Dorothy Hamill talks about persistent chemotherapy side effects

Olympic figure skating  star Dorothy Hamill was diagnosed with breast cancer nearly three years ago. However, despite being cancer free for two years, the  54-year-old told People magazine that she still suffers some side effects from the surgery, radiation and chemotherapy treatments she underwent.  “I don’t have a lot of energy,” she says. “I get really tired. Even when I’m not skating I get tired.” Hamill is currently taking Tamoxifen, a drug that interferes with the activity of the female hormone estrogen. Studies show that Tamoxifen helps prevent the original breast cancer from returning and also helps prevent the development of new cancers in the other breast.  Hamill says that Tamoxifen makes her “achy,” even if she is not skating.

What are some of the long term term side effects of chemotherapy for breast cancer?

Common long-term side effects of chemotherapy include:

  • Early menopause
    • Some chemotherapy can damage the ovaries and stop regular menstrual cycles. For some women, this is temporary, for others the change can be permanent. This is more common in women over 40. Symptoms include  hot flashes and vaginal dryness.  Because the onset of menopause is abrupt, these symptoms may be more intense than with natural menopause.
    • Early menopause can affect fertility, although storing embryos before chemotherapy will allow some of these women to bear children.
  • Weight gain
    • Weight gain is common in women who are treated with chemotherapy, especially those who go into early menopause.
    • Chemotherapy can change metabolism, and a less active lifestyle can contribute to weight gain.
  • Fatigue
    • Although mainly a short-term side effect, fatigue can affect some people for a long time.
  • Rare side effects include heart problems and leukemia.
    • Leukemia can be associated with the use of medications- cyclophosphamide, doxorubicin and epirubicin.
    • Heart problems, such as cardiomyopathy (enlarged, weakened heart) and congestive heart failure, have been linked to the use of doxorubicin and epirubicin.
  • Cognitive function/ “Chemo-brain”
    • Some people will have difficulty with their cognitive functioning such as mental “fogginess” and trouble with concentration and memory. This is often referred to as “chemo-brain”.  For most people this is a short term problem, while others have long-term mental changes.

What are some of the more common side effects of tamoxifen?

The known, serious side effects of tamoxifen are blood clots, strokes, uterine cancer, and cataracts. Other side effects of tamoxifen are similar to the symptoms of menopause. The most common side effects are hot flashes and vaginal discharge. Some women experience irregular menstrual periods, headaches, fatigue, nausea and/or vomiting, vaginal dryness or itching, irritation of the skin around the vagina, and skin rash. As with menopause, not all women who take tamoxifen have these symptoms.

Mark Boguski, M.D., Ph.D. is on the faculty of Harvard Medical School and is a member of the Society for Participatory Medicine, "a movement in which networked patients shift from being mere passengers to responsible drivers of their health" and in which professional health care providers encourage "empowered patients" and value them as full partners in managing their health and wellness.

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