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Maribel traveling and embracing life after cancer treatment. Sitting at a bridge overlooking Toledo, Spain in the background

Why are so many side effects of breast cancer tratement not discussed?

Overall, the average risk of a woman in the United States developing breast cancer sometime in her life is about 13%. This means there is a 1 in 8 chance she will develop breast cancer. I don’t share these statistics to scare you. I want to share my cancer experience so that more people hear about the silent struggles that cancer patients experience. There are many unspoken side effects of breast cancer treatment that we don’t talk about enough. According to Time Magazine, one of the reasons these symptoms may not be discussed often is because “there is little data on how extensive these side effects really are among a large group of women from different ethnic and economic backgrounds.” These side effects can create travel challenges after cancer.

Maribel - travel challenges after cancer.  Seeing the world from the cliffs on the Aran Islands

Challenges of Life After Cancer Treatment

Going through cancer treatment has been one hell of a battle. But some of the real struggles began after I finished chemo. Dealing with the physical, emotional, and mental aftermath is a constant fight. After my breast cancer diagnosis in late 2018, the hurricane that is treatment and staying alive became my main focus. A few days ago, I realized that I seem to only share about that part of the process, but I don’t share nearly enough about life after treatment. These silent struggles of life after treatment deserve just as much attention because many of them are lifelong.

At the end of chemo, most people assume that the process is over for the patient. For many of us, this is when the healing begins. The aftermath of breast cancer treatment can bring a host of physical, emotional, and psychological challenges that are often overlooked or minimized. These unspoken side effects can profoundly impact a woman’s quality of life, self-image, and overall well-being long after the initial round of treatment.

Each person may navigate cancer treatment differently than others because under the term “cancer”, there are really over 200 different diseases. Here are some of these side effects that may not have been fully discussed during the initial Dr. appointments:

Premature Menopause and Loss of Fertility

One of the most significant yet underreported consequences of breast cancer treatment is the onset of premature menopause. Chemotherapy and certain other medications and therapies can damage or destroy a woman’s ovaries, leading to an abrupt and permanent stop of menstrual cycles and the associated hormonal changes. This sudden transition into menopause can be emotionally and physically devastating, particularly for younger women who may not have been prepared for menopausal symptoms earlier than expected.

I was lucky that my oncologist was very thorough when we discussed what my treatment would be. She made sure I understood that I would be in chemically induced menopause. It lasted 1.5 years. She also asked me if I wanted to have my eggs frozen before treatment so that I would be able to conceive later on if I chose to. I knew at a very early age that I wanted to be child-free, so I declined this offer. While options like egg freezing or using donor eggs may be available, the emotional and financial toll, especially in a country with a healthcare system like the US, can be significant, and the decision-making process itself is agonizing.

My oncologist also discussed having options for therapy to help me handle the diagnosis and the emotional rollercoaster of treatment. She discussed that this would have an impact on my sexual life. Hot flashes, night sweats, vaginal dryness, and disrupted sleep patterns can take a toll on a woman’s daily life and relationships. The emotional impact of premature menopause should not be underestimated, as many women struggle with a sense of loss, grief, and even a fractured sense of identity as we are forced to transition into a new phase of life.

I regained my periods approximately a year after my first chemo session. Some women never experience their periods again, and for others, the experience of their periods is unpredictable and different from what their periods were like before undergoing chemotherapy.

Ongoing Treatment Repercussions

Even after surviving the initial battle with breast cancer, the repercussions of treatment can linger and manifest in unexpected ways. In my case, approximately two years after completing chemotherapy and six surgeries, I had to undergo a complete hysterectomy – the surgical removal of my uterus and cervix.

While the exact cause was not definitively determined, my doctors believe the hysterectomy was likely necessary due to the effects of the aromatase inhibitor (Tamoxifen) medication I am taking to reduce the risk of breast cancer recurrence. These drugs, commonly prescribed as part of ongoing treatment plans, can sometimes lead to uterine complications requiring additional surgeries.

The hysterectomy was crucial for my continued health. Yet, it was another profound loss – this time, of my ability to bear children naturally, even if I ever wished to do so in the future. I am very open about this. The emotional toll of yet another surgery that felt like a mutilation of my femininity is something that I still work on with a therapist.

Challenges of Early Menopause After Cancer Treatment

Going through menopause prematurely, whether due to chemotherapy, surgery, or other cancer treatments, brings with it a unique set of challenges that women aren’t typically prepared to face until later in life. Beyond the expected hot flashes and hormonal fluctuations, early menopause can accelerate specific age-related processes and conditions.

