Complex Nursing Present121012

MDJ3243 COMPLEX NURSING
Tuesday 9/10/12 2:00 4:00 pmIn order for the body to get better, your mind must do its part.
Nursing management of oncology clients: Symptom management and treatment-related side-effects Complementary and alternative medicine
Lecture Venue at: PBL 17 & 18 (level 2) Broad objective: Uses the appropriate nursing management of patients with oncology problems
SHANUI SHABAS, DON-FMHS (09NSG MX OF ONCOLOGY CLIENTS 10-12)
SHANUI SHABAS, DON-FMHS (09-10-12 (2-4pm)) 1
References:
Bernay, T and Porrath, S (2006). When it's cancer: The essental steps to follow after your diagnosis. Holtzbrinck publishers: United States of America. American Cancer Society: External Radiation Side effects Worksheet http://www.cancer.org/acs/groups/content/@nho/documents/document/acsq-009503.pdf
Signs and Symptoms of Cancer What are signs and symptoms?
Signs and symptoms:

Are both signals of injury, illness, disease, or that something is not right in the body. A sign is a signal that can be seen by someone else - maybe a loved one, or a doctor, nurse, or other health care professional. For example, fever, fast breathing, and abnormal lung sounds heard through a stethoscope may be signs of pneumonia.
SHANUI SHABAS, DON-FMHS (09-10-12)
SHANUI SHABAS, DON-FMHS (0910-12)
Nsg MX of oncology clients
Signs and Symptoms of Cancer What are signs and symptoms?
A symptom is a signal that is felt or noticed by the person who has it, but may not be easily seen by anyone else. For example, weakness, aching, and feeling short of breath may be symptoms of pneumonia.
SHANUI SHABAS, DON-FMHS (09-10-12) SHANUI SHABAS, DON-FMHS (094 10-12)
Signs and Symptoms of Cancer Having one sign or symptom may not be enough to figure out whats causing it. For example, a rash in a child could be a sign of a number of things, such as measles, a skin infection, or a food allergy.
But if the child has the rash along with other signs and symptoms like a high fever, chills, achiness, and a sore throat, a better picture of the illness, then a diagnosis can much faster.
Signs and Symptoms of Cancer
Sometimes, a patients signs and symptoms still dont give the doctor enough clues to be sure what is causing the illness. Medical tests, such as x-rays, blood tests, or a biopsy may be needed.
How does cancer cause signs and symptoms? Cancer is a group of diseases that can cause almost any sign or symptom. Where the cancer is, how big it is, and how much it affects the organs or tissues? Cancer has spread (metastasized), signs or symptoms may appear in different parts of the body.
How does cancer cause signs and symptoms?
As a cancer grows, it can begin to push on nearby organs, blood vessels, and nerves. This pressure causes some of the signs and symptoms of cancer. If the cancer is in a critical area, such as certain parts of the brain, even the smallest tumor can cause symptoms.
Cancer starts in places where it will not cause any signs or symptoms until it has grown quite large. Cancers of the pancreas, for example, usually do not cause symptoms until they grow large enough to press on nearby nerves or organs (this causes back or belly pain).
Others may grow around the bile duct and block the flow of bile. This causes the eyes and skin to look yellow (jaundice).
This means it has grown and spread beyond the place it startedthe pancreas. By the time a pancreatic cancer causes signs or symptoms like these, its usually in an advanced stage.
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A cancer may also cause symptoms like fever, extreme tiredness (fatigue), or weight loss.
This may be because cancer cells use up much of the bodys energy supply, or they may release substances that change the way the body makes energy from food.
Or the cancer may cause the immune system to react in ways that produce these signs and symptoms.
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Sometimes, cancer cells release
substances into the bloodstream that cause symptoms which are not usually linked to cancer. For example, some cancers of the pancreas can release substances that cause blood clots in veins of the legs.
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Some lung cancers make hormone-like substances that raise blood calcium levels.
This affects nerves and muscles, making the person feel weak and dizzy.
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How are signs and symptoms helpful?
Treatment works best when cancer is found early While its still small and is less likely to have spread to other parts of the body.
This often means a better chance for a cure, especially if the cancer can be removed with surgery.
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An example of the importance of finding cancer early is melanoma skin cancer.
It can be easy to remove if it has not grown
deep into the skin.
The 5-year survival rate (percentage of
people who live at least 5 years after
diagnosis) at this stage is around 97%.]
Once melanoma has spread to other parts of
the body, the 5-year survival rate drops below

