They were the axes of a day open to recovered patients, with the aim of inviting them to actively participate in their health care after the illness. The cardiac and emotional benefits of exercise, what to do when there is a history of oncology in the family and tips to protect irradiated areas from the sun during treatment.
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Along with early diagnosis and the prescription of appropriate treatment, prevention is a fundamental tool to confront breast cancer, the tumor that most affects women and the one with the highest number of cases in Argentina. Maintaining an active life, with a physical activity routine appropriate to each person’s capabilities, provides multiple benefits not only to reduce the risks of developing the disease, but also to better cope with the treatment and subsequent recovery.
This theme was the opening axis of the meeting of women who experienced breast cancer, which was held in September within the framework of the National Mastology Conference, organized jointly between the Society of Obstetrics and Gynecology of Mar del Plata and the Argentine Society of Mastology. The impact of heredity on this type of tumor and skin care in the stages after the disease was also discussed there. The objective, in advance of Breast Cancer Awareness Month, which is commemorated throughout October, was to actively involve patients in their own care, providing them with a space in which they can train and learn more about their disease process and protagonists of their own story.
“Firstly, exercise improves cardiovascular health in all populations, but especially in patients who have had breast cancer, since it helps improve circulation, aerobic capacity and blood pressure, and collaborates with the management of associated climacteric symptoms. to some of the treatments and above all it provides a subjective feeling of well-being, management of stress, anxiety and subjective emotional symptoms that often accompany a cancer diagnosis,” explains Dr. María Florencia Calvo (MN 129537), a doctor specializing in mastology. and breast surgery at the Italian Hospital of Buenos Aires.
The expert adds that physical activity also expands the range of joint movement and helps prevent sarcopenia or loss of muscle mass, which in turn is a very important predictor of frailty in older patients. “Specifically, rowing, given its characteristics, offers a form of natural mechanical lymphatic drainage, which helps to improve in some cases lymphedema that can develop to a greater or lesser extent after axillary surgery,” details Calvo, who is a member of the Argentine Society of Mastology (SAM). In general, he clarifies, it is recommended that physical activity be in accordance with the aerobic potential of the person who underwent treatment and adapted to their age and physical condition.
It can be aerobic or strength training: the important thing is that it is authorized by the doctors who accompany the patient and know the particularities of her case.
An active life
Maintaining an active life has a positive impact on heart health: it reduces the risk of cardiovascular disease, heart attack and stroke. But it also reduces sleep disturbances, improves self-esteem and perception of body image, and is associated with long-term physical and emotional benefits. In addition, it offers other indirect advantages, such as meeting other people, socializing and managing anxiety and stress.
“The habit of exercise is difficult to incorporate in those who have not done it previously. For this reason, we encourage patients to start ‘getting moving’ with gradual activities and efforts, that are not excessively demanding at the start, to minimize frustration and encourage persistence over time. Generally, as they notice and reap the benefits, it becomes a virtuous cycle of positive feedback in which they feel encouraged to continue exercising at increasing intensity. The more important the physical well-being achieved, the more permanence patients achieve in the activity and the better they feel. It must also be taken into consideration that many oncological treatments can cause fatigue, tiredness or listlessness, which sometimes takes a long time to subside. For this reason, it is recommended that exercise be incorporated in a sustained but progressive manner, respecting the times and needs of each individual patient,” he maintains.
hereditary breast cancer
An important fact that was raised during the day is that a third of people diagnosed with cancer have close relatives who also had the disease. Knowing this situation is essential to define a more appropriate prevention strategy, which may include controls at younger ages, stricter controls, or that include more specific studies, depending on the characteristics of each case.
“Many times, this family history increases the chances of cancer developing and must be evaluated to know exactly what the risk is in each situation. Between 5-10% of cancers are caused by genetic errors (mutations) that are inherited. In these cases, the risk of developing the disease can be very high, sometimes reaching values as high as 80% and in some cases 100% throughout life. Identifying cases of familial and hereditary cancer allows us to establish prevention measures in all people in that family group, helping to improve survival,” explains Dr. Silvina Sisterna (MP 117256), specialist in medical genetics, gynecology and obstetrics at the Hospital. Private community of Mar del Plata.
