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Breast cancer therapy has multiple parts, depending on your treatment plan, and each type of therapy comes with its own possible side effects.

Everyone wants the best possible results from your therapy; to achieve this you must be aware of -- and report -- any changes in your body, mind, and habits during and after your treatment to your cancer care team. Another important player in your cancer treatment path is your primary care physician, who can help you mitigate potential side effects alongside of your cancer care team.

Endocrine/Hormone Therapy

Endocrine therapy, also known as hormone therapy, is given to reduce the risk of breast cancer coming back or the development of a new breast cancer. You may receive this treatment for many years.

Among the common side effects of endocrine therapy are menopausal symptoms such as hot flashes, night sweats, vaginal dryness, reduced sex drive, and mood changes. In addition, you can expect to feel fatigue and joint or muscle pain and stiffness, and you may experience nausea.

Blood clots, also known as venous thromboembolism, are another potential side effect. If you have swelling, pain, or tenderness not caused by injury, or skin that is warm to the touch or is red or discolored in your leg or arm, contact your healthcare providers as soon as possible.

Because is a concern with aromatase inhibitor therapy, your healthcare providers will monitor your bone health. A healthy lifestyle is crucial for bone health; when possible, physical activity should be increased, including balance training, weight-bearing, flexibility, or stretching exercises in order to reduce the risk of fractures caused by falls.

Your care team may recommend that you add vitamin D and calcium supplements to your diet.

Among the common-sense actions for everyone, no matter their health status, you should also consider:

• Reducing alcohol consumption

• Quitting smoking, if you're a smoker

• Eating a healthy, balanced diet

• Getting enough sleep and rest

• Exercising regularly

Targeted Therapy

Among the many different types of targeted drugs to treat breast cancer, some have very few side effects, while others may have more. Many targeted therapies cause a rash or other skin changes -- these develop during the course of treatment.

These changes may occur in the way your skin feels (irritated, like a sunburn), you may have a mild rash, or your skin may feel more sensitive to sunlight.

Topical corticosteroids or moisturizers can help alleviate skin irritation, and antihistamines and topical steroids may be considered to help relieve symptoms.

A cardiologist or other healthcare provider may monitor your cardiac function through tests such as echocardiograms if you were treated with agents that can affect your heart function.

Some targeted therapies can cause gastrointestinal problems such as diarrhea, nausea, vomiting, abdominal pain, and bloating.

Fatigue is also a common side effect of targeted therapies. Engaging in light physical activity, ensuring adequate sleep, and maintaining a balanced diet can all help combat fatigue.

Immunotherapy

Immunotherapy side effects are related to the immune system becoming overactive and attacking healthy tissues. This could happen to your skin (via rash or itching).

Diarrhea is one of the most common side effects, along with pulmonary side effects such as coughing or trouble breathing; nausea and vomiting are less common. There is also a possibility of muscle, joint, and bone pain.

Among the rare side effects of immunotherapy are kidney issues, nervous system side effects, anemia, and inflammation of eye tissue.

Surgical Therapy

Surgery for breast cancer typically involves procedures such as lumpectomy or mastectomy. You may have numbness, tingling, or shooting pain in your armpit, shoulder, or chest wall due to damage to these nerves during surgery. Your shoulder may become stiff and painful after surgery, or you might have some slight swelling in your arm or hand after the operation.

Radiation Therapy

Radiation therapy side effects can vary depending on the individual and the specific treatment. Common side effects include fatigue; breast swelling; and skin irritation, such as itching, redness, peeling, or blistering that is similar to a sunburn.

Chemotherapy

The type and intensity of side effects related to chemotherapy differ. You will undergo a baseline cardiologic evaluation, including electrocardiogram and echocardiography before starting certain chemotherapy, and you should be reassessed at the end of treatment and every 6 months for the first year.

Short-term side effects typically resolve with the end of chemotherapy; the duration of treatment has a major impact on the total side effect burden you may experience. Most adjuvant treatment regimens are approximately 4-6 months in duration.

Many people over 40 experience after breast cancer chemotherapy; for younger patients, although 30-year-olds, for example, may not go into menopause right away, they may have decreased ovarian function and earlier menopause, and decreased fertility. It is also important to discuss fertility preservation for younger patients prior to chemotherapy.

Long-term side effects of breast cancer chemotherapy may include cognitive impairment, insomnia, fatigue, and weakness, numbness, and pain from nerve damage, usually in the hands and feet – this is known as peripheral neuropathy.

Fatigue, insomnia, and peripheral neuropathy may decrease if you engage in light physical exercise; discuss other possible options with your medical team.

Read previous installments in this series:

For Your Patients: Breast Cancer Basics

For Your Patients: The Crucial Role of the Biopsy in Breast Cancer

For Your Patients: Understanding Early-Stage Breast Cancer

For Your Patients: New Therapies, New Hope in Later-Stage Breast Cancer

For Your Patients: The Importance of Genes in Breast Cancer

For Your Patients: Understanding Palliative Care for Breast Cancer

For Your Patients: Next Steps After Breast Cancer Surgery

"Medical Journeys" is a set of clinical resources reviewed by physicians, meant for the medical team as well as the patients they serve. Each episode of this journey through a disease state contains both a physician guide and a downloadable/printable patient resource. "Medical Journeys" chart a path each step of the way for physicians and patients and provide continual resources and support, as the caregiver team navigates the course of a disease.