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SHANUI SHABAS, DON-FMHS (09-10-12) Nsg MX of oncology clients
Sometimes people ignore symptoms: .. dont know that the symptoms could mean something is wrong.
.. frightened by what the symptoms could mean and dont want to get or cant afford to get medical help.
Symptoms, such as tiredness or coughing, are more likely caused by something other than cancer.
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.Symptoms can seem unimportant, . theres an obvious cause OR the problem only lasts a short time. . a person may reason that a symptom like a breast lump is probably a cyst that will go away by itself. No symptom should be ignored or overlooked, especially if it has lasted a long time or is getting worse.
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important to have them checked out -
The American Cancer Society and other health groups recommend cancer-related check-ups and certain tests:American
Cancer Society Guidelines for the Early Detection of Cancer
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What are some general signs and symptoms of cancer?
.. any of these symptoms and that they last for a long time or get worse,
see a doctor to find out whats going on.
- Unexplained weight loss:
lose weight for no known reason, its called an
unexplained weight loss. An unexplained weight loss of 10 pounds or more may be the
first sign of cancer.

This happens most often with cancers of the pancreas, stomach, esophagus (swallowing tube), or lung.
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- Fever Fever is very common with cancer, but it more often happens after cancer has spread from where it started. Almost all patients with cancer will have fever at some time, especially if the cancer or its treatment affects the immune system. (This can make it harder for the body to fight infection.) Less often, fever may be an early sign of cancer, such as blood cancers like leukemia or lymphoma.
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- Fatigue
Fatigue is extreme tiredness that does not get better with rest.
may be an important symptom as cancer grows.
may happen early, in some cancers, like leukemia.
Some colon or stomach cancers can cause blood loss
thats not obvious.
This is another way cancer can cause fatigue.
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- Pain
Pain may be an early symptom with some cancers like
bone cancers or testicular cancer. A headache that does not go away or get better with treatment may be a symptom of a brain tumor. Back pain - a symptom of cancer of the colon, rectum, or ovary. Most often, pain due to cancer means it has already
spread (metastasized) from where it started.

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- Skin changes
Along with cancers of the skin, some other
cancers can cause skin changes for example,

Darker looking skin (hyperpigmentation)
Yellowish skin and eyes (jaundice)

Reddened skin (erythema)
Itching (pruritis)
Excessive hair growth
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Signs and symptoms of certain cancers -...... its important to see a doctor about them as soon as possible. GI & URINARY TRACT: - Change in bowel habits or bladder function Long-term constipation, diarrhea, or a change in the size of the stool may be a sign of colon cancer. Pain when passing urine, blood in the urine, or a change in bladder function (such as needing to pass urine more or less often than usual) could be related to bladder or prostate cancer. Report any changes in bladder or bowel function to a doctor.
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Signs and symptoms of certain cancers Sores that do not heal Note: Skin cancers may bleed and look like sores that dont heal.
A long-lasting sore in the mouth could be an oral cancer, especially in people who smoke, chew tobacco, or often drink alcohol.

