Life After Breast Cancer: What No One Tells You

Breast Cancer Treatment Aftereffects

Three years ago Karen Richards feared she wouldn't survive after doctors diagnosed her with breast cancer. A double mastectomy and reconstructive surgery set her on the road to recovery. But a year later, when her left arm began to swell and ache, the 45-year-old systems analyst fromChicago realized that living as a cancer survivor had its own challenges. Her doctor had warned her of this possible aftereffect of surgery, called lymphedema. "It's extremely disappointing. I've beaten my cancer," Richards says, "but I’m not back to my old self."

Breast cancer survivors are often taken aback when they get socked with treatment-related health problems long after their tumor is gone. Surgeons and oncologists who treat breast cancer admit that they don't want to overwhelm patients with too much bad news, so they sometimes minimize treatment aftereffects -- or don't mention them at all. "Even though there have been improvements in the past five years, some doctors at top hospitals still often ignore what cancer treatment does to your body, because they're so focused on eradicating the tumor," says Maureen Schilling, head of the New York City
Lymphedema Support Group. And too often women suffer in silence. "Women think they're supposed to be so happy they've beaten cancer that they feel guilty complaining about a swollen arm," she says.

The good news is that most women diagnosed with breast cancer -- an estimated two-thirds of patients have cases that haven't spread to the lymph nodes -- are spared debilitating aftereffects. "Studies show that they generally have high levels of physical and emotional health that are comparable to women their age without cancer," says Patricia A. Ganz, MD, a professor of medicine and public health at UCLA who has done extensive research on the aftereffects of breast cancer treatment.

The more aggressively a woman's breast cancer is treated, however, the worse the aftereffects can be. Women who have both chemotherapy and radiation, for example, have greater long-term fatigue and a higher chance of developing lymphedema than those who have either treatment alone. "Breast cancer survivors and their doctors need to acknowledge that lingering health problems are possible, but that they can be managed," says Dr. Ganz. Knowing what to expect, for better or worse, can help the estimated 2.3 million breast cancer survivors in the United States find help and enjoy healthier lives. Here are just some of the health obstacles that take women by surprise.