The effects of cancer treatment vary among patients. Some side effects continue after cancer treatment is over, while some can develop after treatment has ended. Many older adults have other health conditions such as diabetes, heart disease, and osteoporosis. Sometimes it is hard to tell if physical changes are the effects of cancer or its treatment, or are caused by other health conditions or simply the result of getting older.
Some of the most common problems that older cancer survivors report are:
Fatigue, or feeling extremely tired, is the most common complaint during the first year after cancer treatment ends. Cancer-related fatigue is different from everyday fatigue. Rest or sleep does not help it. For some survivors, fatigue is mild and temporary, but for others it can last for months after cancer treatment and makes going about daily activities difficult.
Doctors do not know the exact cause of treatment-related fatigue, but many factors may contribute. The causes seem to be different for people who are undergoing treatment than for those who have finished treatment.
Fatigue during treatment can be caused by cancer therapy. Chemotherapy, radiation therapy, and other therapies may cause fatigue. Other problems such as anemia (having too few red blood cells), stress, poor nutrition, lack of exercise, and depression may be linked to this type of fatigue. Researchers are still learning about what may cause fatigue to linger after treatment ends.
What can you do about fatigue?
The best thing you can do for fatigue is talk to your doctor or health care professionals about it so you can get the help you need to deal with it. Ask them about the medications you are taking and if they could affect your energy level. Talk to them about how to manage any pain, nausea, or depression you may have. They may also be able to suggest medications or nutritional supplements that may help lessen your fatigue.
Here are some other ways you can manage or cope with your fatigue.
- Plan your day so that you balance rest and activity. Be active at the time of day when you feel most alert and energetic. Take short breaks or naps throughout the day, rather than one long rest period. Too much rest can decrease your energy level.
- Save your energy. For example, change the way you do things. Sit on a stool while you cook or do dishes. Take rest breaks between activities. Decide which activities are more important and which ones aren’t. Try to let go of things that don’t matter as much now.
- Let others help you. Don’t be afraid to ask your family or friends to help with the things you find tiring or hard to do. This may be a task such as preparing meals, doing housework, or running errands.
Think about joining a support group. Talking about your feelings with others who have had the same problem may help you find new ways to cope.
Physical Changes – Memory, Pain, and Nervous System Problems
After cancer treatment, some people find that they can’t pay attention or remember things the way they used to, have pain that remains, or have problems with damage to their nervous system. These changes may be side effects of treatment.
Some survivors notice that they can’t focus on the job at hand or they have trouble remembering details like names and dates. Sometimes it takes them longer to finish tasks, because their thinking and processing seems to be slower. For older adults, it can be hard to tell whether changes in memory and concentration are because they are getting older or are the result of treatment.
These changes, sometimes called “chemobrain”, can begin during cancer treatment or they can occur much later. The exact causes are unknown, but people who have had chemotherapy or who have had radiation to the head seem to be more likely to experience these problems.
The best thing you can do about memory and concentration problems is to talk with your doctor. Discuss whether medications you are taking, depression, problems sleeping, or anxiety could be contributing to your problems. If these problems last for a long time, your doctor may suggest that you see a specialist who can help you.
Here are some ideas that can help with your memory and concentration.
- Jot it down. Write down your appointments, important dates, and phone numbers. Make lists and write down plans for your day.
- Put small signs around the house to remind you of things to do, such as locking the doors.
- When doing a task with several steps, such as cooking, whisper each step to yourself.
- Repeat what you want to remember. Saying it a couple of times can help your mind hold on to the information.
Some people have a lot of pain after cancer treatment, while others have less. Some types of pain associated with cancer include pain from surgery and pain or numbness in the hands or feet caused by nerve injury following some treatments.
Another type of pain is called phantom pain. If you have had a limb or breast removed, you may still feel pain or unusual feelings that seem to be coming from the absent (phantom) body part.
Many older adults are reluctant to ask for help to relieve their pain. Some may believe that pain is just part of having cancer and of aging, or fear that taking pain medications will cause drug addiction. Some think that mentioning pain or discomfort makes them a problem for caregivers. Others are afraid that their doctor won’t focus on curing the cancer if they spend their time treating pain.
But you don’t have to be in pain. Controlling your pain is a way to help you feel better and stay active. And newer medications made available in this past decade have helped control pain due to cancer better than ever before.
Talk to your doctor. Describe your pain as clearly as possible and point out where it hurts. Describe how it feels — sharp, throbbing, etc. Explain how often it occurs, how long it lasts, and what seems to trigger it, make it worse, or lessen the pain. Explain how the pain affects your daily life.
It may be useful to keep a “pain diary” or record of your pain that includes:
- Time of day you experienced the pain
- Level of pain– how much pain you had. Based on a scale of 0-10, where “0” is no pain and “10” is the worst pain imaginable
- Activity you were doing when you felt the pain
- Result of medication– how well medications worked to relieve your pain.
Sometimes cancer treatment can cause damage to your nervous system or problems with nerve functions. This is called neuropathy and the severity and symptoms vary widely from person to person.
