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Some of the most common problems people report from cancer treatment are:
Fatigue is one of the most common complaints during the first year of recovery. Rest or sleep does not cure the type of fatigue that you may suffer after cancer treatment. Doctors do not know its exact cause or how long it will last. For some, fatigue gets better over time. Some people, especially those who have had bone marrow transplants, may still feel energy loss years later.
It can be frustrating when fatigue lasts longer than expected and it gets in the way of your normal routine. Ask your doctor or nurse about:
- Any medicines you are taking or other medical problems that might be affecting you energy level
- Exercise programs that may help boost energy level
- Changes in diet, drinking more fluids, medicines or nutritional supplements
- Any specialist such as physical therapist, occupational therapist, nutritionists or mental health care provider
- Acupuncture helps build the immune system and increase the rate of healing, as well as boost energy levels. Used after treatment it can build strength and prevent recurrence
What You Can Do
- Save energy when doing every day things. For example, sit down while cooking or washing dishes.
- Plan your day. Plan your errands and appointments at the time of day when you feel most alert and energetic.
- Take short naps or rest breaks between activities. Do not plan back to back activities throughout the day.
- Keep a regular sleep schedule. Try to go to sleep and wake up at the same time every day.
- Do what you enjoy, just less of it. Continue to participate in your favorite activities; just try to do them for a shorter amount of time. Also, try to let go of things that do not matter as much now.
- Let other help you. Let friends or family cook a meal or run an errand. If no one offers, ask for help, others might not know you need it.
- Join a support group. Talking with others who have gone through the same issues may help you find new ways to cope.
Memory and Concentration Changes
Research show that one in four people with caner reports memory and attention problems after chemotherapy. It can sometimes be referred to as “chemobrain”. The symptoms range from difficulty paying attention, finding the right word or remembering new things. The effects can begin soon after treatment or may not appear until much later.
Research is starting to explore why only some people develop problems with memory and concentration. It seems that people who have had chemotherapy or radiation to the head area are more likely to develop these problems. Also, people who have received high doses of chemotherapy may have memory problems, but even those who had average levels report memory changes.
Ask Your Doctor About:
- You may want to see a specialist called a neuropsychologist to help with your memory and/or thinking problems.
- You think a medicine you are taking might be causing or adding to your memory problems.
- You believe you are suffering from anxiety or depression; these conditions can affect attention, concentration and memory.
- You are going through menopause because some memory and concentration problems can be related to this.
What You Can Do:
- Write it Down: Keep it simple and be realistic about how much you can get done in one day. Plan your whole day by writing down each task, how long it will take and where you need to go in a notebook or pocket calendar.
- Set up reminders: Put small signs around the house to remind you of things to do.
- Talk yourself through tasks: When doing a task with a number of steps, whisper each step to yourself.
- Manage your stress level: Managing your stress may better improve your memory and attention. Learning to relax can help you remain calm even in stressful moments.
- Repetition helps: Saying it a couple times can help you mind hold on to the information.
Some people have pain after treatment while others have less. Types of pain you may feel after cancer treatment include:
- Pain or numbness in the hands and feet due injured nerves. Chemotherapy or surgery can damage nerves, which can cause severe pain.
- Painful scars from surgery
- Pain in a missing limb or breast. While doctors do not know why this pain occurs, it is real. It is sometime called, “phantom pain”.
Ask your Doctor About
Wanting to control your pain is not a sign of weakness. It is a way to help you feel better and stay active. Pain may be caused by treatment or other health issues such as arthritis. Your doctor will assess how severe your pain is and may recommend one or more of the following:
- Pain-relief medicines – Usually doctors will try the mildest medication first and then work up to a stronger one if needed. To keep your pain in control, do not skip doses or wait until you feel the pain set in. If you use the correct dose and see your doctor regularly, there is little chance of becoming addicted to pain medication.
- Antidepressant medicine – Some of these types of medicines are prescribed to reduce pain or numbness from injured nerves. Maximum relief from antidepressant can take several weeks and can generally be moderate.
- Physical Therapy – Going to physical therapy may help relieve your pain. Heat, cold, massage pressure and/or exercise may be used to help lessen your pain.
