Getting Help for Your Symptoms
Pain
Other Ways To Treat Pain
Anxiety
Fatigue
Nausea and Vomiting
Constipation
Loss of Appetite and Body Changes
Sleep Problems
Confusion
"The nighttime is harder than
during the day. There's not all that
routine going on to take my mind
off of things. Sometimes I fall
asleep, but then wake up in the
middle of the night sweaty and
shaky."
- Susan
Cancer and its treatment affect people differently. Some
have symptoms, while others have no symptoms for a long
time. As we said earlier, you have a right to comfort care
throughout your illness.
Sometimes people assume their symptoms will get worse as
their cancer progresses. But with good supports in place and
good care, your symptoms should always be managed. So don't
downplay your symptoms if you're having them. It's important
to report how you are feeling. Tell your doctor, members of
your health care team, and your loved ones. If you feel very sick
or tired, your doctor may be able to adjust your treatment or
give you other medicine.
Following are some of the symptoms you may have.
Having cancer doesn't always mean that you'll have pain. But
if you do, you shouldn't accept pain as normal. Most types of
pain can be treated. Your doctor can control pain with
different medicines and treatments.
You may want to ask your doctor if you can talk to a pain
specialist. Many hospitals have doctors on staff who are
experts at treating pain. They may also have palliative
medicine specialists.
Managing your pain helps you sleep and eat better. It makes
it easier to enjoy your family and friends and focus on what
gives you joy.
There are a few different ways to take pain medicine,
including:
- By mouth
- Through the skin (like with a patch)
- By shots
- Through an
I.V.
or an
S.C.
pump
Your medicine, and how you take it, will depend on the type
of pain and its cause. For example, for constant pain you
may need a steady dose of medicine over a long period of
time. You might use a patch placed on the skin or a slowrelease
pill.
Medicines can be used for all types of pain, including:
- Mild to medium pain
- Medium to very bad pain
-
Breakthrough pain
- Tingling and burning pain
- Pain caused by swelling
You should have regular talks with your health care team
about the type and extent of your pain. That's because pain
can change throughout your illness. Let them know the kind
of pain you have, how bad it is, and where it hurts.
You may want to keep a "pain diary." Write down the
information that's noted in "Controlling Pain: What to Tell Your Doctor". Include the
time of day that the pain occurred and what you were doing.
Rate the pain on a scale of 0 to 10. (Zero means no pain,
and 10 is the worst pain you could have.) Use the diary when
you talk to your doctor about your pain.
Unlike other medicines, there is no "right" dose for many
pain medicines. Yours may be larger or smaller than
someone else's. The right dose is the one that relieves your
pain and makes you feel better.
Cancer pain is usually treated with medicine and other
therapies. But there are also some non-drug treatments.
They are forms of
complementary and alternative medicine
(CAM). Many people have found the methods listed below
helpful. But talk with your health care team before trying
any of them. Make sure they are safe and won't interfere
with your cancer treatment.
-
Acupuncture
is a form of Chinese medicine that
stimulates certain points on the body using small
needles. It may help treat nausea and control pain.
Before using acupuncture, ask your health care team
if it is safe for your type of cancer.
-
Imagery
is imagining scenes, pictures, or experiences
to feel calmer or perhaps to help the body heal.
-
Relaxation techniques
include deep breathing and
exercises to relax your muscles.
-
Hypnosis
is a state of relaxed and focused attention.
One focuses on a certain feeling, idea, or suggestion.
-
Biofeedback
is the use of a special machine to help
the patient learn how to control certain body
functions. These are things that we are normally not
aware of (such as heart rate).
-
Massage therapy
brings relaxation and a sense of
well-being by the gentle rubbing of different body
parts or muscles. Before you try this, you need to
check with your doctor. Massage is not recommended
for some kinds of cancer.
These methods may also help manage stress. Again, talk to
your health care team before using anything new, no matter
how safe it may seem. Ask your health care team for more
information about where to get these treatments. To learn
more, see the NCI booklet
Thinking About Complementary and
Alternative Medicine: A Guide for People With Cancer.
Controlling Pain: What to Tell Your Doctor |
When describing pain to your doctor, be as detailed as
you can. Your doctor may ask:
- Where exactly is your pain? Does it move from
one spot to another?
-
How does the pain feel - dull, sharp, burning?
-
How often does your pain occur?
-
How long does it last?
-
Does it start at a certain time - morning,
afternoon, night?
- What makes the pain better? What makes it worse?
|
Using Strong Drugs To Control Pain |
People with cancer often need strong medicine to help
control their pain. Don't be afraid to ask for pain
medicine or for larger doses if you need them. The drugs
will help you stay as comfortable as you can be.
When treating pain in people with cancer, addiction is
not an issue. Sadly, fears of addiction sometimes prevent
people from taking medicine for pain. The same fears
also prompt family members to encourage loved ones to
"hold off" between doses. But people in pain get the
most relief when they take their medicines and
treatments on a regular schedule.
|
Cancer takes a toll on both your body and your mind. You
are coping with many different things now. You may feel
overwhelmed. Pain and medicines for pain can also make
you feel anxious or depressed. And you may be more likely
to feel this way if you have had these feelings before.
Here are some signs of anxiety:
- Feeling very tense
and nervous
-
Racing heartbeat
-
Sweating a lot
-
Trouble breathing or
catching your breath
-
A lump in your throat or a knot in your stomach
-
Sudden fear
Feeling anxious can be normal. But if it begins disrupting
your daily life, ask for help from the members of your health
care team. They can recommend someone for you to talk to.
