Version July 2025
| Effect | Management options |
| Surgical | |
| Cosmetic effects | Plastic surgery |
| Functional disability of arm or chest wall, pain | Physical therapy |
| Scarring/adhesions | Plastic surgery |
| Lymphedema | Physical therapy, avoid trauma to involved arm* |
| Radiation | |
| Pneumonitis, pulmonary fibrosis | Symptomatic management |
| Cardiac damage | Lifestyle risk-reduction (diet, exercise, tobacco avoidance)¶ |
| Lymphedema | As above |
| Second malignancies | Image masses arising near radiation field |
| Systemic therapy | |
| Neuropathy (eg, taxanes and platinums) | Symptomatic management (eg, antidepressants, antiseizure medications for painful neuropathy) |
| Cognitive dysfunction | Cognitive therapy |
| Weight gain | Exercise and diet |
| Fatigue | Exercise, rule out other causes |
| Cardiomyopathy (eg, anthracyclines) | Symptomatic management |
| Kidney toxicity (eg, cisplatin) | Symptomatic management |
| Ototoxicity (eg, cisplatin) | Symptomatic management |
| Sexual dysfunction | Counseling, lubricants |
| Menopausal symptoms | Gabapentin, SNRI (eg, venlafaxine), SSRI |
| Premature menopause and infertility (eg, alkylating agents) | Referral to infertility specialist |
| Osteoporosis (eg, hormonal therapy, chemotherapy) | Calcium, vitamin D, exercise, anti-resorptive therapy |
| Second malignancies (myelodysplasia and leukemia) | Check CBC if symptoms of leukemia arise |
CBC: complete blood count; SNRI: serotonin-norepinephrine reuptake inhibitors; SSRI: selective serotonin reuptake inhibitors; TSH: thyroid stimulating hormone.
* Surgical approaches are also available for management of lymphedema.
¶ Referral to a cardiologist is appropriate.
