Symptom Management: Treating The Emotional and Physical Challenges of Cancer

Cancer is an illness that causes many symptoms. In addition to the physical symptoms that cancer and its treatment can cause, emotional symptoms occur in many patients as well. Providing comfort, relieving symptoms, and easing distress caused from cancer and its treatment is known as symptom management. This type of care is important during all stages of cancer treatment and is aimed at controlling symptoms and improving quality of life. It also addresses the family's needs throughout the course of the illness. Participating in symptom management is of key importance because it enables patients to focus their time on feeling better.

In recent years, there has been an increased focus on symptom management in cancer patients. Because of more frequent early detection and better treatments, cancer patients are living longer than they were years ago. There is also an increased focus on symptom management and quality of life. It is very important to begin symptom management early in the treatment process. If left untreated, these symptoms can significantly impair a patient's quality-of-life and cause them to function at a lower level in their daily activities.

Common Symptoms of Cancer and Its Treatment

Here are some of the most common symptoms caused by cancer and its treatment. Patients and their families need to talk to their health care team early in the process to address symptoms.

Anxiety
Anxiety is a normal reaction to cancer. It is an emotional reaction to fear and causes the body to respond as though it were under physical attack. This symptom may occur after a diagnosis, while awaiting test results, while undergoing treatment, or from anticipating a recurrence of the illness. Anxiety can cause the heart to beat faster, a rise in blood pressure, stress hormones (such as adrenaline) to be released into the system and may make the palms sweat. It can also cause worry and panic, interfere with sleep, cause nausea and vomiting, and severely decrease a patient's quality-of-life and ability to function properly. Anxiety can be treated in different ways. Medications, quality-of-life counseling, hypnosis, or a combination of these methods are commonly used.

Depression
Depression is a common side effect of cancer and its treatment. Studies show that 50% of cancer patients show mild to moderate symptoms of anxiety and depressive behavior. About 20% - 25% have more severe depression. Depression can have very negative effects on quality-of-life and significantly impair a patient's ability to continue working, participate with family, make health care decisions, and have social relationships. Depression may be effectively treated. It's important that it be discussed early on.

Pain
Pain management has become a higher priority in our country during the last several years, and, health care policymakers, health care professionals, regulators, and the general public have increasingly taken an interest in providing better pain therapies. One of the first things people with advanced cancer worry about is pain. Approximately 60% of patients with advanced stages of cancer experience pain, however, there are medications to control this side effect. To ensure an active role in decision making, patients should consider allowing a family member or close friend to learn as much as possible about pain treatment. Proper pain management is important. Whatever strategy is used to treat pain, the doctors, nurses, and caregivers must work together. Oncologists must work hand-in-hand with nurses, primary care physicians, and other caregivers on the health care team such as psychologists or therapists to provide consistent and aggressive pain relief.

Fatigue
Tiredness, or fatigue, during chemotherapy treatment is common and can be overwhelming if not diagnosed and treated. Fatigue is the most common symptom associated with cancer and its treatment - affecting about 90% of all cancer patients at some time during their illness. Fatigue can be described as an excessive overall body tiredness or weariness that is not relieved by sleep or rest. Fatigue may be short or long-term, depending on the type of treatments patients are undergoing. Fatigue affects everyone in different ways. Some patients find they have very mild fatigue, and it does not interfere with their daily activities. For others, fatigue can be very disruptive. If left untreated, it can have a negative impact on quality-of-life and can affect the patient's family members as well. There are many ways to handle fatigue.

Nausea and Vomiting
Nausea and vomiting are two common side effects of cancer treatment. Nausea can be immediate and begin a few minutes after a treatment such as chemotherapy and last a short period of time. Less often, it can be delayed and begin two to three days after treatment. This timing varies by patient and depends on the type of chemotherapy treatment given. Some patients may even become physically ill in anticipation of having chemotherapy. Nausea can also be caused by some pain medicines. The causes of nausea can be many in number and complicated. Unlike many years ago, there are very good medications available today to control both nausea and vomiting caused by cancer and its treatment. Patients who are experiencing these symptoms should talk to their doctors and nurses immediately to get help. While these symptoms may be caused by the treatment, they can also be due to other changes in the body that can accompany cancer. Patients should ask the health care team what is causing the nausea.

Loss-of-appetite
Loss-of-appetite is a common symptom that affects people fighting cancer. This can occur when cancer is first diagnosed, and most likely is due to stress and anxiety during chemotherapy or radiation. Advanced stages of cancer can also cause loss-of-appetite. Chronic nausea often suppresses one's appetite. Chemotherapy can temporarily decrease the patient's ability to taste food. This is another factor that may interfere with appetite. Cancer patients have many challenges in getting proper nutrition. It is very important that patients continue to eat during treatment in order to keep up strength and maintain nutrition to fight the cancer. Encouraging the patient to eat as best as possible under the circumstances is suggested. There are some specific medications that can also be prescribed by the physician that can stimulate appetite. These include some hormones, anabolic steroids, and medicines active in the central nervous system. While these medicines are safe when used as directed, it is very important that your cancer care team supervises them. Supplements such as "Ensure" or "Boost", which are readily available at most grocery and drug stores, may help.

For More Information About Symptom Management and Quality-of-Life

If you would like more detailed information about symptom management and quality-of-life, please click here to download "The Strength to Fight Cancer: A Family Guide" - a short, easy-to-read book published by the Quality of Life Foundation to help patients and families navigate the uncertain waters of cancer.

The book contains the following chapters:

• Chapter 1 When Your Doctor Says It's Cancer
• Chapter 2 Talking to Your Doctors and Your Nurses
• Chapter 3 The Emotional Challenges
• Chapter 4 The Physical Challenges
• Chapter 5 Coping With Physical Changes
• Chapter 6 Death and Dying
• Chapter 7 Spirituality and Cancer
• Chapter 8 Illness and Family Relationships
• Chapter 9 Workplace Challenges
• Chapter 10 Paying for Cancer Care
• Chapter 11 Participating in Research and Clinical Trials
• Chapter 12 Finding Support and Asking For Help
• Chapter 13 Cancer and Healthy Living
• Chapter 14 Resources
• Glossary of Terms
• About the Quality of Life Foundation and the authors

| Privacy Notice | About Us | Symptom Management | Our Physicians |
| Our Partner Hospitals | Cancer Registry | Quality of Life Foundation | Publications | Links | Contact Us |