Triple Negative Breast Cancer

Supportive Care

Many parts of your diagnosis and treatment are out of your hands, but don’t let that overwhelm you. Instead, identify what you can control, and reclaim your life with confidence. Ask your nurse navigator to recommend supportive care resources to help manage the emotional, social and physical challenges related to triple negative breast cancer (TNBC) and its treatment. In the meantime, these suggestions may help.

Watch for serious side effects. Severe side effects are not common but can occur. For people on immunotherapy, immune-related adverse events (irAEs) can develop rapidly and become serious, even potentially life-threatening, without swift medical attention. If immunotherapy is in your treatment plan, ask your doctor about symptoms to watch for, and act immediately if you experience them. Be alert for them up to two years after finishing treatment. See below for more common treatment-related side effects.

Lead a healthy lifestyle. Following a nutritious diet helps you tolerate treatment better and reduces the risk of cancer recurrence and secondary cancers. Know that your appetite and weight can fluctuate during treatment. A poor appetite may lead to weight loss, whereas fatigue and lack of exercise, combined with steroid treatment, may cause weight gain. Hormone therapy can increase your chance of weight gain and make it difficult to lose weight. Exercising can help you feel better overall. Do some type of physical activity daily, even walking for just 10 minutes. Use sunscreen if your activities are outdoors.

Find a positive emotional outlet. Your feelings may range from stress and fear to anger and depression. Many survivors find it comforting to talk with others who’ve gone through something similar. Opening up to a TNBC support group or therapist may help you work through some emotions. Journaling, meditating and guided imagery may increase your overall sense of well-being.

Explore fertility preservation options. If having a biological child is in your plans, consult with your medical team and a fertility expert before committing to any treatment options, if possible. Some treatments may affect your ability to have children.

Talk to your children about cancer. Telling your kids you have cancer may be difficult, but remind them it won’t affect how much you love them. The basic information they need is the name of the cancer, the body part it affects, how it will be treated and how their lives will be affected. Use age-appropriate language. Younger children may only understand that you’re sick and need medicine to get better, whereas older children will likely want to know more.

Maintain the household routine.Your family needs to feel some sense of predictability. That means school activities, social events and family dinners must go on, if possible. Ask everyone to do their part to keep the household running. Be careful not to put too much responsibility on older kids. Although they may be very capable of picking up the slack, they still need time to be kids.

Manage your career. Working helps you feel normal, and maintaining normalcy is key right now. Ask your medical team to arrange your treatment plan around your work schedule. For example, if side effects predictably occur 24 hours after treatment, get your treatment on a Friday afternoon so the side effects happen on Saturday when you’re home and have family support. Ask your human resources (HR) department at work about accommodations that can be made for you through the Americans with Disabilities Act (ADA) and the Family Medical Leave Act (FMLA). This could be especially helpful if you need to take off for appointments or rest after treatments.

Become comfortable with your body image. Depending on your treatment, your physical appearance may change dramatically, which can affect your self-esteem. Although your physical health is the priority, it’s easy to feel down when you’re unhappy with your appearance. Ask your nurse navigator about programs geared toward boosting your self-image.

Pay attention to your social self. Changes in how you feel about your sexuality may affect dating and intimacy. Physical changes may make you feel less desirable or insecure about being with a partner. Certain treatments may bring on premature menopause, which can result in additional side effects. Communication is crucial, so talk with your partner or a therapist about these issues.

Common Treatment-related Side Efects

Side Effects Ways to Manage
Anemia (low red blood cell count) Get plenty of rest; participate in regular physical activity
Chemo brain (cognitive dysfunction) Take notes; keep lists; use a daily planner, don't multitask
Constipation Drink more liquids; increase physical activity; contact your doctor before trying over-the-counter medications or adjusting your diet
Diarrhea Drink plenty of fluids; eat several small meals; avoid greasy foods, know where clean restrooms are to prevent accidents
Emotional distress Speak to a counselor or mental health professional; join a local or online cancer support group; seek help immediately for thoughts of suicide
Fatigue Balance activity and rest; take short naps; sleep regularly, participate in regular activity; ask for help
Hair loss (alopecia) Wear a wig, scarf or hat; use a wide-toothed comb; sleep on a satin pillowcase; ask your doctor for a prescription for a wig or a cooling cap
Lymphedema Wear a compression garment; elevate the swollen limb
Mouth Sores Brush teeth often with a toothbrush with soft bristles; eat soft foods; drink plenty of fluids
Nausea, vomiting Take antiemetics as prescribed; eat several small meals; drink plenty of fluids; avoid unpleasant odors
Neuropathy Avoid tight clothes or shoes; keep hands and feet warm; avoid standing for long periods of time
Neutropenia (low white blood cell count) Wash hands frequently; avoid crowds and children; wash fruits and vegetables carefully; contact your doctor for a fever higher than 100.5°F
Skin reactions Use mild soap; use thick cream (with no alcohol, perfume or dye) to moisturize skin