By Shannon Malburg Today Margie walked in the door, Saw me and said: “You’re still alive!” (We hadn’t seen each other in over a year) She came toward me, all embodied surprise and joy The biggest smile (Everyone should be smiled at like that) Held my shoulders out from her in a pre-hug And beamed at me “I’m so glad” she said “Good job” (The words were a hug As much as her arms were) But it wasn’t until later How this hit me I felt proud of myself Of my being-aliveness In a way I hadn’t Maybe Ever? But certainly not since cancer When every intuition-steeped choice Still yielded mixed results Less than hoped outcomes It’s back It’s spread Inching closer and closer to un-aliveness Disappointment Disillusionment Failure Failure Failure Despair But Yes! Here I am Still alive Good job intuition Good job body Good job invisible forces What a grace to feel proud of us Even if it’s fleeting A respite from the judgement And shame Of not healing right Share your poetry: https://www.survivingbreastcancer.org/submit-breast-cancer-story SurvivingBreastCancer.org Resources & Support: Podcast Weekly Meetups Free Events

Cancer brings with it a particular kind of loneliness that is difficult to describe to anyone who hasn’t felt it, and difficult to forget for anyone who has. SurvivingBreastCancer.org  |  By William Laferriere I just read this heart-wrenching meme on social media and it spoke to me as an epiphany (I apologize for failing to capture the meme’s author name before it disappeared). There is a variety store somewhere — the kind with fluorescent lights that never quite commit to brightness, where the refrigeration units hum a low, tuneless note all night, and the hours between 2am and 5am move like water through sand. A clerk works the late shift there. She has, most nights, almost no one to talk to. One night, a customer came in at an hour when almost no one does. They bought something small — it doesn’t matter what. And before leaving, they asked the clerk if she would write something on the receipt. Not a coupon code, not a return policy reminder. Something human. Anything at all. She did. Maybe it was a few words about the night sky. Maybe it was something she'd been thinking about and hadn’t had anyone to say it to. The receipt was thermal paper, the kind that fades, the kind nobody keeps. She handed it over and the customer left. Then another customer came in. Word had spread, the way quiet things sometimes do — not virally, not loudly, but person to person, in the particular telegraph of people who are awake when the rest of the world is not. They asked for the same thing. She wrote again. And then another person came, and another. The late-night store became, without anyone planning it, a gathering place for the people who live in the margins of the social day — the ones who work odd hours, who can’t sleep, who have nowhere else to be, who simply needed someone to acknowledge that they existed. One handwritten note on thermal paper, and somehow a community had formed around it. Most of us know that feeling — of needing someone to just notice we’re here. The loneliness that doesn’t have a name. Cancer brings with it a particular kind of loneliness that is difficult to describe to anyone who hasn’t felt it, and difficult to forget for anyone who has. It is not the ordinary loneliness of a quiet weekend or an empty apartment. It is something more layered and more specific. There is the loneliness of sitting in an infusion chair surrounded by other patients, all of you tethered to your poles and your drip bags, each person sealed inside their own private reckoning — and not being able to say a word to any of them, because what is there to say, and where would you even begin. There is the loneliness of coming home the night of your diagnosis and watching the people who love you most suddenly go quiet, searching for something helpful to say and finding nothing, their silence not unkind but vast, a new distance that opened without warning. They love you and cannot reach you. There is the loneliness of being finished with treatment while still feeling broken in ways that don’t show. The world, which has been watching and worrying, begins to exhale and drift back to ordinary life. People say you must be so relieved. And you are, partly — but you are also frightened in a way that doesn’t diminish when the IV comes out, and grateful that the hard part is over while also grieving that it happened at all, and unsure who you are now on the other side of it. The world expects celebration. You are standing in your kitchen at noon, still in yesterday’s clothes, not sure how to explain any of this. And then there is the 3am loneliness — the one that belongs entirely to darkness. The fear that arrives when the house is quiet and there is no distraction left and the mind