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Life after breast cancer: aftermath tests mind, body and wallet

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After treatment: what to watch for

Women who have been treated for breast cancer sometimes develop the following:

1. Lymphedema.

Breast cancer survivors face the possibility of developing lymphedema, or swelling of the arm from buildup of fluid, for the rest of their lives. Any treatment that involves removing or giving radiation to the axillary lymph nodes carries the risk of lymphedema.

2. Uterine cancer.

Women who are taking tamoxifen or toremifene are at increased risk for uterine cancer and should have annual pelvic exams. This risk is highest in women who have gone through menopause.

3. Diminished bone health.

Women who are taking an aromatase inhibitor or are pre-menopausal and taking tamoxifen or toremifene, especially need to monitor their bone health. A bone density test may be in order.

4. Recurrence.

If symptoms, exams, or tests suggest a recurrence, imaging tests such as an X-ray, CT scan, PET scan, MRI scan, bone scan, and/or a biopsy may be done. Your doctor may also measure levels of blood tumor markers.

The American Cancer Society

Updated: October 2, 2012 10:17AM

No matter how many times you have faced cancer in the past, a diagnosis of breast cancer is a scary obstacle to overcome.

“When I was pregnant with my first child I found out I had thyroid cancer,” said April Rietjens Sedall, 45, of Glen Ellyn. “Because I was pregnant, they had to do surgery at a very specific time to not hurt the baby. I had surgery to remove my thyroid gland when I was 15 weeks [pregnant]. Then, I waited for treatment until she was 10 weeks old. It had to be put off or it would have hurt the baby.”

Fifteen years later, in 2009, Rietjens Sedall was back to battling cancer. This time it was a bout with breast cancer.

“It was really shocking and horrible,” Rietjens Sedall said. “I had never smoked and have always been a healthy eater. I felt like I did everything right. Bad stuff happened to me with no family history.”

Doctors removed the cancerous breast. They later found suspicious cells in Rietjens Sedall’s other breast, which was also removed as a precaution.

Early detection and improvements in breast cancer treatment are linked to decline in breast cancer deaths. According to the American Cancer Society, breast cancer death rates decreased 2.2 percent per year from 1990 to 2007, after having increased 0.4 percent per year from 1975 to 1990.

Upon receiving a diagnosis, breast cancer patients need to make many difficult choices regarding their treatment. Such was the case for Rietjens Sedall.

“After two years there were suspicious cells in my other breast and I didn’t want to take any chance,” Rietjens Sedall said. “I ended up having both breasts removed.”

Sometimes the scariest part of the process takes place after the cancerous cells have been removed via surgery.

Mary Maryland, patient nurse navigator for the American Cancer Society at Loyola University Bernadine Cancer Center, sees the trepidation.

“To some degree, after whatever intervention has happened, there is a ‘now what?’ feeling,” Maryland said.

The journey of breast cancer carries on for years after diagnosis and treatment — taking a toll on the mind, body and wallet.

“Every six months I see my oncologist,” Rietjens Sedall said. “I don’t take tamoxifen anymore, but now [a different medication] for between five and ten years.”

The stress of cancer can be elevated to a whole other level if a patient does not have insurance or the best coverage. According to a 2009 synthesis of published evidence on the National Center for Biotechnology Information’s website, the estimated lifetime per-patient cost of breast cancer in the United States ranges from $20,000 to $100,000. Continuing care accounted for the largest share of lifetime cost due to the relatively long survival of breast cancer patients. Susan G. Komen For the Cure reports in its “Facts for Life” that a generic form of tamoxifen costs about $100 per month.

Rietjens Sedall, who has two daughters, said after facing cancer a second time she decided to do something she had always dreamt of.

“As the result of the second cancer, I opened a personal office management company,” Rietjens Sedall said. “We help people with projects in their home. Overcoming cancer gave me the courage to leave big companies and start my own thing.”

According to Dr. Patricia Robinson, assistant professor in the hematology and oncology division in the department of medicine at Loyola University, after diagnosis, treatment and recovery, the process comes full circle.

“Don’t let one’s diagnosis define who they are, but take it as one step in their cancer journey,” Robinson said. “When you transition from treatment to cancer survivor it loops back to prevention. Employ strategies to reduce the risk of getting any type of cancer, like colonoscopies, pap smears and dermatology.”

Rietjens Sedall promises to remain vigilant in making sure her cancer doesn’t come back.

“Knowing me, I am a fighter,” Rietjens Sedall said. “I am not a worrier, but I’m a warrior. All we have is our ability to be strong and fight things.”

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