Breast Cancer Preventive & Targeted Therapies

What to Expect and How OT Can Help

For individuals at high risk for developing breast cancer, or for survivors seeking options to reduce the chance of recurrence, medications and targeted therapies can be powerful tools. These treatments, ranging from hormonal drugs to targeted inhibitors and immunotherapy, are typically prescribed after a detailed discussion with your oncology team about your risk factors, benefits, and potential side effects.

While they may greatly improve long-term outcomes, these therapies can also impact your daily activities, comfort, and energy. This is where Occupational Therapy (OT) can play an important role in helping you manage side effects, maintain independence, and continue engaging in the activities that matter most.

I tell my clients that we go through oncology treatment in order to be able to live a full, satisfying life. Sometimes, though, life on cancer-preventatives and targeted therapies can feel like a struggle. This post details information about common interventions and strategies to address side effects to maximize your daily life function.

Common Breast Cancer Preventive and Targeted Therapies

1. Tamoxifen

How it works: Blocks estrogen receptors on breast cells to reduce the chance of cancer developing.
Who it’s for: Often prescribed for pre- and postmenopausal women at high risk.
Common side effects: Hot flashes, night sweats, joint stiffness, fatigue, mood changes, and risk of blood clots.

2. Aromatase Inhibitors (AIs) – e.g., Letrozole (Femara), Anastrozole (Arimidex), Exemestane (Aromasin)

How they work: Lower estrogen levels in postmenopausal women by blocking the enzyme aromatase.
Who they’re for: Usually for postmenopausal women at increased breast cancer risk or after early-stage treatment.
Common side effects: Joint and muscle pain, bone thinning, fatigue, hot flashes, mood changes, and decreased range of motion.

3. CDK4/6 Inhibitors – e.g., Ribociclib (Kisqali), Palbociclib (Ibrance), Abemaciclib (Verzenio)

How they work: Target proteins (cyclin-dependent kinases 4 and 6) that regulate cell division, slowing cancer cell growth.
Who they’re for: Often used with hormonal therapy in hormone receptor–positive, HER2-negative breast cancer; some research supports use in reducing recurrence risk.
Common side effects: Fatigue, nausea, diarrhea, lowered blood counts (neutropenia, anemia), increased infection risk, headaches.

4. Immunotherapy – e.g., Pembrolizumab (Keytruda), Atezolizumab (Tecentriq)

How it works: Stimulates the body’s own immune system to recognize and attack cancer cells.
Who it’s for: More common in triple-negative breast cancer or cancers with specific biomarkers. Also being studied for preventive and/or maintenance uses in certain individuals who have high-risk.
Common side effects: Fatigue, skin rashes, flu-like symptoms, diarrhea, joint pain, inflammation in organs (rare but serious).

OT’s Role in Managing Side Effects

As you can tell, these different therapies can affect your musculoskeletal system, energy levels, immune health, and mood. All of which influence how you function in your daily roles, habits and interests. Occupational Therapy can help you manage and cope with side effects by:

Managing Joint and Muscle Pain

Gentle, progressive stretching and strengthening programs to reduce stiffness.
Manual therapy for trigger point release and muscle re-balancing.
Joint protection and ergonomic education to prevent overuse injuries.
Custom orthotics can be fabricated when needed.

Supporting Bone Health

Weight-bearing and resistance exercises to counteract bone density problems.
Strength ABCs is one program designed for progressive resistive (strengthening) exercises which are proven to build bone density.
Tailored exercises to avoid bone and joint stress in individuals who have osteopenia or osteoporosis.
Education on safe movement and fall prevention strategies.

Addressing Fatigue

Energy conservation strategies, pacing, and scheduling high-energy tasks during peak energy times.
Learning to make “deposits” into the energy savings bank with mindful “withdrawals” to avoid over-drafting the energy reserve.
Developing a set of home exercises that are a “just-right” challenge.
Mind-body interventions like guided breathing and relaxation to reduce perceived fatigue.

Coping with Hot Flashes and Night Sweats

Environmental modification strategies for the home, workplace, and bedroom.
Breath work and relaxation techniques to lessen episode severity.
Education on alternative practices such as acupuncture and yoga for symptom reduction.

Immune System Support (especially for CDK4/6 inhibitors & immunotherapy)

Education on hygiene and avoiding high-exposure environments during vulnerable periods.
Gradual, monitored reintroduction of activities after illness or treatment breaks.

Promoting Emotional Well-Being

Coping strategies for anxiety, mood changes, and lifestyle adaptations.
Structuring routines to maintain a sense of normalcy and control.
Communication strategies to maximize support from loved ones.
Meal prep strategies to maintain nutrition and hydration despite appetite changes.

Living Well While Protecting Your Health

Preventive and targeted therapies can be powerful tools in reducing breast cancer risk and recurrence. But optimal results come when medical treatment is paired with quality-of-life strategies.

At Katherine Jackson Occupational Therapy, PLLC, we help you navigate these side effects so you can maintain strength, comfort, and independence throughout your preventive or targeted therapy journey. By combining medical guidance with practical daily living solutions, you can protect your health without losing sight of the life you want to live.

Katherine Jackson Occupational Therapy, PLLC