turns, as it always does at that hour, toward the hardest questions. That loneliness has no audience. You don’t want to wake anyone. You’re not even sure what you would say. So you just sit with it, alone, in the way that so many people with cancer have sat with it — this particular 3am silence that has no good answer, only the long wait for morning. There is also, and this one is perhaps the loneliest of all, the loneliness of feeling like a burden. Of watching the people who love you rearrange their lives and wear their worry quietly and not wanting to add one more phone call, one more request, one more difficult conversation to the weight they’re already carrying. So you say you’re fine. You say you’re managing. You carry as much as you can alone, and the aloneness compounds. What the research knows, and what it costs It turns out that loneliness is not merely painful — it is physiologically costly. Social isolation is associated with increased inflammation, suppressed immune function, and worse outcomes across a range of serious illnesses, including cancer. Patients who lack strong social support are significantly more likely to experience depression and anxiety during treatment. And in survivorship, perceived social connection is one of the most powerful predictors of quality of life — not the number of friends, not the frequency of social events, but the felt sense that someone, somewhere, knows what you’re going through and is present with you in it. This is not a minor footnote. It means that connection is not a comfort measure. It is a health measure. The loneliness that cancer patients carry is not weakness or self-pity. It is a real and serious condition, with real and serious effects — and it deserves to be taken as seriously as the physical protocols of treatment. What the clerk understood The store clerk didn’t design a program. She didn’t convene a task force or launch a campaign. She just looked at another person who needed to be seen, and she wrote something true on a piece of thermal paper. That was all. And it was enough to change the quality of someone’s night — and then another person’s night, and then another. What SurvivingBreastCancer.org does is not so different, at its core. The support groups, the community programs, the spaces where people with breast cancer can find each other — they exist because someone understood that patients deserved a place where another person would write something human on the receipt. Not a pamphlet. Not a list of resources. A real acknowledgment, from one person to another, that says: this is hard, you are not invisible, and you do not have to carry this part alone. The formats are different from a late-night variety store. But the impulse is the same. The door is open If you have been sitting with your loneliness quietly — not wanting to explain it, not sure it’s bad enough to warrant attention, not wanting to be a burden even to people whose entire purpose is to be present for this — you don’t have to explain anything.  You can just come in. SBC’s support groups and community programs ask very little of you at the door. You don’t have to be articulate about what you're feeling, or ready to share, or certain that what you’re going through qualifies as hard enough. You just have to show up at the hour when you need someone to write something human on the receipt. That’s what we are here for. Read More: Living Well with Breast Cancer How Cancer Trauma Can Impact Your Life and Ways to Move Forward The Psychological Impact of Breast Cancer: Strategies for Coping On the Podcast: Breast Cancer Conversations The Hidden Trauma of Breast Cancer: PTSD, Fear, Triggers, and Healing Share your story, poetry, or art: https://www.survivingbreastcancer.org/submit-breast-cancer-story SurvivingBreastCancer.org Resources & Support: Podcast  Weekly Meetups Free Events

A daily pill has helped transform outcomes for hormone receptor-positive breast cancer, but navigating its side effects takes real-world know-how. Debbie Ciak's story shows why listening to your body and speaking up can make all the difference. SurvivingBreastCancer.org  |  Breast Cancer Conversations | By Laura Carfang Debbie Ciak, 75, lives outside Pittsburgh. She was diagnosed in early 2023 with stage 2B ER-positive, HER2-negative breast cancer after noticing an indentation in her breast one morning after a shower. Debbie's Ki-67 score was 57%, indicating an unusually fast-growing tumor. She underwent a single mastectomy and radiation. When her oncologist strongly recommended Verzenio to reduce her high risk of recurrence, Debbie didn’t hesitate. It was her second month on Verzenio when Debbie first noticed something was off. She’s a walker, and she began noticing that climbing hills was harder than it used to be. Then came the stairs. “I started to notice