Sores on the penis or vagina may either be signs of infection or an early cancer.
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Signs and symptoms of certain cancers Note: - White patches inside the mouth or white spots on the tongue may be leukoplakia. Leukoplakia is a pre-cancerous area thats caused by frequent irritation. Caused by smoking or other tobacco use (smoke pipes or use oral or spit tobacco). Leukoplakia can become mouth cancer if its not treated. Any long-lasting mouth changes should be checked by a doctor or dentist right away.
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Unusual bleeding or discharge Unusual bleeding can happen in early or advanced cancer. Coughing up blood in the sputum (phlegm) may be a sign of lung cancer. Blood in the stool (which can look like very dark or black stool) could be a sign of colon or rectal cancer. Cancer of the cervix or the endometrium (lining of the uterus) can cause abnormal vaginal bleeding. Blood in the urine may be a sign of bladder or kidney cancer. A bloody discharge from the nipple may be a sign of breast cancer. Thickening or lump in the breast or other parts of the body Many cancers can be felt through the skin. These cancers occur mostly in the breast, testicle, lymph nodes (glands), and the soft tissues of the body. A lump or thickening may be an early or late sign of cancer and should be reported to a doctor, especially if youve just found it or notice it has grown in size. Keep in mind that some breast cancers show up as red or thickened skin rather than the expected lump.
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Indigestion or trouble swallowing Indigestion or swallowing problems that dont go away may be signs of cancer of the esophagus (the swallowing tube that goes to the stomach), stomach, or pharynx (throat). But like most symptoms on this list, they are most often caused by something other than cancer. Recent change in a wart or mole or any new skin change Any wart, mole, or freckle that changes color, size, or shape, or that loses its sharp border should be seen by a doctor right away. Any other skin changes should be reported, too. A skin change may be a melanoma which, if found early, can be treated successfully. Nagging cough or hoarseness A cough that does not go away may be a sign of lung cancer. Hoarseness can be a sign of cancer of the voice box (larynx) or SHANUI SHABAS, (09thyroidDON-FMHS gland. SHANUI SHABAS, DON-FMHS (09-10-12) Nsg MX of oncology clients 10-12)
Other symptoms The signs and symptoms listed above are the more common ones seen with cancer, but there are many others that are not listed here. If you notice any major changes in the way your body works or the way you feel especially if it lasts for a long time or gets worse let a doctor know. If it has nothing to do with cancer, the doctor can find out more about whats going on and, if needed, treat it. If it is cancer, youll give yourself the chance to have it treated early, when treatment works best.
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Integrative therapy Integrative therapy is a term often used to describe the combined use of proven mainstream treatments and complementary methods. You may have heard the term integrative oncology. Some cancer treatment centers and clinics now offer this option for patients who might be helped by complementary methods as well as mainstream treatments.
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Alternative therapy Alternative therapy is used instead of mainstream treatment.
Alternative therapies are either unproven because they have not been
scientifically tested, or they have been disproved (that is, they have been tested and found not to work). They may cause the patient to suffer because they are not helpful, because they can delay the use of proven methods, or because they are actually harmful.
The American Cancer Society urges patients who are thinking about
using any alternative or complementary therapy to first discuss this with their health care team.
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SHANUI SHABAS, DON-FMHS (09SHANUI SHABAS, DON-FMHS (09-10-12) 10-12)
When it is cancer, What now ?

The 10 essential steps to follow:
1. Take control
2. Break the news and build the support team 3. Understand your diagnosis 4. Analyze findings and support your decision.
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5. Manage side-effects 6. Support body, mind and spirit. 7. Plan ahead 8. Address legal and finacial issues. 9. Understand palliative care 10. Address End-of-life matters.
Nursing management of oncology clients: treatment-related side-effects

Treatments and Side Effects: General information about the types of treatments used against cancer.
Traditional therapies (such as surgery, chemotherapy,
and radiation therapy). Newer forms of treatment (including information on clinical trials), and Complementary and alternative therapies.
The possible side effects of specific treatment.

Nsg MX of oncology SHANUI SHABAS, clients
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DON-FMHS (09-
10-12)
Physical Side Effects
The physical side effects that can be caused by different cancer treatments. CHEMOTHERAPY EFFECTS Chemotherapy drugs are powerful medicines that RADIATION THERAPY EFFECTS Radiation therapy can cause side effects by
can cause side effects.
damaging normal,
healthy cells near the
cancer.
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MANAGING SIDE EFFECTS OF CHEMOTHERAPY Chemo side effects: What causes side effects? Cancer cells tend to grow fast, and chemo drugs kill fast-growing cells. These drugs travel throughout the body, and they can affect normal, healthy cells that are fast-growing, too.

Damage to healthy tissue causes side effects. Side effects are not always as bad as you might expect, but many people worry about this part of their cancer treatment.
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MANAGING SIDE EFFECTS OF CHEMOTHERAPY Chemo side effects:
The normal cells most likely to be damaged by chemo are: blood-forming cells in the bone marrow; hair follicles; and cells in the mouth, digestive tract, and reproductive system. Some chemo drugs can damage cells in the heart, kidneys, bladder, lungs, and nervous system. In some cases, medicines can be given with the chemo to help protect the bodys normal cells.
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Chemo side effects:

