Prevention
Modern medicine is increasingly transitioning towards preventive care. This shift towards prevention has also been observed in breast cancer care in recent years, particularly with the discovery of the BRCA gene. Subsequently, multiple genes and risk factors have been identified. Depending on these factors, a personalized screening strategy can be chosen. Therefore, it is crucial to understand these genetic and risk factors.
Diagnosis
I was diagnosed with cancer ... This website serves as a portal designed to assist you and your loved ones in accessing personal information and finding solutions to your concerns.
The primary goal of this website is to offer guidance and support to patients as they navigate their journey toward recovery and improved quality of life. The "Diagnosis" section of our website is divided into two main categories. Firstly, under "Anatomy and Physiology," we provide fundamental knowledge about the breast. Secondly, in the "Tumors and Disorders" section, we delve deeper into various breast-related conditions.
Moreover, we aim to provide information to women who may be concerned about potential breast issues but are hesitant to seek immediate medical advice. Knowledge and information can often offer immediate reassurance if a woman is able to identify the issue herself and determine that no specific treatment is necessary. Conversely, we also strive to educate women who have received a diagnosis of a serious breast condition, such as breast cancer, and wish to approach their doctor well-informed and prepared.
Treatment
The treatment for breast cancer should immediately include a discussion about reconstruction. Our foundation has no greater goal than to raise awareness of this among patients and oncological surgeons. By making an informed decision beforehand, we avoid closing off options for later reconstruction while still considering the oncological aspect. Of course, survival is paramount, and the decision of the oncologic surgeon will always take precedence.
The "Reconstruction or not?" page contains all the information you can expect during an initial consultation before undergoing tumor removal. This page is comprehensive, and your plastic surgeon will only provide information relevant to your situation.
"Removing the tumor" details the surgical procedure itself. This is the most crucial operation because effective tumor removal remains paramount. We guide you through the various methods of removal, a decision often made by a multidisciplinary team comprising oncologists, radiologists, pathologists, radiotherapists, breast nurses, gynecologists, oncological surgeons, and plastic surgeons.
The "Breast Reconstruction" section includes information and illustrations of the different reconstruction options along with corresponding steps.
Revalidation
Those treated for cancer often need a long period to recover.
Cancer is a radical illness with a heavy treatment. Often, people have to deal with psychosocial and/or physical problems afterwards, such as stress, anxiety, extreme fatigue, painful joints, reduced fitness, lymphedema... This can have a major impact on general well-being.
There are rehabilitation programmes offered by most hospitals. We cover some of the major topics here.
Quality of life
Quality of life is a key factor in coping with breast cancer. Therefore, it is important to find coping mechanisms that work, which will be different from patient to patient. For some, it may be finding enjoyment in activities they engaged in prior to diagnosis, taking time for appreciating life and expressing gratitude, volunteering, physical exercise... Of prime importance, studies have shown that accepting the disease as a part of one’s life is a key to effective coping, as well as focusing on mental strength to allow the patient to move on with life. In this section we are addressing some topics that patients experience during and after treatment and we are providing information to address them.
Skin troubles and skin care during chemotherapy
The skin is the largest organ in our bodies, which acts like a barrier that protects us from noxious environmental bacteria, viruses and fungi. It also regulates our temperature in our bodies and enables us to receive sensory impulses: the way we perceive things in the environment; heat or cold, and when we touch things. It also is in charge of forming Vitamin D, which is very important for our overall health.
The importance of this is that during chemotherapy treatment, most drugs block the activity or the ability of cells in our bodies to divide or grow, and therefore most chemotherapy will not be able to differentiate between a cancer cell that they are destroying or a normal cell such as skin cells that are growing. This leads to the dermatologic side effects as outlined below:
Dry skin
Rash
Many chemotherapy drugs may induce a photosensitivity rash.
Steroids are often used to reduce the risk of reactions and sickness around the time of chemotherapy sessions which can cause an acneform rash.Hand foot syndrome.
This is an adverse effect of some chemotherapy drugs such as oral capecitabine, 5-fluorouracil and doxorubicin. This manifests as a low grade mild redness of the palms and soles of the feet. However it may progress to painful blisters and peeling of the skin.
Radiation recall
This is an area of redness that develops in the field of radiation therapy after receiving a certain chemotherapy drugs.Inflammation of the oral mucosa
Hand-foot reaction
This side effect occurs in many patients in the course of chemotherapy. The hand-foot skin reaction manifests itself as:
itching, tingling
a feeling of tightness
burning
peeling, dry skin
a dull feeling
painful palms and / or soles of the feet
higher sensitivity to hot objects
redness
swelling, chapping, callus, or blistering at the rub sites of the palms of the hands and soles of the feet.
The symptoms usually appear after a few cycles. You may already apply the tips from the start of your treatment.
TIPS
Have the existing callus on hands and feet taken care of by a medical pedicure before the start of the treatment. Have the callus taken care of, but do not cut it!
Apply an emollient cream often to your hands and feet, especially where the skin is dry. For example a cold cream or a lipophilic cream.
In case of itching, you can rub the hands and feet with a urea-containing ointment.
