Body

Feeling Whole After Breast Cancer

Reconstruction and physical therapy play a major role in helping patients find a new normal

By Jessica Lawlor

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After facing a breast cancer diagnosis, surgeries, chemotherapy and radiation, Jean Marie Lown, a physical therapist from Lake Ariel, Pennsylvania, certainly didn’t feel like her usual energetic, outdoor-loving self.

It wasn’t until after reconstructive surgery and physical therapy at Cancer Treatment Centers of America® (CTCA) in Atlanta, Georgia, that Lown began to feel whole again.

For many patients fighting breast cancer, reconstruction and physical therapy play a role in helping them get back to everyday activities and regain a sense of normalcy.

A shocking diagnosis

Lown learned she had breast cancer in 2013 in the most unexpected of ways: trying to get life insurance.

A previous work injury and visit to the doctor alerted her to a questionable mass in her right breast and thyroid. So, when Lown, 48 at the time, inquired about life insurance, the company told her she would need an ultrasound.

Lown had multiple mammograms, an ultrasound and biopsy all on the same day—two days before her daughter’s high school graduation. The morning of graduation, Lown received the difficult news that she had stage II invasive ductal carcinoma of the right breast.

Lown, who is vegan, says her one requirement was that she choose a facility that integrated naturopathic medicine into her treatment plan. Her husband, Larry, remembered hearing about CTCA, and made a phone call.

The couple made an appointment to visit in August, and Lown decided to complete treatment at CTCA. She had a nipple-sparing mastectomy, with a request to take just the sentinel node. However, because the cancer had spread, additional lymph nodes had to be removed. After recovery from surgery, she completed four rounds of chemotherapy and underwent radiation.

How reconstruction helps patients feel whole again

The following year, Lown returned to CTCA for reconstructive surgery.

“Reconstruction can play a vital role in helping breast cancer survivors recover physically, as well as mentally, emotionally and socially,” says Frederick Durden, MD, a plastic and reconstructive surgeon at CTCA in Atlanta. “After having a mastectomy or partial mastectomy some women have the concern of not feeling ‘whole’ anymore as a part of their body that makes them feel and look like a woman has been altered.”

There are several options for reconstructing the breast, including symmetrizing breast surgery, the creation of nipples, implants and the use of natural body tissue, Dr. Durden explains.

“We have an awesome team that has the rewarding task of helping women see the ‘light at the end of the tunnel’ following their fight with breast cancer,” says Dr. Durden.

Discovering the benefits of physical therapy

After reconstruction, Lown may have looked the way she did pre-breast cancer, but she still didn’t feel 100 percent herself. She couldn’t lift her arm up all the way, and struggled to get dressed.

She began to experience other side effects. “What is this thing under my arm?” she wondered as she saw what looked like spider webs inside her arm. Lown requested an appointment with the physical therapy team at CTCA where she learned she had lymphedema and axillary webbing syndrome.

Lown worked closely with a physical therapist, and while the axillary webbing syndrome improved, the lymphedema worsened. Bruising badly, Lown did her own research and worked with the team to develop a new and personalized technique.

Pamela Veale, a physical therapist at CTCA in Tulsa, Oklahoma says physical therapy can have an important role in helping breast cancer patients get back to normal before and after surgery.

Before surgery, Veale says physical therapists meet with patients to identify baseline range of motion, measure arm circumferential and identify level of fluid in the arm which can help to find lymphedema later.

“We educate patients in range of motion exercises for after surgery to help them experience fewer complications and maximize quality of life,” Veale says.

After reconstruction, Veale says physical therapists work with the surgical team to keep the reconstructed breast mobile, while abiding by any post-op restrictions. They follow up with exercises and retest fluid levels in arms as a potential way to stimulate the lymphatic system.

Physical therapy helped Lown—eventually, she was able to lift her arm up about 60 degrees, and after several more sessions both at CTCA and at home, to 90 degrees.

“Before, I felt so disabled. I couldn’t cook, couldn’t get stuff out of the cabinets,” says Lown. “Being able to put my own shirt on in the morning was really nice. I was thrilled.”

Lown returns to CTCA for annual checkups—and continues to work on her strength and mobility. She’s up to completing 12 pushups!

“We educate patients, which gives them a sense of control, help manage side effects and give them tools to use at home to self-manage their recovery,” Veale says. “We help patients with regaining strength and endurance to do ‘normal things’ even if they have to do them differently.”

Veale says physical therapy follow-up is different for everyone, but that most patients undergoing reconstruction can expect an average of 1-3 visits.

“I have my life back”

Lown returned to CTCA this past spring to celebrate a major milestone—her five-year anniversary. She looks forward to spending time with her family and watching her grandkids and nieces and nephews grow up.

“I’m here to see all of that now. It means everything. Nothing is missing,” says Lown. “I feel like I have my whole life back.”

 

No case is typical. You should not expect to experience these results

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