Posts Tagged ‘cancer treatment side effects’

Coping with Survivor’s Guilt After Cancer

woman cancer survivor serious Being diagnosed with cancer can bring on many different types of emotions, from fear to sadness to relief; however, many patients don’t think about how they might feel after they complete their treatment. Many are surprised when they begin to feel guilty. This is known as survivor’s guilt. It is a feeling that is often experienced by those who have survived a major or traumatic event, such as being diagnosed with cancer. The feelings may come from a sense of guilt that they survived the disease and another patient did not, or they did well with treatment while another had a very difficult time recovering.

Here are some things to keep in mind if you think you might be suffering from survivor’s guilt:

  • You are not alone. Survivor’s guilt is very common. It is a natural response for many cancer patients. It often feels like sadness, depression or even grief.
  • Tell someone about how you’re feeling. Talk with a friend or family member you trust. You can always reach out to a social worker to help you process these feelings. Acknowledging these feelings can help you process them and ultimately overcome them.
  • Consider keeping a journal. Sometimes it is helpful to write down how we are feeling in order to help us manage those emotions. Starting an art project is another creative way to cope with survivor’s guilt.
  • Remind yourself that every patient’s cancer journey is different, and that’s OK. It is unrealistic to compare your treatment outcomes to someone else’s because everyone is different.
  • Be supportive. If you know someone who is going through treatment and having a difficult time, it is important to provide them with as much support as possible. As a cancer survivor, you offer a unique type of support because you have been there.
  • Attend a cancer survivor’s support group. Reaching out to other survivors can be helpful.

Don’t wait to get help if you think you are experiencing survivor guilt. It is important to acknowledge and address the issue sooner rather than later. Patients can talk directly to oncology social workers through the following community organizations: www.livestrong.org, www.cancer.org, and www.cancercare.org.

Emory Healthcare

At Emory Healthcare, we’re here to help you find the care you need when you need it. With more than 2,800 doctors and 300 locations, including 11 hospitals, as well as primary care offices, urgent cares, and MinuteClinics, we’re delivering specialized care across the region. Find a doctor near you to help you get and stay healthy.

Talk to Our Nurses

Emory HealthConnection is where registered nurses can help you find a location or specialist that’s right for you. Call 404-778-7777 from 7:30 a.m. to 6 p.m. EST (M-F).

Winship Cancer Institute of Emory University

Seeing over 17,000 patients a year, Winship Cancer Institute of Emory University is Georgia’s only National Cancer Institute-designated comprehensive cancer center and serves as the coordinating center for cancer research, education and care throughout Emory University.

About Joy McCall, LCSW

Joy McCallJoy McCall, LCSW, is a Winship social worker with bone marrow transplant, hematology, and gynecologic teams and their patients. She started her professional career at Winship as an intern, working with breast, gynecologic, brain, and melanoma cancer patients. She graduated with a Bachelor of Science in Psychology from Kennesaw State University and a Master of Social Work from the University of Georgia. As part of her education she completed an internship with the Marcus Institute working on the pediatric feeding unit, and an internship counseling individuals and couples at Families First, supporting families and children facing challenges to build strong family bonds and stability for their future. She had previously worked with individuals with developmental disabilities for over 4 years, providing support to families and caregivers.

Related Resources

 

7 Steps for Better Sleep During Cancer Treatment

Better Sleep with Cancer(This blog was originally posted on January 15, 2015 on the WebMD website)

One of the most common complaints I hear working with people who have cancer is that they can’t sleep. We all know the misery of not being able to fall or stay asleep, and the misery that awaits the next day, including fatigue, irritability and foggy headedness. And being awake at night, especially when you have cancer, is lonely, scary and frustrating. All the worries about your diagnosis, treatment and future are at their most intense when you don’t have daytime light, noise and people to distract you. Call it the 3am Misery. Understandably many cancer patients ask their doctor for a sleeping pill like Ambien or Xanax. While this may be an easy solution, it might not be the right solution. So before you assume that sleeping pills are the answer, pause. Have you and your doctor talked about what is really causing your sleep problem?

For people with cancer, sleep problems generally fall into three categories: daytime escape, after-dark fear, and body aches. Knowing your category is the first step in dealing with the sleep problem.

Daytime Escape

“Wake me up when it is over!” Who would not want to escape from cancer? Escaping into your bed during the daytime and letting sleep take you away from the cancer reality seems pretty appealing. Unfortunately, the bed escape can backfire. The more time you spend in your bed during the day, the less time you sleep at night. If you are in the daytime escape category, the remedy for sleeplessness is not a sleeping pill, but a plan that helps you stay out of bed during the day, so you may rest well at night.

