Controlling symptoms of secondary breast cancer

Feeling very tired is called fatigue. It is common. If it is caused by the cancer, treatments may help improve tiredness. You are likely to be tired during treatment, especially if you are having chemotherapy. But this should slowly improve once you finish chemotherapy.

If you are having ongoing treatment and are struggling with fatigue, tell your cancer doctor. They may suggest adjusting the dose of your treatment, if it they think it may help.

Make sure you get enough rest. But try to balance this with some physical activity, such as short walks.

Sometimes tiredness is caused by a low number of red blood cells. This is called anaemia. Your doctor can do a blood test to check this. They may give you tablets to treat it. You may need to have a blood transfusion.

We have more information about managing fatigue.

This can be caused by:

• cancer treatment drugs, for example chemotherapy
• anti-sickness drugs
• painkillers.

Your cancer doctor or GP can prescribe a medicine called a laxative to help. Things you can do to help are:

• eating more fibre
• drinking plenty of fluids
• being more physically active if you can – for example going for short, regular walks.

We have more information on managing constipation.

There are many different painkillers. The painkiller you have will depend on the type of pain you have. You may need more than 1 type of painkiller.

You usually have painkillers as tablets. You can also have them as a skin patch, an injection into the skin, or sometimes as a suppository (into the back passage).

It is important to:

• take your painkillers regularly – this will help give you constant pain control
• let your cancer doctor or specialist nurse know if the painkillers are not controlling your pain.

Radiotherapy works well in treating bone pain if the cancer has spread to the bones. Bone-strengthening drugs can help to reduce bone pain.

Steroids are used to reduce swelling and control pain. We have more information about controlling pain.

If breast cancer has spread to the bones and is causing pain, there are different ways it can be controlled. You may be given:

• drugs called non-steroidal anti-inflammatory drugs (NSAIDs)
• bone-strengthening drugs called bisphosphonates or denosumab
• a single session or short course of radiotherapy.

Radiotherapy is very effective at treating bone pain but can take a few weeks to work. Take your painkillers regularly until the radiotherapy works.

There are different things that can cause breathlessness. Tell your cancer doctor or specialist nurse if you feel breathless. They will check what is causing your breathlessness. They may arrange some tests or scans. They will give you advice on how to manage your breathlessness, and they may give you some medicines to help.

Sitting down when you are doing daily tasks such as washing, dressing or making food can help you to manage breathlessness. Controlled breathing or relaxation techniques may also help.

If cancer cells spread to the tissues that line the lungs (the pleura), it can cause fluid to build up. This is called a pleural effusion. It can make you breathless.

Your cancer doctor can treat this by passing a narrow tube into the chest to drain off the fluid. This usually improves your breathing straight away. If it comes back, the fluid can usually be drained again. It may be possible to have a special catheter put in. This allows you to drain the fluid into a bottle when you are at home.

Treating the cancer may also help to slow down or stop the fluid building up again.

To stop fluid build-up, your doctor may recommend a treatment that seals the 2 layers of the pleura together. This is called a pleurodesis. You will need to have a short stay in hospital.

During a pleurodesis you have a tube put into the chest to drain the fluid. The doctor injects sterile talcum powder through the same tube. This helps seal the layers of the pleura together.

A pleurodesis can also be done using a procedure called video-assisted thoracoscopic surgery (VATS). We have more information about pleurodesis.

A secondary brain tumour can cause different symptoms. These may include headaches, sickness, vision problems or weakness in an area of the body. These can be frightening, but the symptoms may often be controlled with:

• drugs called steroids, which reduce swelling in the brain caused by a tumour
• radiotherapy to the head or a specialised type of radiotherapy called stereotactic radiotherapy
• surgery to reduce the pressure in the area of the brain.

Radiotherapy can often improve symptoms quickly. You can also have drugs to treat headaches or to control fits (seizures) if needed.

We want everyone affected by cancer to feel our information is written for them.

We want our information to be as clear as possible. To do this, we try to:

• use plain English
• explain medical words
• use short sentences
• use illustrations to explain text
• structure the information clearly
• make sure important points are clear.

We use gender-inclusive language and talk to our readers as ‘you’ so that everyone feels included. Where clinically necessary we use the terms ‘men’ and ‘women’ or ‘male’ and ‘female’. For example, we do so when talking about parts of the body or mentioning statistics or research about who is affected.

You can read more about how we produce our information here.