Managing breast cancer treatment side effects beyond medication

Support during endocrine therapy

Many people taking aromatase inhibitors or tamoxifen, or who have gone through early chemical or surgical menopause, are committed to staying on their therapy for as long as their oncologist recommends. These treatments often last 5 to 10 years, so side effects like joint pain, hot flashes, and sleep problems can affect daily life for a long time.

Sue said,  “These are years that you don’t want to miss out on. You want to go to your son’s baseball game and not feel like you’re in pain. You want to see your daughter graduate.” She described pain that can make it “hard for you to move in and out of a car.”

Her advice: “Why not give something like this a try? Movement and yoga or acupuncture or a nutrition consult.” Regular use of a therapy like this may help make those years easier.

Support for people living with metastatic breast cancer

For people living with metastatic breast cancer, treatment is often ongoing.

“You’re going to be on some type of treatment, maybe with a couple breaks in between,” she said. “Why not have something that’s going to complement it in a way that makes you feel better, gives you better sleep? We all know if we have good sleep, our emotional well-being is more intact. It’s all connected.”

For this group, Sue emphasized emotional support, especially professional counseling. “If we can help the mind heal, the body follows,” she said, noting that emotional distress often shows up as physical symptoms. She also stressed the importance of joy. “We need to have joy during this time,” Sue said. “This is now a new normal for our metastatic community.”

There is no one-size-fits-all plan

One of Sue’s main points was that there is no single answer. “I always say there’s not one magic bullet,” she said.

Some people get the most benefit from acupuncture and yoga, as Sue did. Others prefer oncology massage, counseling, sexual health support, or fitness. “All will help with maybe exhaustion, sleep, energy,” Sue explained. “They all got there a different way, but it doesn’t matter. The outcomes were the same.”

The best approach is to choose what fits your body, schedule, and preferences, and to keep your care team informed. “We’re all different,” Sue said, “and that’s important to have that distinction, that it’s not a one-size-fits-all.”

Making sense of nutrition advice

Nutrition is one of the most confusing topics for people with cancer, and social media is full of strong claims. “It’s hard to navigate these days,” Sue said. “In the world of social media, everybody is an expert. You just have to really be careful.”

Sue’s advice on nutrition:

• Focus on whole foods. Instead of looking for one “miracle” food or a restrictive meal plan, aim for an overall eating pattern that includes fruits, vegetables, beans, nuts, and seeds, with less processed food. Sue encouraged people to “look at food from a lens of abundance instead of restriction. It’s not just one food, it’s not just one menu or one meal plan.”
• Be careful with supplements. “We do not approach nutrition through supplements,” Sue said. “If you are deficient, yes, that’s where supplements come in. I take a vitamin D, because I’m deficient in vitamin D, but my doctor is talking to me about that.” Some supplements can interfere with chemotherapy or radiation, so talk with your oncologist before starting any of them.
• Look for the right credentials. A registered dietitian with oncology experience can help with specific problems like mouth sores, metallic taste, and GI symptoms. “I would not get your advice through a social media post or the newest and latest news article,” Sue said. “I would talk to your physician about it.”

Finding a qualified practitioner

Not every practitioner is trained to work with people who have cancer. “It’s really important for you to go to one that knows cancer care,” Sue said. This is especially important for hands-on therapies.

• Oncology massage: The Society for Oncology Massage (S4OM) has a directory of therapists with additional oncology training. These therapists know how to work around port sites, reduce lymphedema risk, and adjust pressure for someone in treatment. “They’re not going to do a heavy, deep massage,” Sue explained. “It might not feel like you’re getting the type of pressure that you want, but your body is in treatment now. You want to make sure that you’re getting something that is going to be useful and going to support your healing.”
• Acupuncture: Look for licensed acupuncturists listed in professional association directories, and ask whether they have experience treating people with cancer.
• Check your insurance. “Look at your insurance, see if they cover acupuncture,” Sue suggested. Some plans cover acupuncture or other supportive therapies.

Many other services, including counseling, nutrition consultations, yoga, meditation, and fitness, now work well over telehealth, which Sue says helps people feel more comfortable. 

If you’re unsure about trying something new, Sue suggests changing the question you ask yourself. “What could go right is maybe a better question to ask,” she says.

Unite for HER, other nonprofits, cancer centers, and community programs offer supportive care. Ask your nurse navigator or social worker to help you find out what is available near you.

Check out part one of our recap to learn more about how integrative therapies can complement your care.

Disclaimer: The information provided in this article is for informational purposes only and is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Outcomes4Me is not acting as your caregiver, and any suggestions or guidance offered should not replace the advice of your healthcare provider or qualified medical professional. Always seek the guidance of your physician or other qualified health provider with any questions you may have regarding a medical condition.