The severity varies greatly from person to person.
Talk to your doctor and nurse:
which side effects are most common with your chemo,
how long they might last,

how bad they might be, and when you should call the doctor/ return to the clinic.
Medicines to prevent some side effects before they happen.
Many people have no long-term problems from chemo. Side effects can be unpleasant, they must be measured
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against the need to kill the cancer SHANUI SHABAS, DON-FMHS (09- cells.
10-12)
When to call your doctor

. likely more in tune with your body than you ever have been in your life. notice every physical change and imbalance. Do not take any physical symptoms you may have lightly because some side effects are fleeting and minor, but others may be a sign of serious problems. You should not be the judge.
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SHANUI SHABAS, DON-FMHS (0910-12) SHANUI SHABAS, DON-FMHS (09-10-12)
Tell your doctor right away if you suffer from any of the following symptoms during your chemo treatment:
A fever of 100.5F or greater;
Bleeding or unexplained bruising;

A rash or allergic reaction, such as swelling of the mouth or throat, severe itching, trouble breathing or swallowing Intense chills Pain or soreness at the chemo injection site or catheter site
Unusual pain, including intense headaches

Shortness of breath Long-lasting diarrhea or vomiting Bloody stool or blood in your urine
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TRACKING SIDE EFFECTS

Write down your side effects, when they occur and how lont they last. Share these notes with your doctor or nurse. sharing these notes help you, your doctor or
nurse to plan for managing side effects.
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TRACKING SIDE EFFECTS

External radiation side effcts worksheet (American model)
Radiation therapy uses special equipment to deliver high doses of radiation to cancerous tumors, killing or damaging them so they cannot grow, multiply, or spread. Although some normal cells may be affected by radiation, most appear to recover fully from the effects of the treatment.
Unlike chemotherapy, which exposes the entire body to cancerfighting chemicals, radiation therapy affects only the tumor and the surrounding area. Radiation therapy is one of the most common treatments for cancer and is used in more than half of all cancer cases.
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Understanding Radiation Therapy:

What can I do, to take care of myself during treatment?
Take special care of yourself to protect your health during radiation treatment.
Your doctor or nurse will give you advice based on your treatment and the side effects you might have. Here are some other tips: Be sure to get plenty of rest. You may feel more tired than normal. Try to get good, restful sleep at night. Severe tiredness, often called fatigue, may last for several weeks after your treatment ends. Eat a balanced, nutritious diet. Depending on the area of your body getting radiation (for example, the belly or pelvic area), your doctor or nurse may suggest changes in your diet.
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Benefits of good nutrition

Good nutrition is especially important if you have cancer because both the illness and its treatments can change the way you eat. Cancer and cancer treatments can also affect the way your body tolerates certain foods and uses nutrients. The nutrient needs of people with cancer vary from person to person. Your doctor, nurses, and a registered dietitian can help you identify your nutrition goals and plan ways to help you meet them. Eating well while you are being treated for cancer. Rationales: feel better. keep up your strength and energy. maintain your weight and your bodys store of nutrients. better tolerate treatment-related side effects. lower your risk of infection. heal and recover faster. Eating well means eating a variety of foods that will give your body the nutrients needed to help fight cancer. These nutrients include protein, carbohydrates, fat, water, vitamins, and minerals. SHANUI SHABAS, DON-FMHS (09NSG MX OF ONCOLOGY CLIENTS 10-12)
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NUTRIENTS Proteins For growth, to repair body tissue, and to keep our immune systems healthy. When your body doesnt get enough protein, it might break down muscle for the fuel it needs. This makes it take longer to recover from illness and can lower resistance to infection. People with cancer often need more protein than usual. After surgery, chemotherapy, or radiation therapy, extra protein is usually needed to heal tissues and help fight infection. Good sources of protein include fish, poultry, lean red meat, eggs, low-fat dairy products, nuts and nut butters, dried beans, peas SHANUIand SHABAS, DON-FMHS (09lentils, soy foods. SHANUI SHABAS, DON-FMHS (09-10-12 (2-4pm)) 44and NSG MX OF ONCOLOGY CLIENTS
10-12)
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Fats Fats play an important role in nutrition. Fats and oils are made of fatty acids and serve as a rich source of energy for the body. The body breaks down fats and uses them to store energy, insulate body tissues, and transport some types of vitamins through the blood.
You may have heard that some fats are better for you than others. When considering the effects of fats on your heart and cholesterol level, choose monounsaturated and polyunsaturated fats more often than saturated fats or trans fats.
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FATS Monounsaturated fats -vegetable oils like olive, canola, and peanut oils. Polyunsaturated fats -mainly in vegetable oils like safflower, sunflower, corn, and flaxseed. They are also the main fats found in seafood. Saturated fats - in animal sources like meat and poultry, whole or reduced-fat milk, cheese, and butter. Some vegetable oils like coconut, palm kernel oil, and palm oil are saturated. Saturated fats can raise cholesterol and increase your risk for heart disease. Less than 10% of your calories should come from saturated
fat.
Trans-fatty acids are formed when vegetable oils are processed into margarine or shortening. Sources of trans fats include snack foods and baked goods made with partially hydrogenated vegetable oil or vegetable shortening. Trans fats also are found naturally in some animal products, like dairyTrans fats can raise bad
cholesterol and lower good cholesterol; try to eliminate them from your diet products.
Understanding Radiation Therapy: Benefits of good nutrition
Carbohydrates Carbohydrates are the bodys major source of energy. Carbohydrates give the body the fuel it needs for physical activity and proper organ function. The best sources of carbohydrates fruits, vegetables, and whole grains also supply needed vitamins and minerals, fiber, and phytonutrients to the bodys cells.
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Understanding Radiation Therapy: Benefits of good nutrition Whole grains or foods made from them contain all the essential parts and naturally occurring nutrients of the entire grain seed. Whole grains are found in cereals, breads, flours, and crackers. Some whole grains, such as quinoa, brown rice, or barley, can be used as side dishes or part of an entree. When choosing a whole-grain product, look for the words whole grain, stone ground, whole ground, wholewheat flour, whole-oat flour, or whole-rye flour.
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Understanding Radiation Therapy: Benefits of good nutrition
Fiber plant foods that the body cannot digest.
2 types of fiber. Insoluble fiber helps to move food

