8 Key Messages from Consumer/Patient Day

We’ve pulled together eight of the most important messages that were discussed on the day.

The speakers covered a lot of content, and if you’re interested in watching the full talks and Q&A sessions, we’ve got the videos on our website for you to view.

1. Exercise reduces your risk of breast cancer recurrence

Two speakers talked about exercise as a major priority for breast cancer survivors. Nutritionist Kaytee Boyd recommends 3-5 hours a week, and says we should find something active that we love doing, and stick to it!

Oncologist Pamela Munster was asked about tamoxifen and weight gain, and confirmed that yes, cancer treatments can make you gain weight – it’s not all Cadbury’s fault! She says that for reducing the risk of recurrence, being active is more important than losing that extra weight. So even if it’s not making a difference on the scales, keep exercising – it’ll be making a difference to your health.

2. There are two types of reconstruction available: Implants and flap reconstruction. If your surgeon doesn’t discuss both options with you, ask why.

The different types of reconstruction suit different people, and have their own advantages and disadvantages. Some surgeons only perform implant reconstructions, while others might only do flaps, but all surgeons should be able to talk you through your options. If you end up favouring one type of surgery over the other, find someone who will perform the surgery you want.

Overseas, some patients have an immediate reconstruction before radiation. This isn’t common practice in New Zealand, but ask your doctor if it’s possible for you.

3. Recent research supports taking hormone therapy for ten years, rather than five.

Staying on tamoxifen or aromatase inhibitors for ten years is now supported by a large amount of research, and countries like the UK and Australia are changing their practice guidelines. Even if you’ve done your five years and been off tamoxifen for a while, you’ll benefit from going from back on for another five.

However, the magnitude of those benefits differ from woman to woman. Talk to your oncologist about whether you should consider extending your course of hormone therapy, and weight up the benefits with the severity of any side-effects you experience.

4. Talk to your doctor about the side-effects from hormone therapy, and try to find a way of continuing on your medication.

The side-effects from hormone therapy range from non-existent to so severe that some women stop taking their medication all together. Dr Pamela Munster thinks other steps can be taken to alleviate these problems.
Firstly, talk to your oncologist. You might be able to switch to a drug that your body tolerates better, reduce your dose, or ease into therapy slowly.

Secondly, find out what other things you can do to help with the side-effects. Dr Munster talked about exercise to reduce joint pain – riding a bike or working out on an elliptical trainer can be better than walking. There’s also an NZ clinical trial piloting the use of magnesium to combat concentration issues and memory loss with hormone therapy. Talk to your doctor about the side–effects that you’re suffering from, and what can be done about them.

5. Your oncologist, surgeon and breast nurse are doing the best they can for you, but their assumptions aren’t always correct. Make sure your voice is heard.

Dr Andy Evans discussed the treatment of low-risk cancers. In the UK, the LORIS trial is comparing survival outcomes for women with low grade DCIS, half of whom are treated the usual way (surgery and radiotherapy) and half of whom aren’t treated at all, but monitored to see if the cancer advances.

He described a survey the researchers performed before the trial started. They expected a large group of women to say that they wouldn’t participate in the trial, because they would want to make sure they could have treatment. They were right – many women didn’t want to participate in the trial, but it was because they wanted to be in the active monitoring group, and didn’t want treatment.

What your doctor assumes you want isn’t always correct, so make sure you get your opinion across.

6. Radiotherapists are making major steps forward in reducing side-effects from radiotherapy.

Radiotherapy techniques are being refined constantly to make sure that women are receiving as much benefit as possible from breast radiation, with minimal harm.

Radiotherapists now bring the radiation in from the side, rather than from above, so that the breast tissue is being irradiated, and as little radiation as possible is getting to the heart.

Some radiologists also encourage breath-holding. For some women, holding the breath for short periods of time during radiation moves the heart far enough away from the radiation field that no radiation reaches the heart, decreasing the chance of damage to the heart.

Christchurch hospital now has deep-inhalation breath holding machines, which allow this technique to be applied with more precision.

7. Pregnancy after breast cancer is safe, but Dr Sheridan Wilson recommends waiting for two years after finishing treatment before becoming pregnant.

Dr Wilson admits there isn’t a whole lot of research in this area, but there are two main reasons why experts think you should wait.

Firstly, your risk of relapse is highest in the first two years after treatment. After that, your risk decreases. Secondly, two years gives your body time to recover completely from your cancer treatment. After two years, your body should be strong enough to cope more comfortably with the rigours of pregnancy.

8. BRCA testing offers huge benefits, no matter what the result is.

Dr Pamela Munster, being BRCA positive herself, knows how much a definitive genetic diagnosis can put your mind at ease. Women who are BRCA positive can take preventative action, and women who aren’t can find peace of mind.

If you’ve got a family history of breast cancer, make it known to your GP or oncologist. Not many people will be eligible for testing – cancer-causing genetic mutations are rare – but if you’re eligible, make sure you take the test.

Want more details? Watch all the Consumer/Patient Day talks here.