Normal, Interrupted

May 2007 Special Sections

When Kathy Flynn arrived home from work just after being diagnosed with stage four breast cancer, she made a powerful decision. Watching her then sixteen-year-old daughter, Megan, dealing with a status quo teenage crisis on the phone and listening to her then-fiancé talking about his tough workday, she decided to wait until the next morning to break the life-changing news. “I wanted to maintain some normalcy even if it was just for a few hours longer,” recalls Flynn, a nurse practitioner in women’s healthcare at Advanced Specialty Care for Women in St. Paul. “Deep in my heart, I knew I wouldn’t have the comfort of ‘normal’ for a very long time.”

Although approximately 180,000 women are diagnosed with breast cancer in the United States each year, thanks to advances in breast cancer research and treatment, the five-year survival rate for breast cancer is 89 percent, which means a lot of survivors are dealing with breast cancer as a chronic disease rather than a terminal one.

“I think there is this myth out there of ‘When I am done with treatment, I am going to stop worrying about this disease,’” says Jeanne Harkness, RN, a breast cancer nurse specialist at Park Nicollet Jane Brattain Breast Center. “In truth, that is just not likely to happen because there are other reflections and symptoms post-recovery that can come into play.”

Hot Flashes
The drop in estrogen levels prompted by some breast cancer treatments, such as tamoxifen, can lead to premature menopause, causing symptoms such as mood swings and the dreaded hot flashes, which can persist for months or even years.

As cited on breastcancer.org, a nonprofit organization dedicated to providing information about breast cancer to the public, self-help measures such as reducing caffeine, lowering the thermostat, and wearing clothing in layers might help to some degree (literally), but 10 to 15 percent of all women who experience hot flashes also seek medical advice.

“Beyond sticking your head in the freezer, there are some medications that can help,” says Harkness. Examples include low-dose antidepressants (e.g. Effexor) and blood-pressure-lowering medications (e.g. clonidine and Aldomet). “If you [have] hot flashes interfering significantly with daily routines and activities, the best next step is to see your doctor,” she says.

Cognitive Changes
Memory lapses and general mental fogginess are attributed in part to both chemotherapy and general stress that accompanies a cancer survivor’s life. “When people are going through chemotherapy, they have difficulties with what we call executive function,” says Thomas Flynn, MD, an oncologist with Minnesota Oncology Hematology, PA. “They can’t multitask, and they have difficulty remembering where they put things.”

Because not much conclusive data is available to pinpoint the causes of the cognitive changes associated with breast cancer and its treatments, there is not much sound information on what works best. Stress-reduction techniques such as exercise and relaxation might have some benefit. Keeping your mind sharp by doing mentally challenging puzzles and tasks might also help clear the cobwebs.