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July 2008
Breast Cancer – Questions
Here are just a few of the questions I get asked by so many breast cancer patients. I hope by sharing these questions and answers it can or will help relieve your mind or thoughts too.
Is my disease catching? Can my partner get cancer from me if we have sex?
No, cancer is not catching. You cannot give cancer to your partner by kissing, hugging, or having intercourse.
If I am receiving radiation therapy as part of my treatment, am I radioactive? Can I transmit radiation to my partner during intimacy or sex?
No, you are not radioactive. You cannot give radiation to your partner by any form of touching including intercourse.
Sometimes during a time of illness and recovery, partners are hesitant to talk to each other about physical, emotional, or sexual needs. Your partner is probably concerned about your physical stamina and might feel protective of you. You might start a conversation about what you feel comfortable doing, or show your partner through actions.
Will chemotherapy affect menstruation?
Usually. If you were having regular menstrual periods before beginning chemotherapy, you might stop ovulating after taking some of the drugs, and you will probably stop menstruating during the course of your chemotherapy. Ask your doctor or nurse how your particular treatments will affect your menstrual and ovulation cycles.
Will I begin menstruating again after I discontinue the chemotherapy?
This answer depends on the type of chemotherapy used, and the age of the patient. Not all chemotherapy permanently stops menstrual cycles. One of the most effective drugs for the treatment of breast cancer is cyclophosphamide (Cytoxan®) or the related alkylating agents. Almost all of these drugs cause ovulation and menstruation to stop during treatment. All standard adjuvant* chemotherapy combinations for breast cancer contain cyclophosphamide or a related drug. (*Adjuvant describes the "preventive" chemotherapy given after a mastectomy or lumpectomy when all the tests show no evidence of remaining tumor).
Most patients who are more than 40 years old will stop their menstrual periods during the time they take chemotherapy, and only 5% to 25% of these women will resume regular menstrual periods. But only about 40% of women who are younger than 40 will stop having menstrual periods, and about half of the women who periods stop will resume having them. They will probably go through menopause earlier than if they had not taken chemotherapy.
Will I need to use birth control while I am on chemotherapy?
Yes. If you have not gone through menopause, it is very important not to become pregnant while you are receiving chemotherapy. You must use some form of birth control, but not birth control pills. If you have an Intrauterine Device (IUD), let your doctor know.
If you have questions about which methods of birth control you can use, ask your doctor. Your doctor can help you choose an effective means of birth control, such as a diaphragm, condoms, or a barrier cream or gel.
Will it be possible for me to become pregnant after chemotherapy?
The ability to become pregnant depends on the normal functioning of the ovaries. The ovaries of younger women are more resistant to chemotherapy. If a woman's ovaries stay normal during chemotherapy or return to normal function after she stops chemotherapy, she can become pregnant. A woman will have regular menstrual cycles if the ovaries are functioning normally. However, many women who do not have regular periods can still become pregnant. Occasionally a woman who thinks she has gone through "the change" (menopause) because she has stopped having menstrual periods does get pregnant. A special blood test of the hormone levels can determine fairly accurately whether a patient has gone through menopause.
Is it safe for me to become pregnant after I have completed my chemotherapy?
Many doctors have reported that, in their experience, pregnancy has no adverse effects on women who have recovered from breast cancer. The general recommendation is that a woman waits at least 2 to 3 years after breast cancer is diagnosed before becoming pregnant. This allows enough time to determine whether the tumor is likely to recur (come back).
We do not recommend that patients become pregnant if their tumors have ever recurred. However, if a patient has not had a tumor recurrence after her mastectomy (or lumpectomy and radiation) and if she did not have an aggressive type of tumor, it is probably safe for her to become pregnant 2 to 3 years after diagnosis. If you have any questions about becoming pregnant after your treatment, ask your doctor.
Will I have hot flashes if I stop menstruating because I'm on chemotherapy? If so, is there anything I can do to alleviate them?
Hot flashes are a sign that the ovaries are no longer producing enough estrogen (a female hormone). The amount of estrogen necessary to prevent hot flashes is less than the amount necessary to have normal menstrual periods. Therefore, many women will stop having menstrual periods, but will not have hot flashes. The closer the patient is to age 40, however, the more likely it is that she will have hot flashes and also experience menopause.
Hot flashes are not a medically serious problem, but they can be very annoying. Often just knowing that these are hot flashes and are not serious is enough to reduce the anxiety associated with them.
I have always had large breasts and feel very "one-sided" and "unbalanced" when I wear a nightgown or pajamas since I've had a mastectomy.
After a mastectomy many women are more comfortable wearing a leisure or lightweight bra with a lightweight prosthesis when they go to bed. Also, some nightgowns are made so that ruffles can be added to the front, giving a fuller appearance to the side of the mastectomy.
