Living with and beyond cancer

Published on 09/04/2015 by admin

Filed under Hematology, Oncology and Palliative Medicine

Last modified 09/04/2015

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24 Living with and beyond cancer

Case update

It is now 5 years later and Michelle is 50 years old. She remains disease free and is about to be discharged from the follow-up clinic. She will be invited to have a mammography every 3 years as part of the national breast cancer screening programme.

From a medical point of view, Michelle has physically ‘recovered’ from her cancer and its treatment, however she is experiencing a number of chronic effects of treatment. Although Michelle’s cytotoxic therapy did not induce an early menopause, she has experienced hot flushes, vaginal dryness, poor libido and weight gain since commencing tamoxifen.

The surgery has restricted her left arm and shoulder movement which has made carrying bags, swimming and household chores very difficult. Michelle is considering whether she should have a breast reconstruction. She feels that this may have a positive affect on her body image, although she is worried about undergoing further surgery.

The radiotherapy has resulted in dilated blood vessels under the skin around the mastectomy site. This is not painful but, visually, Michelle feels very conscious of this.

Any slight twinge, ache or pain Michelle experiences, she wonders if the cancer has come back. Michelle constantly fears the cancer may reoccur – this is quite debilitating and is a particular problem during the night, affecting her sleep. She is also concerned that the cancer might be linked genetically (even though she has no family history herself), and is anxious that her daughter may be at increased risk of developing breast cancer.

Michelle has been back at work for 4 years and, although she likes the people she works with, she is feeling bored and would like a new job that would stretch her mentally and have more potential to earn more money. She isn’t sure whether she should tell prospective employers about her past medical history and is worried that if she moves jobs she may loss her entitlement to sick leave and pay.

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