going up steps... just a little bit of shortness of breath,” she recalls. She reported it at her next appointment. Nothing was done. What followed was a months-long medical odyssey that would take Debbie through an ER visit on the day before Thanksgiving, three different pulmonologists, a bronchoscopy with ten biopsies, and a diagnosis of drug-induced pneumonitis (permanent lung scarring) that her pulmonologist now describes as feeling like “a straight jacket” around her lung. She will never be able to take a fully deep breath again. Debbie tells her story not to frighten anyone, but because she believes deeply that if she had known what to watch for, things might have gone differently. “You’ve got to listen to your body,” she says. “When something’s telling you it’s not right, don’t just let it go. You’ve got to pursue it until you get some answers.” Extra protection from Verzenio Verzenio (abemaciclib) belongs to a class of drugs called CDK4/6 inhibitors. By blocking proteins that cancer cells depend on to divide and replicate, these therapies can meaningfully slow or stop tumor growth in ways that hormone therapy alone cannot. For patients with HR-positive, HER2-negative breast cancer at high risk of recurrence, like Debbie, whose Ki-67 score came back at 57%, signaling an exceptionally fast-growing tumor, Verzenio can represent a crucial extra layer of protection. As Debbie understood it, Verzenio was her best extra line of defense against recurrence. The drug carries known side effect risks, but she was “ willing to take that risk,” she says. “I want to continue to live my long, full life.” But she also walked into treatment without a full picture of what the drug could do, and she believes that gap cost her. For many patients, Verzenio is a pill taken every day for years. What it does to the body day-to-day matters enormously. The side effect everyone talks about — and how bad it can actually get Ask anyone on Verzenio about side effects and the conversation starts in the same place: diarrhea. Debbie is no exception. “The diarrhea was terrible — three or four times a day, no warning. I literally almost could not leave my house.” She became severely dehydrated, her kidney function became elevated, and her hemoglobin dropped. She needed five hospital infusions for dehydration in the first month alone. All the while, her weekly check-in calls from the nurse practitioner came back marked “normal, normal, normal.” GI symptoms are real and, for some patients, genuinely disabling in the early weeks. There are strategies that help (careful hydration, anti-diarrheal medications started proactively, smaller meals, easy-to-digest foods) and for many patients, symptoms do ease as the body adjusts. But Debbie’s experience is also a reminder that “common” doesn’t mean “minor,” and that patients shouldn’t have to white-knuckle through symptoms alone. Practical strategies to manage GI side effects Ask your oncology team about anti-diarrheal medications before symptoms start Stay well hydrated throughout the day; consider using electrolyte drinks Eat smaller, more frequent meals rather than large ones Focus on low-fiber, easy-to-digest foods during flare-ups Track symptoms carefully: timing, frequency, and triggers to help your team respond faster One note worth flagging: Debbie had been prescribed Verzenio at the highest starting dose of 150mg. She had questioned this at the time, but was told the logic was that if problems arose, the dose could be reduced. Since then, she says, protocols have shifted — many providers now start patients at lower doses and titrate up. If you’re starting Verzenio, it’s worth asking your oncologist about current dosing approach and what flexibility exists. The side effect that changed everything: ILD Among Verzenio’s less common but more serious potential side effects is interstitial lung disease (ILD), also called pneumonitis. In plain language, this is inflammation in the lung tissue that can reduce its flexibility and make breathing feel more labored. The FDA issued a warning about this risk in 2019. It appears in the drug’s prescribing information. It is mentioned, in small print, at the bottom of Verzenio advertisements. Debbie had sat through a mandatory hour-and-a-half session with a pharmacist and nurse practitioner before starting the drug. She does not remember anyone discussing shortness of breath as a serious warning sign. When she arrived at the ER with respiratory symptoms two months into treatment — at the same hospital system where her oncologist practiced, with access to her full medication record — the clinical team checked for a pulmonary embolism, ruled it out, and sent her home with an antibiotic. Nobody called a pulmonologist. Nobody flagged the drug she was taking. “I think there was a total unawareness of the