It seems to me that some of my friends, co-workers, relatives, and others are very awkward when they are around me, and they don't know how to handle the fact that I've had breast cancer. Remember, other people will take their cue from you. If you are comfortable using words like "breast," "cancer," "breast surgery," "mastectomy," and "chemotherapy," others may pick up on this attitude, and they too will be able to add these words to their vocabularies.
Occasionally, an awkward situation may occur, such as a prosthesis slipping out of place, a person staring at your chest, or even someone repeating a joke about breasts. If you should be in a situation similar to this, please try to have a sense of humor - - humor is wonderful and can help you through a tough and trying time. What has happened to you is certainly not funny but humor often diffuses an awkward situation.
Every time I get an ache or pain now, I think that perhaps I have a new cancer.
This anxiety is very common and will subside as time goes on. Be sure you follow your doctor's instructions for follow-up appointments and proper care of your body. If you feel you have a medical problem, discuss it with your doctor as soon as possible.
I seem to be having a difficult time accepting what has happened to me. As with so many things in life, adjustments of any type take time. Do not be too hard on yourself. Soon you will probably be doing everything you did before your treatment or surgery, and maybe even more because of an added determination!
Sometimes it helps to talk to someone who has had the same type of surgery as you. Many times what you feel and think are the very same questions and concerns ladies who have had breast cancer thought and felt too.
Take one day at a time and remember talking about your problems can help.
Scientists estimate that each year up to 7 million Americans become sick from contaminated tap water, which can also be lethal. Pollution, old pipes and outdated treatment threaten tap water quality. Find out if you should be concerned about your tap water, and what you can do to protect yourself and your family. There is a need for education of consumers regarding the sources and types of water contamination, the recognition of symptoms of waterborne diseases, and home methods for prevention and control of drinking water hazards. While these simple consumer tips and precautions may help in avoidance of acute illness caused by waterborne microorganisms and certain inorganic pollutants, for example, nitrate and arsenic, the far more serious danger of the chronic and lifetime exposure to potentially carcinogenic organic chemicals will persist and remain unanswered. Only our government and a more environmentally responsible corporate industrial society can lower the carcinogenic hazards lurking in our water and food supplies, since only they have the resources to prevent or remove these contaminants.
Bottled Water Usage and Safeguards.
Public concern with both the quality and safety of drinking water has become so compelling that many consumers now rely almost exclusively on bottled water for drinking purposes. Bottled water is now preferred by millions of Americans and the cost is enormous. The regulations governing the purity and safety of bottled water are often less stringent than those for municipal water supplies may come as a surprise to some consumers. Bottled water is a luxury to many and a necessity to others. Company advertising has promoted bottled water as "purer," "safer, <70> "chlorine-free," and an essential component of a healthy lifestyle. It is not generally recognized that one-third of all bottled water in the United States comes from public water supplies and is no safer than the water obtained from the faucet.
An Environmental Policy Institute Report (1989) refers to the frequency of contamination of bottled water with low levels of heavy metals, solvents, and bacteria. The carcinogenic chemical migrants (for example, methylene chloride and vinyl chloride) from plastic bottle containers are also a concern. Despite the value of bottled water as an alternative source of drinking water at times of emergency, consumers should not presume that bottled water is invariably preferable to tap water.
Consumer Concerns and Home Water Treatments.
The most frequent questions asked by consumers are about the level of lead in their drinking water and about taste and odor problems. "Is our water safe to drink?" "Do we need to substitute bottled water?" "Should we install a home water treatment unit and, if so, which type of unit would be most satisfactory for our particular needs?" The EPA provides information in response to inquiries about the necessity for home treatment units. It does not regulate the manufacture, distribution, or use of these units. The EPA stresses that the units should not be relied upon for the removal of organisms and chemicals injurious to our health. Nonetheless, certain filtration units, especially reverse osmosis, will lower the concentration of several contaminants, including lead, copper, nitrates, pesticides, and parasites. No system is warranted for complete elimination of all contaminants. You might consider buying bottled water if you should notice anything from the list below.
If your drinking water suddenly becomes turbid, changes in color or taste, or an unpleasant odor develops.
- If you learn that the public water system has become contaminated and you are instructed to boil the water. Bottled water is a simpler alternative.
- At times of floods or earthquakes when water contamination is a common hazard.
- If your home has lead pipes or lead solder. Drink bottled water until your water has been tested.
- If you have a private well and you suspect contamination with coliform bacteria or nitrates. Drink bottled water until the well water is tested.
- If your neighborhood has a cluster of cancer patients and water contamination from a landfill is suspected. Bottled water may be safer than community water supplies or private wells.
- If you need to limit your intake of sodium for medical reasons. Bottled waters of low sodium content or distilled water may be preferred to public supplies.
- If you are traveling and suspect contamination of local water supplies. Drink only brand named bottled waters from sealed containers.
- If your water tastes strongly of chlorine. Bottled water is preferable for cooking as well as drinking. Bottled water does not contain chlorine and does not taint food.
