Note: The contents of this blog are for informational purposes only and should not be construed as medical advice or substitute for professional care. For medical emergencies, dial 911!
Cancer pain can be an often-overlooked side effect. People who are first diagnosed with the disease will immediately worry about side effects like nausea; however, pain can often be a major influence in one's life.
Cancer treatments, like surgery, can be painful. Tumors can press on bones, nerves or organs as they grow, causing pain. Although cancer pain can't be eliminated, it can be controlled.
The more specific you are about your pain, the more your doctor can treat it. Make sure to include information about when your pain started, what it feels like and how long it lasts. Note changes in your pain, and if it is constant or if it comes and goes. Always let your doctor know what you do to relieve the pain and how well it works. Ranking your pain on a scale makes it easier for your doctor to understand.
Always remember that there are several things you can do at home to reduce your cancer pain. Home treatments to manage pain include:
After passing a bill that allows marijuana use for medical purposes, New Jersey is the fourteenth state to have legalized its use.
Although the federal government still regards marijuana as illegal, it is becoming a popular drug at the state level.
What most people don't realize is that a synthetic version of marijuana is already legal and available by prescription in all states. Marinol, a synthetic THC, received FDA approval in 1985.
Doctors who prescribe the drug generally use it to treat chemotherapy side effects like nausea and vomiting, among other conditions.
If you don't live in a state that allows marijuana to be used for medical purposes, there are other ways to curb side effects. Before starting chemotherapy, make sure that you have a friend or family member who can attend your session with you and bring you home. Many people feel fine for the first few hours following chemo. Some reactions may occur about four to six hours later while other people don't react until up to 48 hours later.
If you're worried about nausea, discuss it with your doctor. She might suggest eating a small, light meal before chemo and eating only what you think you can tolerate after treatment. Starches and other grains are generally well tolerated. Avoid skipping meals; drink plenty of fluids including teas, water, sports drinks and diluted juices. If your doctor has prescribed anti-nausea medicine, have the prescription filled before your treatment.
Another side effect you might experience is appetite or taste changes and a heightened sensitivity to odors. Try to eat a low-fat diet with a lot of whole grains, fruits, vegetables and plant-based proteins. At times, you might also need to trick yourself into eating. Try to eat warm (not hot) foods and avoid places where foods are cooked -- the smells are more pronounced there. Instead, try eating in a room that isn't attached to your kitchen.
Cancer patients often have a hard time coping with hair loss. Remember, not all chemotherapy medicines cause hair loss, and doctors can tell you what to expect.
Although hair loss doesn't occur right away -- and hair grows back after treatment -- losing one's hair can be an emotional experience, especially because hair loss occurs on all parts of the body -- facial hair, arm and leg hair, underarm hair and pubic hair.
During chemotherapy, hair and scalp need special care.
Use a mild shampoo and a soft hair brush.
Try to air-dry your hair.
Wear a short hair cut, which will make hair look thicker and fuller.
Sleep on a satin pillowcase.
Do not use rollers, dye hair or get a perm.
Use a sunscreen, sunblock, hat, scarf or wig to protect the scalp from the sun.
Some feel more comfortable leaving their heads uncovered. Others like to wear scarves, turbans or wigs.
If you choose to wear a wig or hairpiece:
Shop before losing hair to match color, texture and style.
Try borrowing first. The local American Cancer Society can help
Remember that a hairpiece needed because of cancer treatment is a tax-deductible expense and may be covered by health insurance. Check the policy, and ask for a prescription for a "hair prosthesis."
Experience Project is launching a new online cancer support network , The Cancer Support Project, on October 1st, 2007.
Experience Project is built around dynamic groups of users who come onto the platform, share narratives and personal stories about their life experiences, and then connect with others who are going through the same experiences. Experience Project will never ask for your name; you can keep your identity completely private while meeting new friends who can understand you.
The central goal of The Cancer Support Project is to provide a hub for emotional and psychological support for all experiences involving cancer, including experiences as a survivor or a caregiver, something that is not currently widely addressed as many sites focus on sharing information regarding therapies. The Experience Project will also be launching a Facebook application within The Cancer Support Project to enable people to show their support and raise cancer awareness via Facebook, MySpace, blogs and web pages.
The Cancer Support Projectwill be launching on October 1st, but you can check it out now. I know I will be checking it out for sure!The Cancer Support Project is located here.
