In this section we will try to share with you simple, reliable and understandable information about Cancer designed to support you and the people you care for or who care for you.
Our goals are:
- To better understand the disease
- To find practical instructions for everyday life
- To feel more secure in the care you provide
- To learn about the importance of Palliative Care
The information in this page serve as a support and does not replace clinical examination and advice of your physician.
Please always consult a qualified health care professional, for anything that concerns you.
Cancer
Cancer & Body Image Change
Cancer treatments can cause many different changes in the body.
"Suddenly I became a wreck. I didn't look my best and that made me angry. I liked my long hair. I didn't feel like myself anymore."
"I've always valued my strength and my ability to do things on my own, but there are things I can't do to support myself anymore."
Cancer and its treatments can cause changes
- Appearance – how a person looks
for example, surgery may leave scars or result in the removal of a body part (such as a breast or a limb).
- Functionality—how the body functions
for example, some people may require a colostomy—a surgically created opening in the abdomen through which stool passes into a pouch—or there may be changes in speech, swallowing, or fertility.
- Sensation—how a person perceives their body
For example, after oral cavity reconstruction, the area may feel different, there may be changes in hearing or tingling, numbness, and pain in the hands and feet.
Body image is a person’s perception of their own body, and it is very important. A negative change in the body undermines one’s identity and self-esteem and can cause distress and at times, devastation.
- age
- the progression of the disease the individual’s ability to cope with difficulties
- the time it took for the change—the disability—to set in (rapidly or slowly)
- the limb’s function prior to the disease
- the potential for recovery
- the individual’s attachment to their physical appearance
- whether the affected limb is visible or not
It is normal for the patient to experience the change through the following four phases:
- Impact – loses control – cannot accept the news – fears for their life and experiences anxiety and distress
- Regression – escaping reality and returning to a more psychologically comfortable stage of life
- Recognition – mourns the loss
- Recovery – reassesses positive strengths and takes action to restore balance – dares to make plans and tries to find solutions to his problem.
How can Cancer and its treatments can cause changes
At first, changes may seem overwhelming and difficult to cope with. Everyone adapts at their own pace, and the adjustment process can take weeks, months, or even years.
The impact a change has on the body does not always depend on its size, severity, or visibility.
For example: a small scar can still have a significant impact on your mood, self-confidence, and sexuality.
You can reach out to others and/or find ways to help you adjust, such as:
Talk about the changes in your body
It would help to be open and not withdraw into yourself, because that might stop you from doing things you’d enjoy or from getting the help you need.
Talk to someone you feel comfortable with: your partner, a family member, another patient with the same condition, a healthcare provider, a counselor, or a psychologist.
Doctors and specialized healthcare professionals are accustomed to discussing physical changes and specific concerns, so feel free to discuss your worries with them.
Write down your questions and concerns, as well as the responses from the healthcare professional you’ve chosen, since it may be difficult to remember everything that was discussed.
In some areas, “peer support” programs or “mutual support groups” are available, or you can find support online.
Talk to your care team for help
Your care team could:
* give you advice on clothing choices and accessories, such as wearing a scarf or headband to cover hair loss
* Ensure that you are using the most appropriate and discreet products—for example, a speech valve following laryngectomy.
* Refer you to appropriate services or groups for advice on concealing makeup
* Refer you for prosthetics, such as a breast prosthesis
Seek spiritual support
If you feel it would help, you could:
* seek help from a spiritual advisor (priest) to address the psychological issues caused by the illness.
* Prayer can provide comfort and help you face the problem with a positive attitude.
* Reading spiritual books could be rejuvenating for the soul.
Cancer & Should the patient know?
Not telling the patient has certain advantages.
– We don’t upset them (to put it more precise, we postpone their distress)
– We don’t become the people who delivered the “bad news”
For these reasons, in past decades, the prevailing tendency was to keep things hidden.
However, if we look more closely, keeping the patient in the dark has serious drawbacks.
- The patient is placed in an atmosphere of “secrecy,” even though they often understand what is wrong with them.
- A patient who is unaware cannot participate in decisions regarding their treatment, which places them in a passive role and increases their risk of developing depression.
- A patient who is unaware may think that things are much worse than they actually are.
- In cases where cancer cannot be cured, a patient who is not told anything is deprived of the opportunity to prepare for their death, loses the chance to reflect on and do things that might give meaning to their life, and risks facing death alone.
For all these reasons, the right question is NOT whether the patient should be told if he or she has cancer, but rather, how much should the patient be told?
