Categoría Dos: Motivación

not funny!). I was teaching

fourth grade during my first

chemotherapy, and a little

girl came up to me, she was

the one designated to be

the messenger, ‘Mrs. Axler,’

she seriously said, ‘we had

a conference with all the

girls and we think you have

malaria. In the Little House

on the Prairie books, when

they get hot and cold and

sweat they have malaria.

We think you should go to

the nurse.’

— Susan

C H A P T E R 4 / M A N A G I N G S Y M P T O M S A N D T R E A T M E N T S I D E E F F E C T S 4 7

risk for developing blood clots, as well as increased appetite and weight gain. For these reasons, your doctor may recommend other treatments first. • The blood pressure medicine clonidine

can decrease the sweating and rapid heart rate that sometimes accompany hot flashes. But it can make some women feel sluggish and lethargic. If your blood pressure is typically on the low side, this may not be an option for you.

Many claims have been made about various complementary or alternative therapies like black cohosh or phytoestrogens as treatments for hot flashes. So far, there has been little scientific evidence to support these claims. Additionally, phytoestrogens (products that mimic estrogen in the body) are not recommended for women with breast cancer.

ALWAYS tell your doctor if you want to try any alternative or complementary therapies.

Sexual Side Effects

Sexuality can be an important part of who you are and how you relate to others. Many treatments for metastatic breast cancer may affect your sexual function, which can be difficult to face.

Hormonal treatments can cause vaginal dryness and/or discharge and can lower your libido. These are side effects that may be difficult to talk about—for both you and your doctor. Some doctors have little training or experience in discussing sexuality. As tough as it may seem, it is important for you to bring up sexual side effects that concern you with your doctor.

As with all side effects, you don’t have to suffer in silence. If you don’t want to tell your doctor, talk to your nurse about what you’re experiencing and get helpful advice on how to make things better. Others going through the same treatment will probably have helpful tips as well. Remember to ask your doctor about any type of remedy or L I F E S T Y L E C H A N G E S T H AT M AY

H E L P M I N I M I Z E H O T F L A S H E S

• Avoid spicy foods, alcohol and smoking

• Avoid saunas and hot baths or showers

• Wear layered clothing, preferably cotton

• Exercise—this can help with many symptoms and side effects

• Deep, slow abdominal breathing techniques may decrease the severity of hot flashes

• Try acupuncture—some people find that this can help relieve a number of their symptoms; make sure you talk to your health care team first.

4 8 F R A N K L Y S P E A K I N G A B O U T C A N C E R : M E T A S T A T I C B R E A S T C A N C E R

treatment you might want to try as some remedies for vaginal dryness may include estrogen or progesterone which may be contraindicated because of your breast cancer. In general, lubricants can help with vaginal dryness and make vaginal intercourse more pleasurable. Sometimes, your doctor might feel comfortable prescribing low dose vaginal estrogens if your symptoms are severe and they feel it is appropriate for you. The most important thing to do, however, is talk to your partner about how you’re feeling, and work together on how to deal with times when you are or are not in the mood for physical intimacy. For information on enhancing intimacy, turn to page 60 of this book.

Most people with metastatic breast cancer experience some form of fatigue, which can have many different causes. Having breast cancer can decrease your energy and make you feel less energetic than you felt before cancer. Chemotherapy, hormonal therapy, targeted therapies and radiation therapy can all make you feel tired or weak. It is also possible that the psychological or emotional effects of living with metastatic cancer can cause fatigue and a reduction in your energy

levels. Additionally, treatments used to minimize side effects like nausea or hot flashes can have their own side effects, including fatigue.

It’s important to try to figure out what’s causing the symptoms. If fatigue is related to treatment, and impacting your ability to perform your regular activities, you might be able to take a break or switch to another treatment. Together with your doctor you can discuss the best options for you. M A N A G I N G P R O B L E M S T H AT C O U L D B E S I D E E F F E C T S , T H E D I S E A S E , O R B O T H