Common long-term side effects of
chemotherapy include early menopause and weight gain. Rare side effects
include heart problems and leukemia.
Learn about short-term effects of chemotherapy.
Some chemotherapy drugs can damage the
ovaries and stop regular menstrual cycles (amenorrhea). In women under
40, this condition is often temporary (periods usually start again). In
women over 40, it is more often permanent, meaning menopause begins
earlier than expected .
Some women may begin having periods again
months or years after chemotherapy ends. However, even for women whose
periods return, menopause may still begin at an earlier age than for
other women .
Going through early menopause can be very
upsetting. As with natural menopause, you may have symptoms such as hot
flashes (including night sweats) and vaginal dryness (also called
vaginal atrophy). And, because the onset of menopause is abrupt, these
symptoms may be more severe than with natural menopause.
Early menopause can also affect bone
health. Menopause can cause a loss of bone density (osteopenia or
osteoporosis). And, some women who go through menopause have muscle or
Learn about ways to ease menopausal symptoms.
If you were hoping to have a child after
breast cancer treatment, early menopause can be very tough. However,
there are things you can do that may allow you to have children after
treatment. Speak to a fertility specialist before starting treatment to
learn about your options.
The most common procedure for preserving
fertility involves storing embryos before chemotherapy begins. In this
procedure, some of your eggs are collected and fertilized by sperm from a
spouse, partner or donor.
Unfertilized eggs (which do not require a
sperm donor) can also be frozen and stored. In the past this method was
less likely to result in pregnancy compared to using fertilized eggs
that had been frozen and stored. However, with modern techniques for
freezing unfertilized eggs, pregnancy rates are similar .
Insurance coverage for fertility services
varies widely from state to state, so it is best to check with your
insurance provider to find out what is covered.
There are no known treatments guaranteed
to protect the ovaries from the damaging effects of chemotherapy.
However, some drugs that shut down the ovaries during chemotherapy may
help women return to regular menstrual periods. This may help preserve
fertility in the long term (learn more).
Learn more about fertility options for women undergoing chemotherapy.
Weight gain is a common side effect of chemotherapy, especially in women who go into early menopause .
Changes in metabolism caused by chemotherapy and a less active
lifestyle add to weight gain during treatment. One study found that
breast cancer survivors who got chemotherapy were 65 percent more likely
to gain weight compared to those who did not get chemotherapy .
Women who gain weight usually put on about five to 15 pounds . The more weight a woman gains, the less likely she is to return to her pre-diagnosis weight .
Maintaining a healthy weight after a breast cancer diagnosis is important and may improve survival [36-38]. Learn more about body weight and survival after breast cancer.
Eating tips to manage your weight
Making healthy food choices and getting
regular exercise during treatment (if possible) may help prevent weight
gain. Seeing a dietician may also help. Learn more about a healthy diet and exercise.
Browse over 600 healthy recipes. Keep in mind, these recipes are meant to encourage healthy food choices, not necessarily reduce your risk of breast cancer.
Although mainly a short-term problem,
fatigue can affect some people long-term . You may feel like you
don’t have any energy and may feel tired all of the time. Sometimes,
getting enough rest doesn’t help.
Regular exercise, even just walking for
20 minutes every day, can help reduce fatigue [28-30]. Getting a good
night’s sleep is also important. Talk with your health care provider if
you are fatigued or have problems sleeping (insomnia).
Learn more about fatigue and insomnia.
Some people have cognitive problems after chemotherapy, including mental “fogginess” and trouble with concentration, memory and multi-tasking [40-41]. This condition is often called “cancer brain” or “chemo-brain.”
Most people have mild symptoms, though
some have more troubling cognitive problems that can impact daily life.
Symptoms may last for one to two years after treatment or longer. Most
people report that they go away over time.
The link between cognitive problems and
breast cancer diagnosis and treatment remains unclear. Stress, anxiety
and depression can affect cognitive function. Symptoms may first appear
with the stress related to diagnosis and treatment and then become worse
after chemotherapy. Medications used to treat the side effects of
chemotherapy (such as sleeping aids and anti-nausea medications) can
also cause these symptoms. Age may also play a role. Some studies show
older women tend to have more cognitive problems after chemotherapy than
younger women . At this time, the true extent of the cognitive effects of chemotherapy is not well understood.
Cognitive problems may not be limited to
women treated with chemotherapy. They have also been reported after
other breast cancer treatments (such as hormone therapy) . More research is needed in this area.
Although there are no data to show the tips below improve cognitive function, they may help some people with memory problems .
Tips to improve cognitive function
Adapted from selected sources .
Heart problems and leukemia are rare but
severe side effects of certain types of chemotherapy. These risks are
related to the dose and type of chemotherapy drug. With the doses given
today, the risk of having either heart problems or leukemia is low [43-44].
Heart problems, like cardiomyopathy
(enlarged, weakened heart) and congestive heart failure, have been
linked to the use of certain chemotherapy drugs (such as doxorubicin and
epirubicin) and to the use of trastuzumab [43-45]. (Learn more about trastuzumab.) These conditions can sometimes be reversed if the drugs are stopped at the first sign of heart damage .
With drugs that may cause heart problems, extra care is taken to avoid
heart problems. For example, before you begin chemotherapy with the drug
doxorubicin, your heart function will be measured to make sure there
are no pre-existing heart conditions.
Leukemia has been linked to the use of certain chemotherapy drugs including cyclophosphamide, doxorubicin and epirubicin .
For most people with breast cancer, the benefits of chemotherapy outweigh these risks.
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