Hereditary tumors usually present at younger ages and may have a greater risk of recurring after initial treatment, which is why the topic took on special interest in the day shared by recovered patients in Mar del Plata. What are the guidelines that may lead one to suspect a hereditary predisposition to a breast tumor? Dr. Sisterna details the most important ones:
- Cancer at an early age.
- Bilateral or multicentric cancer.
- Triple negative cancer.
- Two or more family members with the same cancer.
- Cancer in more than one family generation.
- Two primary tumors in the same individual.
- Cancer in the less common gender (for example: breast cancer in men).
- Occurrence of rare tumors (for example: medullary thyroid cancer, desmoid tumors, pheochromocytomas, retinoblastomas, etc.).
- Risk ethnicities (for example: Ashkenazi Jews).
The level of risk can be known from a genetic evaluation and counseling consultation. “When an alteration is identified in a breast cancer predisposition gene, it is likely that the controls after the diagnosis of breast cancer will be more rigorous than in a patient who does not carry a mutation. These controls will be subject to the type of altered gene. There are high oncological risk genes and moderate oncological risk genes. This will determine which breast studies should be ordered and how often. Likewise, in some cases an oncological risk reduction surgery (mastectomy) could be considered,” adds the expert.
Skin care, a key point
Among the recommendations for women who have undergone breast cancer treatment, there are some guidelines for daily life that are important to keep in mind. Dr. Ana Mariela Motta (MN 107930), member of the Argentine Society of Mastology and the Mastology, Gynecology and Obstetrics Unit of Mar del Plata, focused during the day on the importance of “adapting our daily routine to care for the skin to reduce and prevent the side effects of the treatment.” In that sense, he listed a series of tips on what they should do:
- Use moisturizing and restorative creams at least twice a day.
- Use mild, unscented products, such as neutral soaps.
- Take short showers with warm water, and dry your skin gently with a soft towel.
- Drink enough water to maintain good hydration.
- Wear comfortable clothing made of natural fibers to avoid skin irritation.
- Protect yourself from the sun: using high SPF sunscreen, even on cloudy or rainy days to prevent or reduce skin spots, and wearing hats and long-sleeved clothing when outdoors.
On the contrary, the expert highlighted that as guidelines for what not to do, it is necessary not to expose the irradiated areas to the sun during the treatment, even if sunscreen is applied; and avoid artificial tanning and tanning beds during treatment.
“It is important to remember that skin changes during treatment are temporary. That is why it is key to communicate with the medical team and follow their recommendations to achieve a successful recovery,” he said, emphasizing that it is crucial to care for and protect the skin even after completing the treatment. “Maintaining healthy skin using the appropriate products and following the recommendations will help us minimize side effects,” he said.
A shared experience
At the time of conclusions, and within the framework of Breast Cancer Awareness Month, Dr. Calvo affirms that the meeting held in Mar del Plata “left us, both doctors and patients, with the feeling that it is easier to work for a common objective when it is collaborative. It allowed you to put yourself in the other’s shoes, better understand their needs, respect their times, know the things that concern them and be able to develop strategies together to better share the responsibility of care, empower shared decision-making and give room for doubts and concerns that can often interfere with adherence to treatments or follow-up and ultimately hinder access to the desired common good, which is the well-being and physical, emotional and social health of each patient we accompany on their journey.”
“It is a way to give relevance to the patient’s needs and put them on the agenda, sharing space with many of the same professionals who accompany them daily. The particular thing about this meeting was that it was organized within the scientific program of the national conference, opening the door for patients and doctors to collaborate side by side in their healing. It was also a great opportunity to disseminate the activity carried out by the Roses of the Sea and also offer genuine testimonies from patients that can give encouragement to other people who face similar difficulties today,” concludes the expert from the Argentine Society of Mastology.
