Common side effects and coping tips

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Hot flashes are one of the most common side effects of hormonal treatment, and have a lot to do with the hormonal changes within your body. These changes can be caused by menopause and medication, and may be influenced by lifestyle.

Here are some common hot-flash triggers

• Alcohol
• Spicy foods
• Diet pills
• Hot tubs
• Hot showers
• Hot food
• Caffeine
• Hot rooms
• Saunas
• Smoking

Coping tips:

It may help to write down when your hot flashes occur, and what you were eating, doing, and feeling at the time. That way, you can start to figure out what things trigger your hot flashes — and try to avoid them if you can.

Talk to your doctor about certain medications that reduce hot-flash triggers inside the brain. They may be an option that’s right for you.

You may also want to try adjusting the timing of your hormonal treatment. Start by figuring out how much time passes from when you take your hormonal treatment to your hot flash. You can then choose to take your pill at a time that leads to a hot flash at the least inconvenient time.

Many women find that stress is one of the most common triggers of hot flashes. To help avoid being stressed out, try these ideas

• Take more time to plan work, shopping, or outings
• Give yourself a chance to relax and cool off when you have a busy schedule
• Plan your schedule to avoid stressful situations at times of the day when you’re most likely to be in a sweat
• Ask for the help you need from family members or friends to keep things manageable

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Certain cancer treatments, such as surgery, radiation, and chemotherapy, can change the way your body responds to food. You may, for example, experience symptoms of nausea and vomiting, or changes in taste, smell, or bowel habits, as a result of these treatments. While symptoms are usually temporary, you may need to adjust what, when, and how you eat to keep up your strength during treatment.

Coping tips:

On days when you simply can’t bring yourself to eat, don’t worry. Just do what you can to make yourself feel better and get back to eating as soon as you can. If your appetite doesn’t return in a few days, talk to your doctor. Specific medications may help. Let your doctor know if nausea/vomiting is interfering with your daily activities. He or she can discuss treatment options.

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Some women taking ARIMIDEX may experience joint pain.

Sometimes this joint pain is the result of taking hormonal treatment, like aromatase inhibitors, and sometimes it can be a result of a pre-existing joint condition.

Coping tips:

• Talk to your doctor to discuss treatment options, such as over-the-counter pain relievers like acetaminophen or prescription pain relievers.
• Apply a little heat. Try using a heat pack or taking a hot shower

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Postmenopausal women in general may be at increased risk for bone loss (osteoporosis). Certain hormonal treatments for breast cancer can increase this risk. Chemotherapy can also increase this risk by decreasing estrogen levels in your body. The impact breast cancer can have on your bones depends on several factors, including

• How strong your bones were before you were diagnosed with breast cancer
• Which type of breast cancer treatments you receive
• Your menopausal status

Coping tips:

• Make sure you eat a balanced diet full of calcium and vitamin D
• Weight-bearing exercise, such as walking, can help. Consider doing it with a friend to help stay motivated. Talk to your doctor before starting any exercise program
• Avoid smoking and limit your alcohol consumption

Ask your doctor to do a bone mineral density (BMD) test to help determine if you are at risk for osteoporosis.

In a clinical study of postmenopausal women with early breast cancer, women taking ARIMIDEX had a decrease in bone mineral density compared to when they started the study.

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Even if you and your doctor have discussed the possibility of losing your hair, it can still make you feel uneasy.

Coping tips:

Here are some things you can do to help prepare

• Ask your doctor or nurse if and when your hair might start to fall out, and how much you should expect to lose
• Go for a short haircut before you start treatment. It’s easier to style and can help you adjust more easily to losing hair
• Use mild shampoos and soft hairbrushes to protect your hair as it starts to thin
• If you plan to wear a wig and want it to match your natural hair color, shop for it before treatment begins
• Find a funky hat, comfy turban, or scarf — try on a bunch until you find a look that makes you feel most comfortable

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Sometimes breast cancer treatment can cause weight gain or loss.

Coping tips:

• Keep track of your weight and eating patterns in a journal so you can talk about any concerns with your treatment team
• If you’re losing weight, a dietitian or nutritionist can offer specific advice on how to healthfully increase your intake of high-calorie foods and protein. These may also help you regain energy
• If you’re gaining weight, your doctor may advise lowering the fat and calories in your diet and increasing exercise. Research shows that a regular program of moderate exercise, such as walking or swimming a few times a week, offers benefits both during and after cancer treatment

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Treatment-related fatigue can be physically and mentally draining.

Unlike normal tiredness — relieved by rest, exercise, or a good night’s sleep — fatigue brought on by cancer treatments can leave you feeling "wiped out," even after getting plenty of rest. It may also make it hard to concentrate or think clearly.

Coping tips:

Don’t overdo it. Be aware of your energy levels and pace yourself accordingly. Listening to your body can help you carve out “windows of opportunity” for important activities.

If you can’t beat fatigue with rest or moderate activity, talk to your doctor. Treatment-related fatigue can also be related to anemia — a manageable condition that occurs when your red blood cell count is low.

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Vaginal dryness caused by cancer therapy can be uncomfortable. If you are sexually active, this condition may make it more difficult to relax, and as a result, intercourse may not be as enjoyable.

Coping tips:

• Try a water-based vaginal lubricant or moisturizer. These products are available without a prescription. Avoid petroleum jelly, which can increase the risk of vaginal infection as well as damaging condoms.
• Ask your oncology nurse if samples are available
• Help yourself relax by setting the mood with candlelight and soft music

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Some women who have had breast cancer that affected the lymph nodes may develop lymphedema. This is a swelling of the arm that is caused by an accumulation of lymphatic fluid. It sometimes occurs after surgery or radiation treatment for breast cancer. Some warning signs include redness, swelling, rash, and pain.

Coping tips:

These precautions may help you avoid or manage lymphedema

• Avoid using your affected arm to lift or carry shopping bags, large purses, or other heavy objects
• Wear gloves when gardening or washing dishes to protect yourself from infection
• Apply moisturizing cream to the arm daily, especially after bathing
• Avoid wearing anything tight on the affected arm, including clothing, watchbands, or bracelets
• Use your unaffected arm for blood tests, injections, and blood pressure checks whenever possible
• Keep your affected arm elevated when possible and when resting
• Wear a compression sleeve to help pooling fluid drain
• Ask about massage or physical therapy for the affected arm
• Perform gentle exercises to maintain flexibility and range of motion
• Call your doctor if your arm or hand becomes red, warm, or swollen. You may have an infection that requires immediate treatment