When Will I Start to Feel Better After Breast Cancer Treatment?

This question is asked of me quite often, and I have hesitated to answer it until I  had some solid proof about when you will really start feeling better.    I have an internet support group of about 20 women who keep in touch regularly through a Facebook group.   We met on  a breast cancer discussion group as we all started chemotherapy within four weeks of each other in January, 2012.  Some had surgery before chemo, some had surgery after chemo, most had radiation.   We all helped each other get through the tough times. These amazing women range in age from 30s to 70s and live all over the USA, Australia, and Israel.

One interesting thing occurrred, however.  We all started feeling better this month!  Not just a little better. Noticeably better.  Enough to write about it.  Enough to say, “Wow, my stamina is coming back.”  “I am able to travel again.”  “I can keep up with my toddlers again.”  “I am the top salesperson  in my company once again.”   “I am starting to dance again.”   “I am feeling pretty darn good, not my old self, but good.”   “Suddenly, I feel better than I have since breast cancer.”   These are the comments that appeared on our Facebook page this month!

The common denominator is we all had  Chemotherapy (AC and Taxol).  A few had Herceptin for a year.  Thirteen months after Chemo ended we all started to feel better simultaneously.  It did not matter our age, how we made a living, what stage our cancer was, or if we had a lumpectomy or mastectomy.

So from now on when I get asked, “How long before I start feeling better after treatment?”  my answer will be 13 months after Chemo ends!   For those of you in the midst of Chemo, this probably sounds like so much time to wait.  But it is a gradual thing.  The energy comes back little by little and one day you realize – “wow, I cleaned the house, walked around the park, watched the babies, and stayed up until 11 pm all in one day!”   That is a far cry from not even being able to go to the grocery store or stand up long enough to load the dishwasher!

Of course, there are always exceptions to the 13 month rule, but I feel confident that it does take at least this amount of time to start feeling better.  If you have just ended Chemo, don’t be too hard on yourself.  It is a process.  Don’t worry that family and friends think you should be better than you are.  Just tell them, “It will take at least 13 months or more!”

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Breast Cancer Around The World

I hear from women around the globe who all have one thing in common:  Breast Cancer.   We may be from different countries, but our emotions and fears are the same.  Are we going to live?  How much do we have to suffer?  How do I possibly get through this?  The power of the internet never ceases to amaze me and because of the push of one little “Translate” button on their computer screen, women are connected no matter what language we speak.  Every week when I look at my statistics from WordPress, chances are I discover another country. This week it was Brunei Darrusalem.  I’ve always been pretty good at geography, but I’ve never heard of that country.  It is on the coast of Borneo in Southeast Asia.  In total, people from 138 countries have visited my website mostly looking for two things:   COURAGE and HOPE

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What surprises me is that the treatment for breast cancer is just about the same worldwide for more advanced breast cancers which is Adriamycin Cytoxan and Taxol or Taxotere in the chemotherapy realm.  And just when I get a tad feeling sorry for me as I have to drive 60 miles (95 kilometres) one way to see my Oncologist, I get an email that puts it all into perspective.   Women who live in extremely remote areas that have to fly in a small float plane every week to and from treatment, women who live on islands that have to take a ferry or a boat to treatment, and women who are forced to relocate sometimes thousands of miles away from friends and family because they feel treatment close to home isn’t as good. They leave everything familiar to seek healing.

Perhaps one of the most unexpected emails I received was from a cloistered nun from a Monastery in Australia.  One of her sisters at the Monastery who was not computer literate, was undergoing Chemotherapy and needed some help and information.   Recently, I got a follow-up email from her telling me how well that Sister was now doing after treatment!  These nuns pray for me, I am happy to report!

Today I apologized to a young mom who lives in Mexico for my wrong beliefs.  She was diagnosed at age 34 with Triple Negative Breast Cancer.  She went to Houston, Texas for surgery and is receiving chemotherapy in Mexico as she wanted to be near her husband and daughter while undergoing treatment.  I am sorry to admit that when I think of treatment in Mexico, I immediately think it is substandard to the United States.  Where this young woman is being treated in a modern hospital in a mid-size city in Mexico, that is definitely not true.  Her Oncologist just returned from the American Society of Clinical Oncologists (ASCO) conference in Chicago and is up on the latest and newest treatments for breast cancer.  He hospitalizes her overnight after each AC chemo to keep a watchful eye on her after infusion since she is receiving dose dense.   She tells me that her hospital room in Mexico is much nicer than the one she had in Houston.