possibility of what the drug I was taking might have been doing to my lungs.” — Debbie Ciak It was Debbie herself who, over that Thanksgiving weekend, searched “FDA alert Verzenio” and found the 2019 warning. When she called her oncologist Monday morning and shared what she’d found, she remembers “total silence on the other end of the phone.” Her oncologist told her not to take the drug again. By the time Debbie reached the third pulmonologist — the first two either didn’t know about CDK4/6 inhibitor-related pneumonitis or treated it generically — the damage was done. Steroids that might have helped were too late. She now has pulmonary fibrosis and has completed 12 weeks of pulmonary rehabilitation. She has undergone regular pulmonary function tests ever since. “Now it's in my chart,” she says. “Nobody will ever prescribe anything like that to me.” Tell your care team right away if you notice new or gradually worsening shortness of breath, especially with activity that felt easy before; a dry cough that’s new or persistent; chest tightness or a sensation of not being able to take a full breath; noticeably reduced stamina on walks, stairs, or daily tasks. These symptoms have many possible causes, but they require prompt evaluation, not a wait-and-see approach. What Debbie wishes the system had done differently Debbie is measured and thoughtful when she talks about this. She isn’t angry. But she is clear about the gaps she experienced: a care system where specialists operated in silos, where an ER team looked for the one thing they were asked to rule out and stopped there, where a known FDA-listed drug side effect wasn’t on anyone's radar in the room. “Everybody’s in their own little silo and only looking at one thing,” she says. “The nurses at a different hospital would have been more on top of what was going on. It’s a big lack of education piece.” She later participated in a medical webinar on ILD and CDK4/6 inhibitors, as the patient voice alongside an ER physician, a radiologist, and a medical oncologist. All three agreed: this is a significant and underrecognized issue, and clinicians need better awareness of what to look for when imaging a patient on these drugs. Movement as medicine: Debbie’s path forward Here’s the part of Debbie’s story that matters just as much as the warning: she didn’t stop living. Despite permanent lung limitations, she walks. She practices restorative yoga. She does Pilates. She is enrolled in a cancer and exercise research study through Colorado State University. She credits the SurvivingBreastCancer.org virtual exercise program and a local Pittsburgh organization called Cancer Bridges with being central to her recovery. “Exercise has been very important to me in my recovery — which is the one big positive change since having cancer, because I was not an exerciser before,” she shares. Her pulmonologist put it bluntly: “You can’t be sedentary. It would only make it worse. You have to keep active.” She schedules her classes the way she schedules medical appointments, because that’s what it takes. “I’m one that’s had to put it on the calendar.” For anyone who struggles with motivation during treatment, that framing alone is worth something. Questions for your next appointment Ask your oncologist before or during Verzenio treatment What starting dose is recommended for me, and what’s the reasoning? What respiratory symptoms should I watch for, and how urgently should I report them? If I go to an urgent care or ER, what should I tell them I’m taking? Are there supportive medications I should have on hand from day one? What is my bloodwork monitoring schedule, and what are you watching for? Should I be tracking symptoms between visits? How detailed should those notes be? The bottom line Verzenio is an important drug. For patients at high risk of recurrence, it may be the difference that matters. Debbie knew that going in — and still believes she made the right choice in trying it, even knowing how it ended for her. What she wants other patients to have is what she didn’t: a full picture, a care team that communicates across specialties, and the confidence to keep pushing when something feels wrong. “Keep asking those questions,” she says, “and don’t stop until you get the answers.“ Survivorship is not passive recovery. It is active navigation. Debbie Ciak is proof of that. Listen to the full episode: Debbie Ciak tells her complete story — including her diagnosis, treatment, the Thanksgiving ER visit, and what she’s learned about advocacy — on Breast Cancer Conversations , the SurvivingBreastCancer.org podcast. Listen below, or wherever you listen to podcasts. This article is for informational purposes only and does not constitute medical advice. Always consult your oncology team regarding treatment decisions and symptom management.