waste out of the body quickly, and soluble fiber binds with water in the stool to help keep stool soft. Other sources of carbohydrates include bread, potatoes, rice, spaghetti, pasta, cereals, corn, peas, and beans. Sweets (desserts, candy, and drinks with sugar) can supply carbohydrates, but provide very little in the way of vitamins, minerals, or phytonutrients
Benefits of good nutrition Water

Water and liquids or fluids are vital to health. All body cells need water to function. If you do not take in enough fluids or if you lose fluids through vomiting or diarrhea, you can become dehydrated (your body doesnt have as much fluid as it should). If this happens, the fluids and minerals that help keep your body working can become dangerously out of balance. You do get some water from the foods you eat, but a person should drink about eight 8-ounce glasses of liquid each day to be sure that all the body cells get the fluid they need. You may need extra fluids if you are vomiting or have diarrhea. Keep in mind that all liquids (soups, milk, even ice cream and gelatin) count toward your fluid goals.
Vitamins and minerals The body needs small amounts of vitamins and minerals to help it function properly. Most are found naturally in foods. They are also sold as supplements in pill and liquid form. They help the body use the energy (calories) found in foods. A balanced diet with enough calories and protein and plenty of vitamins and minerals. Can be hard to eat a balanced diet when you are being treated for cancer, especially if you have treatment side effects that last for a long time. In this case, your doctor or dietitian may suggest a daily multivitamin and mineral supplement.
Vitamins and minerals

Be sure to discuss this with your doctor first. Some of these substances can be harmful, especially when taken in large doses.
In fact, large doses of some vitamins and minerals may make chemotherapy and radiation therapy less effective.
If your oncologist says it is OK for you to take a vitamin during treatment, it may be best to choose a supplement with no more than 100% of the Daily Value (DV) of vitamins and minerals and one without iron (unless your doctor thinks you need iron).
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Antioxidants
Antioxidants include vitamins A, C, and E; selenium, and zinc; and some enzymes that absorb and attach to free radicals, preventing them from attacking normal cells; Health experts recommend eating a variety of fruits and vegetables, which are good sources of antioxidants. Taking large doses of antioxidant supplements or vitamin-enhanced foods or
liquids is usually not recommended while getting chemo or

