Managing the Side Effects of Your Treatment
You probably already know about ways to manage the side effects of cancer treatment. If so, parts of this section will be a review for you. It outlines some of the support therapies cancer patients have found helpful.
You have a right to comfort care both during and after treatment. This kind of care is often called palliative (PAL-ee-yuh-tiv) care. It includes treating or preventing cancer symptoms and the side effects caused by treatment. Comfort care can also mean getting help with emotional and spiritual problems during and after cancer treatment.
People once thought of palliative care as a way to comfort those dying of cancer. Doctors now offer this care to all cancer patients, beginning when the cancer is diagnosed. You should receive palliative care through treatment, survival, and advanced disease. Your oncologist may be able to help you. But a palliative care specialist may be the best person to treat some problems. Ask your doctor or nurse if there is a specialist you can go to.
Having cancer doesn't always mean that you'll have pain. But if you do, you shouldn't accept pain as normal. Your doctor can control pain with medicines and other treatments. Managing your pain helps you sleep and eat better. It makes it easier to enjoy your family and friends, and to focus on the things you enjoy.
Have regular talks with your health care team about your pain. Let them know what kind of pain it is, where it is, and how bad it is. These talks are important because pain can change throughout your illness. And your pain may show where cancer has returned after remission. Many hospitals have doctors who are experts in treating pain. Tell your doctor if you would like to talk to a pain specialist.
Treatments 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.
There are different ways to take pain medicine, such as:
- By mouth
- Through the skin (with a patch)
- By shots
- Through an I.V. 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 slow-release pill.
You may want to keep a pain diary to help you explain your pain to your doctor. In the diary, write down:
- The time of day you had the pain
- What you were doing when you felt the pain
- What it felt like
- Where you felt it.
Your doctor may also ask you some questions about how your pain affects your daily routine (see Controlling Pain: What to Tell Your Doctor). Having your pain managed means that you can focus on living your life and not be distracted by pain.
To learn more, see the NCI booklet Pain Control.
Controlling Pain: What To Tell Your Doctor
When describing pain to your doctor, give as much detail as you can. Your doctor may want to know:
- Where exactly is your pain? Does it move from one spot to another?
- How does the pain feel - dull, sharp, burning?
- How often do you have pain?
- How long does it last?
- Does it occur at a certain time of day - 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. And the drugs will help you stay as comfortable as possible.
People with cancer hardly ever get addicted to these drugs. 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 pain is usually treated with medicine and other therapies. But there are also some nondrug treatments. They are types 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 to 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.
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 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 doctor or nurse at your next visit. Ask about medicines that can help with fatigue.
- Eat a well-balanced diet
- Plan your days and do only what is important to you
- Take short breaks every day to rest and relax
- Take naps
- Ask others for help.
Nausea and Vomiting
Nausea is feeling sick to your stomach. Vomiting means throwing up. Both can be a problem for cancer patients. Untreated nausea and vomiting can make you feel very tired. They can also make it hard to get treatments or to care for yourself. There are many drugs to help you control nausea and vomiting. Ask your doctor which medicines might work best for you.
You also may want to make these changes to your diet:
- Eat small amounts of food five to six times a day.
- Avoid foods that are sweet, fatty, salty, spicy, or have strong smells. These may make nausea and vomiting worse.
- Have as much liquid as possible. You'll want to keep your body from getting too dry (dehydrated). Broth, ice cream, water, juices, herb teas, and watermelon are good choices.
For some patients, it's hard to eat the foods they normally enjoy. For others, it's hard to eat anything at all. Are you having trouble eating or digesting food? If so, you may want to talk with your doctor about your diet. They may suggest:
- A special diet
- Other ways of getting the nutrition you need
- Tips on eating during treatment
- Seeing a dietitian.
For more information, see the NCI booklet Eating Hints for Cancer Patients.
Illness, pain, stress, drugs, and being in the hospital can cause sleep problems. These problems may include:
- Having trouble falling asleep
- Sleeping only for 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 lights, making the room warmer or cooler, and using pillows to support your body
- Dressing in loose, soft 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, tea, cola, hot cocoa)
- Keeping regular sleep hours
- Avoiding naps longer than 15-30 minutes
- Talking with your health care team about drugs to help you sleep.
Sometimes people with cancer feel pain in different parts of their body. Others feel weak and tired. And some feel stiffer than they used to. So it can become hard to move different body parts. If you are having any of these problems, your health care team may suggest you see a physical therapist. The therapist may use heat, cold, massage, pressure, or exercises to help you. Physical therapy may reduce tiredness and help your body function better. It may help with strength and balance as well. It also may help with stiffness and other side effects of radiation therapy.
Complementary and Alternative Medicine
Complementary and alternative medicine (CAM) treatment can be helpful for some people. And some CAM treatments are safe, such as those listed in Other Ways to Treat Pain. But you may have read about different diets, vitamins, and herbs for treating your cancer or symptoms. Talk with your health care team before you try anything new. Here's why:
- Some CAM treatments are not proven to work and could actually harm you.
- You may have a dangerous reaction. Or the CAM treatment could interfere with the medicine your doctor has prescribed.
- A "natural" product doesn't mean that it's a safe product.
Seek information about CAM treatments from trusted sources. Federal agencies and nonprofit cancer groups are good sources. You might also want to read the NCI booklet Thinking About Complementary and Alternative Medicine or go to NCI's Office of Complementary and Alternative Medicine (www.cancer.gov/cam).