NEW YORKDaughters of women with breast cancer face a
broad range of medical, practical, and emotional issues, from their
roles as advocates and caregivers to their own risk of developing the
disease. A teleconference organized by Cancer Care, Inc., addressed
these issues for an audience of more than 400 in the United States
The 1-hour teleconference, titled A Shared Purpose: Helping
Daughters Whose Mothers Have Advanced Breast Cancer, was
moderated by Carolyn Messner, ACSW, Cancer Cares director of
education and training.
Cancer Care Teleconferences: An Ongoing Series
A Shared Purpose: Helping Daughters Whose Mothers Have Advanced
Future teleconferences will cover such topics as advanced melanoma,
Cancer Care is a national nonprofit organization providing help for
Cancer Care can be reached through its toll-free number,
It featured Karen Antman, MD, director of the Herbert Irving
Comprehensive Cancer Center and chief of the Division of Medical
Oncology, Columbia-Presbyterian Hospital, New York, and Patricia
Spicer, CSW, coordinator of the breast cancer program at Cancer Care.
Dr. Antman stressed that every person with breast cancer is
different, and its important to talk with your own doctor or
your mothers doctor. She reviewed the standard treatments
for breast cancer and newer treatments with hormones and biologics,
as well as the option of participating in a clinical trial. She
cautioned daughters, however, against pinning hopes on experimental
treatments hyped by the media, such as angiostatins, which may be
years away from standard clinical use, if indeed they prove to be
effective at all.
What Symptoms to Expect
Dr. Antman also advised the daughters on what symptoms to expect from
the cancer and its treatment and how they are managed. In addition to
medications to counteract nausea, she said, breast cancer patients
may benefit from nutritional support and agents to prevent infection,
strengthen bones, and relieve pain.
She mentioned the use of G-CSF (Neupogen) to counter neutropenia and
lower the risk of infection, and bis-phosphonates to strengthen bones
weakened by metastases.
Dr. Antman was emphatic that total pain control should be the goal,
and that narcotic pain medication rarely represents an addiction risk
in cancer patients.
Patients do best when their pain is entirely relieved and they
can go about their normal activities, she said. People
who are in pain dont eat very well, dont sleep very well,
and that gets in the way of their recovery.
Once a mother is diagnosed with breast cancer, her daughter becomes a
woman with a family history of breast cancer, Dr. Antman observed.
Whether that represents an increased risk, however, depends on the
mothers age at diagnosis, whether other close relatives
developed breast cancer at an early age, and whether the family is
Jewish, which, she explained, is a group in which hereditary risk for
breast cancer is more common.
Dr. Antman urged daughters to discuss with their health care provider
whether earlier or more frequent screening is recommended and whether
use of prophylactic tamoxifen (Nolvadex) should be considered [See
article on the STAR trial on page 4.}
Furthermore, decisions about birth control and hormone replacement
postmenopause should be made with the mothers diagnosis in
mind. Finally, she said, daughters of breast cancer patients should
consider adopting a healthy life-style, including maintaining ideal
weight and eating a diet high in vegetables.
In her presentation, Patricia Spicer, CSW, focused on psychosocial
issues the daughter of a breast cancer patient might face. Many
daughters become the primary caregiver when their mother develops
breast cancer, she observed.
In addition to the day-to-day burden of caring for their mother,
daughters may experience fear for themselves and their own children,
anger when faced with a possibly demanding patient, and guilt or
other conflicted feelings that may have predated the diagnosis or may
develop in the course of giving care.
Ms. Spicer urged daughters to take care of themselves as well as
their mothers. Taking time off, soliciting and accepting the help of
others, seeking counseling, and joining a support group are among the
strategies she suggested.