Navigating Treatment By Staying Active
- Despite being dismissed by her doctor at age 26, researcher and powerlifter Lashae Rolle pushed for further testing, which confirmed she had Stage 2B estrogen receptor-positive breast cancer.
- “The first thing that every breast cancer patient gets tested is their estrogen [ER], progesterone [PR], and HER2 [receptor status],” says Dr. Ankit Madan, a medical oncologist and hematologist at MedStar Health in Washington, D.C.
- Dr. Madan adds that ER and PR hormone receptor status help determine how sensitive tumors are to the hormones: estrogen and progesterone, which influence which treatment to utilize.
- Chemo works by traveling through the bloodstream, killing cancerous cells. However, healthy cells are also impacted in the process, leading to side effects that include fatigue, hair loss, nausea, gastrointestinal issues, and neuropathy.
- “Neuropathy is probably one of the most challenging side effects,” says Dr. Renata Urban, a gynecologic oncologist at the University of Washington in Seattle. Neuropathy results from damage to the peripheral nerves.
- Rolle continued weight training during chemotherapy, publishing research showing exercise helps mitigate side effects, preserve strength, and empower survivors to reclaim agency.
“I went to my doctor, and she said it was nothing, so I didn’t think about it. I was told I was good,” Rolle told Today.com.
Read MoreView this post on InstagramDespite the reassurance, her training and research told her otherwise. She pushed for further testing, even as her concerns were met with skepticism.
“You sure you want to go ahead and do this? Because you can’t get breast cancer at age 26,” she recalled hearing at the doctor’s office.
“If I had any advice for you following a cancer diagnosis, it would be, first, to seek out multiple opinions as to the best care,” National Cancer Institute chief of surgery, Dr. Steven Rosenberg, tells SurvivorNet. “Finding a doctor who is up on the latest information is important, and it’s always important to get other opinions so that you can make the best decisions for yourself in consultation with your care providers.”
WATCH: The Difference a Second Opinion Can Make.
That persistence paid off. A mammogram confirmed what her gut already knew—she had breast cancer, specifically Stage 2B estrogen receptor-positive breast cancer.
“The first thing that every breast cancer patient gets tested is their estrogen [ER], progesterone [PR], and HER2 [receptor status],” says Dr. Ankit Madan, a medical oncologist and hematologist at MedStar Health in Washington, D.C.
ER and PR hormone receptor status help determine how sensitive tumors are to the hormones: estrogen and progesterone. Should the tumors be sensitive to these two hormones, blocking them through hormone therapies, with drugs like tamoxifen (ER blocker), can help deter cancer growth. Additionally, the presence of these receptors can indicate a disease that will usually lead to better outcomes than cancers without these receptors.
Similarly, HER2 is a protein present on many breast cancer cells and can drive their growth. If cancers express or over-express HER2 (termed HER2+), they can be candidates for drugs like trastuzumab (brand name Herceptin), pertuzumab (brand name Perjeta), and ado-trastuzumab emtansine (brand name Kadcyla) that specifically target HER2+ cells, inhibiting their growth and reducing the risk of recurrence.
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When to Screen for Breast Cancer
The medical community has a broad consensus that women should have annual mammograms between the ages of 45 and 54. However, an independent panel of experts called the U.S. Preventive Services Task Force (USPSTF) is saying that women should now start getting mammograms every other year at the age of 40, suggesting that this lowered age for breast cancer screening could save 19% more lives.
The American Cancer Society recommends getting a mammogram every other year for women 55 and older. However, women in this age group who want added reassurance can still get annual mammograms.
WATCH: When you’re getting a mammogram, ask about dense breasts.
Women with a strong family history of breast cancer, a genetic mutation known to increase the risk of breast cancer, such as a BRCA gene mutation, or a medical history, including chest radiation therapy before the age of 30, are considered at higher risk for breast cancer.
Experiencing menstruation at an early age (before 12) or having dense breasts can also put you into a high-risk category. If you are at a higher risk of developing breast cancer, you should begin screening earlier.
Rolle’s diagnosis marked the beginning of a grueling treatment journey. But Rolle refused to let cancer strip away her sense of agency. Drawing on her research, she leaned into strength training to reclaim control and preserve normalcy.
“I didn’t choose to do the treatments—it was more like I had to do that to get past the situation. I had to lose my hair. I lost a lot of control, but with strength training, I was able to get up, go to the gym just like normal, and it was under my own will,” she explained.