radiation therapy.
Benefits of good nutrition Phytonutrients Phytonutrients or phytochemicals are plant compounds like carotenoids, lycopene, resveratrol, and phytosterols that are thought to have healthprotecting qualities. Found in plant products such as fruits, vegetables, and teas. Pill or supplement forms of phytochemicals have not been shown to be as helpful as eating the foods that contain them.
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Herbs Herbs have been used to treat disease for hundreds of years, with mixed results. Today, herbs are found in many products, like pills, liquid extracts, teas, and ointments. Many of these products are harmless and safe to use, but others can cause severe and harmful side effects. Some may even interfere with proven cancer treatments, including chemo, radiation therapy, and recovery from surgery. If you are interested in using products containing herbs, talk about it with your oncologist or nurse SHANUI SHABAS, DON-FMHS (09first. S 55 55 10-12)
NSG MX OF ONCOLOGY CLIENTS HANUI SHABAS, DON-FMHS (09-10-12 (2-4pm))
What can I do to take care of myself during treatment? Take care of the skin in the treatment area.
If you get external radiation therapy, the skin in the treatment area may become more sensitive or look and feel sunburned. Ask your doctor or nurse before using any soaps, lotions, deodorants, medicines, perfumes, cosmetics, talcum powder, or anything else on the treated area. Some of these products may irritate sensitive skin.
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What can I do to take care of myself during treatment?

Do not wear tight clothes over the treatment area. This
includes girdles, pantyhose, or close-fitting collars. Instead, wear

loose, soft cotton clothing. Do not starch your clothes. Do not rub, scrub, or use adhesive tape on treated skin. If your skin must be covered or bandaged, use paper tape or other tape for sensitive skin. Try to put the tape outside the treatment area, and do not put the tape in the same place each time. Do not put heat or cold (such as a heating pad, heat lamp, or ice pack) on the treatment area. Talk with your doctor first. Even hot
water may hurt your skin, so use only lukewarm water for washing
57 the SHANUI SHABAS, DON-FMHS (09NSG MX OF ONCOLOGY CLIENTS treated 10-12) area.
What can I do to take care of myself during treatment?

Protect the treated area from the sun. - Skin may be extra sensitive to sunlight. If possible, cover the treated skin with dark-colored clothing before going outside. Ask your doctor if you should use a lotion that contains a sunscreen. If so, use a sunscreen product with a sun protection factor (SPF) of at least 15. Reapply the sunscreen often. Continue to give your skin extra protection from sunlight for at least 1 year after radiation therapy. Tell your doctor about all medicines you are taking before treatment, even things like aspirin, vitamins, or herbs. Dont forget to list those you take only when you need them, such as sleep aids, antacids, headache remedies, and antihistamines. Its a good idea to keep a list like this with you at all times, in case of emergency, even when you arent getting cancer treatment.
Side effects can vary.

Tell your doctor about any changes in the way you feel and about any side effects you are having, including skin changes, tiredness (fatigue), diarrhea, or trouble eating. Be sure that you understand any home care instructions and know whom to call if you have more questions. Side effects vary from person to person and depend on the radiation dose and the part of the body being treated. Some patients have no side effects at all, while others have quite a few. There is no way to know who might or might not have side effects. Your overall health can sometimes affect how your body reacts to radiation treatment and whether you have side effects.
How long do side effects last?

Radiation therapy can cause early and late side effects. Early side effects are those that happen during or shortly after treatment. They usually are gone within a few weeks after treatment ends. Late side effects are those that take months or years to develop. They are often permanent.
The most common early side effects are fatigue (feeling tired) and skin changes. Other early side effects usually are related to the area being treated, such as hair loss and mouth problems when radiation treatment is given to the head.
How long do side effects last?

People often become discouraged about how long their treatment lasts or the side effects they have. If you feel this way, talk to your doctor. If needed, your doctor should be able to suggest ways to help you feel better.
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TRACKING SIDE EFFECTS Using Worksheet

This worksheet will cover 6 weeks of radiation therapy. Fill in the date for the start of each week. For example, the week you start therapy is Week #1. If your therapy lasts beyond 6 weeks, you will need to print an additional worksheet. Side effects are listed in the left column. For each week, go down the column for that week and check the appropriate box describing the severity of each side effect. If you do not have a particular side effect, check the None box. Take this worksheet with you to your doctor visits. If you have a side effect that can be described as severe, notify your doctor right away. At the end of the list, we have left spaces for you to add any side effects you may have that are not listed here. Use the same format to describe the severity of the symptom and any medications you took to treat it.
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PAIN And Pain Management in Cancer

The common cause of pain in cancer is cancer itself or cancer treatment. Talk to your doctor or nurse about treatment for pain. Cancer pain should not be thought as normal part of cancer. Talk to your doctor or nurse about your pain. Take pain medication exactly as presc ribed. DO NOT wait until pain is severe to take medication. Keep tract of any pother side effects that you notice.
FATIGUE
What is fatigue?
Fatigue (fuh-teeg) is feeling tired physically, mentally, and emotionally.