For many survivors, battling weight gain becomes an uphill battle, as the metabolic changes associated with menopause make it increasingly difficult to shed excess pounds.

Bone density loss and decalcification are also common concerns, making the risk of osteoporosis and fractures higher at a younger age than anticipated.

Additional symptoms like brain fog, vaginal atrophy, and increased cardiovascular risks can further complicate the menopausal experience when it occurs decades before its typical onset.

Navigating these new risks requires vigilance, lifestyle adjustments, and open conversations with healthcare providers and doctors to properly manage the different effects of premature menopause in the aftermath of cancer treatment.

Maribel receiving chemotherapy.

Cognitive Changes and “Chemo Brain”

Another often-overlooked side effect of breast cancer treatment is a form of cognitive impairment, commonly referred to as “chemo brain.” Many of us survivors report experiencing memory lapses, difficulty concentrating, and struggle with multitasking or processing information after chemotherapy. These cognitive changes are frustrating and disruptive, impacting a patient’s ability to work, engage in social activities, or manage daily tasks.

Before cancer, I could grasp things very quickly, concentrate even in very distracting situations, and finish tasks easily and quickly. Post-chemo, I do not feel the same. Focusing on completing a task can take me an hour or two. I now forget things easily, to the point that I have to write things down in my journal daily to ensure I do not forget things I would’ve usually easily remembered. 

While doctors do not fully understand the exact mechanisms behind chemo brain, researchers believe it may be linked to the toxicity of chemotherapy drugs, hormonal changes, or even the psychological stress of battling cancer. Regardless of the cause, the impact on a survivor’s quality of life and self-confidence can be profound, especially if these cognitive issues last long after treatment has ended.

Overcoming the cognitive challenges of “chemo brain” involves having open and honest conversations with your healthcare providers and actively seeking out support resources. Talking to your doctors about any memory issues, trouble concentrating, or other cognitive difficulties you may face is important. They can offer guidance on coping strategies, mental exercises, or therapies that could help alleviate these symptoms.

Additionally, many cancer support organizations provide programs and resources specifically designed to address cognitive challenges in cancer survivors. These may include workshops on memory training, classes to improve brain fitness, or support groups where survivors can connect and learn from each other’s experiences. By utilizing these resources and working closely with healthcare professionals, survivors can develop personalized strategies to manage the “chemo brain” and rebuild confidence in their cognitive abilities.

Lymphedema and Chronic Pain

For many breast cancer survivors, the physical toll of treatment extends far beyond the initial recovery period. Lymphedema, a chronic condition characterized by swelling in the arm, breast, or chest area, can occur as a result of surgery or radiation therapy. This swelling can be painful, limit mobility, and increase the risk of infections, further compounding survivors’ challenges.

Chronic pain is another common but often underreported issue among breast cancer survivors. Whether it’s lingering surgical pain, nerve damage from chemotherapy, or the long-term effects of radiation, persistent discomfort can significantly impact a woman’s daily activities, sleep quality, and overall well-being.

In my case, I have been dealing with tennis elbow on my right side, pain in my right hip, and lower back pain that extends into the leg for almost the past year. I have seen pain specialists, had shots, and gone to physical therapy and yoga to help with the pain. I also drink a few meds to help with the pain because it is constant, and being in constant pain affects anyone’s state of mind.

Body Image and Sexual Intimacy Struggles

The physical changes brought by going through breast cancer treatment take a significant toll on a woman’s body image and sense of femininity. Mastectomies, breast reconstruction surgeries, and other visible scars left behind can be a constant reminder of the “battle fought,” leading to feelings of self-consciousness, insecurity, and even a loss of sexual confidence.

Days, months, and years later, many of us go through body dysmorphia. In the case of breast cancer, it is not just about how our breasts look after multiple surgeries and radiation. During chemo, your body is entirely unrecognizable. You may spend days vomiting and going through bouts of diarrhea and losing weight due to that. If you are taking prednisone or other steroids, you may end up swelling and experiencing a “moon face” a few days later. You may have burnt skin from radiation treatment. Your skin gets gray and clammy, your nails turn black, your gums and nose bleed for no reason, you’ve lost your eyelashes, eyebrows, and all hair on your body, and you may even lose teeth.