After-Dark Fear

“When I turn out the lights, I worry I am going to die.” Intense fear about your cancer prognosis, heavy grief about changes in your life because of cancer, racing thoughts and catastrophic thinking (“there are absolutely no good days ahead for me”) are symptoms of anxiety and depression. Fortunately, anxiety and depression can be treated, but not with a sleeping pill. In fact, sleep medicines may make some depressive symptoms worse. Strategies to manage after-dark fear include helpful thoughts (“I will deal with this in the morning”), limit setting (no cancer internet searches before bed) and relaxation (an evening bath). These strategies need to be practiced everyday to be most useful.

Body Aches

Body aches, otherwise known as treatment side effects, are major contributors to 3 a.m. misery. Pain, either aching muscles or sharp, shooting nerve pain, keeps you from falling or staying asleep. There may also be cottonmouth, urges to pee and nausea. Getting rid of body aches requires a bit of work, but worthwhile if you are able to turn down the volume on your symptoms and avoid 3am Misery. Keep track of your body aches in a written calendar and talk to your oncologist about your symptoms. If you have “as needed” medicines (prochlorperazine, hydrocodone, oxycodone), definitely don’t take them without keeping track of how they work for you. Write down the date, your symptom on a scale of 1-10 and then try one medicine at a time. Be sure to only continue with the pill if the medicine allows you to be more awake and active during the day. Some people develop body aches from too little movement as muscles and joints get deconditioned during cancer treatment. Talk to your oncologist about a physical therapy referral. Safe daytime movement will certainly improve your sleep at night.

Below is a 7 Point Program that may be your best shot at minimizing 3 a.m. misery. Different parts of the program target escape, night fear and body aches.

The 7 Point Program

  1. Absolutely no cancer talk or internet searches after dinner; repeat “I will manage that in the morning.”
  2. Pick a bedtime and a wake time with 8 hours in between. Write and post the times around your home. Be a stickler.
  3. Caffeine is off limits after noon. No smoking either (nicotine is another stimulant that kills your sleep).
  4. Pick a helpful thought. “This shall pass.“ Repeat slowly & calmly, while you breathe slowly & deeply, three times before bed and if you waken in the night.
  5.  One nap a day max, 45 minutes or less, before 4 p.m.
  6. Motion is lotion. Walk the dog, or with a friend, daily (if your oncologist says ok).
  7. Chill for one hour before bedtime (stretch, read, listen to music or journal).

Of course, everyone’s medical status is unique. For example, people with very advanced disease or a heavy treatment burden may need extra daytime rest. So adjust the plan to fit your specific condition, then challenge yourself to stick it – all 7 points for 2 weeks. If you’re still having trouble sleeping, talk to your doctor.

In certain situations sleep medicines and pain pills may be necessary, but you should know the source of your sleep problem before you start a sleep medication. And the goal of any medication or sleep program should be to feel more energetic, happy and clear-headed over time, so that you can well not just tonight, but in the weeks and months to come.

About Dr. Baer

Wendy Baer, MDWendy Baer, MD, is medical director of psychiatric oncology at the Winship Cancer Institute of Emory University, with appointments in the Department of Psychiatry & Behavioral Sciences in the Emory School of Medicine, and the Department of Hematology and Medical Oncology at Winship.
In her work at the Winship Cancer Institute, Dr. Baer helps patients and their families deal with the stress of receiving a cancer diagnosis and subsequent treatment. As a psychiatrist, she has expertise in treating clinical depression and anxiety both with medications and with psychotherapy to help people manage emotions, behaviors, and relationships. The fundamental goal of Dr. Baer’s practice is to promote wellness and maximize patients’ quality of life as much as possible. She believes strongly in the team approach to patient care and collaborates regularly with the doctors, nurses, and social workers that make up a patient’s care team.
Dr. Baer attended medical school at the University of North Carolina at Chapel Hill, where she graduated with honors. From UNC she went to the University of Pennsylvania, where she completed her residency in psychiatry and served as the chief resident in her senior year. Prior to moving to Atlanta, Dr. Baer worked with patients dealing with cancer at the Swedish Cancer Institute in Seattle, WA.

Related Resources

How Will I Cope With Cancer?

Key Steps for Coping with Cancer-Related Fatigue

cancer fatigueFatigue is one of the most common side effects reported by cancer patients, and symptoms of cancer- related fatigue differ significantly from the fatigue patients experienced before cancer diagnosis.

Cancer-related fatigue is not only caused by the disease itself, but cancer treatment as well as the emotional and psychological effects of fighting cancer can also contribute. Described by patients as more pronounced during treatment, cancer-related fatigue can leave patients feeling wiped out by simple and small activities. It can also last years after treatment.

According to the American Cancer Society, characteristics of cancer-related fatigue include:

  • Extreme tiredness that may vary in severity from day to day
  • Weakness, weariness or lethargy even after sleep
  • Feeling worn out after simple tasks like standing up from a chair or getting out of bed
  • Heaviness in arms and legs
  • Trouble with concentration and memory

Kay Halbert, Director of Outpatient Services at Emory Johns Creek Hospital, works with cancer patients undergoing cancer treatment on energy conservation. “Energy conservation is coming up with ways to decrease the amount of energy patients use to complete a task while still achieving similar end results so they continue to function in their day-to-day lives.” One energy-conserving technique is using a rolling cart to move heavy dishes rather than carrying them. Another example is prior to getting up from a chair, scoot to the edge, lean forward and push off with the arms and then straighten the legs.

