Breast cancer survivorship: Help for what comes next

With more than 4 million breast cancer survivors in the United States, there is a growing focus on providing care after breast cancer treatment. This number is expected to grow because of improved screening and treatment.

Most patients treated for breast cancer will live cancer-free, but they may have increased risk for chronic medical conditions, including:

• Bone health problems

• Vaginal or sexual health problems

• Heart disease

• Anxiety, depression and other mental health problems

• Recurrence

• New cancers

UW Health Breast Cancer Survivorship Program

After breast cancer treatment, you might wonder "What comes next? And how do I stay healthy?" The UW Health Breast Cancer Survivorship Program has answers to these and any other question you may have. Our goal is to give you suggestions for staying healthy - now and in the future.

The UW Health Breast Cancer Survivorship Program includes:

• A treatment summary and survivorship care plan based on your needs. This provides information about your treatment and how to manage your healthcare in the future.

• A special clinic for survivors who have completed surgery, chemotherapy and radiation.

• Support for lymphedema, exercise, diet, bone health, sexual health, emotional concerns and genetics as well as expertise in primary care and oncology.

The UW Health | Carbone Cancer Center also does research to better understand the needs of cancer survivors and to develop more effective strategies to meet these needs.

Shortly after surgery, chemotherapy and/or radiation, you will be offered a transition visit and personal survivorship care plan. This visit and plan gives you information for addressing the effects of cancer and treatment and recommendations for identifying treatment-related issues and promoting healthy behaviors.

Program providers also will talk with you about any concerns you may have related to your breast cancer diagnosis and treatment. These discussions may include information about:

• Signs and symptoms of breast cancer recurrence

• Management of side effects from treatment

• Sexual health and fertility concerns

• Bone health recommendations

• Lifestyle recommendations

• Social, financial or other concerns

• Patient questions or concern

Survivorship Clinic

At UW Health, we believe healthcare providers who understand the effects and possible complications of breast cancer should care for cancer survivors. The Survivorship Clinic is run by nationally recognized providers with training and experience in breast and survivorship care. This includes advanced practice providers and internal medicine doctors.

The Survivorship Clinic is open to breast cancer survivors who are referred by their primary care provider or their UW Health cancer team. We provide both long-term follow-up for breast cancer survivors and one-time consultations.

Patients use the Survivorship Clinic for varying lengths of time, depending on the type of cancer and their health status. When your risk of recurrence is low and your concerns are addressed, you will return to your primary care provider for ongoing care. If your cancer comes back or if your treatment plan changes, you will return to the cancer team.

Clinic appointments are available at the UW Health Breast Center in Madison, Wis. and UW Health 1340 Charles St Clinic and UW Health | Carbone Cancer Center Rockford in Rockford, Ill. Each appointment includes a history, a physical exam, as well as any referrals for imaging or specialty care. To ensure continuity, you will receive a summary of your visit. Your primary care provider and cancer team also receive the after-visit summary.

It is important that you follow your healthcare provider’s recommendations for breast cancer screening.

If you are receiving endocrine therapy to prevent breast cancer from coming back, be sure to take your medication as directed; stopping your medication or missing doses can increase your risk of recurrence.

Studies show that the following healthy habits and lifestyle choices can reduce your risk for breast cancer:

• Avoid the use of hormone replacement therapies (HRT). This includes especially oral and transdermal HRT. There is limited information about the safety of "bioidentical estrogens" although they are marketed to women as "safer."

• Maintain a healthy weight, especially after menopause

• Get regular exercise, in at least moderate amounts

• Limit your intake of alcohol. Generally, an average of one-half serving per day or less is recommended