SHARE July slides handouts (1)

Livingwithand aftercancer

AsofJanuary1,2025,about1outofevery18Americans (18.6millionpeople)isacancersurvivor

By2035,thatnumberisprojectedtoexceed22million

(TheAmericanCancerSociety)

4millionbreastcancersurvivorsintheUnitedStates

Lifeafterbreast cancer treatment

Breastcancertreatmentcanlastweekstoyears

Manytreatmenteffectsareshortterm(e.g.nausea, mouthsores,hairloss)

Manypeoplewillexperiencelong-termsideeffects

mayoccurmonthsorevenyearsaftertreatmentends

PHYSICALHEALTH CONCERNS “LateTreatment Effects”

Lymphedema

Hearthealth

Treatmentrelated(cardiotoxicityrisk)

Bonehealth

Osteopenia,osteoporosisandriskforfractures

Pain

Fatigue

Weightgain/loss,metabolicchanges

BrainFog/Cognitivechange/memoryproblems

Menopausalsymptoms

Hotflashes,sexualfunction,impactonintimacy

Lossoffertility,inabilitytobuildfamily

Others?

HOWTO MANAGESIDE EFFECTS?

Symptommanagement=qualityoflife!

Thisisyouroncologyteam’sjob

Palliativecare

Traditionalmedicalapproach

Referraltospecialist

Cardiology,physicaltherapy,gynecology,endocrinology

Survivorshipclinic

Rehabilitation/physicaltherapy

Prescriptionmedicine

Mentalhealth/cognitivebehavioraltherapy

Integrativeapproach

Restoringbodytonaturalstateofwellness

Mind/bodyemphasis:meditation,yoga,mindfulness

Exerciseandnutrition

Aromatherapy,acupuncture,Reiki,energywork

Hydrotherapy–watertherapy,floating,swimming

Palliativecare

Palliativecaredefined:aimstoalleviatepain, symptoms,anddistressassociatedwiththeillness

Canbeginondayoneofdiagnosistomanagesideeffects

Canstartandstoppalliativecareatanytime

Coordinateswithtreatmentteam

Palliativecareisnotthesameashospice

Coordinatingreferralsforsymptommanagement

SurvivorshipProgram

OncologyandPrimarycarecoordination

Communicationiskey

Ifavailableusecancercenterresources

Patientportal,oncologynavigator,referral/callcenter,social workerforreferrals

PHYSICALHEALTH CONCERNS

PainPalliativecareprovider,Painclinic

Lymphedema,Neuropathy,SexualHealthRehabilitationClinic

Assessment,Physical/Occupational/DecongestiveTherapy

HearthealthCardiology

Assessmentfortreatmentrelated(cardiotoxicityrisk

BonehealthPrimarycare

Assessmentofbonedensity

Weightgain/loss,metabolicchangesEndocrinology

Fatigue,Cognitivechange/memoryproblemsPrimarycareand Mentalhealth

Menopausalsymptoms–GynecologyandEndocrinology

Hotflashes,sexualfunction,impactonintimacy

Lossoffertility,inabilitytobuildfamilyReproductive endocrinology

Others?

Longterm survivorship

Emotionsandfeelings

Gratitude,anger,grief,loss,fear

Changesdaytodayandovertime

Whatemotionsarepartofyourjourney?

Paradox

“Iamgratefultobeasurvivor,tobealive,ANDIamalso disappointedthatthingshavenotturnedoutlikeIthought theywould.”

