Frequently asked questions
Q: Can I do anything to minimise the chance of infection when I'm on chemotherapy?
A: Please see my comments in the article Low blood counts and infections
Q: What should I eat to minimise the chance of getting cancer, or of my cancer coming back?
A: See my detailed comments at Eating to be cancer-free
Q: What are the side-effects of tamoxifen?
A: These are set out in my article on Tamoxifen
Q: Can I take anything to relieve hot flashes? Is "Remifemin" safe if I've had breast cancer?
A: Click here.
Q: I've finished my chemotherapy and radiotherapy. What happens now? Can you check to see if there's any cancer left?
A: Click here.
Q: Do you have any tips for dealing with tiredness? I just feel so exhausted!
A: Click here.
Q: No matter what I do I just cannot sleep. Can you help me?
A: You can find some helpful advice in this article on insomnia.
Q: Why Me? - The causes of breast cancer.
A: The most common question I am asked by my patients is “Why me?” Typically, my patients say, “I have never smoked, I have kept pretty fit, I have tried to do the right thing, why me?” Click here to read my attempt at the answer.
Q: I had breast cancer. Is my daughter at risk?
A: Click here to find out.
Q: I am pretty anxious about taking strong pain killers. Won't I get used to them, or addicted to them? Maybe when I really need them they won't work, because I've used them too soon. Maybe I should just put up with my pain. I've never been one for taking a lot of pills, doc!
A: For all your answers it's really important that you and your carers read my page on Pain.
Q: My tumour is hormone receptor negative. Am I missing out on something?
A: Click here.
Q: What does the stage and the grade of the tumour mean?
A: Click here for the answer.
Q: Is there anything I should or should not eat during chemotherapy?
A: All the answers are found on my page Diet and chemotherapy.
Q: What are the new drugs Arimidex (anastrozole), Femara (letrozole) and Aromasin (exemestane)? Should I have them instead of tamoxifen? Should I have them after tamoxifen?
A: Read about the aromatase inhibitors here.
Q: Should I go to Perth, WA, and have Dr Holt’s microwave therapy?
A: Claims were once made on Channel 9’s “A Current Affair” and elsewhere about microwave therapy (also known as VHF therapy, UHF therapy using a machine called a Tronado in Western Australia) performed by Perth-based cancer therapist Dr John Holt. This is not an established form of cancer therapy despite efforts to show that it might have efficacy. The majority of Australian cancer experts interviewed in one large survey felt that microwave therapy was harmful. Dr Holt’s microwave therapy was investigated by the NHMRC, and a seven-year randomised trial was conducted at the Royal Perth Hospital in Western Australia in 1996 on microwave therapy in conjunction with conventional radiotherapy for controlling locally recurrent cancer of the rectum. The study concluded that microwave therapy combined with radiotherapy produces no therapeutic advantage over radiotherapy alone for this cancer. I am unaware of any subsequent data from Dr Holt to show the benefits of microwave therapy over other forms of cancer therapy, or to show that it works when other cancer therapies, like chemotherapy, have failed. However, the whole issue is again being investigated by the NHMRC so watch this space.
Meanwhile, my advice to my patients is that they do not seek this treatment, and I am not referring patients to Dr Holt. Patients who seek this treatment must obtain a referral from elsewhere. I will, of course, provide copies of your medical records on receipt of a written request.
Q: I have been on Zoladex for two years? Should I continue longer?
A: For women who are having Zoladex as adjuvant therapy for early breast cancer we don’t know the answer to this question, as there are as yet no data from clinical trials. The experts at the St Gallen Breast Cancer Conference (January 2005) were asked their opinions. There was no real consensus. 57% voted for, and 21% against 2-3 years. 28% voted for 5 years, while 64% voted against that longer duration. I think if we follow the trials so far, 2-3 years is probably going to be optimal.
My advice: ask your oncologist, of course, but if you are tolerating it well, can afford it, and you had a higher-risk early breast cancer, I would probably stay on it for 3 years. See my article HERE
Q: Why shouldn't all women on adjuvant tamoxifen switch to Arimidex or Femara?
