What Does it Mean to Have Breast Cancer?

Learning you have breast cancer is a life changing experience. But once the initial shock has worn off and you start treatment, your next challenge is managing the demands of your treatment while still fulfilling your work and family obligations.

The good news is that treatments have improved to the point where many people are able to continue their normal, daily activities such as work, childcare, and even exercising (with medical approval) while receiving radiation or chemotherapy. The bad news is that your daily routine has now been complicated by doctor appointments, hospital visits and the physical and emotional stress that can come with a breast cancer diagnosis.

We can help. Our UPMC Breast Care Center team understands the many ways in which a breast cancer diagnosis can impact your life and provides comprehensive support services to help you address these challenges along the way.

The Not-so-Obvious Effects of Breast Cancer

When people talk about breast cancer they often focus on the obvious side effects of the diagnosis and treatment: nausea, hair loss, extreme fatigue, fear of death and the unknown. But there are a host of other ways in which a breast cancer diagnosis can affect and even change your life. Within this section, you will learn about these not-so-obvious effects of breast cancer and ways in which the UPMC Breast Care Center team can help you overcome them. Topics covered within this section include:

Unforeseen Expenses

Breast cancer treatment can be very expensive. Even people with good insurance often find that they must still shoulder some of the costs for their surgery and medications. There are also underlying expenses that people don’t often take into consideration: childcare for when you are hospitalized or have appointments public transportation when you need help getting to your appointments and hotel stays if you have to travel to receive your treatment.

These costs can add up and can put a financial strain on you and your family – particularly if you need to take time off from work following surgery or due to treatment-associated illness.

Fortunately, there is help. The UPMC Breast Center’s nurse navigators can put you in touch with organizations that offer financial assistance for breast cancer medicines and care, as well as local organizations that offer financial assistance for practical needs such as transportation, food and childcare. Additionally, UPMC’s nurse navigators are familiar with pharmaceutical company programs that help pay for the medication costs.

Working Through Treatment

The effects of a breast cancer treatment vary from person to person. Some people have very few physical side effects from treatment, while others have a more difficult time. Not knowing how you will respond to chemotherapy or radiation can make it difficult to decide whether or not you should continue working. Your Breast Care Center team understands the complexities of this decision and can help you understand the challenges that may arise with your particular course of treatment so that you can make an educated decision regarding work.

To Tell or Not to Tell

The first issue that many people with breast cancer face is whether or not to tell their employer about their diagnosis.

The fact is that you don’t have to tell anyone about your diagnosis. However, if you choose to keep it to yourself, questions may be raised if your productivity level is affected or if you miss work for treatment appointments.

Whom you tell at work, and how much you share, is again up to you. What is most important is that you are comfortable with whatever decision you make.

Should you choose to share your news with a supervisor or co-worker, here are some tips to keep in mind:

• Choose a comfortable, yet private area, to share your news
• Talk to one or two people at a time rather than a large group
• Explain that you are committed to your job but may need some help in the short-term
• Ask for some flexibility in your schedule or support with responsibilities
• Allow co-workers to ask questions or to offer to help
• Explain how your treatment may affect you (e.g. hair loss, mouth sores, bad breath, etc.)

Tips for Success

Breast cancer treatment can be accompanied by a host of side effects, the most common of which are nausea and fatigue. These can negatively affect your work routine. If you choose to work through your treatment be sure to let your  Breast Care Center team know. Often, there are ways in which we can help you manage some of these side effects.

“Chemo brain” is a common complaint among those receiving chemotherapy. This is a short-term problem that causes problems with cognition (thinking) and memory. If your treatment is causing you to have trouble staying focused or remembering things, you may want to do the following:

• Start writing things down, including:
  • Meetings and appointments
  • Notes from important conversations
  • Deadlines
  • Things to do
  • Your schedule
• Set realistic goals for yourself so that you can be productive without getting frustrated

Maintaining Job and Financial Security when Taking Time off Work

The decision to take time off work can be out of necessity due to surgery or illness, or simply because you want to focus on healing. Regardless of the reason, there are ways to lessen the financial impact associated with this decision.

