Dicas e cuidados após a mastectomia

Em geral, uma mastectomia demora entre duas e três horas. Porém, esse tempo pode variar em função do tipo de câncer. Depois da cirurgia, você provavelmente ficará no hospital durante uma ou duas noites, período que também poderá variar de mulher para mulher. Os médicos e as enfermeiras acompanharão sua recuperação. Você poderá receber também a visita de nutricionistas, fisioterapeutas, terapeutas ocupacionais, psicólogos ou assistentes sociais. Todos esses profissionais compõem a equipe multiprofissional que vai lhe acompanhar para uma melhor recuperação.

Ao acordar após a cirurgia, você verá um curativo sobre a área do seio. Talvez você tenha também um ou mais drenos no seu seio ou na área sob os braços. Eles permanecerão nesse lugar durante, mais ou menos, uma semana, mas esse tempo pode variar para mais ou para menos, dependendo de sua recuperação. Os drenos removem fluidos que se acumulam enquanto você se recupera. Eles devem ser mantidos sempre presos à roupa e esvaziados duas vezes ao dia. Fique atenta às mudanças na característica do líquido que sai do dreno.

O local operado e a outra mama devem ser examinados com frequência.

As mulheres ficam surpresas ao sentir pouca dor no seio após a cirurgia; porém, pode haver sensações diferentes, como falta de sensibilidade, formigamento ou sensação de puxada na área sob os braços.

Converse com seu médico sobre como se cuidar após a cirurgia.  Antes de deixar o hospital, você deverá receber instruções sobre como proceder no período de recuperação. Caso o seu médico não lhe dê essas orientações, sugerimos que você lhe pergunte o seguinte:

Como cuidar do corpo:

• Como cuidar da ferida e fazer curativo.

• Como cuidar dos drenos.

• Como perceber se você tem uma infecção.

• Que remédios tomar (incluindo analgésicos) e com que frequência.

• A quem recorrer se precisar de ajuda rápida.

Como voltar à vida normal:

• O que comer e o que não comer.

• Que atividades você poderá fazer e quais não.

• Em que momento você poderá retornar ao trabalho.

• Caso você trabalhe, lembre-se de solicitar ao seu médico o atestado de internação e o pedido de afastamento para a sua recuperação. Consulte, também, onde esses documentos deverão ser entregues.

Como acostumar-se a seu corpo após a cirurgia:

• Quando e como começar a usar o braço.

• Quando e como exercitar o braço para evitar que seus movimentos fiquem comprometidos.

• Quando você poderá usar uma prótese mamária (um acessório com formato de seio que pode ser usado sob a roupa).

• Como lidar com os sentimentos que poderão surgir neste momento da sua vida.

• Lembre-se: você precisará de ajuda no período de recuperação. Procure se organizar para contar com o apoio de familiares e amigos no período pós-operatório.

• Como entrar em contato com grupos de apoio ou outras organizações que podem ajudar você no processo de tratamento e recuperação.

Cirurgia conservadora:

Uma cirurgia conservadora, também chamada de cirurgia de conservação da mama (ou cirurgia com conservação mamária), demora em torno de uma hora, mas esse tempo pode variar em função do tipo de câncer. Em muitos casos, você poderá ser submetida a uma cirurgia conservadora sem precisar pernoitar no hospital.

Talvez você precise ficar com um dreno sob o braço após a cirurgia conservadora. O dreno, em geral, é retirado antes que você saia do hospital. Às vezes, o dreno precisa ficar durante mais tempo e poderá ser removido em sua consulta de seguimento com seu médico.

Você precisará de radioterapia complementar em toda a mama após a cirurgia conservadora. Se estiver sendo tratada com quimioterapia, seu médico pode querer que você espere para receber radioterapia. A maioria dos médicos vai querer que você movimente o braço logo depois da cirurgia, para estimular a recuperação.

Efeitos colaterais:

Os efeitos colaterais ou efeitos adversos são sintomas indesejados ou problemas que acontecem por causa do tratamento.

A maioria dos tratamentos para o câncer causa efeitos colaterais porque esses tratamentos precisam ser potentes o bastante para matar as células cancerosas, o que acaba por danificar também as células saudáveis. Conforme as células saudáveis vão sendo danificadas, você poderá se sentir doente, sem energia e até perder o cabelo. A maioria desses efeitos colaterais desaparece depois que o tratamento termina.

Existem formas de ajudar a prevenir ou deter alguns dos efeitos colaterais. Informe-se com o seu médico sobre:

• Os possíveis efeitos colaterais do tratamento.

• A probabilidade de você sofrer efeitos colaterais.

• O que pode ser feito para prevenir os efeitos colaterais ou lidar com eles.

• Por quanto tempo durarão esses efeitos colaterais?

• Os efeitos colaterais desaparecerão depois do término do tratamento?

Os médicos falam com frequência sobre efeitos colaterais comuns e raros.

Efeitos colaterais comuns:

• Dor de estômago.

• Perda de apetite.

• Mudança nos hábitos alimentares.

• Perda decabelo.

• Sensação de cansaço.

• Boca seca ou dolorida.

• Hematomas ou sangramentos.

• Aparecimento de novas infecções.

Efeitos colaterais raros:

• Dano ao coração, fígado e rins.

• Perda auditiva.

• Dano aos nervos das mãos, pés e pernas.

• Risco de ter um segundo câncer.

  • Cansaço:

Algumas pessoas que fazem tratamento contra o câncer sentem-se realmente cansadas. O que acontece: Os tratamentos contra o câncer realmente podem fazê-la sentir-se muito cansada. Esta sensação, chamada fadiga, é o efeito colateral mais comum do tratamento de câncer. A fadiga é diferente da sensação de não ter dormido o suficiente. É como se seu cérebro, corpo e emoções estivessem cansados. A fadiga pode ocorrer no início da quimioterapia ou da radioterapia, podendo, até mesmo, demorar algumas semanas para que você sinta o mal-estar.