Even during chemotherapy, which often leaves patients exhausted, Rolle continued powerlifting. Her commitment wasn’t just personal—it became part of her professional mission.
She published her findings in the peer-reviewed journal Lifestyle Medicine, concluding that “delayed post-treatment exercise, and moderate-to-high-intensity workouts effectively mitigate side effects while preserving muscle mass and strength.”
Now, Rolle shares her story to remind others that cancer doesn’t define them.
“I want them to know that they’re strong after cancer,” she says. “You can do so much more than you think.”
Helping Patients Cope with Chemotherapy
Managing Chemotherapy and Its Side Effects
Chemotherapy is an effective tool for oncologists to help treat cancer by stopping cancerous cells from growing, dividing, and spreading to other organs. Chemo works by traveling through the bloodstream, killing cancerous cells. However, healthy cells are also impacted in the process, leading to side effects.
Patients almost universally experience fatigue, often alongside gastrointestinal side effects, such as nausea. Doctors have many effective medications to combat chemo-induced nausea. “But mitigating that fatigue often depends on the patient,” says Dr. Renata Urban, a gynecologic oncologist at the University of Washington in Seattle.
“Neuropathy is probably one of the most challenging side effects,” says Dr. Renata Urban, a gynecologic oncologist at the University of Washington in Seattle. Neuropathy results from damage to the peripheral nerves. It usually resolves after chemotherapy treatment, but sometimes symptoms can persist. While it’s typically characterized by numbness or a pins-and-needles sensation in the hands and feet, neuropathy can have several different symptoms, including:
- Weakness in the hands or feet
- Stabbing or burning pain in the hands or feet
- Difficulty gripping, such as when holding a fork
- Difficulty with fine motor skills, such as writing or buttoning a shirt
Nausea and vomiting are common side effects of chemotherapy. When chemotherapy affects the rapidly dividing cells in the lining of the stomach, the resulting cellular havoc in the gastrointestinal tract can lead to side effects such as nausea and vomiting. However, doctors can help patients mitigate the hit with various medications before, during, and after treatment.
“Part of the chemotherapy prescription includes a set regimen of anti-nausea medications,” says Dr. Renata Urban, a gynecologic oncologist at the University of Washington in Seattle. “We also ensure that patients have medications at home that they can use should they develop nausea after treatment.”
Hair loss is another side effect of chemotherapy.
WATCH: Coping with hair loss.
“For cancer patients, losing one’s hair can be unbelievably stressful. To start with, the dread of losing one’s hair can lead to some sleepless nights and feelings of anxiety,” Dr. Samantha Boardman, a New York-based psychiatrist and author, told SurvivorNet.
Chemotherapy can cause hair loss. It usually begins about three to four weeks after chemotherapy and continues throughout treatment.
It happens because this treatment targets quickly dividing cells throughout the body. That includes cancer cells but also hair cells.
Most patients can expect regrowth four to six weeks after treatment. However, it is possible that when your hair grows back, you may notice some changes in its color and texture.
RELATED: How are chemotherapy side effects managed for ovarian cancer treatment?
Tips for Navigating Chemo Side Effects
When dealing with fatigue, doctors don’t have an arsenal of weapons to combat fatigue in terms of prescription medications. However, you can do several things to help minimize the hit and restore your energy.
- Exercise: While it may be counterintuitive, physical activity can help alleviate side effects, especially fatigue. “Although ovarian cancer is not common, we often draw upon the experience of patients with breast cancer and colon cancer, who have shown that physical activity can not only improve quality of life but may also have beneficial impacts on cancer outcomes,” Dr. Urban says.
- Eat well: Even though nausea may interfere with your ability to eat a healthy diet, it’s essential to ensure you’re eating appropriately, getting enough protein, and not losing weight. Not only will nourishing your body support your recovery, but it may also help you feel more energized.
- Sleep: Want to mitigate fatigue? Be sure to maintain your regular sleep-wake cycle while on treatment. Sticking to a set sleep schedule helps reduce fatigue by ensuring enough hours for your body to heal and restore itself each night. It may also help you recover more quickly by keeping energy levels high during the daytime.
Treating Neuropathy Symptoms
Doctors have several strategies for helping patients deal with this side effect. Once a patient begins experiencing the symptoms of neuropathy, they’ll be carefully monitored to make sure it doesn’t get worse. Before each chemotherapy infusion, the attending oncologist will assess whether the symptoms have progressed. If the symptoms worsen, they may adjust the dose or delay treatment. They may also try switching to another chemotherapy drug.