Surviving Breast Cancer offers guidance on sex after breast cancer, helping survivors navigate intimacy, relationships, and emotional healing. Breast Cancer & Intimacy Sex After Breast Cancer In a previous blog and podcast we opined on the difficulties of maintaining relationships with loved ones, family, spouses, partners, etc. following a breast cancer diagnosis. Now we look at the adversarial effects of breast cancer towards sexual intimacy. Many, although not all, women find that breast cancer treatment, I.e. surgery, radiation, chemotherapy, estrogen eliminating hormonal therapy, severely hampers intimate sexual relations. Poor self image, physical exhaustion, painful treatment, and emotional distress all tend to weigh in negatively regarding sex drive. But overall recovery from breast cancer is partially dependent on overcoming the above referenced issues and participating in warm loving sexual acts. Sex can thus play a pivotal role. As we have mentioned in previous posts, single women who have been diagnosed worry how breast cancer will affect their relationship prospects, and also about how and when to tell those prospective lovers about their condition. The most uncomfortable stuff to talk about is probably your sex life and the changes that have taken place with your illness. You may not know what needs fixing or how to fix it, but you know things are different. Many women report having less sex than before their illness, for several reasons: • The breast cancer experience slows down your body. It takes longer to do lots of things, including getting interested in and starting and finishing sexual intercourse. • Sex may be uncomfortable or even painful if you've been thrown into sudden onset menopause. No surprise that you tend to have less sex, for now. Many women may have had little or no sex from the time of diagnosis through treatment. Most people have wild ideas about what goes on in other people's bedrooms. Give yourself a break: The carefully researched book Sex in America (by Michael, Gagnon, Laumann, and Kolata) tells us that Americans have a lot less sex than the movies, television, and the guys in the locker room would have you believe. The averages reported in that book are: • seven times a month between ages 30 and 40 • six times a month between ages 40 and 50 • five times a month between ages 50 and 60 For people over 60, the numbers continue to decline. But although you may assume that no one in their 70s and 80s has a sex life, that's just not so. Don't let the myths about other people's sex lives get in the way of what's happening in yours. And remember that there are exceptions to every pattern. If your sex life is not working the way you want it to, your doctor or nurse may be able to referee these issues with your partner and you. You can cue your doctor in advance, since he or she has most likely already touched on delicate issues with you. Maybe he or she can be the tour guide for the two of you. If your partner is there when you talk with the doctor who's managing your care, you and your partner both get a chance to air and dispel fears, and replace myths and false information with facts. Help from a pro Not all doctors and nurses are comfortable discussing sexual issues and practices. Most doctors don't routinely ask about your sex life. And patients don't usually begin to discuss their love life with a doctor who hasn't mentioned it. Nobody's talking! Someone has to break the pattern. A trained social worker, sex therapist, psychologist, or psychiatrist can help you open up communication with your partner and get around to talking about intimacy and sex issues. A support group may be more helpful than you might realize. Women in these groups often share advice that extends to the bedroom, including ways to increase sexual pleasure that are explicit and specific for women who've had breast cancer. Meeting needs in other ways Most marriages have problems that don't get fixed. Marriage is a package deal, and in marriages that work, the good things outweigh the bad. But as a survivor, you may find that breast cancer highlights the problems in your marriage. Can you live with those problems? Can you enjoy your marriage even as you contemplate what's missing? Can you capture the missing pieces in other ways? Give serious thought to your needs and how to meet them. Other ways to meet your needs: • Fantasy can enrich your life. Countless women read to fill the vacuum (romance novels are enormously popular). • Join a book club, a church or synagogue, or a group that meets to discuss investments, movies, or local politics. • Do more