After you complete breast cancer treatment, you might experience some longer-term side effects of certain treatments, including:
Talk to your healthcare team about any symptoms you have during your follow-up visits, so they can help you manage them.
Give yourself and your body time to recover from the physical and emotional impact of treatment. It’s important to take care of your health and wellbeing after treatment, including through:
- getting plenty of physical activity within your ability
- eating a healthy diet
- avoiding alcohol and tobacco.
If you have been using complementary therapies, you may wish to continue complementary therapies even after treatment to help improve your wellbeing.
Read more about living well after cancer.
Fatigue
Fatigue is one of the most common side effects of cancer treatment.
People usually describe fatigue as feeling tired, weak or exhausted. Yet it’s a different kind of tiredness – one that doesn’t go away after a good rest or nap. Fatigue can be caused by the physical effects of treatments, such as chemotherapy or radiotherapy. It can also be a result of the emotional impact of diagnosis and treatment for breast cancer.
It’s important for women not to push themselves. With time and rest, energy levels will gradually return to normal. The important thing to remember is that fatigue will improve with time.
Some women worry that others will expect them to bounce back once treatment is over and that they shouldn’t complain about being tired. However, fatigue can be a significant issue for many women and it’s important that women and those close to them to acknowledge it and adjust their activities accordingly.
How long will fatigue last?
For some people, fatigue is mild and temporary. For others, it lasts months after treatment and makes going about daily activities impossible. Some women find they can only do one or two things before feeling exhausted when they would usually have been able to do many more tasks in a day. This can be very frustrating.
If you're feeling fatigued, talk with your doctor about what factors might be causing your fatigue and what you can do to improve your symptoms.
Tips to help with fatigue
While you may not be able to avoid fatigue completely, thereare things you can do to conserve your energy and make the most of the energy you do have. It'simportant that you are guided by what your body tells you and build any new activities slowly.
- Exercise: A normal reaction to feeling tired is to rest. Although it may not be what you’d expect, regular exercise can help you to feel less tired. Research shows that exercise is effective in reducing cancer-related fatigue after cancer treatment. Try going for a short walk or find a gentle yoga or tai chi class – this will help to gradually restore your energy without exhausting you. Some women find that more strenuous exercise is also helpful.
- Get enough sleep: But don't overdo it. Try listening to a guided relaxation CD as you’re falling asleep. This can help you to rest more deeply. You can find these sorts of CDs at your local library. If you feel tired during the day, it’s OK to take short naps (no longer than an hour) but try not to rest for long periods – to avoid not sleeping well at night.
- Ask for help: Don’t think you have to do everything yourself. See if friends and family can help with things like shopping, cleaning or running errands.
- Don’t overdo it: Save your energy for the things you enjoy by taking breaks when you need to and rest before you get too tired.
- Make lists: Lists can be a great way of helping you remember what needs doing and can stop you worrying.
- Take the load off: You can be resting even while you’re doing things. Sit down while you’re talking on the phone, chopping up vegetables, or ironing. If you have young children, try to play with them sitting or lying down with board games, puzzles or drawing.
- Plan ahead: Don’t do too much in one day or at times of the day when you know you’ll feel tired. Try not to rush and leave plenty of time to get to where you need to go. Don’t do the shopping during busy times. Keep track of when you feel best and schedule activities for these times.
- Eat well: Maintain your energy by eating a varied and healthy diet.
Insomnia and disrupted sleep
Many women experience insomnia and disturbed sleep after breast cancer. People with insomnia or disrupted sleep have difficulty getting to sleep or staying asleep. Disrupted sleep can cause fatigue and tiredness. People’s experience of ‘a good night’s sleep’ varies. People often describe disrupted sleep as having trouble sleeping, dissatisfaction with quality of sleep, and feeling tired during the day.
Not being able to fall asleep or stay asleep can be upsetting and frustrating. Feeling anxious about trying to get enough sleep can add to the stress and difficulty of falling asleep.
Tips to help with disrupted sleep
- Before bed, avoid caffeine-based drinks, alcohol, and other stimulants like cigarettes. If you’re used to having a bedtime drink, try a non-stimulating herbal tea, like chamomile.
- Use the bedroom for sleep only – no TV or written work (sex is fine!).
- Establish a regular bedtime and waking routine – it’s OK to take short naps (no longer than an hour) during the day, but try not to rest for long periods, to avoid not sleeping well at night.
- Don’t exercise strenuously before bedtime.
- Only go to bed if you are sleepy.