• Disability Insurance
  It’s always best to have a plan in place before illness strikes. This means having an emergency savings fund, as well as short- and long-term disability insurance. With disability insurance, a percentage of your income is provided to you in the event of an injury or illness that prevents you from working. These plans may be offered by your employer as part of your benefits package, or you may be able to purchase plans through an insurance agent or financial institution. Be sure to speak with your employer’s human resources representative to find out what options are available to you.
• Family and Medical Leave Act (FMLA)
  Through the FMLA you are allowed to take up to 12-weeks unpaid leave to heal from a serious health condition. You are not paid for this time off; however, you will keep your benefits and maintain your position within the company. The downside is that FMLA only applies to employers of 50 or more people, and you must be a full-time employee with at least one year of service.
  
  When you return to work, keep in mind that you may need some time to ease back in to the routine. Be sure to speak with your employer about any changes you need to make in your work hours or responsibilities as you recover. If you need to work full time to keep your health insurance, speak with your employer about taking rests or breaks during the day.

Managing Psychological Stress

A breast cancer diagnosis can bring tremendous physical, emotional and social challenges that can cause stress. Some studies have shown that high stress levels may affect a tumor’s ability to grow and spread. While more research needs to be done in this area, there is one thing that is certain: stress in a person with breast cancer can lead to an increased risk of depression, anxiety and feelings of hopelessness and helplessness.

UPMC Breast Care Center’s team recognizes how damaging stress can be to someone who is undergoing treatment. That’s why we provide a wealth of support services designed to help our breast cancer patients through their initial diagnosis and treatment, and then throughout survivorship. These services emphasize education, group support, nutrition, and more.

Early-Onset Menopause

Menopause is a gradual and natural part of the aging process that occurs, on average, around age 50 . Unfortunately, some breast cancer treatments can fast-track this process and force a woman into what is called medical or surgical menopause.

When this happens, the woman experiences a sudden and dramatic shift in her body’s hormonal system. This takes place over the course of days or weeks – rather than years – and can add to the physical and emotional stress of cancer treatment.

Reasons for early-onset menopause in women with breast cancer can include:

• Taking certain medicines that slow or stop the function of the ovaries. This type of menopause may be temporary and last only as long as treatment or it may be permanent. The effects depend largely upon the type of medication you are receiving.
• Oophorectomy, or the removal of the ovaries through surgery, is sometimes recommended. This causes immediate menopause.
• Some medications don’t cause actual menopause but rather, menopause-like symptoms.

In addition to the discomfort of early-onset menopause, breast cancer treatment can also raise concerns about fertility and long-term effects like bone loss.

If your treatment puts you at risk of early-onset menopause, members of your UPMC Breast Care Center team will work with you to address any concerns or questions you may have. They will also help you understand how to manage your menopause symptoms so that you can live more comfortably.

Pregnancy and Breast Cancer

It’s rare for a woman to be diagnosed with breast cancer during pregnancy…but it does happen. Thankfully, the National Comprehensive Cancer Network, a group of 19 leading cancer institutions in the U.S., has developed guidelines for treating breast cancer during pregnancy. UPMC Breast Care Center is one of the hundreds of institutions in the nation that follow these guidelines.

Women who have been diagnosed with breast cancer, but who hope to have children in the future, are often very concerned about how treatment will affect their fertility. The UPMC Breast Care Center team understands this concern and will work with you to identify your risk of infertility, the seriousness of your diagnosis and whether pregnancy is a safe option for you to pursue following treatment.

As appropriate, we will help you access the procedures necessary to preserve your future chances of getting pregnant.

A Note about Intimacy

Physical intimacy and breast cancer aren’t two topics that are often discussed in unison, yet they should be.

Many women have reported that their breast cancer diagnosis and treatment made it difficult for them to be intimate either with their current partner, or with someone they may meet in the future. This can happen for a number of reasons including:

• The physical changes associated with breast cancer surgery
• Side effects of treatment (exhaustion, nausea and pain)
• Emotional chaos of the diagnosis
• Overall changes in self-image

Should you have concerns about how your diagnosis is affecting your ability to be intimate, either now or in the future, please speak with a member of your UPMC Breast Care Center team. We can direct you to resources to help both you and your partner.

Providers

• Lisa K. Torp, MD
• Katherine A. Barton, MD
• Theresa M. Lee, MD
• Kit Lu, MD
• Brynn Sigal Wolff, MD
• Rachelle J. Gehr, GC
• Beth A. Rudge, CRNP
• Meagan E. Smith, GC

Need more information?

Phone: 717-545-5000

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Locations

UPMC Breast Care Center
11 Sprint Drive
Suite C
Carlisle, PA 17015
Phone: 717-960-3360
Fax: 717-706-6709