with individual friends, like walking, shopping ("retail therapy"), or travel. • Make a bigger deal of birthdays and anniversaries. • Expand your involvement in community or spiritual activities. • Get politically active in the breast cancer movement: camaraderie for a cause close to your heart. Having a serious illness almost always takes some kind of toll on your sex life. But breast cancer can bring all thoughts of intimacy and sexuality to a screeching halt. Treatments can bring on temporary -- and sometimes permanent -- premature menopause, making intercourse painful. Chemotherapy and radiation often lead to crushing fatigue. You may want to stay in bed, but you don’t want to use it for anything but sleep. The medications you take, as well as the emotional effects of the disease, can lead to depression. And of course, from the changes wrought by surgery to the hair loss and puffiness of chemotherapy, breast cancer can have a devastating effect on your body image and your ability to feel sexy. The sexual side effects of breast cancer can linger long after treatment stops. A 2007 follow-up report on young breast cancer survivors, conducted by researchers at the University of California-Berkeley, found that some women reported persistent sexual difficulties five years after their treatment had ended. And according to the National Cancer Institute, about one out of every two women who’ve undergone breast cancer treatment experiences long-term sexual dysfunction. That’s the bad news. But the good news is there is sex after breast cancer! > Sex and self-image Breast cancer changes the way you see your body. “Women sometimes feel very disconnected from their bodies when they go through this,” says Jean Carter, PhD. Carter is a licensed psychologist and the sexual health counselor for the sexual health program at Memorial Sloan-Kettering Cancer Center. “Your body’s been through so much and it’s worked to get well,” she says. ”But there have been sacrifices.” One thing you need to know early on is that your partner still finds you attractive and desirable. That’s rough on the days when you look in the mirror and can’t imagine ever feeling sexy again, much less looking sexy to someone else. It’s important to prepare yourself and your partner for what you’ll see. If you haven’t yet had surgery, ask your breast center if they have photographs of women after the kind of surgery you’ll undergo. Look at them with your partner and talk about what to expect. There's no denying that the sexual side effects of breast cancer can linger long after treatment is over, but there is sex after breast cancer. Lumpectomies, Mastectomies, Breast Reconstructions and Thoughts on Body Image. It was created by women in a cancer survivors’ group at Penn State. “The way your partner looks at your incision for the first time,” says Lillie Shockney, RN, “you’ll remember that forever.” Shockney is administrative director of the Johns Hopkins Breast Center and a breast cancer survivor herself. “If he has no clue what to expect and has a puzzled look on his face, the woman may interpret it as ‘He thinks I’m ugly, he thinks this is awful.’ Showing photographs can take the surprise away.” Communication is important. Talk with your partner about what you’re comfortable with, and what you’re not. “Both partners may be waiting for the other one to make the first move,” says Shockney. “She’s waiting for him to tell her he wants sex, and he’s waiting for her to touch him.” Your partner may be afraid of hurting you, or afraid that you’ll think he’s pushing you to have sex when you’re not ready simply by asking about it. If your breasts were major erogenous zones for you before surgery, you may be feeling particularly bereft after a mastectomy or even a lumpectomy . Shockney suggests taking the pressure off by exploring and discovering other areas of your body, rather than trying to “force it” in areas where you still have performance or body image issues. “For some women, the diminished arousal in areas of a newly constructed breast or scar tissue might serve as a painful reminder that their sex life has changed,” Shockney says. Instead, think of areas like shoulders, ears, and knees as new hot spots for intimate touch. If you’re still not comfortable with your new body, that’s what lingerie is for! There’s nothing wrong with getting a little help. A soft, satin nightie can be sexy and arousing. At the same time, it can help to conceal areas you’re still shy about. Or you can get even more creative. “I asked a patient to try using a feather boa to help her feel sexy, and at the same time keep her scars