Heart Health and Chemotherapy
The American Heart Association warns that chemotherapy and radiation for breast cancer may increase the risk of heart failure, cardiomyopathy, and other cardiac issues—sometimes years after treatment. However, patients should not avoid necessary therapy. To reduce risk, maintain a heart-healthy diet long-term after treatment.
Certain chemotherapy drugs and targeted therapy (Anthracyclines, Mitoxantrone, Taxanes, Trastuzumab, Pertuzumab) are known to affect heart function. Cardiac testing before treatment and close monitoring during therapy are recommended. Dosages should never exceed maximum cumulative limits.
Note: High-dose Cyclophosphamide (>100mg/kg/day, used for blood cancers) can cause acute heart issues, but breast cancer protocols use much lower doses.
Emotional and Cognitive Effects:
1. Anxiety, Depression, and Fatigue
Chemotherapy itself is stressful, often causing emotional distress (panic, sadness, or feeling overwhelmed). Seek support from family members, loved ones, patient groups, counsellors, or social workers. Immediate psychological help is critical if suicidal thoughts arise.
2. “Chemo Brain” (Cognitive Decline)
Some patients experience memory lapses, poor concentration, or slowed thinking during/after chemo. Contributing factors may include:
- Direct drug effects on brain cells
- Treatment-related fatigue or mood disorders
Management Strategies:
- Simplify daily tasks
- Use lists/reminders
- Prioritize rest, brain-healthy foods (leafy greens, berries), and regular exercise
- Stimulate the mind with puzzles or new skills
Lymphedema
The lymphatic system transports lymph fluid through vessels to nodes located throughout the body – particularly concentrated in the armpits, groin, chest, abdomen, and neck. These nodes filter out harmful bacteria and viruses, helping protect against infection. When this system becomes damaged or blocked, lymph fluid can accumulate in tissues, leading to swelling known as lymphedema.
Both axillary lymph node dissection (surgical removal of underarm nodes) and radiation therapy can damage lymph nodes or vessels, disrupting normal lymph flow and potentially causing lymphedema.
Lymphedema—swelling caused by lymphatic fluid buildup—can develop months/years after lymph node removal or radiation. Early signs include arm heaviness or tightness.
While lymphedema cannot be cured, the swelling can be effectively managed. Proper treatment helps control fluid buildup, improves limb function, and reduces the risk of cellulitis (a potentially serious skin infection). Physical therapy, specialized massage (manual lymphatic drainage), and compression garments can all significantly relieve discomfort and improve quality of life.”
Prevention/Care:
- Avoid arm strain
- Use compression garments
- Seek specialized massage/physiotherapy
- Monitor for infections (cellulitis risk)
Bone Health and Menopause
1. Osteoporosis Risk
Chemotherapy or hormonal therapy (hormone blockers for ER+ cancers) can accelerate bone loss.
Prevention:
- Weight-bearing exercise (walking, strength training)
- Calcium/Vitamin D-rich foods (dairy, greens, fortified options)
- Limited alcohol, no smoking
2. Menopausal Symptoms
Hormone therapy cessation often causes hot flashes, insomnia, and vaginal dryness.
Relief Options:
- Non-hormonal therapies (discuss with doctor)
- Soy foods (evidence supports safety)
- Vaginal moisturizers (for dryness)
Intimacy After Treatment
Physical changes (surgical scars, vaginal dryness) and emotional factors may affect sexual health.
Solutions:
- Water-based lubricants or vaginal moisturizers
- Open communication with partners
- Counselling for body-image concerns
Myth: Cancer is not sexually transmitted, and intimacy doesn’t cause recurrence.
Sleep and Recurrence Prevention
1. Sleep Disorders
Pain, anxiety, or metabolic changes disrupt sleep in 30–60% of patients.
Improvement Tips:
- Establish a bedtime routine
- Try meditation/yoga
- Avoid caffeine/screens before bed
- Reserve sleep medications for short-term use
2. Reducing Recurrence Risk
- Maintain a healthy weight (obesity worsens outcomes)
- Regular aerobic exercise
- Stress management (chronic stress weakens immunity)
Returning to Work
Post-treatment adjustments are normal. Experts recommend:
- Gradual physical reconditioning
- Emotional support networks
- Workplace accommodations (e.g., adjusted schedules)
Our sincere thanks to Taiwan Love and Hope Association for their helpful review and contributions to this information.