O que você pode fazer:

Se você se sentir cansada, tente seguir os seguintes passos:

• Cuide-se.

• Durma bastante.

• Alimente-se bem.

• Peça ao seu médico remédios que possam lhe ajudar.

• Ingira líquidos, especialmente água e sucos.

• Faça exercícios, se possível. Isto poderá lhe dar mais energia.

Estabeleça limites:

• Não se force a fazer mais do que você se sente capaz. Respeite seu ritmo e seus limites.

• Decida quais são as coisas mais importantes para você fazer. Descanse bastante e guarde sua energia para essas coisas.

• Seja paciente e respeite seu ritmo e suas limitações. Elas são temporárias e gradativamente as coisas tendem a se normalizar.

• Deixe que outras pessoas a ajudem. Não queira fazer tudo sozinha.

  • Linfedema:

O linfedema é um inchaço do braço. Pode começar após alguns tratamentos que afetam os nódulos linfáticos localizados debaixo do seu braço.

O que acontece: O linfedema é um acúmulo de líquidos que causam inchaço do braço. A quantidade de inchaço varia de mulher para mulher. Algumas mulheres podem apresentar um inchaço que faz com que os anéis fiquem apertados nos dedos. Em outras mulheres, o braço pode inchar até o dobro do tamanho normal.

O linfedema pode começar logo após a cirurgia ou radioterapia, ou surgir meses ou anos depois. O mais frequente é que apareça de forma lenta. Ocorre em mulheres que tiveram os nódulos linfáticos removidos durante a cirurgia ou que receberam radioterapia na área dos nódulos linfáticos. Aproximadamente, uma em cada cinco mulheres com câncer de mama terá linfedema.

Como diminuir as chances de ter linfedema:

• Tente evitar as infecções. Faça os exames de sangue e aplique injeções no braço não afetado pela cirurgia. Mantenha a pele limpa e proteja-a quando tiver cortes ou queimaduras. Use luvas quando fizer alguma atividade que possa machucar suas mãos.

• Tente evitar queimaduras. Proteja seu braço das queimaduras de sol. Use luvas para forno quando estiver cozinhando. Evite respingos de comida que estiver no fogo ou no micro-ondas. Não tome banho quente de banheira e não vá a saunas. O calor pode causar retenção de líquido.

• Tente evitar roupas ou outros itens que apertem ou pressionem o braço ou o ombro afetado.

Evite o uso de correntes ao levar bolsas. Tire a sua pressão no braço não afetado (ou na coxa quando ambos os braços estão fragilizados). Quando fizer viagens aéreas, use uma manga elástica (uma bandagem feita sob medida colocada ao redor do braço para reduzir o inchaço) para proteger-se contra mudanças na pressão. Fale com seu médico ou fisioterapeuta se você deve usar ou não a manga elástica.

• Tente evitar esforços musculares. Continue fazendo suas atividades diárias normais com o braço afetado, mas não exagere. Faça exercícios, mas não sobrecarregue o braço. Fale com o seu médico ou fisioterapeuta sobre o nível de atividade adequado para você.

O que você pode fazer: Se passou por uma cirurgia de nódulos linfáticos ou radioterapia nos nódulos linfáticos (área embaixo dos braços), procure por sinais de linfedema. Observe a parte superior de seu corpo na frente de um espelho a cada duas semanas. Converse com seu médico se notar qualquer um destes sinais:

• Sensação de inchaço ou de aperto no braço.

• Impressão de que o braço do lado do corpo em que seu câncer foi tratado parece maior do que o outro.

• Fraqueza no braço ou dificuldade para movê-lo tão bem quanto antes.

• Mudanças na pele, como se ela perdesse elasticidade.

É possível que você tenha outros efeitos colaterais. Pergunte ao seu médico sobre eles.

Após a quimioterapia, talvez você tenha dificuldade para pensar ou lembrar-se das coisas. Você também poderá ter feridas na boca. Pergunte ao seu médico sobre o que fazer com esses efeitos colaterais. Outros efeitos colaterais possíveis são os seguintes:

• Mudanças na pele e no seio. A radioterapia pode fazer com que sua pele fique mais grossa, mais vermelha (como após uma queimadura de sol) ou causar alterações nota manho de seu seio. Essas mudanças geralmente desaparecem entre seis e doze semanas após o tratamento. A quimioterapia pode fazer sua pele ficar vermelha, ressecada, com coceira ou descamação.

• Perda de cabelo em qualquer parte do corpo e não somente na cabeça. A perda de cabelo por causa da quimioterapia pode ocorrer dias ou semanas após o início do tratamento. Tudo depende da forma com que seu organismo reagirá a ela. Após a quimioterapia, seu cabelo voltará a crescer.

• Adoecimento mais fácil. Alguns tratamentos podem debilitar seu corpo e fazer que você adoeça, sangre ou tenha hematomas mais facilmente do que antes.

• Ondas de calor, alterações vaginais e outros efeitos da terapia hormonal. Outros possíveis efeitos adversos são: secura e/ou prurido vaginal, períodos menstruais irregulares, dor de cabeça, náusea, erupção cutânea, fadiga e ganho de peso.

• Mudanças nos hábitos de evacuação. Você poderá ter prisão de ventre ou diarreia no período de tratamento com quimioterapia.

• Maiores chances de ter outro câncer. É muito raro, mas às vezes o tratamento pode facilitar o crescimento de outro câncer no corpo. Se isso acontecer, será vários anos após o tratamento de câncer de mama.

Fonte: Femama

Dicas de como levar a vida após o câncer.

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