Emotional support

A diagnosis of secondary breast cancer can be traumatic and devastating. Approximately two or three out of every 20 patients with secondary cancer receive professional psychological help. Anxiety, depression, anger are common emotions.

Ask your GP or medical treatment team for advice. A patient may wish to see a counselor, see a psychologist or psychiatrist, or talk to others with secondary breast cancer. Psychological help may help you cope, reduce your distress, allow you to improve your quality of life.

Pain relief

There are many effective ways to treat pain depending on its severity. There are analgesics such as paracetamol and non-steroidal anti-inflammatory drugs such as Ibuprofen to treat mild, moderate or severe pain. Other options are weak opioids, such as codeine, tramadol or dihydrocodeine. Strong painkillers are opioids including morphine.

Other pain treatments include: radiotherapy, surgery, bone strengthening drugs, steroids, antidepressants and anticonvulsants (to reduce pain due to nerve damage).

For severe pain areas of the body can be numbed by injecting medications into the spine or other nerves.

Feeling fatigued

Fatigue is a common problem for people with secondary breast cancer. It can be caused by medication, having trouble eating or sleeping, depression, low levels of red blood cells or cancer treatment.

Help is at hand. A patient’s medical team can make an assessment so her or his quality of life is improved. Some approaches are medication including glucocorticoids, psychostimulants, antidepressants and erythropoietin. Your doctors may suggest treating the cause of fatigue i.e. anaemia or depression.

Physical exercise can also help.

Some patients choose complementary therapy but there is little scientific proof these treatments work.

The risk of infection

Surgery to treat cancer or its symptoms comes with a risk of infection. Reducing the risk of this is important because an infection can be dangerous if the body and immune system is weak. A secondary breast cancer patient’s medical team can make an assessment of how to do this.

Many anti-cancer drugs can cause neutropenia, which is a reduction in the number of your white blood cells that fight infection. Removal of lymph nodes during past or recent breast surgery (e.g. from the armpit) can damage the lymphatic system, which plays a role in fighting infections.

If you have neutropenia you may need to have a break from anticancer drugs or reduce the dose, so your immune system can become stronger. A doctor may also prescribe antibiotics and antifungals to take as a precaution against infections. He or she could suggest taking granulocyte colony stimulating factor (G-CSF). G-CSF helps your body to produce more white blood cells, which fight infection.

If you develop a fever and have a low white blood cell count (neutropenia), you may need to be admitted to hospital urgently to receive intravenous antibiotics.

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