Cancer News

Last Updated: 2008-04-01 11:17:07 -0400 (Reuters Health)

Developing anemia during chemotherapy to treat early-stage breast cancer seems to affect the risk of the cancer coming back. The small study reviewed here found that women who became anemic while getting chemotherapy after early-stage breast cancer surgery were more than twice as likely to have the cancer come back 5 years after surgery compared to women who didn’t develop anemia. Almost 20% of the women with chemotherapy-related anemia had the cancer come back 5 years after surgery compared to only 8.9% of the women who didn’t develop anemia.

Many women in the study were followed for more than 5 years. The researchers found that the women in the study who developed anemia had a risk of the cancer coming back at any time (including longer than 5 years after surgery) that was almost 3 times greater than the women who didn’t develop anemia.

Although the risk of the cancer coming back in the breast was different, the researchers found that the risk of the cancer coming back in another place in the body (metastatic cancer) was the same for women who did and didn’t develop anemia. Also, the risk of dying from breast cancer was the same for women who did and didn’t develop anemia.

Chemotherapy is commonly used after early-stage breast cancer surgery to lower the risk of the cancer coming back. Anemia is a common side effect of chemotherapy, but not all women who get chemotherapy develop anemia. Radiation therapy is also used to lower the risk of the cancer coming back when a woman has lumpectomy instead of mastectomy. In addition to chemotherapy, the women in this study got radiation therapy if they had lumpectomy.

The researchers aren’t sure why the women who developed chemotherapy-related anemia were more likely to have the cancer come back.

Doctors sometimes use medicines to prevent or treat chemotherapy-related anemia. This research didn’t look at whether these medications could lower the risk of the cancer coming back. Even with these medicines, many women will still develop some level of anemia, which could affect their risk of the cancer coming back.

If you’re getting chemotherapy after surgery as part of your treatment plan for early-stage breast cancer, talk to your doctor about anemia and steps you can take to lower both the risk of anemia and the cancer coming back. Visit the breastcancer.org Chemotherapy section to learn more about chemotherapy and its side effects.

Constipation is when bowel movements become less frequent and stools are hard, dry, and difficult to pass. You may have painful bowel movements and feel bloated or nauseous. You may belch, pass a lot of gas, and have stomach cramps or pressure in the rectum.

Drugs such as chemotherapy and pain medicine can cause constipation. It can also happen when people are not active and spend a lot of time sitting or lying down. Constipation can also be due to eating foods that are low in fiber or not drinking enough fluids.

Ways to manage

• Keep a record of your bowel movements. Show this record to your doctor or nurse and talk about what is normal for you. This makes it easier to figure out whether you have constipation.
• Drink at least 8 cups of water or other fluids each day. Many people find that drinking warm or hot fluids, such as coffee and tea, helps with constipation. Fruit juices, such as prune juice, may also be helpful.
• Be active every day. You can be active by walking, riding a bike, or doing yoga. If you cannot walk, ask about exercises that you can do in a chair or bed. Talk with your doctor or nurse about ways you can be more active.
• Ask your doctor, nurse, or dietitian about foods that are high in fiber. Eating high fiber foods and drinking lots of fluids can help soften your stools. Good sources of fiber include whole-grain breads and cereals, dried beans and peas, raw vegetables, fresh and dried fruit, nuts, seeds, and popcorn.

When you eat more fiber, be sure to drink more fluids.

• Let your doctor or nurse know if you have not had a bowel movement in 2 days. Your doctor may suggest a fiber supplement, laxative, stool softener, or enema. Do not use these treatments without first checking with your doctor or nurse. Check with your doctor or nurse before using fiber supplements, laxatives, stool softeners, or enemas.

• Trouble wearing contact lenses. Some types of chemotherapy can bother your eyes and make wearing contact lenses painful. Ask your doctor or nurse if you can wear contact lenses while getting chemotherapy.
• Blurry vision. Some types of chemotherapy can clog your tear ducts, which can cause blurry vision.
• Watery eyes. Sometimes, chemotherapy can seep out in your tears, which can cause your eyes to water more than usual.

If your vision gets blurry or your eyes water more than usual, tell your doctor or nurse.