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Research into living with breast cancer

As well as researching treatments, doctors and researchers are keen to improve the quality of life of people with breast cancer. It is important to research these areas so that people have as few side effects as possible and have the information and support they need to cope with the disease. Cancer Research UK supports many UK and international clinical trials.

There is research into

  • Minimising side effects of treatment, such as pain after surgery and menopausal symptoms
  • Aspects of living with breast cancer, including use of complementary therapies
  • Problems with sleep during treatment
  • Diet and exercise after breast cancer
  • The importance of seeing familiar doctors and nurses throughout a course of treatment

 

CR PDF Icon You can view and print the quick guides for all the pages in the Treating breast cancer section.

 

 

Why we need research

As well as researching treatments, doctors and researchers are keen to improve the quality of life of people with breast cancer. It is important to research these areas so that people have as few side effects as possible and have the information and support they need to cope with the disease. Cancer Research UK supports many UK and international clinical trials.

There is research into

  • Minimising the side effects of treatment, such as pain after surgery and menopausal symptoms
  • Aspects of living with breast cancer, including use of complementary therapies
  • Problems with sleep during treatment
  • Diet and exercise after breast cancer
  • The importance of seeing familiar doctors and nurses throughout a course of treatment
 

Complementary therapies

People with cancer sometimes use complementary therapies at the same time as their conventional breast cancer treatment. This is very different to alternative therapies, which some people use instead of conventional medical treatment. Complementary therapies aim to ease stress and help you cope with your cancer and treatment. They may also help to boost the immune system and help the body fight cancer.

Trials are looking at whether acupuncture and moxibustion can help to reduce some side effects of breast cancer treatment such as tiredness (fatigue) and feeling sick. Other complementary therapies that have been researched in breast cancer include reflexology and visualisation.

There is detailed information about complementary therapy research in the complementary and alternative therapy section. You can find out more about complementary therapy trials for breast cancer on our clinical trials database. Go to the advanced search and choose 'breast' from the dropdown menu of cancer types and 'complementary therapy' from the list of treatment types. If you want to see all the trials, tick the boxes for closed trials and trial results.

 

Treating lymphoedema

Some women develop a swelling in their arm called lymphoedema after surgery or radiotherapy to the armpit area for breast cancer. There is a trial looking at why some women develop lymphoedema after surgery for breast cancer. Researchers are trying to understand how the drainage of tissue fluid from the arm goes wrong in lymphoedema and why some women get it but most do not. 

There is a study looking at a new way of detecting early signs of lymphoedema after breast surgery. It is possible to look for early signs of swelling by taking arm measurements using a perometer. Researchers want to compare this with another technique called multifrequency bioimpedance. This is a test that measures the amount of fluid in the arm. The researchers hope this study will help to improve the method of predicting who will develop lymphoedema.

The PLACE trial is trying to find out if treating early signs of arm swelling with an elastic sleeve (external compression) reduces the number of women who go on to develop lymphoedema after surgery.

A London study is looking at how people manage lymphoedema after surgery for breast cancer. The researchers want to learn more about how people with swelling of their arm stick to the daily self care of managing lymphodema, and how they decide whether the swelling has got better or worse. The researchers hope the information will help them provide better care and information for people having lymphoedema treatment. And help them better understand the challenges of carrying out self care for lymphoedema.

A small trial looked at acupuncture and moxibustion for lymphoedema. Acupuncture uses fine sterile needles which are put just under the skin at particular points (acupuncture points) on the body. In this trial, they did not put the acupuncture needles in the area affected by lymphoedema. Moxibustion uses a dried herb called mugwort which is rolled into a stick. The moxibustion practitioner holds the glowing end of the lit stick over acupuncture points to warm them.

The trial team found that acupuncture and moxibustion were safe for people with lymphoedema, especially when the needles were not put in the area of lymphoedema. The people taking part reported some improvement in their symptoms. The team suggest that more research is needed to see how much it could help improve symptoms.

Another study is looking at reflexology to manage lymphoedema after breast cancer treatment. Reflexology is applying pressure and massage to your feet and hands. A small study has shown that reflexology may help to reduce lymphoedema in the arm after treatment for breast cancer. So researchers now want to do a larger study to see if they can get the same results. This study has now closed and we are waiting for the results.

 

Research into quality of life

We know that many people who are diagnosed with breast cancer have a range of symptoms that can affect their general wellbeing and quality of life. There is a study in Glasgow looking at quality of life in women with recently diagnosed breast cancer. The research is learning about women's health and well being in the year after their breast cancer diagnosis. This study collects information about common problems such as sleep difficulties, severe tiredness (fatigue), anxiety, coping problems, depression and pain. It will give health professionals important information about when and how they can best support patients after diagnosis.