- If you can’t sleep, get up and do something else until you feel sleepy again.
- Try controlled breathing – deep slow abdominal breathing.
- Consider asking your general practitioner for a short-term mild sedative.
If you’re having trouble sleeping, or you regularly wake up feeling anxious or worried, talk to your doctor. Treatments are available that can help.
Lymphoedema
Lymphoedema usually develops gradually and can occur months or even years after treatment is finished. There’s no known cure for lymphoedema, but it can be managed with appropriate care.
Lymphoedema after breast cancer is caused by damage to or removal of lymph nodes from the armpit or breast area. Lymph nodes may be damaged by radiotherapy or surgery as treatment for breast cancer. The risk seems to be higher for people who have several lymph nodes removed and for those who have both surgery and radiotherapy to the lymph nodes. However, many people who have lymph nodes removed and radiotherapy to the armpit don’t develop the condition.
Current evidence suggests that around one in five women treated for breast cancer will develop lymphoedema.
Find out more
Menopause
A number of treatments for breast cancer can cause menopause.
These effects can be temporary or permanent.Symptoms of menopause include:
- hot flushes
- sleep disturbance
- vaginal dryness and/or discharge
- a decrease in libido or sex drive
- no menstrual periods, or irregular menstrual periods.
Women who have reached menopause are also at risk of developing osteoporosis. Osteoporosis is the thinning of the bones that can lead to bone pain and fractures.
Find out more
Pain
Some women experience pain or discomfort after treatment for breast cancer has finished.
This may continue weeks to years after treatment. After breast cancer treatment has finished women may experience muscle stiffness, joint pain, pain from surgery scars, numbness, and general aches and pains. Some women also feel pain in a breast after it has been removed. This is called ‘phantom pain’. Phantom pain is real and you are not imagining it.
Many women think that telling others that they are in pain means that they are complaining or being a nuisance. However, it is important that you do not put up with pain. You should report any pain to your doctor even if it is minor. Your doctor can investigate the cause of your pain and recommend appropriate pain relief or provide reassurance.
If you have pain after treatment has finished talk to your doctor. You doctor will be able to assess if this requires treatment.
Diet
Diet is an important part of looking after yourself after your cancer treatment ends.
There’s a lot of information in the media about different foods and diets that are good for cancer and this can be overwhelming. It can be difficult to know what to eat and what to avoid.
A healthy, balanced diet with a range of fresh food from the five major food groups is recommended.
More information about healthy eating and cancer
Several State and Territory Cancer Councils produce booklets about diet and cancer (call the Cancer Council Helpline on 13 11 20).
You can also get detailed advice on your particular needs from an accredited, practising dietitian.
Exercise
Regular activity is an important part of staying healthy after treatment for breast cancer. Health professionals may suggest that a woman joins an exercise class after treatment for breast cancer, especially if the woman has fatigue.
Exercise is one of the ways of supporting the body to recover after cancer treatment and it’s also a good way of keeping spirits up in the post-treatment period. Studies have shown exercise boosts the immune system and increases energy levels.
Some women are given upper body and arm stretches by a hospital physiotherapist. Doing these regularly in the first few months will help to reduce the arm or shoulder stiffness. Gentle exercise can help both in the prevention and management of lymphoedema.
It’s important to get advice from a health professional before starting a new exercise program and to start slowly and build strength and stamina gradually.
More recent studies have demonstrated promising results suggesting that actively participating in moderate exercise at least 5 times a week can reduce the risk of recurrence from breast cancer.
Tips for maintaining regular exercise
- Start small and build up. Be gentle, particularly in the weeks just after treatment. Start with some slower forms of exercise like tai chi, gentle yoga, walking or aqua-aerobics.
- Do something you enjoy. It’s no good jogging if you hate it!
- Try something new. As your energy starts to return, try something you’ve always wanted to do but never got a chance – flamenco dancing or joining a bush walking club.
- Find an exercise partner. Find a friend or relative who wants to exercise too and make plans to do it together.
- Set yourself clear goals. And decide on a reward if you reach your goals (choose a reward that will be sure to motivate you).
- Join a class. It can be hard to stay motivated on your own – it really helps to join a class or a group.
Find out more
- The Encore program provided through the YWCA is an exercise program specifically for women who have had breast surgery.
- Breast Cancer Network Australia (BCNA) has a Breast Cancer and Exercise booklet available to help women diagnosed with breast cancer to exercise regularly and can be ordered free-of-charge from BCNA by calling 1800 500 258 or downloaded from www.bcna.org.au.