Counseling from a mental health professional has been
shown to help many people cope with anxiety. Your doctor
can also give you medicines that will help. Some of the
complementary and alternative medicine choices for pain
may work for your anxiety as well (see
"Other Ways to Treat Pain"). Art therapy
and music therapy have also helped people cope.
Fatigue is more than
feeling tired. Fatigue is
exhaustion - not being
able to do even the
small things you used
to do. A number of
things can cause
fatigue. Besides cancer and its treatment, they include
anxiety, stress, and changes in your diet or sleeping patterns.
If you are having some of these problems, you might want to:
- Tell your health care team at your next visit. Some
medicines can help with fatigue.
-
Ask about your nutrition needs.
-
Plan your daily activities. Do only what you really
must do.
-
Hand over tasks to others who are willing to help you.
-
Include short periods of rest and relaxation every day.
-
Take naps (no longer than 15-30 minutes).
-
Ask others for help, especially when you are
feeling fatigued.
-
Do light exercises that are practical for you.
Nausea and vomiting may be a problem for cancer patients.
Both can make you feel very tired. They can also make it hard
to get treatments or to care for yourself. If you feel sick to
your stomach or are throwing up, there are many drugs to
help you. Ask your health care team which medicines might
work best for your nausea and vomiting.
You also may want to:
- Make small changes in your diet. Eat small amounts
5-6 times a day.
-
Avoid foods that are sweet, fatty, salty, spicy, or
have strong smells. These may make nausea and
vomiting worse.
-
Drink as much liquid as possible. You'll want to keep
your body from getting dried out (dehydrated).
Water, broth, juices, clear soft drinks, ice cream,
and watermelon are good choices.
-
Choose cool foods, which may help more than hot ones.
-
Try acupuncture.
Constipation is a problem in which stool becomes hard, dry,
and difficult to pass, and bowel movements do not happen
very often. Other symptoms may include painful bowel
movements, and feeling bloated, uncomfortable, and
sluggish. Chemotherapy, as well as other medicines
(especially those used for pain), can cause constipation. It
can also happen when people become less active and spend
more time sitting or lying down.
Here are some ways to help manage constipation:
- Drink plenty of fluids each day. Many people find that
drinking warm or hot fluids helps with bowel
movements.
-
Be active. You can be active by walking, doing water
aerobics, or yoga. If you cannot walk, talk with your
doctor or nurse about ways you can be active, such as
doing exercises in bed or a chair.
-
Ask your doctor, nurse, or dietitian if you should eat
more fiber. He or she may suggest you eat bran,
whole wheat bread and cereal, raw or cooked
vegetables, fresh and dried fruit, nuts, and popcorn
and other high-fiber foods.
-
Let your doctor or nurse know if you are in pain or
discomfort from not having a bowel movement.
He or she may suggest you use an enema or take a
laxative or stool softener. Check with your doctor or
nurse before using any of these.
-
Ask your doctor about giving you laxatives when you
start to take pain medications. Taking a stool softener
at the same time you start taking pain drugs may
prevent the problem.
Eating and appetite changes are common in the later stages
of cancer. As your cancer progresses, your appetite may
become poor.
On the other hand, you may be eating enough, but your
body can't absorb the nutrients. This can cause you to lose
weight, fat, and muscle.
Nutrition goals may become less important at this time. Even
if your family members think you should have food, let your
body be the judge. The goal should not be weight gain or
improving your eating but rather comfort and symptom relief.
Your nurse, dietitian, and other members of your health care
team can help. They can help you decide on changes to your
diet that may be needed to keep you as healthy as possible.
There are also new drugs to improve appetite and get rid of
nausea. Ask your health care team about them.
Illness, pain, drugs, being in the hospital, and stress can
cause sleep problems. Sleep problems may include:
- Having trouble falling asleep
-
Sleeping only in short amounts of time
-
Waking up in the middle of the night
-
Having trouble getting back to sleep
To help with your sleep problem, you may want to try:
- Reducing noise, dimming the lights, making the
room warmer or cooler, and using pillows to support
your body
-
Dressing in soft, loose clothing
-
Going to the bathroom before bed
-
Eating a high-protein snack 2 hours before bedtime
(such as peanut butter, cheese, nuts, or some sliced
chicken or turkey)
-
Avoiding caffeine (coffee, teas, colas, hot cocoa)
-
Keeping regular sleep hours (avoid naps longer than
15-30 minutes)
-
Talking with your health care team about drugs to help
you sleep. These may give relief on a short-term basis.
You may start noticing signs that you feel confused. This can
occur in some people with advanced stage cancer. It can also
be caused by some medicines. Confusion may begin suddenly
or come and go during the day. Possible signs include:
- Sudden changes in feelings (such as feeling calm
then suddenly becoming angry)
-
Having trouble paying attention or concentrating
(such as feeling easily distracted, having trouble
answering questions, or finding it harder to do tasks
that involve logic, such as math problems)
-
Memory and awareness problems (such as
forgetting where you are and what day it is or
forgetting recent events)
If you notice these signs, talk to your health care team to try
to find out the cause. Meanwhile, try one or more of the
following to help relieve confusion:
- Go to a quiet, well-lit room with familiar objects.
-
Reduce noise.
-
Have family or loved ones nearby.
-
Put a clock or calendar where it can be seen.
-
Limit changes in caregivers.
-
Ask your health care team about drugs that may help.
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