Another study is researching the needs of women after treatment. At the moment we don't know much about the needs and experiences of women who have finished breast cancer treatment. We know that issues can include mental, emotional and social problems, fatigue, pain and lymphoedema. There is very little information about how needs differ in people from different backgrounds. Researchers in this study will talk to women who have completed breast cancer treatment, to find out how best to support other women in the future. This trial has now closed and we are waiting for the results.

 

Sleep during cancer treatment

Sleeplessness (insomnia) is a common problem for people with cancer. This can be due to a number of things such as anxiety, stress or the side effects of treatment. People who can't sleep well are more likely to be anxious and depressed than people who don't have problems sleeping. People with insomnia also find it more difficult to cope with their situation, and it can affect how they feel physically.

Doctors are looking at ways to help people with insomnia during their treatment. Trials in the UK are looking at a type of supportive therapy called cognitive behaviour therapy (CBT) to see if that helps people sleep better. Some early trials found that cognitive behavioral therapy helped people to

  • Go to sleep more quickly
  • Sleep more deeply
  • Sleep for longer

You can find details of these trials on our clinical trials database. Choose breast cancer from the dropdown list of cancer types and type sleep into the text box. If you want to see all the trials, tick the boxes for closed trials and trial results.

 

Diet and exercise after breast cancer

There is a lot of interest in the possible benefits of dietary changes and supplements for women with breast cancer. Many studies are looking at how diet, exercise and lifestyle affect how women cope with breast cancer. 

The DietCompLyf study found that women often change their diet after being diagnosed with breast cancer, generally eating fewer calories and less sugar, fat, red meat and refined grains. And eating more whole grains, fruit, vegetables and lean protein. Some researchers think that a group of chemicals found in plants, called phytoestrogens may affect breast cancer. But in this study, the researchers found that the level of phytoestrogens in the diet did not affect factors associated with how well women were likely to do after treatment (their prognosis). They did find some links between phytoestrogens eaten before diagnosis and certain risk factors for breast cancer, such as body weight and having children. The research team continue to follow the women who took part in this study to look at if and when breast cancer comes back.

The WINS (UK) study showed that giving dietary advice helps women to cut the amount of fat in their diet after breast cancer. 

The B-AHEAD 2 study is looking at healthy eating and exercise in women having chemotherapy for breast cancer. The researchers had found in an earlier study that women having chemotherapy had more problems with weight control. So the researchers have developed a diet that may help. They want to see how well a low carbohydrate diet, 2 days a week, works to prevent weight gain from chemotherapy compared to a continuous low calorie diet.

You can find out more about trials for breast cancer and diet on our clinical trials database. Choose 'breast' from the dropdown menu of cancer types and type diet into the text box. If you want to see all the trials, tick the boxes for closed trials and trial results.

 

Emotional effects of surgery

Some trials are looking at how breast surgery affects women's feelings and their self esteem. 

Researchers want to find out how having a breast removed (mastectomy) and a type of breast reconstruction operation affects women's quality of life. The QUEST A trial is comparing women's feelings after having different types of latissimus dorsi breast reconstruction (LDBR) surgery. LDBR creates a new breast shape using muscle from your back and tissue from under your shoulder blade. Some women also have a salt water or silicone implant as part of the surgery. The researchers want to find out if there is any difference in women's quality of life and feelings after the different types of surgery. 

The QUEST B trial is looking at how women feel after breast reconstruction at the same time as mastectomy compared to mastectomy with breast reconstruction done at a later stage. Researchers want to find out if the different timings of breast reconstruction surgery affect women’s well being, satisfaction with the procedure, and quality of life.

 

Exercise and breast cancer

During and after diagnosis and treatment for breast cancer, women can have problems such as depression, fatigue, weight gain and lack of self esteem. Research is going on into the effects of exercise as a way of helping women cope with treatment and also recover quickly after breast cancer. Results from a Cancer Research UK trial, published in 2004, suggest that including an exercise programme as part of follow up can improve recovery and give a sense of well being. This included lower levels of depression, better quality of life and weight loss. Another study has been looking at the effect of exercise and dietary changes for women recovering from breast cancer treatment. The researchers found that women who followed an exercise programme and received advice about diet lost a moderate amount of weight and reported an improvement in their quality of life. Research into this area is ongoing.