“It’s important for patients and survivors to understand their bodies aren’t the same after cancer treatment,” Halbert explains. “It’s okay for them to modify how they accomplish daily tasks and learn to let go of some things completely.”

Some specific energy-conserving tips are:

  • Keep items within easy reach to limit how often you have to get up.
  • Avoid reaching for items overhead and/or below your knees; keep needed items and work surfaces at a comfortable height.
  • Decide which tasks are absolutely necessary. Let the rest go.
  • Share your workload with family and friends. Remember to delegate.
  • Complete tasks that require the most energy during times throughout the day when you have the most energy. Journaling can help you keep track of these high-energy vs. low-energy periods of time.
  • Alternate between easy and difficult tasks and rest 10 to 15 minutes every hour.
  • Stop before you feel worn out.

“Think about your energy levels as if it were a gas tank. Be economical about the how much energy you use, and make sure you refuel before you’re completely out of gas,” adds Halbert.

It’s very important to note that not all patients experience the same after affects of cancer, such as fatigue, but knowing about ways to help you cope may limit the severity of these after effects with early intervention and modification.

Related Resources

Prepare for Life after a Diagnosis of Cancer

Prepare for Life After a Diagnosis of Cancer

Cancer SurvivorshipAccording to the American Cancer Society, there are over 13.5 million survivors of cancer in the US today (a cancer survivor is defined as anyone from the moment of diagnosis throughout the balance of his or her life). This number is expected to significantly increase over the next 20 years due to improved early detection, improved treatment options, aging baby boomers and longer life expectancies. With longer life expectancies, cancer survivors can experience a higher burden of illness than others not diagnosed with cancer.

Few experiences in life match the feeling patients and family members have when they complete acute treatment for cancer and begin their road to survivorship. Some patients move on quickly and experience no further challenges associated with cancer, but others experience “after effects,” or long-term or late effects. Cancer survivors, and their families, should be aware of these potential after effects so they can prepare themselves to deal with them as they get back to a more normal life.

After affects can range from mild to severe and vary from survivor to survivor.

  • Long–term effects of cancer develop during cancer treatment and may not go away.  Some long-term effects can improve such as anemia, fatigue or anxiety.  Some potentially permanent long-term effects are limb loss, weakness or nerve damage.
  • Late effects are delayed effects of cancer treatment and they can surface months to years after treatment.  Some late effects of cancer treatment are heart disease, lung disease, lymphedema, osteoporosis, depression and secondary cancers.

After effects are categorized into physical, emotional and practical after effects.

Physical after effects include:

  • Fatigue
  • Loss of limbs
  • Scars
  • Pain
  • Early menopause
  • Infertility
  • Loss of limb or use of limb
  • Lymphedema
  • Impotence
  • Loss of bladder and bowel control

Emotional after effects include:

  • Body image changes
  • Sexuality changes
  • Insomnia
  • Depression
  • Chronic fatigue
  • Anger
  • Anxiety
  • Fear

Practical after effects include:

  • Difficulty working due to physical and emotional after effects
  • Changes in relationships with loved ones, friends or co–workers
  • Problems getting or retaining health or life insurance coverage
  • Challenges communicating with healthcare team members
  • Financial stressors
  • Employment discrimination

It is very important to note that not all patients experience significant after effects of cancer, but knowing about them will help you cope and may limit the severity of these after effects with  early intervention and treatment.

Talk to your care provider about the after effects you might expect with your cancer and what you possibly could experience based on your treatment regimen. Keep a record of your symptoms to discuss with the care provider and make sure to schedule screening tests and follow up exams as recommended.

About Joan Giblin, NP

Joan Giblin, Winship Cancer Institute

Joan Giblin, NP has a total of 43 years of nursing experience, 25 as a family nurse practitioner and 16 as an oncology nurse practitioner, where she is actively involved in patient care and clinical trials.  In 2011, Ms. Giblin assumed a new role as the director of the Winship Survivorship Program with primary responsibilities for developing the program as a resource for patients and a means to facilitate continued good health and quality of life for cancer survivors.  Prior to this, she was the director of the Winship Call Center, the first point of contact for new cancer patients, and was instrumental in establishing protocols and procedures to streamline access to care at Winship.

Clinical Specialties: Ms. Giblin’s experience as an oncology nurse practitioner gives her unique perspective on the needs of cancer patients and cancer survivors. As a clinical nurse practitioner, she was part of the aerodigestive team, specializing in the care of patients with lung, head and neck and throat cancers.

Research Focus: Ms. Giblin’s current research is in the area of survivorship related to long term and late effects of cancer treatment and adherence to follow up.

Related Resources: