While everyone knows what it feels like to be occasionally exhausted, cancer patients who suffer from fatigue — resulting from the disease itself or its treatment — often suffer from a debilitating exhaustion that can last days, weeks or months.

Cancer fatigue, often described by patients as a total lack of energy, is a near universal problem among cancer patients. It is the most common side effect of cancer and its treatment, affecting 76 percent of patients undergoing therapy. Unfortunately, while medical science has been making steady progress in treating cancer itself, cancer-related fatigue is frequently over-looked, under-recognized and under-treated.

“For many patients, fatigue is the constant reminder that they have cancer. Yet despite its prevalence and distressing consequences, it is one of the least understood symptoms of cancer,” said Russell Portenoy, M.D., Department of Pain Medicine and Palliative Care, Beth Israel Medical Center, New York City, and chairman of The Fatigue Coalition, a multi-disciplinary group of medical practitioners, researchers and patient advocates that authored a recent survey about fatigue. …read the rest of this entry»

Though everyone experiences cancer fatigue differently, the following tips may help you manage your symptoms:

• Plan your day so that you have time to rest
• Take short naps or breaks rather than one, long rest period
• Eat as well as you can, and drink plenty of fluids
• Take short walks or do light exercise if possible
• Try easier or shorter versions of activities you enjoy
• Try activities that are less strenuous, like listening to music or reading
• Keep a diary of how you feel each day to help you plan your daily activities …read the rest of this entry»
  

Participant introductions

My name is Bonnie, and in 1983 when I was 33 years old I was diagnosed with breast cancer. There are so many things to deal with when you have a cancer diagnosis. The physical aspects of treatment, the emotions and feelings you have, and then you have to deal with the system: managed care, insurance companies, the whole healthcare bureaucracy. In a few minutes, you’ll hear six cancer survivors talk about how they dealt with issues like understanding your treatment options and getting the information you need from your doctor, navigating the healthcare system, making sure your treatments are covered, and working with insurance companies and agents.
Medical broadcaster Andrew Schorr, the discussion leader, was diagnosed two years ago with chronic lymphocytic leukemia. Ann is from Massachusetts and was diagnosed with colorectal cancer in 1988. Susan from California is 41. She was diagnosed with breast cancer in 1991. Laurie is from Connecticut. She was diagnosed with lung cancer in 1988. Doug is from Minnesota. He is a 15-year survivor of non-Hodgkin’s lymphoma and works in the health insurance business.
This discussion is unique in that it represents the view and opinions of real people living with cancer. This means that it does not necessarily represent expert opinion, nor the opinions of the American Cancer Society. Information represents what has worked and not worked for others dealing with cancer. People deal with their cancer in many unique ways. It is up to the listener to determine what is appropriate and relevant for them. We hope the information is helpful, and we welcome your feedback.

Asking questions

Anne, Massachusetts
ANDREW:
Anne, I understand that you found out you had colon cancer in 1988. …read the rest of this entry»

Finding colorectal cancer

ANDREW:
Hello, and welcome to the American Cancer Society’s Cancer Survivors’ Network, the service created by and for cancer survivors. In Seattle, I’m your discussion leader, Andrew Schorr. Joining us from New York City is Barbara Barrie, a veteran television, screen, and stage actress, and also a colon cancer survivor. Currently, Barbara is well known for her portrayal of Brooke Shields’ “Nana,” on the hit NBC sitcom, “Suddenly Susan.”

She’s been actively working as an actress for the past 35 years and in that time has been nominated for an Academy Award, an Emmy, and a Tony. And she won an Obie, a Drama Desk award, and the Best Actress Award at the Cannes Film Festival. But, all the awards in the world could not have prepared Barbara, now 68 years old, for colon cancer. Since that time, Barbara has been through three operations, chemotherapy, and radiation. Now she has a colostomy, but, she still wears bathing suits and leotards.

She divides her time among acting, writing-she’s written three books-and activism about colon cancer. Barbara, thank you for being with us today.

BARBARA:
Thank you for having me.

ANDREW:
Over the next few minutes Barbara, I know we can discuss some very important issues for people. Issues such as: finding your own way of handling the experience of diagnosis and treatment; bringing colon cancer out into the open-which is often hard, and maybe especially hard for women; the importance of monitoring your healing; the gift of clarity that can come over time when you have cancer; and also how life’s experiences can turn you into an activist. Maybe first, you could tell us how all this started for you? …read the rest of this entry»

Symptom and Description You are receiving chemotherapy for your cancer. One of the possible side effects is damage to the nerves in your body. This may result in a feeling of ‘‘pins and needles’’ or the feeling that your hands and/or feet are asleep. You may have difficulty picking up a coin or buttoning your shirt or blouse. Another problem may be constipation. It is important to tell your doctor or nurse if these or any other changes occur. Your treatment plan can be evaluated to prevent further nerve damage.