A study in 2010 looked into exercise for women having breast cancer treatment. The study found that 45 minutes of exercise twice a week helps women having treatment for early stage breast cancer. It gave improved fitness levels, shoulder mobility and mood 3 months after breast surgery. These benefits continued and after 6 months women who exercised also had an improved quality of life with less fatigue and hormonal symptoms. The research team concluded that exercise provided a functional and psychological benefit. And they advise doctors to encourage their patients to exercise.

About 75 out of every 100 women (75%) diagnosed with breast cancer put on weight during treatment, including women who were a normal healthy weight before their diagnosis. Many women would like advice about diet and exercise but at the moment very few women are given this information. The researchers say that there is increasing evidence that weight control and exercise may reduce the risk of the cancer coming back, reduce the risk of other health problems, and improve quality of life. 

New research suggests that a few hours of walking or other exercise each week may help breast cancer survivors live longer. A US study of nearly 3,000 women found that those who exercised were less likely to die of their breast cancer than women who got less than 1 hour of physical activity each week. More research needs to be done to confirm this.

Another study is looking at physical activity during chemotherapy for breast cancer. After treatment, some people notice changes to their memory, concentration and how quickly they can work things out. Doctors call this your cognitive functioning. Researchers want to see if moderate exercise can help improve cognitive functioning and how you feel during chemotherapy.

There is more information about exercise for people with cancer in our cancer questions and answers section.

 

Tiredness after breast cancer treatment

Some people who have been treated for early breast cancer have serious problems with tiredness and lack of energy (fatigue). There is a small study looking into possible links between tiredness and sleep and memory problems in these people. You can read about the tiredness study on our clinical trials database. Researchers are also looking at blood samples from people to see if they can identify proteins linked to tiredness. This may help in the future to identify patients who are at a high risk of getting fatigue after treatment. And it may help doctors to find ways to prevent or reduce this tiredness.

The MFAB study is looking at a form of meditation called mindfulness. It is for women who have breast cancer that has spread to other parts of the body (secondary breast cancer). Mindfulness aims to increase your awareness of the present moment. If you are able to worry less about the past and the future, it may help to reduce stress. The researchers want to find out whether mindfulness can reduce tiredness and depression.

A phase 3 trial has looked at acupuncture to help women with fatigue following chemotherapy. The women who took part in the trial were split into 2 groups. 227 women had acupuncture once a week for 6 weeks, and 75 women had the usual care and education on coping with fatigue. The women filled out questionnaires about how tired they felt and how they were feeling generally. From comparing the results of the completed questionnaires, the research team concluded that acupuncture could help women with fatigue after treatment for breast cancer.

 

Lifestyle changes

Another study is looking at the lifestyles of people who have had treatment for breast cancer in the last 5 years. People who have had one cancer have a higher risk of getting another one. Certain lifestyle changes, like stopping smoking, eating healthily or taking more exercise, can help to protect you from getting another cancer, as well as from other health problems. The researchers want to find out how people feel about making changes in their lives, and if such changes make a difference to their quality of life. You can read about the lifestyle study on our clinical trials database.

 

Pain after surgery

Breast cancer treatment can be very successful. But after surgery, some women have pain that can last for a long time (chronic pain). A study has been looking into pain after breast surgery to find out if there are any factors that make it more likely that a woman will have this kind of pain. The researchers found that women who had painful symptoms for more than 3 months before surgery, were 3 times more likely to have pain on movement shortly after surgery. The team also found that the type of surgery to the breast and armpit can affect the pain you have after surgery. For example the women who had a sentinel lymph node biopsy were less likely to have pain in the 1st week after surgery than those who had 4 or more lymph nodes removed. From the results of questionnaires, the researchers found that women who were more optimistic and had a positive outlook were likely to have less pain after surgery. The study team will follow up these women to see how they recover in the months after surgery.

As well as long term pain, another problem you may have after mastectomy is difficulty moving your shoulder on the side you had surgery. Both these side effects can delay how quickly you get back to normal life. The SUBLIME study is looking at whether giving continuous local anaesthetic directly to where you had surgery (as well as the morphine pain relief you would normally have) can improve pain control and quality of life. If you are more comfortable after surgery, and your arm movements get back to normal more quickly, this may reduce longer term problems such as shoulder stiffness and pain.

 

Joint aches and pains after treatment

The JACS study is looking at women’s experiences of joint aches, pain and stiffness in breast cancer to try to understand more about what causes this. Pain can be caused by the cancer (a symptom), or by treatment (a side effect). This study is looking at pain as a side effect of treatment. The researchers hope their findings will help doctors to give information to patients when deciding on their treatment plan. And they also want to find ways of treating the aches and pains.

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Updated: 26 October 2012