To be diagnosed with cancer can be very frightening. There is the fear that the cancer treatment will not be successful. There is the fear that the cancer will return. There is the fear of pain. And there is the fear that you may not survive this disease. All these feelings are normal and very understandable.
The information below gives some suggestions for coping with these feelings.
After the completion of the treatment, there is always fear that the cancer will return. Any new symptom makes you worry that the cancer has come back. These feelings are more likely to occur just before your next follow-up visit with your doctor and especially if you know that x-rays, scans or blood tests may be ordered to check your progress.
It can also be very worrying if you hear about other cancer patients who are not doing well. Stories told by friends and family members, even television programmes, can increase your anxiety about what is happening to your body. It is important for you to realise that these fears are normal and are to be expected.
Family members also worry about these things. They will suggest foods, herbs or medicines to build up your immunity. This can be very confusing especially if your family's advice conflicts with your doctor's instructions. If you are planning to try a special diet or herbal medicines, discuss these with your doctor so that you can make a decision based on as much accurate information as possible.
If you do have symptoms which are troubling you, you should seek medical attention early so that your doctor can examine you and reassure you if nothing is wrong. It is also important to remember that, even if cancer does recur, the treatment can be successful. Many patients survive following further treatment.
It will assist your recovery if you have a positive attitude towards your diagnosis and treatment. Some people find that prayer or meditation is helpful. Others enjoy the company of others with whom they can share their feelings and explore the meaning underlying the experience of illness. All agree that what matters most is love, laughter and taking pleasure in the simple things of life.
Your treatment is meant to destroy the original cancer cells. However, a small number of cancer cells sometimes survive and continue to multiply. If the body's natural defences do not detect and destroy these cells, tumours may develop from these cancer cells. These tumours are made up of the same type of cells as the original cancer, no matter where the new tumours are found. For example, if cancer of the ovary recurs in the lung, this is not lung cancer, but cancer of the ovary that has spread to the lung.
Cancer can recur in 3 places -- local, regional or distant. Local recurrence means that the cancer has come back in the same place as the original cancer. Regional recurrence means that the cancer cells have spread to the lymph nodes or tissues near the site of the original cancer.
Distant spread, also called metastases, means that the cancer cells have spread to organs or tissues some distance from the original cancer site. For example, if cancer of the cervix has spread to the bones, the tumours in the bone are called bone metastases.
If your cancer has recurred you may have noticed unusual symptoms such as weight loss, bleeding, a new lump or a persistent pain. Sometimes there are no obvious signs or symptoms and your doctor may find evidence of illness only when examining you.
The doctor will then want to have answers to some of these questions:
The treatment that is recommended by your doctor for cancer recurrence depends on the type of cancer, its size and location, your general health, and other treatments you have already had for the original cancer.
It is very important that you ask your doctor about the treatment. You need to understand why one treatment is being recommended over others. You need to understand the benefits, risks, side effects, cost of treatment, and the possible impact of the recommended treatment on your quality of life.
These are some of the questions you may wish to ask your doctor about treatment.If you obtain answers to these questions, you and your doctor will be able to make the best possible decision about which treatment is best for you.
Not everyone with cancer has pain. However, pain can occur at any stage of the disease. It is important to remember that, if there is pain, there are many ways to relieve it.
Cancer pain usually occurs because the growing tumour presses on the surrounding tissues. Therefore, if the cancer is causing your pain, your doctor may recommend surgery, radiotherapy or chemotherapy to remove or shrink the tumour.
You may also need pain medication to relieve the pain. There are many different types of pain medication. Different pains require different types of medicine. This is why your doctor will often prescribe a combination of medicines for your pain.
Most pain can be controlled with medicines that are taken by mouth. Medications like paracetamol (Panadol), non steroidal anti-inflammatory drugs such as naproxen (Synflex) and opioids such as codeine or morphine are commonly used.
However it is not always necessary to take pain medications by mouth or by injection. Fentanyl, a strong pain medicine which should only be used if prescribed by your doctor, is available in a small adhesive patch, which is placed on the skin. The medicine is absorbed through the skin. The patch is replaced every third day.
Sometimes medications that are normally used for other conditions, are used to treat pain. For example, anti-depressant medications or anti-epileptic medications can also help nerve pain that has tingling, burning or shooting quality. If your doctor prescribes these medications, it does not mean that you are depressed or likely to have epileptic fits.
Pain medicine works best if taken before the pain becomes severe. This is why your doctor will recommend that you take your medicine at regular intervals, not just when the pain returns.
Your doctor needs to know as much about your pain as possible. These are some of the questions you will be asked about your pain:
Morphine is made from the sap of the poppy plant and is a very effective pain medicine for severe pain. Morphine belongs to a group of medicines called opioids that work on nerve cells in the spinal cord and in the brain to decreased the sensation of pain.
Morphine is available in two oral forms -- short acting mixture and long acting tablets. The effect of short acting morphine mixture lasts only 4 hours and therefore it must be taken every 4 hours.
Long acting morphine tablets (also called slow release morphine tables or MST) are made so that the effect of the tablet will last up to 12 hours. Therefore long acting tables are usually taken every 12 hours. This means that the effect of the medicine will last throughout the night.
If you are taking long acting tablets and you have an episode of severe pain, you should not take additional long acting tablets. Instead you should take a dose of short acting morphine mixture which will relieve your pain very quickly. However, if you need many doses of short acting morphine mixture each day, your doctor may decide to increase your dose of long acting morphine tablets.
Long acting morphine tablets must not be crushed or chewed but should be swallowed whole.
Morphine can also be given by injection. Sometimes the morphine is given by a portable pump called syringe driver. The syringe driver injects a small dose of morphine continuously via a fine needle which is inserted under the skin and secured with adhesive plastic.
People are sometimes concerned about taking morphine. The fear of addiction is one of the main reasons why people either refuse to take morphine or take less than the amount prescribed. However, morphine is a safe and effective pain medication when used as prescribed by the doctor.
Palliative care, also called hospice care, is offered to people with advanced disease when the focus is on control of symptoms and emotional support. If your disease has progressed and you require additional support, your doctor can refer you to the palliative care physician or to one of the hospice home care programs.
Hospice staff will come to your home to assess your medical, nursing and emotional needs and will work with you and our family to develop a plan of care. They will arrange to visit you regularly. If there is an emergency, there will always be someone from the hospice on-call to assist you and your family.
If the family is no longer able to provide care at home, there are also in-patient hospices that provide short-term admission.
For others who are well enough to enjoy creative activities and outings, there are hospice day care centres that provide a supportive environment for people who attend the centre for the day.
Families who experience hospice care feel that it offers great comfort and support for them when they are caring for someone with advanced cancer.
If cancer recurs, it is sometimes difficult to recover physical and psychological strength. You may face prejudice and discrimination as you attempt to resume an active life.
However, this is an opportunity for you to re-evaluate what life is about, who you are, and what you value most. You may find that, when you have faced the challenge of living with cancer, you have a greater appreciation of life are better able to respond to your own needs and to the needs of others.
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