Sadly, I hear from women who lose their jobs because of breast cancer.   One woman from Ireland who lives in a very small town and was fired from her job during treatment, knows that it will be extremely difficult for her to find a new job as everyone in town knows she had breast cancer.   She said that being fired from her job was more traumatic for her than being diagnosed with breast cancer.

I cry each and every time when I hear from women of young children who pray they can make it to their children’s high school graduation.  It does not matter what country they live.  And I cry even more when I hear from breast cancer survivors who never thought they would make it to that milestone in their children’s lives, and they have as their kids may now be in college, getting married, or starting families of their own.   These survivors never take that for granted!

So if you are in the middle of chemo, facing a Mastectomy, or scared silly about Radiation or Radiotherapy as it is called in some countries, remember your sisters from around the world.  We are all in this together.

Adriamycin and the heart…

Adriamycin (Doxorubicin) does cause heart attacks and heart failure.   I had a heart attack while going through Adriamycin as the heart damage is evident on all my heart tests and confirmed by three Cardiologists.  The vast majority of emails I get from readers of my blog have to do with Adriamycin Cytoxan Chemotherapy known as the “Red Devil”.    There doesn’t seem to be any rhyme nor reason on why some women have very few side effects, and others have debilitating side effects.  Now I have to give you more bad news to watch for serious heart side effects and not overlook them.

I had symptoms of a heart attack during Adriamycin, but thought it was side effects.  Clearly, I remember the night with shoulder pain, chest pain, and sweating. From then on walking up my steps, I had to rest every other step I was so out of breath.  Immediately, I developed a serious cough and even more fatigue.  You might ask, “Why didn’t you do something?”    Well, in my case the side effects of AC were so bad this seemed normal to me.   I never even mentioned this to my Oncologist as being out of breath is normal on AC.   My heart rate also elevated to 112 beats per minute which also can be normal during AC.

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Thank God my Oncologist sent me to the Cardiologist when my Echocardiogram came back with “scary bad results” to quote my Oncologist.   We all blamed it all on Herceptin, but looking back, the symptoms were during Adriamycin.  Herceptin just added to the damage.  The Cardiologist immediately put me on heart meds.  After 10 months of heart meds, my heart has greatly improved I am thrilled to report. 

MD Anderson, the #1 cancer hospital in the USA, recently completed a study about heart failure and Doxorubicin (Adriamycin) with some amazing findings discovering the molecular basis for Doxorubicin’s damage to the heart.  It explains why some people can have a very small dosage of the drug and still get heart damage, yet others who have large doses have no heart trouble:

“Even in this age of targeted therapies, doxorubicin remains an effective agent used mainly in combination with other drugs against a variety of malignancies, including breast, lung, ovarian and bladder cancers,  as well as leukemia and lymphoma,” said Edward T.H. Yeh, M.D., professor and chair of MD Anderson’s Department of Cardiology and senior author of the study.

“However, its use is limited by its cardiotoxicity, which can lead to heart failure,” Yeh said. “We’re excited because we’ve identified the molecular basis for doxorubicin’s damage to the heart.”

The full article can be found here:   http://www.mdanderson.org/newsroom/news-releases/2012/key-discovered-to-how-chemotherapy-drug-causes-heart-failure.html

Because of their findings, MD Anderson is undertaking yet another study to determine if a simple blood test could tell a patient’s risk for cardiac toxicity during Doxorubicin (Adriamycin).   I find that to be absolutely incredible!

But as we wait for that to occur, if you are currently on Adriamycin, watch for these severe heart problems and let your Oncologist know immediately.  Do not hesitate to use that word “heart” when talking to your Oncologist.   If you have taken Adriamycin in the past, pay close attention to your heart.  After my experiences, I would recommend that you see a Cardiologist so your heart can be monitored.  Heart failure can happen many years after taking Adriamycin.

Has all of this been worth it?  Yes, I am still feeling better each day.  That is worth so much.  Do not get discouraged.  It is all overwhelming, but pay attention and speak up!