It means having less energy to do the things you normally do or want to do. In people with cancer, it can be caused by the cancer itself, cancer treatment, and other factors. Fatigue can last a long time and can affect your mood, employment, daily routines, self-care, recreation, relationships, and your sense of self. Fatigue from cancer treatment is the most common and distressing side effects of cancer and its treatment Often more intense than the feelings of being tired we all have from time to time and Can have a major effect on a persons quality of life.

FATIGUE
Some Description of Cancer-related fatigue:
some people describe it as feeling weak, listless, drained, or
washed out. Some people may feel too tired to eat, walk to the bathroom, or even use the TV remote. It can be hard to think, as well as move your body.
Rest does not make it go away, and just a little activity may
make you feel exhausted. For some people, this kind of fatigue can cause even more distress than pain, nausea, vomiting, or depression.
FATIGUE
Cancer-related fatigue can:
Differ from one day (how bad it is and how much it bothers you) Be overwhelming and make it hard for you to feel well Make it hard for you to be with your friends and family Make it hard for you to do your normal activities, including going to work Make it harder for you to follow your cancer treatment plan Last different lengths of time, which makes it hard to guess how long
yours will go on.
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FATIGUE
Cancer-related fatigue
Research suggests that anywhere between 70% and 100% of cancer patients getting treatment have fatigue. And about 30% to 50% of cancer survivors have said that their fatigue lasts for months or even years after they finish treatment. Even though fatigue is a very distressing symptom, doctors and nurses seldom focus on it, and patients and caregivers rarely report it. It may be hard to talk about fatigue in people with cancer. Something can be done to help a patient who are having this problem.
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NAUSEA
Tuesday
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PHYSICAL CHANGES
Weight Loss Breast loss Hair loss Voice loss Skin disorders
Opportunistic diseases
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PHYSICAL SIDE EFFECTS that can be caused by different cancer treatments.
CHEMOTHERAPY EFFECTS Chemotherapy drugs are powerful medicines that can cause side effects.
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PHYSICAL SIDE EFFECTS

RADIATION THERAPY EFFECTS - Radiation therapy can cause side effects by damaging normal, healthy cells near the cancer.
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Weight loss
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ANEMIA
Anemia is having a lower than normal number of red blood cells in your blood. Red blood cells carry oxygen throughout your body. Not having enough of them can result in feeling weak, tired, or short of breath.
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LYMPHEDEMA Lymphedema is a build-up of lymph fluid in the fatty tissues just under your skin. This build-up causes swelling (or edema), most often in the arms or legs. Lymphedema can result from surgery or radiation therapy to treat certain cancers.
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PSYCHOLOGICAL / Emotional Issues

Cancer is a physical illness but it also takes emotional toils because the mind and body work interactively. The outward emotional distress are such as anxiety and depression. Cancer patients routinely experience a more profound subconscious sense of grief. WHY? The illness is robbing the body, the family, workplace, social roles and the persons independence. The emotional pain of these losses can run deep. All that negative EMOTIONAL energy can UNDERMINE the physical healing process.
PSYCHOLOGICAL / Emotional Issues

RECOGNISING AND ADDRESSING THESE EMOTIONS: If you have side effects from your treatment, talk with your doctor or nurse: Medication can be prescribed. Individual or group counseling counselors can help you to cope with your emotions that cancer treatment have caused. Talking with friends and family can help you feel better. They comfort you in many ways. Relaxation techniques
INFECTIONS IN PEOPLE WITH CANCER