Additionally, the hormonal changes associated with chemotherapy or surgical menopause impact libido, vaginal dryness, and overall sexual function, further complicating intimate relationships. These deeply personal struggles are often suffered in silence, leaving many survivors feeling isolated and ashamed to seek support or guidance.

Maribel smiling at the mirror - Life before cancer 2018

Mental Health Challenges and PTSD

While the physical effects of breast cancer treatment are well-documented, the emotional and psychological impact is often overlooked or minimized. The trauma of diagnosis, the grueling treatment regimens, and the constant fear of recurrence can take a significant toll on a woman’s mental health. Many survivors deal with feeling survivor’s guilt because there are many positive and negative emotions involved in a cancer diagnosis, living through treatment, and then in survivorship.

Post-traumatic stress disorder (PTSD), anxiety, and depression are not uncommon among cancer survivors, yet these conditions are frequently underreported or misunderstood. The constant vigilance required for follow-up appointments, screenings, and monitoring can perpetuate a state of hypervigilance and emotional exhaustion, making it difficult for survivors to truly move forward and reclaim a sense of normalcy. Surviving so many things in the last five years leaves me feeling that it can always happen again. It feels like walking around with a gun pointed at you ALWAYS. Any sharp pain causes significant alarms. The senses are always heightened for fear of recurrence.

Visible scars and changes to the body after breast cancer surgery and treatment.  Maribel in a hospital bed before her mastectomy surgery

Navigating the “New Normal”

For many cancer survivors, the journey towards healing and recovery is not a linear path but rather a constant process of adapting and adjusting. We are always hanging on a thread, holding our breath for the next results… constantly vigilant.

The “new normal” that comes after treatment is a source of uncertainty and anxiety as survivors deal with the physical, emotional, and psychological changes that have reshaped our lives.

Redefining relationships, rediscovering purpose and identity, and finding the courage to enjoy life after cancer are exhausting tasks. Too often, these challenges are met with silence or minimized, leaving survivors to navigate these complexities alone and without the support they so desperately need.

What does this have to do with travel?

In reality it doesnt really have much to do with travel unless you are a travel enthusiast. But what I will say applies to survivors and any passion that they may have and even for people that are not cancer patients that may be reading this: PLEASE DON’T WAIT FOR A CANCER DIAGNOSIS OR ANY OTHER LIFE ALTERING EXPERIENCE TO FOLLOW YOUR PASSION. – Yes I am yelling it from the top of my lungs!

I’ve always loved traveling, but after surviving cancer, I realized how powerful and healing solo travel could be for me and other women going through their own challenges. Getting out there and exploring the world on our own terms, with no one else’s schedule or expectations to follow, is such a liberating experience. It allowed me to reclaim my independence, rediscover who I am after this life-altering experience, and figure out the new normal

With every new solo adventure, I felt more empowered, more resilient, and more alive. I got to create a whole new story for myself – one that celebrated my strength as a survivor and allowed me to be fully present in the moment. Solo travel has become a profound act of self-love and healing..

My purpose is to help other women become confident enough to travel solo, if they wish to do so. Why? Becuase women, especially Latinas, are typically told to diminish themselves and their dreams for the benefit of others.

My purpose is to share my cancer experience with others! Why? Because many women are not told about the potenttial loss of fertility after going through cancer treatment or many of the lifelong side effects.

My purpose is to build a community of women that support each other through Perimenopause and Menopause. Why? Because these are natural stages of life and whether you arrive there early or later in life, there is no avoiding it. So I rather women are better prepared for it than arriving at this stage in life blindly.

Finding freedom and living life to the fullest as a cancer survivor.

Looking Forward

The road to navigating this “new normal” after cancer is long and exhausting, filled with challenges that test our strength and resilience. However, by coming together as a community of survivors, and supporters, we can find strength in shared experiences and can draw inspiration from one another’s journeys. It’s a path that demands courage, vulnerability, and an unwavering commitment to self-care, but one that also promises growth, self-discovery, and a deeper appreciation for the beauty that lies within and around us.

I hope you find inspiration and empowerment throughout this blog.

If this is your first time on my blog, make sure to read Why Latinas Should Never Solo Travel. If this you would like to read about my reader’s stories, you can also read Elena’s travel story

If you want to solo travel but don’t know where to start, I have an entire Guide to help you Solo Travel.

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Meet Maribel, The Queen of Trips, a survivor who turned her cancer journey into a source of inspiration for fellow travelers. Join her as she fearlessly explores the world, showing that life after cancer is a testament to resilience and the power of living fully.

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