Health Take-Away: As more survive breast cancer, a new journey begins
Berkshire Eagle – Monday, October 14, 2019

By Kathy Hart and Amanda Bayliss

Thanks to early detection through annual mammograms and steady advances in treatment, millions of patients who would have lost their lives to breast cancer are surviving the disease. But with survival comes another big hurdle — dealing with the physical and emotional realities of survivorship.

Completing treatment for breast cancer can be bittersweet. Patients are relieved to be done with that phase, but often have conflicting feelings. After months of appointments and treatments, they may feel a void and wonder who's going to watch over them now. They worry the cancer will return and about lingering short- and potential long-term effects.

Cancer survivors require comprehensive, coordinated follow-up care, not only for their medical and physical recovery, but to address emotional issues like depression, anxiety, body image, sexual function and interpersonal relationships. Financial and work-related concerns also loom large.

Cancer survivorship is a day-to-day, never-ending process that begins with your diagnosis and continues through treatment, recovery and the rest of your life. It's about living with, through and beyond cancer. It includes people who are cancer-free and those who continue to have treatments to either reduce risk of recurrence or manage chronic disease.

Today there are more than 3.5 million breast cancer survivors in the U.S., including patients still being treated and those who have completed treatment. In 2019, there will be an estimated 271,270 new cases of invasive breast cancer diagnosed in women and 2,670 in men.

Whether you're among those newly diagnosed, in treatment or post, here's a checklist to improve your prospects for a successful outcome:

- Shared decision-making. Have a family member or friend attend appointments with you for support, to ask questions, take notes. Get a full explanation of your diagnosis and prognosis. Tell your doctors what's most important to you, so your goals are included your treatment plan. Discuss treatment options, including the benefits and side effects. If you want a second or third opinion, get them.

- Treatment and post-treatment planning Ask for a clearly written plan of care, including: Frequency of treatments and tests, side effects and how to manage them, any disruptions to expect for work, family, other responsibilities, resources to better understand your diagnosis and treatment, how to contact your care team, involvement of caregivers.

For post-treatment, have them address what recovery will be like, any physical or emotional concerns you have, short- and long-term side effects and what to do if symptoms arise, screening for recurrence or new cancers and diet, exercise and other recommendations.

- Ongoing health care during and after treatment. Ask if you will need someone to drive you to treatments. Schedule all necessary appointments and get a copy.

For post -treatment, discuss who will manage your care — your oncology doctor, your primary or both. How will it be coordinated?

- Emotional/mental health issues. During and following treatment, discuss your emotional or psychological concerns. Ask for support or counseling for emotional, sexual or relationship issues. Identify support groups; many patients find sharing their experience with others is key to recovery.

- Financial health. Get full information on costs of treatment. Discuss any financial or insurance concerns. Ask for resources for support, if needed. Talk to your employer if you need time off. Ask about your rights under the Family and Medical Leave Act.

- Caregivers. Ask how caregivers can get help or training to care for you at home.

Surviving breast cancer is a journey you need not take alone. Rely on your care providers, family, friends and fellow patients to help you through this life-changing experience.

Kathy Hart, RN, is manager of care navigation services at the BMC Cancer Center in Pittsfield, where Amanda Bayliss, MS, is a certified cancer and exercise trainer and strength and conditioning specialist.