Breast Cancer Awareness: In the spa

The spa professional’s role in recognizing changes in the skin and modifying therapies

Fewer women are dying from breast cancer today than in the past. Breast cancer deaths have decreased due to earlier detection and greater awareness. This awareness is imperative, and all spa professionals need to be educated about the signs and symptoms of breast cancer, so they can recognized it.

That being said, it is not our role as spa therapists to diagnose cancer, but simply to make the client aware of changes in their skin, and these changes can be noticed during spa treatments, such as underarm waxing, body wraps or other skin care services. By being aware, you can help save a life!

Because a large percentage of women of all ages – and more and more men – visit spas, spa professionals cannot shy away from the reality of breast cancer. When it comes to both sexes, both women and men have breasts; women just have more breast tissue. Each breast lies over the pectoral muscle. The female breast extends from just below the clavicle, to the axilla and across to the sternum. The breast is a mass of glandular, fatty and connective tissue made up of:

• Lobules—glands that produce milk;
• Ducts—tubes that carry milk from the lobules to the nipple; 
• Fatty and connective tissue—surrounds and protects the ducts and lobules, and gives shape to the breast; 
• Areola—the pink or brown circular area around the nipple; and
• Nipple—the area at the center of the areola that dispenses milk.

Ligaments support the breast. They run from the skin through the breast and attach to muscles on the chest. Breast cancer can begin in different areas of the breast: the ducts, the lobules or, in some cases, the tissue in between. There are several types of breast cancer, but some of them are quite rare. In some cases, a single breast tumour can be a combination of types, or be a mixture of invasive and in situ cancer.

Metastatic Breast Cancer
Metastatic breast cancer (sometimes called advanced or stage 4 breast cancer) is breast cancer that has spread to distant parts of the body, such as the lungs, liver, bones, or brain.
Although metastatic breast cancer is considered incurable, it is important to know that there are many treatment options which can control the disease for extended periods of time and allow people to live with a good quality of life, and in many cases, for many years. The signs and symptoms of metastatic breast cancer will depend on the location that the cancer cells have spread to. The main sites of metastasis for breast cancer are the bone, lungs, liver, and brain. Sometimes, metastases may be found before they have a chance to cause any symptoms. In some instances, changes in a person’s health and certain signs and symptoms may prompt them to visit a health care provider. When a person is diagnosed with breast cancer, or they have a breast cancer recurrence, their health care provider will do additional tests to find out if the cancer has spread, even if the person doesn’t have any other notable signs and symptoms. This is called a metastatic work-up. These tests may show that breast cancer has spread beyond the breast tissue.

Signs and Symptoms at location of metastasis

Bone: Bone pain; bone fracture; high calcium levels resulting in fatigue, nausea, constipation, thirst. At the spa: Some modifications to consider: avoid localized area of pain/fracture, modify pressure, shorten the service and ensure that it is gentle and relaxing.

Lungs: Coughing, shortness of breath, chest pain. At the spa: Elevate spa bed to help with breathing and focus on relaxing the client so breathing eases up. Constant shortness of breath may require a 911 call.

Liver: Fatigue, loss of appetite, itchy skin, jaundice (eyes and skin), nausea.
At the spa: Slow, gentle and shorter service, and emollients for skin.

Brain: Headaches, pressure, memory and personality changes, nausea and vomiting. At the spa: Relaxation, use pressure points to soothe headaches.

Holistic or complementary spa therapies
Spa therapists also need to be aware of the possible side effects from cancer treatment and how they can help. Studies have shown that relaxation therapy or acupuncture can ease pain. Even if holistic or complementary therapies, such as a facial, manicure or pedicure, do not lengthen a person’s life, they may improve the quality of life while undergoing cancer treatment. Some physicians will combine both complementary and standard treatments, drawing on the strengths of each. This is often called “integrative oncology.” 

Many physicians are not familiar with all the holistic or complementary therapies available to the spa client. This may mean that your client’s physician may disapprove of their interest in a spa treatment. This requires you to educate your client and, in turn, have them educate their physician about the services you will provide. 
As spa therapists, you can also educate your clients about the importance of regular, monthly breast self-exams and having an awareness of changes occurring in, on and around the breasts and underarm areas.