How to Get a Handle on Nausea
Most of these anti-nausea medications last for more than eight hours. One of the infusions commonly used reduces the degree of nausea for up to three days.
Complementary approaches may also be helpful. A few favorites:
- Ginger: Studies consistently show that ginger helps alleviate chemotherapy-induced nausea. The powerful herb appears to have an anti-spasmodic effect on the gut. Not a fan of raw ginger? Suck on ginger candy, sip ginger ale, or make a steaming cup of ginger tea.
- Pressure bracelets: at your local pharmacy, these bracelets provide consistent pressure on a particular acupressure point on the wrist to reduce nausea.
- Deep breathing: Moving air in and out of your lungs with a few deep breaths can help relieve nausea, particularly if you pair deep breathing exercises with meditation. It can also help you relax and release stress and anxiety.
WATCH: Managing chemo side effects.
Coping with Hair Loss
If losing your hair is a concern for you before cancer treatment, know you have options like wigs, hats, wraps, and scarves, among other things.
Another option that can minimize hair loss is cryotherapy, “just a fancy way for saying cold therapy,” says Dr. Renata Urban, gynecologic oncologist at the University of Washington in Seattle.
Cryotherapy involves wearing cold caps or special cooling caps before, during, and after each chemotherapy treatment.
Help Coping With a Breast Cancer Diagnosis
If you are facing a breast cancer diagnosis, your emotions are likely to run high, which is completely normal. Psychiatrist Dr. Lori Plutchik says emotions are often fluid when coping with a diagnosis.
“The patient or person going through the stressful event should accept that emotions will be fluid. You may feel fine one day and then feel a massive wave of stress the next. It’s also important for those you look to for support, whether that’s a therapist, friends, and family, or both, to understand the fluidity of stress-related emotions,” Dr. Plutchik said.
WATCH: How to cope with complex and changing emotions.
If a stressful event affects how you think and feel, it may be time to seek mental health treatment. This could mean traditional talk therapy, medication, changing lifestyle habits (like exercise and diet), seeking a support group, or many other approaches.
SurvivorNet experts suggest women needing a little extra help coping with a breast cancer diagnosis.
- Let your family and close friends know, and let them help. So many cancer survivors tell us they want and need support, but are often too preoccupied to make specific requests. Urge those close to you to jump in with whatever practical help they can offer.
- Keep a journal. It can be extremely cathartic to let those feelings loose on paper. Grab a pen and a nice journal and chronicle your thoughts throughout the day.
- Join a cancer support group. Groups in nearly every community offer opportunities to connect with others going through a similar journey. You’ll learn constructive insight from others who can tell you what to expect and how to stay strong on tough days.
- Consider seeing a therapist. Ask your doctor to refer you to a therapist so you can discuss your fears and concerns in a safe space. Often, vocalizing your thoughts and feelings rather than internalizing them can provide relief.
Breast Cancer Symptoms & Self-Exams
Women are encouraged to do regular self-exams to become familiar with how their breasts feel normally, so when something unusual, like a lump, does form, it can be easily detected. A self-exam includes pressing your fingertips along your breast in a circular motion.
For some women, that means going to their doctor and walking through what a self-breast exam looks like, so they know what normal breast tissue feels like, so if they do feel something abnormal, whether it’s a lump or discharge from the nipple, they know what to ask and what to look for.
Below are common symptoms to look out for:
- New lump in the breast or underarm (armpit)
- Any change in the size or shape of the breast
- Swelling of all or part of the breast
- Skin dimpling or peeling
- Breast or nipple pain
- Nipple turning inward
- Redness or scaliness of the breast or nipple skin
- Nipple discharge (not associated with breastfeeding)
What To Ask Your Doctor
If you have been diagnosed with breast cancer, you may have questions about keeping your strength through treatment. Here are a few questions to help you begin the conversation with your doctor:
- What treatment will I be receiving?
- What side effects are associated with this treatment?
- Are there steps I can take daily to help minimize these side effects?
- What physical activity routine do you recommend for me during treatment?
- Do you have recommendations for someone who doesn’t particularly enjoy exercise?
- Can you recommend a dietician who can help me with healthy eating tips and weight maintenance?
- I’ve been having trouble sleeping. Do you have any treatment recommendations?
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