Learning to Manage Cancer Side – Effects
It is recommended by Oncology clinicians that one learn to manage cancer treatment side-effects before starting cancer rehabilitation. While knowing how to manage side –effects before rehabilitation may be optimal; it may not be the norm. At the beginning of cancer treatment there are numerous factors and conditions which typically overwhelm most patients. Thus, cancer rehabilitation may be the first focused learning opportunity patients have on managing side-effects.
Thus, knowing how to educate and treat the cancer patient population provides a significant intervention opportunity for Physical Therapy. It is through the delivery of information, care and skills that the Physical Therapist becomes a life long consultant to the cancer population.
Rehabilitation during treatment has been proven within the scientific community to benefit and improve the outcomes of caner treatment. Yet, the cancer patient will not be able to fully enjoy these benefits if pain and nausea prevent them from engaging in therapeutic prescriptive exercise.
Therapeutic, prescriptive exercise can reduce nausea, fatigue and other cancer side-effects. It is important to teach cancer patient the standard methods of managing symptoms before symptoms prohibit meaningful participation in cancer rehabilitation.
The most common side-effects that besiege cancer patients are listed below:
1. Physical Fatigue
2. Cognitive Fatigue Chemo-Brain
3. Pain
4. Nausea
5. Mouth Sores
6. Constipation
7. Diarrhea
8. Sleep Disturbance
9. Lymph edema
10. Peripheral Neuropathy
11. Osteoporosis
12. Heart Disease
1. Physical Fatigue is the most common side-effect and is associated with all cancers and treatments. A patient must identify patterns of fatigue and then plan activities during their peak energy zone. Cancer and cancer treatment causes patients to suffer from Anemia (a lack of red blood cells) thus oxygen saturation may be an issue for the exercising cancer patient. Cognitive Fatigue, Chemo-Brain is a lack of memory and mental acuity which results in delayed response mental activity, chemo-brain may remain for months, even a year or two after cancer therapy.
2. Pain can come from the cancer tumor and or cancer treatment. Radiation therapy can cause skin breakdown, chemotherapy can cause mouth sores, skin irritation, ulcers, and sometimes infections in the mouth and throat. Pain is also experienced from chronic headaches.
3. Nausea and vomiting are common side-effects of many cancer treatments. Both chemotherapy and radiation can cause nausea. Drugs for nausea are called Anti-emetics and are very effective.
4. Mouth Sores are common chemotherapy side-effects. Mouth sores, thrush, white patches caused by yeast infections are part of chemotherapy. Cancer therapy causes a painful and red mouth which makes eating and swallowing very difficult.
5. Constipation is caused by the lack of activity, changes in eating habits and the lack of fluid intake. Being constipated can cause significant belly pain and discomfort. Exercise is very helpful in overcoming constipation.
6. Diarrhea is caused by chemotherapy and radiation. This is especially true if radiation is being done in the abdominal region of the body.
7. Sleep Disturbances, pain and irritation disrupt normal body functioning which cause significant sleep disturbances. Thus, sleep medication will be necessitated to overcome sleep deprivation.
8. Lymphedema, swelling in the arms or legs may result from surgery or radiation. The swelling can start immediately after surgery or therapy or it can start several months later. Physical Therapy will need to be prepared to manage the inevitable occurrence of Lymphedema.
9. Peripheral Neuropathy, Certain types of chemotherapy (Vincristine, Paclitaxel, Cisplatin) and tumors can injure the peripheral nerves, causing numbness in the effected areas.
10. Long-Term side-effects of treatment and cancer. Osteoporosis. Bone loss occurs during treatment and is a silent, asymptomatic side-effect. Chemotherapy (Doxorabicin, Methotrexate, Prednisone, & Decadron) cause bone wasting which are greatest in pre-menopausal women. This represents the breast cancer population to the largest extent.
11. Heat Disease, Many cancer treatments cause weight gain and inactivity. Cancer survivors are four (4) times more likely to die from a heart attack then their health cancer-free counterpart.
These are the primary side-effects we have a responsibility to teach our cancer patient population to manage well during cancer rehabilitation.
References:
Schwartz, Anna L.
Cancer Fitness:
Exercise Programs for Patients and Survivors.