- Braces – These will limit the movement of painful limbs or joints.
- Acupuncture – Because acupuncture can enhance the circulation of energy and blood through the body, it can decrease the swelling and pain from surgery. Cancer treatment-related pain and vascular problems can improve with acupuncture.
- Hypnosis, meditation, or yoga – Any of these may help your pain. A trained specialist can teach you these approaches.
- Relaxation techniques – Many people with cancer have found that practicing deep relaxation techniques helps relieve their pain or reduce their stress.
- Nerve blocks or surgery – If no other methods are helping, your doctor may suggest nerve blocks or surgery. Nerve blocks or surgery often help if you have persistent, limiting pain, but they put you at risk for other problems. Nerve block is the general term used to refer to the injection of a local anesthetic onto or near nerves for temporary control of pain.
What You Can Do:
- Keep a record of your pain. Jotting down notes about your pain can help your track changes over time and show how your respond to any pain medicine or other treatment you receive.
- Use consistent numbers to describe your pain. Talk about how strong your pain is on a scale from 0 to 10, with 0 being no pain and 10 being the worst pain you could have.
- Describe to your doctor what kind of pain you have. Do you feel sharp, dull or throbbing pain?
- Write down how your pain affects your daily life. Does it keep you from work? Can you no longer perform your daily chores around the home? Are you able to keep up a social life?
- List all of your medicines you are taking, whether they are for pain or not.
- Talk to your doctor about side effects you are having from your pain medications. Many pain medicines affect your bowel habits or can make you feel groggy.
Sometimes cancer treatment can cause damage to your nervous system called neuropathy, or problems with nerve function. Sometimes these symptoms can be made worse by other conditions, such as diabetes, kidney failure, alcoholism or malnutrition.
Common symptoms include tingling, burning, weakness or numbness in your hands or feet; sudden, sharp, stabbing or electric shock pain sensation; loss of sensation of touch; loss of balance or difficulty walking; trouble picking up objects; hearing loss; jaw pain; constipation; and being more or less sensitive to heat and cold.
Ask Your Doctor About:
- Treatments including medications, topical creams and pain patches
- Other approaches such as acupuncture, physical therapy, and exercise.
What You Can Do:
- Allow time to rest
- Be Careful when handing knives, scissors, and other sharp objects.
- Avoid falling by walking slowing, holding onto handrails and putting in no-slip bath mats in your tub or shower. Remove area rugs or cords you could trip over and use a cane or other device if needed.
- Wear sneakers or other rubber-soled shoes.
Lymphedema refers to swelling that generally occurs in one of your arms or legs, neck or face. There are many types of lymphedema; some happen right after surgery, are mild and do not last long. Other types can occur months or years after cancer treatment, and can be very painful.
People Who Are at Risk for Lymphedema
- Breast Cancer Survivors – If you had radiation therapy or your underarm lymph nodes removed, or had radiation in the underarm area after lymph nodes were removed
- Melanoma Survivors – If you had lymph nodes removed and/or radiation therapy
- Prostate cancer – If you had surgery or radiation therapy to the whole pelvis
- Cancer of the female or male reproductive organs – If you had surgery to remove lymph nodes or had radiation therapy
- Other cancers that have spread to the lower abdominal area – The pressure from the growing tumor can make it hard for your body to drain fluid.
Ask Your Doctor About:
- Skin care: It is important to keep your skin clean and use lotion to moisturize it.
- Exercise: Find out about exercises to help the body drain lymph fluid and what type of exercise to stay away from. Also, a new study found that breast cancer survivors who performed slowly progressive weight lifting twice weekly for 1 year were less likely to develop lymphedema following cancer treatment.
- Arm or Leg Position: Keeping the arm or leg raised above your chest for periods of time may provide relief.
- Massage: Having special types of massage that can help by moving the lymph fluid from where it has settled may help.
- Special Clothing: Wearing special elastic sleeves and clothing that can help lymph fluid drain.
- Swelling or Infection: Tell your doctor if your arm or leg is painful or swollen
What You Can Do:
- Losing Weight: The importance of weight control in the management of lymphedema cannot be stressed enough. Eat a well-balanced, protein-rich, low-salt diet.
