanging.

Ifyouareconcernedaboutyourhealth,youshouldconsultadoctor.Macmillancannot

acceptliabilityforanylossordamageresultingfromanyinaccuracyinthisinformationor

thirdpartyinformationsuchasinformationonwebsitestowhichwelink.Wefeaturereallife

storiesinallofourarticles.Somephotographsareofmodels.

Thanks

Thisbooklethasbeenwritten,revisedandeditedbyMacmillanCancerSupport’s

informationdevelopmentnursesandeditorialteam.Ithasbeenapprovedbyourmedical

editor,DrTerryPriestman,ConsultantClinicalOncologist.Withthanksto:MorvenAngus,

BreastSpecialistNurse;ProfessorMichaelDixon,ConsultantSurgeonandSeniorLecturer;

VickiHarmer,SpecialistBreastCareAdvisor;DrDavidMorgan,ConsultantClinical

Oncologist;andthepatientreviewers.

Sources

FaithfullS,WellsM.Supportive Care in Radiotherapy. 2003. ChurchillLivingstone.

Chaoetal.Radiation Oncology: Management Decisions. 2ndedition.2002.Lippincott

WilliamsandWilkins.

DoneganWL,SprattJS.Cancer of the Breast. 5thedition. 2002. WBSaunders.

UpToDateOnline.Techniquesandcomplicationsofbreastandchestwallirradiationfor

earlystagebreastcancer.www.uptodate.com(accessed5May2010).

UpToDateOnline.Cardiotoxicityofradiationtherapyformalignancy.www.uptodate.com

(accessed5May2010).

5 waysyou can hElP

somEonE withcancer

Share your cancer experience Supportpeoplelivingwithcancerbytellingyourstory,online,inthemediaorface-to-face.

Campaign for change Weneedyourhelptomakesureeveryonegetstherightsupport.Takeanaction,bigorsmall,forbettercancercare.

Help someone in your community Alifttoanappointment.Helpwiththeshopping.Orjustacupofteaandachat.Couldyoulendahand?

Raise money Whateveryoulikedoing,youcanraisemoneytohelp.Takepartinoneofoureventsorcreateyourown.

Give money Bigorsmall,everypennyhelps.Tomakearegularorone-offdonation–seeover.

Call us to find out more

0300 1000 200macmillan.org.uk/getinvolved

Can you do something to help?We hope this booklet has been useful to you. It’s just one of our many publications that are available free to anyone affected by cancer. They’re produced by our cancer information specialists who, along with our nurses, benefits advisers, campaigners and volunteers, are part of the Macmillan team. When people are facing the toughest fight of their lives, we’re there to support them every step of the way.

We want to make sure no one has to go through cancer alone, so we need more people to help us. When the time is right for you, here are some ways in which you can become a part of our team.

Pleasecutoutthisformandreturnitinanenvelope(nostamprequired)to:SupporterDonations,MacmillanCancerSupport,FREEPOSTLON15851,89AlbertEmbankment,LondonSE17UQ

Please fill in your personal details Mr/Mrs/Miss/Other

Name

Surname

Address

Postcode

Phone

Email

Pleaseacceptmygiftof£

(Pleasedeleteasappropriate)Iencloseacheque/postalorder/CharityVouchermadepayabletoMacmillanCancerSupport

ORdebitmy:Visa/MasterCard/CAFCharityCard/Switch/Maestro

Cardnumber

££££ ££££££££ ££££Validfrom Expirydate

££££ ££££Issueno Securitynumber

£££ £££Signature

Date / /

Don’t let the taxman keep your moneyDoyoupaytax?Ifso,yourgiftwillbeworthalmostathirdmoretous–atnoextracosttoyou.Allyouhavetodoiswriteyournamebelow,andthetaxofficewillgive25pforeverypoundyougive.

£IamaUKtaxpayerandIwouldlikeMacmillanCancerSupporttotreatalldonationsIhavemadeforthesixyearspriortothisyearandalldonationsImakeinfutureasGiftAiddonations,untilInotifyyouotherwise.

I understand that I must pay an amount of Income Tax and/or Capital Gains Tax for each tax year (6 April one year to 5 April the next) that is at least equal to the amount of tax that Macmillan will reclaim on my gifts for that tax year.

Macmillan Cancer Support and our trading companies would like to hold your details in order to contact you about our fundraising, campaigning and services for people affected by cancer. If you would prefer us not to use your details in this way please tick this box. o

In order to carry out our work we may need to pass your details to agents or partners who act on our behalf.

If you’d rather donate online, go to macmillan.org.uk/donate

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#

Cancer is the toughest fight most of uswill ever face. If you or a loved one hasbeen diagnosed, you need a team ofpeople in your corner, supporting youevery step of the way. That’s who we are.

We are the nurses and therapists helping you through treatment. The experts on the end of the phone. The advisers telling you which benefits you’re entitled to. The volunteers giving you a hand with the everyday things. The campaigners improving cancer care. The community supporting you online, any time. The fundraisers who make it all possible.

You don’t have to face cancer alone.We can give you the strength to get through it. We are Macmillan Cancer Support.

Questions about living with cancer? Call free on 0808 808 00 00 (Mon–Fri, 9am–8pm)

Alternatively, visit macmillan.org.uk

Hard of hearing? Use textphone 0808 808 0121, or Text Relay. Non-English speaker? Interpreters available.

© Macmillan Cancer Support, 2010. 3rd edition. MAC11681. Next planned review 2012. Registered charity in England and Wales (261017), Scotland (SC039907) and the Isle of Man (604).

Printed using sustainable material. Please recycle.

Documents

A practical guide to tests and treatments bReAST › Downloads › CancerInformation › ... · 2016-05-05 · Breast swelling A few women will develop swelling of the breast area