Before going to sleep, apply a thick layer of ointment topped with a pair of socks to keep the ointment in place.
Wear cotton gloves and socks in the evenings to allow the moisturizers to penetrate optimally.
It is best to take a lukewarm shower and use a neutral and unscented shower gel. Gently pat the skin with a soft bath towel.
Use a sun protection factor (eg Factor 50) in the sun and an after sun spray to soften the skin.
Wear wide shoes, make sure your feet are not trapped in the shoes. The use of insoles is recommended.
Wear gloves, your hands can be very sensitive in the cold.
Use gloves when washing dishes, wear fine cotton gloves first and then rubber gloves.
A foot bath with magnesium sulfate (MgSO4) can have a soothing effect.
For open wounds, use a disinfectant foot bath once a day.
Consult a pedicure or podologist if you have hard and thickened areas of skin.
Apply corticoid-containing ointments only to the affected areas or you will irritate healthy skin.
Ask your doctor for a medicine for the itching or pain.
PAY ATTENTION
Avoid prolonged exposure to the sun.
Avoid hot showers or baths.
Avoid contact with detergent or other maintenance products. These dry out the skin.
Avoid rubbing the feet and hands, for example when taking a long walk or working with certain tools for a long time.
Do not open the blisters, this can make the symptoms worse.
Be careful with the use of plasters.
Avoid standing upright for a long time.
Avoid thin-soled shoes.
Avoid walking barefoot. It can cool down for a while but you have to watch out for cuts.
Inflammation of the oral mucosa
The mucous membrane in the mouth can become infected by chemotherapy. This is called mucositis. The inflammation is usually temporary but can be painful. The gums, tongue and lips can be sensitive, especially when eating and drinking.
Other complaints in the mouth are:
canker sores
a dry or sore mouth
ulcers
white batter on the tongue
red mucous membrane
bleeding gums
chapped lips
a sore throat
TIPS
Maintain good oral hygiene and well-groomed teeth.
Brush your teeth after every meal, at least 3 times a day.
Always brush your teeth with a soft toothbrush.
Use a mild toothpaste containing fluoride.
Rinse the toothbrush thoroughly and store it dry with the brush head facing up.
Replace your toothbrush every 2 months.
Use a tongue cleaner once a day to clean your tongue. Brush or scrape the back of the tongue and the sides of the tongue.
Floss your teeth once a day.
Always rinse your mouth with water after vomiting.
Rinse your mouth with Dentio 0.05% or another mouthwash without alcohol.
Use the mouthwash after brushing and before going to bed.
Keep lips moist with a lip balm.
Drink a lot (water, lukewarm tea).
In case of pain, eat foods that are soft.
If you have pain or open sores in the mouth, always contact the nurse. The painful areas in your mouth can be treated with a laser treatment.
Remove your dentures and rinse your mouth in case of pain.
Clean the dentures with a denture brush and liquid neutral soap. Do not use toothpaste as this will damage the dental prosthesis. An effervescent tablet does not replace brushing your prosthesis.
PAY ATTENTION
Avoid overly spicy, sour (lemon juice, vinaigrette, mustard), dry, crispy, hard, very cold or very hot food in case of pain or open sores in the mouth.
Avoid toothpaste with whitening properties (eg with peroxide).
Avoid alcoholic drinks.
Reduce or better, quitting smoking is recommended.
Source: brochure UZ Gent
External Links
https://www.cancerresearchuk.org/about-cancer/coping/physically/skin-problems
References
Gandey, Allison, “Minimize Chemotherapy-Induced Hand-Foot Syndrome. Medscape Medical News <http:www.medscape.com/viewarticle/561266> (January 2011).
Haas, Marilyn, and Giselle Moore-Higgs, ed. Principles of Skin Care and the Oncology Patient. Pittsburgh: Oncology Nursing Society, 2010.
Lacouture, M. E., and Melosky, B. L., “Cutaneous Reactions to Anticancer Agents Targeting the Epidermal Growth Factor Receptor: A Dermatology-Oncology Perspective.” Skin Therapy Letter 12.6 (2007): 1-5.
Topical hyaluronic acid vs. standard of care for the prevention of radiation dermatitis after adjuvant radiotherapy for breast cancer: single-blind randomized phase III clinical trial.
Pinnix C, Perkins GH, Strom EA, Tereffe W, Woodward W, Oh JL, Arriaga L, Munsell MF, Kelly P, Hoffman KE, Smith BD, Buchholz TA, Yu TK.
Int J Radiat Oncol Biol Phys. 2012 Jul 15;83(4):1089-94. doi: 10.1016/j.ijrobp.2011.09.021. Epub 2011 Dec 14.
Phase II study assessing the effectiveness of Biafine cream as a prophylactic agent for radiation-induced acute skin toxicity to the breast in women undergoing radiotherapy with concomitant CMF chemotherapy.
Szumacher E, Wighton A, Franssen E, Chow E, Tsao M, Ackerman I, Andersson L, Kim J, Wojcicka A, Ung Y, Sixel K, Hayter C.
Int J Radiat Oncol Biol Phys. 2001 Sep 1;51(1):81-6.