- Avoid trauma to area: Avoid procedures done in the area with lymphedema such as shots or blood tests. Also keep your arm or leg free of cuts, insect bites and sunburn.
- Support Group: Find a source of emotional support to help you cope with lymphedema. You can search your Local Resources Guide to see what groups are in your area.
Many people who have been treated for cancer develop problems with their mouth or teeth. Some problems go away after treatment while others last a long time and some never go away. Some problems develop months or years after you treatment has ended.
Radiation or surgery to the head and neck can cause problems with your teeth and gums; the soft, moist lining of your mouth; glands that make saliva; and jawbones. If you were treated with certain types of chemotherapy, you may also have these problems:
- Dry mouth
- Cavities and tooth decay
- Loss of or change in sense of taste
- Painful mouth or gums
- Infections in your mouth
- Jaw stiffness or jawbone changes
Who is at risk for these problems?
- Almost anyone who has had radiation therapy to the head and neck
- Most people who have had bone marrow transplant
- About two out of every five people treated with chemotherapy
Ask Your Doctor About:
If your problems persist after cancer treatment ends, talk with your doctor about possible causes and ways to control pain. Try to see your dentist soon after you are done and ask how often you should have checkups and ways to take care of your mouth and teeth.
What You Can Do:
- Keep your mouth moist: Drink lots of water; suck on ice chips; chew on sugarless gum or suck on sugarless candy; use a saliva substitute
- Keep your mouth clean: Use extra-soft toothbrush; use mild toothpaste; floss gently every day; rinse mouth several times a day with a solution of ¼ teaspoon baking soda, 1/8 teaspoon salt and 1 cup warm water. (Follow with plain water rinse.)
- If mouth is sore, stay away from: sharp, crunchy foods like chips; hot or spicy foods; sugary foods that can cause cavities; toothpicks; tobacco products; alcoholic drinks
Changes in Weight and Eating Problems
Some survivors who have had certain kinds of chemotherapy or medicines have problems with weight gain. Sometimes they are unable to lose the unwanted pounds after treatment ends. Breast cancer survivors gain weight in different ways and mat lose muscle and gain fat tissue.
Unfortunately the usual way people try to lose weight may not work. Be patient with yourself and look for the positive things you can control such as eating a healthy diet and slowly working an exercise program into your lifestyle. Try to focus on the fact that treatment is over and you are trying to get stronger and healthier with time.
Some cancer survivors have the opposite problem; they have no desire to eat and they lose weight. Some men sat that weight loss or loss of muscle tone is a bigger concern than weight gain.
Ask Your Doctor About
- If you are able begin strength-building exercises if you have lost muscle or gained fat tissue
- Talking to a dietician or nutritionist who can help you plan a healthy diet that will not add extra pounds
What You Can Do About You Lost Appetite
- Start with small meals. Five small meals should be easier to handle than three larger ones.
- Focus on your favorite foods. If the thought of eating still lacks appeal, try foods you really liked before treatment or good old comfort foods. Slowly add fresh fruits and vegetables to the mix.
- Stay active. A short walk before a meal can help you feel hungry.
Some people who have had radiation therapy or chemotherapy may find it hard to eat because they have trouble swallowing. Radiation therapy to the head, neck, breast or chest or surgery involving the larynx may also cause these problems.
What You Can Do
- Eat soft, bland foods moistened with sauces or gravies.
- Use a blender to process solid foods
- Ask advice from your health team
- Tilt your head back or move it forward while you are eating
- Have a sip of water every few minutes to help you swallow and talk more easily. Carry a water bottle with you so you always have some handy.
Bladder or Bowel Control Problems
Bladder and bowel problems are among the most upsetting issues cancer survivors face after treatment. People often feel ashamed or fearful to go out in public.
The loss of control can happen after treatment for bladder, prostate, colon, rectal ovarian or other cancers. Your surgery may have left you with no bladder or bowel control at all or perhaps you still have some control requiring lots of trips to the bathroom. The opposite problem can happen when then medicine you are taking causes constipation.
