How to defeat cancer of the breast and a baby
About 16 thousand Ukrainians annually sick with breast cancer. For women who have been treated successfully, there is an acute problem of preservation of the attractiveness, of femininity and often the ability to have a baby. Many young women that defeated breast cancer, worried about possible infertility in the future. At the same time, modern oncomammology suggests otherwise: after all the stages of complex treatment, surgery, chemotherapy and radiation therapy, the occurrence of natural pregnancy is not fiction, and the ability of the female body for rehabilitation and reconstruction.
What is the connection between breast cancer and reproductive function? And is it possible after the disease to keep women’s attractiveness, sexuality and to experience the joy of motherhood?
We talk with a gynecologist-endocrinologist of the Hospital of the Israeli Oncology LISOD Alexandra Gromova.
— Alexander L., explain the relationship between gynaecology and mammology and why so many women who beat cancer of the breast, face many related gynecological problems. Always there is the cessation of the menstrual cycle, loss of fertility?
— Comprehensive treatment of breast cancer usually consists of surgical intervention, chemotherapy, and hormone-dependent tumors of anti-hormonal treatment. This is a difficult test for all organs and systems of the female body. But we women are remarkably resilient and plastic. We have a lot, including to defeat this disease! The course of cancer treatment ends and start the recovery process. The growth of nails, hair and eyelashes starting to come back, the nausea disappears and appetite appears, the woman returns to himself and finds new colors in life. Many in this period of rethinking life’s priorities, discover a new talent, begin to notice and appreciate the moments that previously escaped attention. And without exception, want to live a full life, to feel like a Woman. However, due to the complex treatment of breast cancer, many significantly inhibited ovarian function, causing pronounced estrogen deficiency. Hence the “tides”, night sweats, mood swings, dryness of the mucous membranes, attacks of palpitation and other symptoms. Subsequently there is a decrease in bone strength, and the woman becomes, in the truest sense of the word, “fragile” — that is, the possible fractures after minimal trauma. Such changes are often left without proper attention on the part of oncologists and gynecologists.
— Often the fault of the “pipeline.” Each specialist focused on his task. Surgeon important quality and uncomplicated to perform the operation, chemiotherapeutic focused on carrying out the most optimal Protocol that will allow you to overcome cancer. We doctors tend to see “their area” and not to think about related to the treatment of “minor” issues. The second problem is the lack of collective decisions. The practice of developing an individual plan of treatment with the obligatory participation of clinical oncologists, chemioterapico and radiation therapists on the territory of Ukraine is only present in the hospital of the Israeli Oncology LISOD.
When there is no such collective guardianship over the woman, the patient may not even know that after chemotherapy and radiation therapy is safe and effective opportunities to minimize the manifestations of deficiency of female sex hormones. In many women, ovarian function is damaged partially or completely restored over time, between 6 months to 2 years. To 40 years it occurs in 60% women after 40 have a 20%. The chances of spontaneous recovery of ovarian function is greater, the younger the woman at the time of the start of chemotherapy. For the period of recovery or in cases where ovarian function is not recovered, the woman is always in need of concomitant therapy. Hormone replacement therapy patients who have had breast cancer, is contraindicated. But maybe without hormone replacement therapy to reduce hot flashes, improve sleep and mood, prevent bone fragility and fractures, to minimize the effect of estrogen deficiency on the skin, mucous membranes and hair. In the Arsenal of a doctor for this there are a number of medicines. In the Arsenal of the patient — healthy eating, physical activity, yoga and swimming. And, most importantly, the support and care of relatives and friends.
After all, if the recovery of the female body has occurred, the patient is cured of breast cancer — can I have successful pregnancy?
The answer to this question can only be a Council clinical oncologist and gynecologist. For oncologist defining moments to “allow” a pregnancy, there will be two: or no hormone-dependent breast cancer in a patient, whether there has been full recovery. The gynecologist will determine whether pregnancy per se and will focus primarily on the preservation of ovarian function and the prospects for its recovery. These perspectives are also different, depending on age and postponed treatment.
In the case of hormone-dependent cancer stop menstruation at a young age is associated with anti-hormonal therapy (the drugs group LHRH agonists— Zoladex, decapeptyl, diphereline, etc.). The cessation of ovarian function as a result of this type of therapy is accompanied with such menopause symptoms: hot flashes, night sweating and, possibly, depressive manifestations. The symptoms are similar, but the essence of the process is fundamentally different. During menopause the ovaries don’t work because of exhausted reserve of follicles and oocytes. In adjuvant therapy, the ovaries remain healthy, but no longer work due to the lack of “a command from above”, from the hypothalamus. It is on this level are the Zoladex and similar drugs. Over time, after the abolition of anti-hormonal therapy, ovarian function in young women is restored. In the event of termination of ovarian function in conjunction with chemotherapy, the prospects are worse, but the chances of recovery are still there, as I said — up to 60% in young women. That is, the occurrence of pregnancy is possible. But is it safe for You? Is it possible that pregnancy in Your case? The issue is complex. And the answer is complicated. Today the problem is solved in the process of individual consultation with a clinical oncologist — based on the data on the hormonal receptors of the tumor stage at the time of the disease, duration of recurrence-free period.
Safe for mother and child pregnancy exist! However, the validity and time of pregnancy are agreed exclusively with the clinical oncologist. So consult and consult again
As a physician and as a woman I wish everyone facing breast cancer, a speedy recovery and bright, filled with joy.
Interviewed By Natalia Tverdokhleb.