Managing Life After Breast Cancer: Risks and Activities for Survivors

Breast cancer sentinel lymph node?

My grandmother is 70 years old and was diagnosed with stage II invasive ductal carcinoma last year, with one or two lymph nodes affected on the right side.
She underwent sentinel lymph node biopsy and a right mastectomy, and has completed chemotherapy.
She has been on Tamoxifen for hormone therapy for six months now and returns to the clinic every three months for follow-up.

Currently, she has started to return to her previous activities, such as gardening, raising chickens, and folding lotus flowers.
Sometimes she uses recycled materials, and due to her religious beliefs, she prioritizes temple activities, including participating in rituals.
She has taken on the role of a bell ringer at the temple, which we do not fully agree with, but she becomes very upset if we express our concerns.
The doctor mentioned that it is important for cancer patients to maintain a positive mindset and engage in activities they enjoy.
Initially, the doctor indicated that the presence of one or two affected lymph nodes could suggest metastasis, and that lymph node removal might lead to complications such as lymphedema.
I would like to ask a medical professional whether engaging in activities like bell ringing or overexerting herself could increase the risk of cancer recurrence for a patient like her.

Yan Yan, 20~29 year old female. Ask Date: 2016/10/11

Dr. Wu Jianting reply Breast and Thyroid

1.
Your grandmother's doctor mentioned lymphatic infection, which likely refers to the metastasis of cancer cells to the lymph nodes, hence the use of chemotherapy.

2.
After treatment for breast cancer, we expect patients to return to their normal lives, adhering to regular medication and follow-ups.
Your grandmother is in this situation, so it should be viewed positively.

3.
There is no definitive conclusion on whether fatigue increases the risk of recurrence, and it is difficult to measure, as it depends on individual tolerance.

4.
For the issue of lymphedema, elevating and massaging the affected area after strenuous work or exercise can help alleviate the symptoms gradually.

Reply Date: 2016/10/11

More Info

Managing life after breast cancer can be a complex journey, especially for survivors like your grandmother, who has undergone significant treatment and is now navigating her post-cancer life. It's important to understand both the risks and the activities that can contribute positively to her well-being.

Firstly, regarding the concern about the potential for cancer recurrence, it’s essential to recognize that while the risk of recurrence exists, many factors influence this risk, including the type of cancer, the stage at diagnosis, and the treatments received. In your grandmother's case, she was diagnosed with stage II breast cancer, which typically has a good prognosis, especially after successful treatment. The fact that she has completed chemotherapy and is now on hormone therapy for five years is a positive sign, as these treatments are designed to reduce the risk of recurrence.

However, the presence of lymph node involvement does indicate a higher risk of recurrence compared to cases where no lymph nodes are affected. The removal of lymph nodes can lead to complications such as lymphedema, which is swelling due to fluid buildup. This condition can be managed with physical therapy and proper care, but it does require attention.

As for your grandmother's activities, engaging in hobbies such as gardening, caring for chickens, and participating in religious activities can be beneficial for her mental and emotional health. Studies have shown that maintaining a positive outlook and engaging in enjoyable activities can significantly improve the quality of life for cancer survivors. It is crucial for her to feel a sense of normalcy and purpose, which these activities can provide.

However, moderation is key. While it is important for her to engage in activities she loves, it is equally important to ensure that she does not overexert herself. Overexertion can lead to fatigue and may increase the risk of complications, including lymphedema. It is advisable for her to listen to her body and take breaks when needed. If she experiences any unusual symptoms, such as swelling in her arm or persistent fatigue, it would be wise to consult her healthcare provider.

Regarding her involvement in religious activities, such as participating in temple duties, it is essential to assess the physical demands of these activities. If they require significant physical exertion, it might be worth discussing with her doctor to ensure that she is not putting herself at risk. Encouraging her to find a balance between her spiritual commitments and her physical health is vital.

In summary, while your grandmother's active lifestyle and engagement in enjoyable activities are beneficial for her mental health, it is crucial to monitor her physical health closely. Encourage her to maintain open communication with her healthcare team about her activities and any concerns she may have. Regular follow-ups and monitoring will help ensure that she remains healthy and can continue to enjoy her life post-cancer. Ultimately, a balanced approach that prioritizes both her physical and emotional well-being will be the best strategy for managing life after breast cancer.

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