from being so evident. She loves it!” says Shockney. “It’s all about finding what you’re comfortable with.” Coping with changes But even as you get comfortable with the “new you” in the mirror, other parts of your body may be causing you problems in the bedroom. You may go through temporary menopause because of chemotherapy. Or if you have estrogen-receptor positive breast cancer, you may be taking hormonal therapy that can leave you in a menopausal state for years. The resulting vaginal dryness and other symptoms may make it painful to even think about having sex. “A lot of women I see are afraid to have sex,” Carter tells WebMD. “They’re really struggling. And it’s a shame, because there are wonderful, simple strategies to improve your sexual experience that, taken together, can work wonders.” Vaginal moisturizers. These aren’t lubricants, which are meant to be used during sex. Instead, they’re like the moisturizers you use on your face and hands, to benefit the tissues themselves. “They’re introduced as a suppository into the vagina adding moisture back into the vaginal space and giving it that natural elasticity,” says Carter. “It’s meant to be absorbed, and it helps the vagina to have more health and moisture for several days.” Lubricants. You definitely still want a lubricant for use during intercourse, says Carter. But lubricants should be combined with regular, ongoing use of vaginal moisturizers for best results. “If you’re feeling a rubbing or burning sensation during intercourse,” Carter says, “you don’t have enough lubrication. If it’s a stretching , painful sensation like the skin is going to split, you don’t have enough moisture.” Exercises. The classic Kegel exercises -- tightening and releasing the sphincter muscle as you do when you urinate -- that so many women use during pregnancy are also great for making intercourse easier. “If intercourse has been painful,” Carter says, “you may tighten up in anticipation of the pain. If you do Kegels right before intimacy , you fatigue the vaginal muscles and it is more open.” Vaginal dilators. A sex therapist, like Dr. Carter, can teach you how to use these dilators, which help gently stretch the vaginal tissue. Over and over again,” Carter says, “I’ve seen women who are completely hormonally deprived be able to have comfortable, enjoyable intimacy by using these strategies. A lot of the time, it’s so easy to fix. It astonishes me how often women come into my office and ask, ‘Why didn’t anyone tell me this? Shockney advises her patients to shake up their previous sexual habits. She tells them they may have been a silent player in bed before. But now she wants them to speak up. She tells them, “Say, ‘This feels good. This doesn’t feel good.’ Don’t rely on grunting for him to figure it out. That’s not the best way to communicate.” She also tells her patients, “If you’ve never watched an x-rated movie, try one -- just one. It may jump-start things, and you’ll be amazed at how active you’ll become. Or try various sex toys. So what if you never did these things before. You never had breast cancer before, either! I’ve had women come to me and say ‘I thought my sex life was great before, and then I thought I was going to lose it. But now it’s better than ever. TOPICS COVERED IN THIS EPISODE -People who refuse aspects of therapy including radiation. -What to expect when going in for radiation-Planning appointment -What is radiation and why would I need it? -Radiation and skin care -Proton Beam Radiation (the science behind protons; a number of clinical trials exploring proton beam radiation in the breast cancer community to minimize cardiac toxicity). -Risks association with radiation, but we still sign the consent. As a young breast cancer survivor, I ask Dr. Jimenez to explain the 10, 20 and 50 year plan for women who go through treatment. HEALTH RISKS -Cardiac toxicity -Field of cardio oncology partners and have mapped out the ideal -Herceptin and anthracyclines. After 5 years of survivorship, you should have a cardiac stress test. -Getting a baseline with an ultrasound of the heart so if there are changes, doctors can track them. -Our job (in Radiation Oncology) in follow up is to open up and make sure that referrals are made. How is your nutrition? Are you exercising? Did you schedule your next mammogram? QUOTES: "Your providers are your providers for life". "You are never a bother, it is our job and privilege to take care of you! " What's the Difference between Diet and Nutrition? On Breast Cancer Conversations, the Podcast Listen Now Looking for more ways to support your healing journey? View Programs