According to an article in CANCER, mental illness and emotional distress in patients with advanced cancer is often overlooked by oncologists, but proper management can improve a patient's quality of life.
The review article was written by Dr. Michael Miovic and Dr. Susan Block from the Dana Farber Cancer Institute and Brigham and Women's Hospital in Boston.
Miovic and Block found that 50 percent or more of patients with advanced or terminal cancer suffer from at least one of three major disorders: adjustment disorders, anxiety disorders and depressive disorders. Medical management of cancer has improved in the last decade, but management of mental health issues has lagged, according to the authors. Studies show that depressive symptoms can even impact patients' lives even more than pain.
The authors recommend listening as the most important screening tool in the oncologist's toolkit.
A new study finds that many people with cancer, over sixty-five percent according to this particular study, said they would be interested in attending a support group. However, only a small minority actually join one.
Study participants said that they wanted practical medical information promptly after diagnosis and about twice as many wanted medical information over emotional support. Eight-two percent wanted groups to include discussion of spiritual issues, however, Allen Sherman, Ph.D, the lead author from the University of Arkansas, said that this may be influenced by the fact that the participants mostly came from the Bible Belt.
The study also found that people prefer drop-in groups as needed and do not mind if the group contains people with different types of cancer.
Recent studies suggest that support groups do not increase survival time, but they do improve coping skills and mood. As always, with any sort of support or counselling, it is wise to use your gut. If you're getting something out of it, that is great. If not, it's best to move on and find the support you need elsewhere.
British Columbia's Cancer Agency offers a new, innovative support group for men whose partners have been diagnosed with advanced cancer. One participant was Rob Barrett, whose wife Diana was diagnosed with advanced lung cancer. Barrett, like many men, did not want to turn to professional counselling, but he did agree to attend such a support group at the BC Cancer Agency Vancouver.
According to the leader of the group, John Christopherson, men tend to be less upfront about their needs and therefore there is a real lack of social support for men.
According to Christopherson, "It isn't typical therapy in the way that most guys think of therapy. It is not conventional and follows no set guidelines, and yet everyone gets something out of it and comes back month after month."
Rob Barrett continues to attend the group, one year after his wife's death, because he feels that he can give back something and help make sense of his grief by helping others.
A new study shows that there is no empirical or statistical evidence proving that grief counseling is harmful to clients, contrary to common beliefs. The study was conducted by Dale G. Larson, PhD and William T. Hoyt, PhD.
A report from 2000 claimed that almost 50 percent of "normal grievers" deteriorate as a result of grief counseling. This report has frequently been cited in both scientific literature and the popular press.
Larson and Hoyt took another look at the data and found that the data on which this report was based have never been published, came from a dissertation that was never peer-reviewed, and utilized a statistical method from another student's dissertation that had also never been peer-reviewed. Larson and Hoyt conducted a peer review of the dissertations and reviewers were unanimous in their conclusion that the report is flawed.
Hoyt states, "It is disturbing that such radical claims, which contradict clinical experience and even common sense, could proliferate in journals, at conferences, and in national reports without anyone's ever acting on the basic scientific obligation to examine the data and analyses on which they were based."
According to Larson and Hoyt, the effects of grief counseling were positive, although smaller than those seen in other forms of counseling.
First up, know your doctor. Gruman advises finding a specialist who is up-to-date on your disease and has lots of experience. She also recommends checking with the state medical board regarding any disciplines or malpractice suits against the physician and assessing any local information obtained from other patients and friends. Dr. Gruman also advises not to be surprised if the doctor cannot answer questions like, "Am I going to beat this disease?" or "How long can I go on like this?" Gruman notes that it is "difficult, if not irresponsible" for a doctor to guarantee certain outcomes.
Gruman also advises getting a second opinion and not worrying about insulting your current physician for doing so. Gruman suggests framing such a request as a desire, "to feel completely comfortable with the treatment you suggest" or even blaming someone else, such as your family for insisting on a second opinion.
Patients seek second opinions for many reasons, including the desire for more information, difficulty communicating with their current physician, dissatisfaction with how treatment is progressing or being told nothing more can be done. Dr. Gruman writes, "While it is true that many diseases cannot be cured, it is never true that there is nothing more to be done."
Gruman, 53, is a survivor of four serious health crises: at age 20 she received a diagnosis of Hodgkin's disease, 10 years later one of cervical cancer, then five years ago came down with viral pericarditis (a serious infection of the heart's lining) and just three years ago was diagnosed with colon cancer.