Learning Needs You need to learn the signs and symptoms of peripheral neuropathy. Tell your doctor or nurse if/when you develop:

• A feeling of ‘‘pins or needles’’ or numbness in your hands and/or your feet
• Difficulty picking up an object or buttoning your shirt or blouse
• Ringing in your ears …read the rest of this entry»
  

Symptom and Description As menopause approaches, whether it is a natural process of aging, the result of surgical removal of the ovaries, or the effects of radiation or chemotherapy, many women will have symptoms of estrogen loss. While every woman will experience menopause in her own way, most will have hot flashes—ranging from rarely to more than ten times a day. Hot flashes are often worse at night and can disrupt sleep, causing mood changes and difficulty making decisions. Some women will complain of anxiety and even periods of depression. These symptoms will improve over time. Other problems can occur because of estrogen loss. The vagina becomes shortened and more dry. These changes can cause itching and burning and can interfere with comfortable sexual intercourse. A woman may also experience more vaginal and bladder infections. Other symptoms include headache, dizziness, skin changes, and thinning of the scalp and pubic hair.

Management The best way to manage the symptoms of menopause is to restore the body’s level of estrogen. This can be done by taking a pill (e.g., Premarin), by applying an estrogen patch to the skin twice a week, or by using a vaginal cream. However, estrogen therapy is not for every woman. Some women prefer to try other means of learning to live with the change of life. Your doctor will help you make the choice that is best for you. The following suggestions may help you with your symptoms of menopause.

…read the rest of this entry»

Symptom and Description You have moderate swelling of your hand or arm (foot/leg), sometimes called lymphedema. This swelling may happen any time after lymph node surgery. The swelling may stay, it may come and go, or it may disappear. Because you have had lymph nodes removed, your body’s ability to move lymph fluid has been changed. New lymph channels have developed to help replace what has been removed. You may have noticed some swelling right after surgery. This was normal, and it decreased after the tissues healed. Now you are noticing mild swelling in your limb. What causes this to happen is unclear. Infection can cause swelling, as can having had radiation to the area where the lymph nodes were removed.

Learning Needs You will learn to notice and report (even if small) any signs of infection or swelling in your extremity on the side of your surgery. (Extremity means hand, arm, foot, or leg.) …read the rest of this entry»

Symptom and Description Pruritus (itching) can occur because of your cancer and the treatment for cancer. The itching can be in one area or all over your body. Pruritus can become so severe and annoying that it causes loss of sleep and changes your daily lifestyle. Scratching and damage of the skin can lead to an infection. Decreasing the itch sensation and keeping your skin healthy is most important.

Learning Needs You need to be aware that pruritus may occur and learn how to prevent it and how to reduce its effects.

Prevention Pruritus may not be prevented. However, there are many things you can do to prevent dry skin and irritation:

• Drink glasses of fluid each day
• Keep skin moist, using moisturizing agents and Aveeno bath treatment
• Keep a humid environment
• Report changes in pruritus to physician/nurse
• Keep finger nails cut short and wear soft mittens on hands and socks on feet, especially at night
• Avoid hot baths and heat …read the rest of this entry»
  

Symptom and Description Diarrhea is defined as more than two loose or watery stools per day. It can be caused by radiation over your bowels. Diarrhea may be worse if you are also receiving radiation treatments over your abdomen.

Learning Needs Loose or watery stools may start a few days after your treatments. If left untreated, diarrhea can result in weakness, weight loss, skin soreness, and poor nutrition. You need to learn strategies for controlling diarrhea, and you need to learn when you should get in touch with your nurse or doctor.

Prevention Eating a low-residue diet may help to reduce the number of loose stools per day. …read the rest of this entry»

There are now many ways to reduce side effects or prevent them from happening again. Two of the most serious side effects are infection and bleeding. A third, anemia, is not life threatening but can lessen quality of life. Special medicines called growth factors can reduce these side effects or prevent them from happening again. In certain situations a doctor or nurse may recommend the following interventions:

• Filgrastim (Neupogenâ , G-CSF) or sargramostim (Leukineâ , GM-CSF) can be given in shot form (injection) starting 24 hours or more after chemotherapy. These drugs help the bone marrow make more white blood cells to prevent infection with fever.
• Epoetin alfa (Procritâ ) can be given in shot form (injection) to stimulate the bone marrow to make red blood cells to prevent anemia. This lessens the chance a person feels tired and fatigued.
• Oprelvekin (Neumegaâ ) can be given in shot form (injection) to stimulate bone marrow to make more platelets that help the blood to clot. …read the rest of this entry»