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The symptoms of secondary breast cancer can often be relieved by treating| the cancer itself.
Sometimes treatment works quickly and you may notice an improvement within a few days. At other times, treatments may take longer to work and it can be several weeks before you begin to feel the benefits. Always let your doctor or specialist nurse know about any symptoms you have.
Apart from treating the cancer itself, there are also lots of other ways to help relieve symptoms. Remember, you won’t experience all or even many of the symptoms mentioned here.
There are many effective ways of treating and controlling pain.| Different types of painkillers, which vary in strength and the way they work, are available. They can be taken as tablets or liquids, suppositories (inserted into the back passage) or as injections under the skin. A combination of different painkillers can be used. Remember to:
Drugs known as non-steroidal anti-inflammatory drugs (NSAIDs) can be helpful in relieving pain, particularly in the bones. Radiotherapy| is also a very effective way of treating pain in the bone, but it may take a few weeks to work. Bisphosphonates| are also used to reduce bone pain.
Moderate pain can be controlled with drugs containing codeine. Stronger painkillers, such as morphine, can also be used. Morphine may make you feel drowsy when you start taking it, but this usually only lasts for a day or so. Constipation| is a common side effect of all these drugs.
There are special NHS pain clinics run by doctors and nurses with expertise in treating pain. Your doctor can refer you if there are problems controlling your pain.
You may have breathing problems if the cancer has spread to the lungs|, or to the linings on the outside of the lungs (pleura). Cancer cells can irritate the pleura and cause fluid to build up, known as a pleural effusion|, making you breathless.
Pleural effusions can be treated by passing a narrow tube connected to a drainage bottle into the chest to drain off the fluid. You may need to spend a few days in hospital until the fluid has been drained away. A procedure called pleurodesis, which sticks the two linings of the lung together so fluid can’t collect there, is sometimes done.
Morphine (a strong painkiller) can be used to relieve breathlessness| as it helps you relax and controls your breathing. Sitting upright means there’s less effort for your lungs to expand. Try using extra pillows or a large triangular support pillow when you’re in bed or resting on a sofa. Cool air blowing onto the front of your face can help you breathe more easily. Try using a small hand-held fan or sitting by an open window. Putting a cool flannel on your face may also help.
Some treatments may make you feel sick| but this goes away when treatment is over. Secondary breast cancer affecting the liver| or the brain| may cause sickness, and so can high levels of calcium in the blood (hypercalcaemia).
There are many anti-sickness drugs available which work in different ways. Let your doctor or nurse know if the one you’re taking isn’t working, as another type can be tried. It’s usually a good idea to take them regularly and about 20-30 minutes before meals.
Many anti-sickness drugs are available as suppositories (inserted into the back passage), which can be helpful if you feel too sick to swallow a tablet. Anti-sickness drugs can also be given as injections into a muscle, or continuously through a small pump attached to a tube with a fine needle placed under the skin.
This is a common and frustrating side effect of treatment and sometimes a symptom of the cancer itself. You may feel like you have no energy at all and it’s difficult to do simple everyday things. You can manage your tiredness| by:
Sometimes, feeling very tired is linked to problems such as depression|, pain, sleep problems, anaemia (low levels of red blood cells) or thyroid problems. So it’s important to find out if there’s a specific reason for your tiredness, which can be treated.
Constipation| can be caused by strong painkillers or by too much calcium in your blood. Having fibre in your diet, drinking plenty of fluids and getting some exercise will help. You may need to take a medicine to stimulate the bowel (laxative), which your doctor can prescribe for you.
If you have symptoms affecting your sleep, for example menopausal symptoms| or pain, controlling these will improve your sleep. Taking a warm herbal or milk drink, or a small alcoholic drink at bedtime may help you to relax. A lukewarm bath with soothing oils or a gentle massage before bedtime can also help. Getting some more exercise during the day can improve your sleeping. Listening to relaxation tapes/CDs/podcasts, relaxation exercises, visualisation, or meditation at bedtime may also help you relax. Your GP can prescribe sleeping tablets, even for just a short period of time, to help re-establish a sleep pattern.
Secondary breast cancer cells affecting a bone| may make extra calcium pass out of the damaged bone and into the blood. High levels of calcium in the blood can make you feel extremely tired and thirsty, and pass lots of urine. It may make you feel sick and some people become irritable and confused. This is treated by giving you plenty of fluids either to drink or through a drip, and with drugs called bisphosphonates| which are usually effective at getting the calcium levels back to normal. You should feel much better within a couple of days.
This is when a secondary tumour in the spine causes pressure on the nerves there. These nerves carry messages between the brain and the rest of the body. Spinal cord compression| rarely happens but it’s important that it is diagnosed quickly.
Some of the common symptoms are:
If you develop any of these symptoms, it’s very important to let your doctor know immediately. An MRI scan is usually done. Spinal cord compression needs to be treated urgently to relieve the pressure and prevent permanent damage to the nerves. It can be treated with a combination of treatments, including steroids|, radiotherapy|, surgery, bisphosphonates, and injections of a special bone cement into the spine.
Secondary breast cancer in the brain may cause headaches because of increased pressure in the skull. Steroids| are given to reduce the swelling and relieve symptoms. They’re usually given in short courses and have few side effects. When taken for long periods they may cause weight gain, a puffy face and muscle weakness.
Women with secondary breast cancer may have lymphoedema| if breast cancer has come back in the lymph nodes in the armpit. The cancer blocks the nodes in the armpit affecting the way lymph fluid drains from the arm and causes swelling there. A recurrence in the lymph nodes in the armpit isn’t secondary breast cancer, but some women may have this along with secondary cancer in other parts of the body.
Lymphoedema is a long-term condition but there are effective ways of reducing swelling. The earlier it’s diagnosed the more effective treatment is. You’ll be given advice on looking after your skin and be shown how to carry out some of the treatments for yourself at home. Any break in the skin can increase your risk of getting an infection, which can make lymphoedema worse. You can protect your arm and reduce the risk of infection by:
If you notice any redness or if your arm is warm to touch and swollen, see your doctor straight away. You may have an infection and will need to take antibiotics to treat it.
Content last reviewed: 1 September 2010
Next planned review: 2013
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© Macmillan Cancer Support 2013
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