Neuropathy can occur at any age, but it is more common in older adults. It can also be caused or made worse by other conditions that are a concern for older adults, including diabetes, kidney failure, and malnutrition.
Most people first notice symptoms, such as tingling or numbness, in their hands or feet. Other common symptoms include sudden or sharp pain sensations, loss of sensation of touch, loss of balance or difficulty walking, trouble picking up objects or buttoning clothes, and being more or less sensitive to heat and cold.
Symptoms can start during or after treatment. Symptoms can improve over time, but it may take up to a year or more. If you start to notice these types of symptoms, talk to your doctor or health care professionals right away. They may suggest medications or pain patches to help alleviate symptoms, or other approaches such as physical therapy.
Here are some steps you can take to help manage nervous system changes:
- Pay attention when handling knives, scissors, or sharp objects. Neuropathy can reduce pain sensation, so you could get a wound and not feel it.
- Avoid falls. Pay attention when you walk and if necessary, use a cane to help steady yourself. Remove objects that you could trip over.
- Wear shoes with rubber soles.
- Avoid extreme heat or cold. Wear gloves and hats when needed.
Some survivors experience other side effects related to their treatment that may include swelling, problems with their mouth and teeth, changes in their weight, and bladder and bowel problems.
Swelling, called lymphedema, occurs when lymph fluids build up just under the skin. It can occur after radiation or surgery to treat any type of cancer. It is most often associated with treatment of breast cancer, melanoma, prostate cancer, lymphoma, and cancers of the female or male reproductive organs.
Lymphedema most often occurs in the arms and legs, but it can happen in other parts of the body including the face, neck, abdomen, and genitals. Other conditions, such as heart disease, also can cause these symptoms.
Symptoms of lymphedema include:
- swelling or a heavy feeling in an area like your arm, leg, or abdomen
- a tight feeling in the skin; or an itching or burning feeling in the legs
Here are some things that might help prevent or relieve lymphedema
- Watch for signs of swelling or infection (redness, pain, heat, and fever). Tell your doctor if your arm or leg is painful or swollen.
- Avoid getting cuts, insect bites, or sunburn in the affected area.
- Keep your skin clean and use lotion to keep it moist.
- Wear loose-fitting clothing on your arms and legs.
Many cancer survivors develop problems with their mouth or teeth. Radiation or surgery to the head and neck can cause problems with your teeth and gums, the lining of your mouth, and glands that make saliva. Certain types of chemotherapy can cause the same problems as well as dry mouth, cavities, and a change in the sense of taste.
The advice to help prevent and relieve mouth and teeth problems is the same for cancer survivors as for people who have not had cancer. Brush your teeth and gums after every meal and at bedtime, and floss your teeth daily. If you have dentures, clean them after every meal and have them checked to make sure they fit well.
Another tip is to avoid foods that may irritate your mouth. For example, sharp or crunchy foods such as chips could scrape or cut your mouth. Foods that are spicy or high in acid, such as citrus fruits and juices, tobacco products, and alcoholic drinks also can bother your mouth.
Weight Loss or Gain Due to Cancer Treatment
Many cancer patients experience changes in their weight during treatment. Among survivors, weight gain is a more common issue than weight loss. Certain kinds of chemotherapy and medicines contribute to this problem.
Sometimes the added pounds stay on even when treatment ends. Breast cancer survivors who received certain types of chemotherapy gain weight in a different way — they may even lose muscle and gain fat tissue. Unfortunately, the usual ways people try to lose weight may not work for them.
If you are having trouble losing weight after treatment ends, ask your doctor about talking with a nutritionist who can help you plan a healthy diet. Your doctor may suggest exercises that can help you regain muscle tone. Stay positive and focus on the fact that treatment is over and you are trying to get stronger.
Some cancer survivors have no desire to eat and they lose weight. To improve your appetite, focus on making foods more appealing to eat. Try the foods you liked before treatment and add some fruit or flavorings to improve the taste. Several small meals throughout the day may be easier to manage than three larger ones.
Bladder and bowel problems are among the most upsetting issues people face after cancer treatment. People often feel ashamed or fearful to go out in public because they worry about having an “accident.” This loss of control can happen after treatment for bladder, prostate, colon, rectal, ovarian, or other gynecologic or abdominal cancers.
Some surgeries to treat cancer may leave a patient with little or no bladder or bowel control. The opposite problem can happen with some medicines that cause constipation. For some people the problems improve over time, but others may experience long-term issues.
It is very important to tell your doctor about any changes in your bladder or bowel habits. Several things may help, such as medications, changes in diet or fluid intake, and exercises. Joining a support group also may be helpful, especially for survivors who have an ostomy (an opening in the body to pass waste material).
- Cancer Prevention
- Common Signs and Symptoms of Cancer
- Commonly Asked Cancer Questions
- Nutrition Guidelines For Cancer Patients
- Nutrition in Cancer Care
- Eating Problems During Cancer Treatment
- Side Effects of Cancer Treatments
- Spirituality in Cancer Care
- Support For Cancer Patients
- Transitional Care Options For Cancer Patients
- When Cancer Returns
- Surviving Cancer
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Source: National Library of Medicine