Ask Your Doctor About
- Problems with constipation – Your doctor may recommend changes to your diet or medicine to help with your constipation.
- Kegel exercises – You can help strengthen muscles in your genital area by going Kegel exercises or stopping the flow of urine while on the toilet.
- Help in coping with ostomies – IS you have an ostomy, an opening from the inside of the body to the outside to pass urine or waste material, there are services and support groups to help you cope. Check out our local resource guide or www.uoa.org.
Some cancer treatment may cause menopause or menopausal symptoms. Almost half of women who have not been through menopause have menopausal symptoms during breast cancer treatment. Even if cancer treatment does not cause menopause immediately, it may cause menopause to start sooner.
After treatment and over time, some women may start getting their periods again (this is more likely for younger women), but others will not.
Common sign of menopause:
- Irregular periods. One of the first signs is a change in your periods. They may become less regular or lighter. Some women have short times of heavy bleeding or have their periods stop all of a sudden.
- Hot Flashes. Hot flashes can happen at any time, leaving you sweaty and red-faced. They often occur at night and can disrupt sleep.
- Problems with vagina or bladder. Tissues in these areas become drier and thinner and you may be more likely to get vaginal infections. As you get older, you may also have problems holding your urine, or urinary tract problems.
- Lack of interest in sex. These changes mat make it hard for you to become sexually aroused.
- Fatigue and sleep problems. You may feel tired or have trouble getting to sleep or staying asleep. Especially if you are having hot flashes in the nighttime.
- Memory and emotional problems. Depression, mood swings, irritability and memory problems may be related to growing older.
- Other changes to your body. Your waist may be getting bigger, and you may notice less muscle and more fat around your body, or thinning and loss of elasticity of your skin.
Ask Your Doctor About
- Medicines and supplements that can help you mange menopause symptoms
- Tests you should have done (such as bone density for risk of osteoporosis)
- Acupuncture or herbal medicine
Body Changes and Intimacy
Some body changes are short-term and others will last forever. Either way, your looks may be a big concern after treatment. Even if your treatment does not show, your body changes may trouble your. Feelings of anger or grief are natural and can lower your sex drive. Changes in the way you look can also be hard for your loves ones.
What You Can Do
- Mourn you losses. They are real, and your have the right to grieve.
- Try to focus on the ways that coping with cancer has made you stronger, wiser and more realistic.
- Look for ways to enhance your appearance. A new haircut, hair color, makeup or clothing may make you feel better.
- If you choose to wear a breast prosthesis, make sure it fits well so you are not self conscience and worrying about it.
- Try to recognize that you are more than cancer. Know that you have worth - no matter how you look.
Changes in Your Sex Life
Many people have changes in their sex lives after cancer treatment. Depending on the cancer you had, these problems may be short-term or long-term. Many cancer survivors say they were not prepared for the changes in their sex lives.
Problems after cancer treatment are often caused by changes to your body from surgery, chemotherapy or radiation or by the effects of certain medicines. Sometimes emotional issues can be the cause of sexual problems.
Common concerns regarding their sex life
- Intimacy after treatment – Some struggle with body image after treatment. Pain, loss of interest, depression or cancer medicines can affect sex drive.
- Not being able to have sex as you did before – Some cancer treatments cause changes in sex organs that also change your sex life.
- Having menopause symptoms – When women stop getting their periods, other problems can affect their desire to have sex.
- Losing the ability to have children – Some cancer treatments can cause infertility.
Ask Your Doctor About
Your doctor may be able to help with some of these problems but you need to bring up the subject. Often, sexual problems will not get better on their own. Sometimes there may be an underlying medical problem that can cause changes, such as:
- Erection Problems – Medicines, assistive devices, counseling services or surgery may help.
- Vaginal dryness – Dryness or tightness in the vagina can be caused by menopause. Ask whether a water-based lubricant during sex and /or taking hormones are an option for you.
- Muscle weakness – You can help strengthen muscles in your genital area by doing Kegel exercises.
- Concerns about children – Discuss family planning concerns with your doctor.
- Talking with a counselor or a psychologist – If you feel that some of your sexual problems are due to your emotions, like stress or body image, talking to someone alone, or with your partner, may help.
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