The answer to this question is usually provided by the patient’s own behavior.
Every person has their own limits:
- on how much they WANT to know
- on how much they prefer NOT to know
- on when they are ready to learn more
We should listen carefully to the patient, understand how much and when they want to learn, and respond accordingly.
The doctor is the right person to inform the patient.
With the help of the patient’s relatives and friends, but primarily based on the patient’s behavior, the doctor will determine what to say, how much to say, and how to say it.
In most cases, the patient himself lets the doctor know what and how much he wants to know, and this is the best guide for the doctor.
Not in our days.
Cancer can often be cured and even when it cannot be cured, there are ways to provide the patient with adequate relief from pain and other distressing symptoms.
There is clear evidence regarding the factors that cause cancer, such as smoking, certain chemicals, certain types of radiation, and certain viruses. So far, it has not been proven that psychological factors cause cancer, and it doesn’t add value to try to determine whether cancer was triggered by emotional distress.
Based on their personal experience, everyone has certain ways of coping psychologically when things in life aren’t going so well.
In the case of a cancer diagnosis, the following have been found to help most people cope:
- Take an active role in your treatment
- Stay informed about your illness
- Be involved in decision-making
- Surround yourself with people who can support you
- Stay active (Having cancer doesn’t necessarily mean you have to stop doing the things you did before or the things you enjoy)
- Many people feel better when they work, perhaps at a more relaxed pace
- Try to eat well and get plenty of rest
- Don’t neglect yourself. Continue to take care of your appearance, personal cleanliness, and physical hygiene, and keep doing things that bring you joy
Cancer & End-of-Life Patient Care
The patient and their family often want to know how long they are expected to live. This is a difficult question.
The progression of the disease is influenced by various factors, such as the location of the tumor and the presence of other pathological conditions.
Although the doctor may be able to make an estimate, based on what he knows about the patient, he is often hesitant to express it. There is always the risk of over- or under-estimating the expected survival.
He may also be reluctant to say since he may offer false hope or destroy any hope that exists.
When the patient:
- hurts and is not relieved by the prescribed dose of analgesics
- is short of breath and appears agitated
- unable to urinate or defecate
- shows intense depression and expresses suicidal thoughts
When the caregiver:
- the patient has difficulty in medication administration
- We spend time with the patient (talking, watching movies)
- We give the patient the opportunity to express their fears and feelings
- We listen to the patient’s memories
- We give them the opportunity to participate in decisions that affect them
- We fulfill the patient’s wishes
- We respect the times when the patient wishes to be alone
- Lethargy
This refers to an increase in sleep periods and/or a lack of response to stimuli. Visits and all activities involving the patient should be scheduled for times when the patient is awake. Most patients can still hear even when they are unable to speak. Therefore, conversations should be conducted on the assumption that the patient is listening, even if they do not respond.
- Confusion
This refers to confusion regarding time, place, and people, visual hallucinations, and the patient’s inability to remain calm in bed. The time, date, and names of the caregivers should be gently repeated to the patient. A gentle approach to communication with the patient helps achieve a degree of mental calm.
- Withdrawal
The patient may be able to hear but may not be able to respond. Therefore, their relatives and friends should speak to them and reassure them that they are nearby.
- Reduced need for food and fluids—anorexia
The patient should be allowed to choose whether and when to eat or drink. Water, fruit juices, or ice chips can provide relief. Dryness of the mouth and lips should be prevented.
- Loss of bladder and bowel control
Special adult diapers are recommended for this purpose.
- Dark-colored urine or reduced urine output
It may be necessary to insert a urinary catheter.
- Cold Upper and Lower Extremities
Patients may not be aware that their extremities are cold. It is recommended to cover the patient with blankets.
- Respiratory Disturbances
Noises during inhalation and exhalation, decreased respiratory rate per minute, alternating periods of increased and decreased respiratory rate, etc. Breathing may be easier if the patient is turned onto their side and pillows are placed under their head and back. In some patients, oxygen administration is recommended.
- Inadequate pain control
If analgesic doses do not provide relief to the patient, medical advice should be sought.
- Involuntary muscle spasms (myoclonus)
- Changes in heart rate
- Absence of reflexes in the upper and lower extremities
It should be noted that not all of these signs are present in every patient, and that the presence of one or more signs in a patient does not necessarily mean that the end is near.
- Absence of breathing or pulse
- The eyes do not move and the eyelids do not open or close
- The pupils are dilated
- The jaw is loose and the mouth is slightly open
- There is urine and feces incontinence
- The patient does not respond to stimuli
