Ask the Doctor

While undergoing treatment for breast cancer, are there any precautions I should take when enjoying the summer outdoors?

While chemotherapy and radiation therapy may increase your sensitivity to the sun somewhat, that's no reason to stay indoors, says radiation oncologist Francine Halberg, M.D., who specializes in treating women with breast cancer. Halberg, who practices at the Marin Cancer Institute and serves as associate clinical professor of radiation oncology at the University of California, San Francisco, encourages her breast cancer patients to be outside and to be active.

"Reclaiming your body by being physically active outside is enormously important for overall health," says Halberg. "This is particularly true because there are new data emerging that women who are physically active have a lower risk of breast cancer recurrence." Chemotherapy lowers your metabolism, she says, so if you eat the same thing you have always eaten, you may gain weight. By exercising-like walking 20 to 30 minutes a day for example-you can counter these effects. She suggests using the following national guidelines to protect yourself from the sun. Then factor in whatever considerations may be necessary because of your particular cancer treatment.

The American Academy of Dermatology (AAD) says we all need sunscreen when we are in the sun for more than 20 minutes. The Academy recommends a broad-spectrum sunscreen of SPF 15 or higher and suggests applying it to dry skin 15-30 minutes before going outdoors-even on cloudy days. Avoid sunbathing and minimize sun exposure from 10:00 a.m. to 4:00 p.m. Wear protective clothing, a broad-brimmed hat and sunglasses.

"Put on lots of sunscreen," says Halberg. "The way these ratings are calculated, you need a thick layer to get the SPF rating. Then reapply the sunscreen every two hours and after swimming. This is good sun care for everyone in the family."

People currently undergoing chemotherapy are likely to beoverly sensitive to the sun, especially if they are on drugs such as capecitabine, 5-FU or adriamycin. But any medication can cause photosensitivity in a small percentage of individuals. Check with your doctor, Halberg says, to see if the drug you are taking may increase your sensitivity. Ifit does, be extra conscientious about following AAD guidelines-then go outdoors!

Radiation is different from chemotherapy in that only the area being irradiated is extra sensitive. For breast cancer patients currently undergoing radiation, it is just the breast, chest area and sometimes the upper lymph node regions that you must be sure to cover up well. There is no increased risk for the rest of your body. And while swimming is an excellent exercise, Halberg suggests giving up swimming during radiation therapy or using special skin care precautions until after treatment, because chlorine can irritate the skin.

The skin that was irradiated may take many months to heal completely. For this reason, it's a good idea to continue covering up that skin at least through the summer after radiation therapy. Halberg says that this is because you will sunburn more readily in the irradiated area or you may end up with a darker tan on one side, leaving you with a lasting reminder of your treatment.

Radiation does not cause hair loss. Many women believe that it does and are frightened unnecessarily-particularly if they will not be receiving chemotherapy. Women who have received chemo, however, may be coping with hair loss and will need to protect their scalp from the sun. Some women wear wigs that match their hair before they got sick, Halberg says. Others wear magnificent scarves, while yet others love to collect hats for different days of the week and to match different outfits. Some hats even have bangs taped to the front of the hat and a ponytail sticking out the back.

"Being outside and physically active in whatever way works for you is very important for all women. It gets us in touch with beauty in the world. It's all a part of healing."

This article was first printed in the summer 2005 issue of Lifeline.

Email This Page:

Your Name:
Your Email:
To Email(s):	Enter up to 5 email addresses, separated by commas
Comments:
	or Cancel