Gruman offers much advice for those given a life-threatening diagnosis. For the first two days, she advises to slow down, yet don't act as if nothing is happening, take care of yourself in the meantime, and do what you need to do in regards to having friends and family around (or not).
Gruman advises not to give too much thought to what you might have done to cause the condition. Gruman points out that "the past is past and that the problem now is how to handle the future."
When the doctor's visits start picking up as treatment plans begin to take shape, Grubman advises bringing someone with you to doctor's appointments to write down what is said or even tape recording the sessions.
With each health crisis, Gruman says she was "stunned, then anguished" and astonished by "how much energy it takes to get from the bad news to actually starting on the return path to health."
The study involved a needs assessment survey sent to about 2,500 participants. Nearly two-thirds of the respondents had at least one unmet psychosocial need including emotional (anxiety, depression), physical (fatigue, nausea, vomiting or pain) and treatment-related needs.
The researchers found that the young reported the most unmet needs. "This may be due to the fact that their resources and support systems may already be stretched to the max in dealing with these problems," says Frances K. Barg, PhD, MEd. Barg goes on to explain that cancer in younger people is "incredible disruptive in terms of role function," including work, parenting and schooling.
When a woman receives a diagnosis of cancer, if she is married, her husband is thrust into the role of caregiver, a role that can be overwhelming. Our culture's expectations of men can complicate this new role even further.
Here is some advice for husbands whose wives have been diagnosed with cancer, from Rene Barrat-Gordon, LISW, a social worker at The Cleveland Clinic:
Never falsely reassure her there is nothing to worry about. Anyone with cancer worries.
Don't feel the need to fix everything.
Have at least one person you can talk with besides your partner. And consider the "safety" and friendliness of a support group.
It's OK to cry-even in front of your partner. It doesn't mean you're weak; it means you love her and you feel afraid, anxious or sad.
For more advice on this topic from Barrat-Gordon, please go here.
In a recent post, I wrote about a study that showed that if we can put a name to our feelings, our brains undergo real changes; our fear is reduced along with the intensity of negative emotions.
Sounds like great advice. Except sometimes it's hard to know exactly what we are feeling.
Marshall Rosenberg, the author of Nonviolent Communication, has created a model for compassionate communication. Rosenberg's model "guides us to reframe how we express ourselves and hear others by focusing our consciousness on what we are observing, feeling, needing, and requesting."
One part of the Nonviolent Communication model is trying to figure out exactly what we are feeling. Rosenberg encourages the use of true "feeling words" when we are communicating our needs to others.
If we can pinpoint how we are feeling during times of stress, whether it be daily stress or the stress related to a cancer diagnosis, recovery, or even a grieving process, we can ask for what we need in a more effective way. And hopefully catch some of that brain-calming effect.
Jeffrey Berman, professor of English at the State University of New York at Albany, has published an essay in Inside Higher Ed, which is adapted and reprinted with permission from his latest book, Dying to Teach: A Memoir of Love, Loss, and Learning.
Berman talks about writing a eulogy for his wife Barbara as she fought end-stage pancreatic cancer,before her death, as a celebration of her life. He then shared this eulogy with his college Expository Writing class, "in which students share with classmates self-disclosing essays on a wide variety of topics that are rarely discussed in the classroom."
According to Berman, this revelation made many of his students cry but it also allowed them see their teacher in a new light. Berman writes, "My new self-disclosure was different, and they now saw me differently. I was still their teacher, but I had now become another member of the class, one who was struggling, like everyone else, with a personal issue."
Berman weighs in on whether this was the right thing to do, "I don't believe that teachers should unburden themselves to students or seek psychological counseling from them, but I do believe that a teacher's careful self-disclosure of a real-life experience can become a profound educational experience for everyone in the classroom."
Personal revelations, including those of profound joy and profound pain, can make us stronger. We learn to tell our stories and perhaps more importantly, we learn to listen.
Unfortunately, in this study, in over 50% of encounters, doctors did not mention patient's name at all upon meeting.
On the flip side, over half of patients would like doctors to introduce themselves using their first and last names, followed by about 30% who would like doctors to use only their last name.
When I meet a new doctor, I do like to be greeted by name, but just my first name is fine. As far as shaking hands, for me, that isn't necessary.