A: See my comments here.
A: Please see my comments in the article Low blood counts and infections
Q: What should I eat to minimise the chance of getting cancer, or of my cancer coming back?
A: See my detailed comments at Eating to be cancer-free
Q: What are the side-effects of tamoxifen?
A: These are set out in my article on Tamoxifen
Q: Can I take anything to relieve hot flashes? Is "Remifemin" safe if I've had breast cancer?
A: Click here.
Q: I've finished my chemotherapy and radiotherapy. What happens now? Can you check to see if there's any cancer left?
A: Click here.
Q: Do you have any tips for dealing with tiredness? I just feel so exhausted!
A: Click here.
Q: No matter what I do I just cannot sleep. Can you help me?
A: You can find some helpful advice in this article on insomnia.
Q: Why Me? - The causes of breast cancer.
A: The most common question I am asked by my patients is “Why me?” Typically, my patients say, “I have never smoked, I have kept pretty fit, I have tried to do the right thing, why me?” Click here to read my attempt at the answer.
Q: I had breast cancer. Is my daughter at risk?
A: Click here to find out.
Q: I am pretty anxious about taking strong pain killers. Won't I get used to them, or addicted to them? Maybe when I really need them they won't work, because I've used them too soon. Maybe I should just put up with my pain. I've never been one for taking a lot of pills, doc!
A: For all your answers it's really important that you and your carers read my page on Pain.
Q: My tumour is hormone receptor negative. Am I missing out on something?
A: Click here.
Q: What does the stage and the grade of the tumour mean?
A: Click here for the answer.
Q: Is there anything I should or should not eat during chemotherapy?
A: All the answers are found on my page Diet and chemotherapy.
Q: What are the new drugs Arimidex (anastrozole), Femara (letrozole) and Aromasin (exemestane)? Should I have them instead of tamoxifen? Should I have them after tamoxifen?
A: Read about the aromatase inhibitors here.
Q: Should I go to Perth, WA, and have Dr Holt’s microwave therapy?
A: Claims were once made on Channel 9’s “A Current Affair” and elsewhere about microwave therapy (also known as VHF therapy, UHF therapy using a machine called a Tronado in Western Australia) performed by Perth-based cancer therapist Dr John Holt. This is not an established form of cancer therapy despite efforts to show that it might have efficacy. The majority of Australian cancer experts interviewed in one large survey felt that microwave therapy was harmful. Dr Holt’s microwave therapy was investigated by the NHMRC, and a seven-year randomised trial was conducted at the Royal Perth Hospital in Western Australia in 1996 on microwave therapy in conjunction with conventional radiotherapy for controlling locally recurrent cancer of the rectum. The study concluded that microwave therapy combined with radiotherapy produces no therapeutic advantage over radiotherapy alone for this cancer. I am unaware of any subsequent data from Dr Holt to show the benefits of microwave therapy over other forms of cancer therapy, or to show that it works when other cancer therapies, like chemotherapy, have failed. However, the whole issue is again being investigated by the NHMRC so watch this space.
Meanwhile, my advice to my patients is that they do not seek this treatment, and I am not referring patients to Dr Holt. Patients who seek this treatment must obtain a referral from elsewhere. I will, of course, provide copies of your medical records on receipt of a written request.
Q: I have been on Zoladex for two years? Should I continue longer?
A: For women who are having Zoladex as adjuvant therapy for early breast cancer we don’t know the answer to this question, as there are as yet no data from clinical trials. The experts at the St Gallen Breast Cancer Conference (January 2005) were asked their opinions. There was no real consensus. 57% voted for, and 21% against 2-3 years. 28% voted for 5 years, while 64% voted against that longer duration. I think if we follow the trials so far, 2-3 years is probably going to be optimal.
My advice: ask your oncologist, of course, but if you are tolerating it well, can afford it, and you had a higher-risk early breast cancer, I would probably stay on it for 3 years. See my article HERE
Q: Why shouldn't all women on adjuvant tamoxifen switch to Arimidex or Femara?
A: See my comments here.