Theparadoxof survivorship

Both/Andthinking

Sweetandsour:

“IamBOTHgratefultobealiveANDangrythatwhenIlookatmy bodyinthemirrorIseescarswheremybreastsusedtobe”

“IamBOTHhappytohaveasupportivepartnerANDalsosadthat Idon’tenjoyintimacylikeIusedto”

MANAGING SYMPTOMSof ESTROGEN DEPRIVATION

Boneloss:

Eatcalcium-richfoods,suchasgreens,shellfish,anddairy

Weight-bearingexercisestrengthensbones-walking,hiking, dancing,gardening

ConsultwithprovideraboutcalciumandvitaminD supplementation

Baselinebonedensity/DEXAScanifonestrogenblockingtherapy

Hotflashes:

Dressinlayers

Recognizeandavoidtriggers

hotdrinks,spicyfood,smoking,caffeine,stress,fatigueandalcohol

Relax

Mindfulness,yoga,sleephygiene

Medicalmanagement:prescriptionantidepressants

Nightsweats:

Keephome/bedroomcool,usefan,makebedwithlayersthatcan beremoved

Avoidheavycomfortersorflannelsheets

Wearlightweightpajamas,ornothing

MANAGING

SEXUAL SYMPTOMS

Vaginaldrynessandpelvicfloortightness:

Vaginalmoisturizers

ReplensorMeAgain,coconutoil,vitaminEcapsules

Askprovideraboutuseoftopicalestrogencreamsandgels

Forvaginalpain(penetrativesex,insertingtampon,or tension)usewaterbasedlubricantlikeAstroglide,K-YJelly, GoodCleanLove

Referraltopelvicfloorphysicaltherapist

Lowlibido,lossofsexualdesire

Hormonalchanges,lackofestrogenandtestosteronecan impactsexdrive

Bodyimageimpactsdesire

Taketime,redefinesexgoals,focusontouch

Talkwithyourprovider/oncologysocialworker

Referralstocounseling(couples/sextherapist)forrelationship concerns,and/orpelvicfloortherapist

Fertilityloss,familybuildingoptions

MENTALHEALTH CONCERNS

Anxiety

Fearofrecurrence

Sleep

Depression

Relationshipdynamics

Family,dating,marriage/partnerships,providers,fellow survivors,colleagues,professionalcontacts

Memoryproblems

MANAGING MENTAL HEALTHNEEDS

Getprofessionalhelpwhenneeded

Oncologysocialworkercanassess

Whoonyourteamcanyoutalkto?

Uncertaintyis“newnormal”

Howcanyoumanagethis?

Whatdoessupport/selfcarelooklike?

onlinesupportgroups,forums,journalingprompts, walking/hikingclubs

Selfcareroutines–walks,baths,class,funnymovie, reading

Selfcaresplurges–massage,fancymeal,weekendtrip

Spendtimewithfamilyandfriendsvs.plantimeaway

FEAROF RECURRENCE

“Ican’tstopworrying,allIthinkaboutisthecancer comingback”

Scanxiety=powerfuleffectonthequalityofyourlife

Howdoyoufeelaboutyour“Cancer-versary”?

Recognizeemotions

Talkaboutfeelingsandconcerns,validate

Noticetriggers–followupappointments,waitingfor results

Journaling,supportgroups,

Roleoftherapistvs.discusswithlovedones

Whenisaprofessionalneeded?

SELFCARE

Whatcanyoucontrol?

Schedulefollowupappointmentsandscreenings–

Mammogram/MRI,skinscreening,colonoscopy,papsmear

Genetictestingandcounselinguptodate

Getascreeningbuddy–accountability,celebratewhenyou bothcomplete–lunch,movie

Eatingwell–oncologydietician,cookingclasses,leadwith curiosity,pre-mademeals

Secondaryprevention:Smokingcessation,limitalcohol

Emotional/MentalHealth

Managestress,copingmechanisms

Physicaltherapy-preventive/functional,notjustwhen somethingispainful

Pelvicfloortherapyforsexualhealth

Planahead–fieldtrips,holidays,todolist

BESTPRACTICES

Let’stalkaboutit

Whatresonatesandworksforyou?

Whatquestionsdoyouhave?

Whatdidwemiss?

Pleasefeelfreetocontactmewithfollowupquestions

EmilyBeard,RN,OCN,CBCN,BHCN

Email:Emily.Beard@northside.com

Phone:404-213-5951(textisbest)