Infections in people who have cancer or are getting cancer treatment can be more serious than those in other people. They can also be harder to treat. By learning more about them, you and your family may be able to help prevent problems that infections can cause.
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SECOND CANCERS CAUSED BY CANCER TREATMENT
Some cancer treatments such as chemotherapy and radiation therapy may increase a person's risk of developing a different types of cancer later in life. Here we discuss the risk of second cancers that may be linked to past cancer treatment.
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SEXUAL SIDE EFFECTS IN MEN Men and their doctors often do not talk about the effects of cancer treatment on their sex lives. Men may feel uneasy talking about sex with a professional like a doctor or even with a close sex partner. In this section, we answer questions and offer information about cancer, sex, and sexuality to help you have open, honest talks about your sex life.
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SEXUAL SIDE EFFECTS IN WOMEN Women and their doctors may not talk about the effects of cancer treatment on their sex lives. Some women may feel uneasy talking about sex with a professional like a doctor or even with a close sex partner. In this section, we answer questions and offer information about cancer, sex, and sexuality to help you have open, honest talks about your sex life.
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FERTILITY AND CANCER: WHAT ARE MY OPTIONS? Cancer and its treatment can sometimes affect a person's ability to have children. Here we offer information on how cancer treatment can affect fertility, ways to preserve fertility before treatment, and fertility options available after treatment.
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DEALING WITH SYMPTOMS AT HOME This guide offers general information about caring for a person with cancer at home. It lists the more common problems people with cancer experience, signs of problems you can look for, and some ideas for things you can do if problems come up.
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What is radiation recall?
If you have had radiation treatments before, you could develop
radiation recall. During or shortly after you get certain chemo drugs, the skin
over the area that was treated with radiation may turn red a
shade anywhere from light to very bright and may itch or burn. This is radiation recall, and the reaction may last hours or even days.
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How to manage radiation recall?
Soothe the itching and burning by putting a cool, wet compress
over the affected area.
Tell your doctor or nurse about any skin irritation or changes.
Skin that has had radiation always should be protected from the sun.
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Other question?
Drink beer, wine, or any other alcoholic beverages to help relax and
increase appetite??
Alcohol may interact with some drugs so that they dont work as well, or it may make the side effects worse.
Take vitamin or mineral supplements?
Note: No single answer to this question, but one thing is clear:

No diet or nutritional plan can cure cancer. Taking vitamin and mineral supplements or any other complementary and alternative medicine should never take the place of medical care. SHOULD NOT take any supplements without talking to your doctor first.
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Nursing management of oncology clients: Complementary and alternative medicine
Complementary and Alternative Methods for Cancer Management You may hear the terms alternative or complementary used to refer to methods
that are supposed to prevent, diagnose, or treat cancer.

You may wonder just what these terms mean.
http://www.cancer.org/acs/groups/content/@editorial/documents/image/acspc-027018.jpg
Nsg MX of oncology SHANUI SHABAS, 86 clients
DON-FMHS (09-
10-12)
COMPLEMENTARY AND ALTERNATIVE MEDICINE
The terms "complementary" and "alternative" are sometimes used to:
refer to non-traditional methods of diagnosing, preventing, or
treating cancer or its symptoms.
Complementary therapy is used along with standard or mainstream medical
treatment. Some complementary therapies may help to

- relieve certain symptoms of cancer, - relieve side effects of cancer treatment, or
- improve a patients sense of well-being.

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Complementary therapy Examples might include,
meditation to reduce stress, peppermint or ginger tea for nausea, and guided imagery to help relieve stress and pain during
medical procedures.
Some of the methods, such as massage therapy, relaxation,
and meditation that are now called complementary and in the

past, have actually been referred to as supportive care
The American Cancer Society urges patients who are thinking about using any
complementary or non-mainstream therapies to first discuss it with their health care team.
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How can you know if these methods are safe and whether they will help you? The information here is offered to help you understand more about safety and think about whether and how you might want to use complementary or alternative methods.
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http://www.cancer.org/acs/groups/content/ @editorial/documents/image/acspc030758.jpg
STAYING ACTIVE
Find out more about staying active during and after cancer treatment. Learn about the importance of exercise, as well as what you need to know if you are planning on working during treatment or returning to work afterwards. more about staying active during and after cancer treatment. Learn about the importance of exercise, as well as what you need to know if you are planning on working during treatment or returning to work afterwards.
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NATIONAL CANCER SURVIVORSHIP RESOURCE CENTER The National Cancer Survivorship Resource Center (The Survivorship Center) is a collaborative effort to shape the future of cancer survivorship care and improve the quality of life of cancer survivors as they transition from treatment to recovery. Learn more about The Survivorship Center and view resources for survivors, health care professionals, and the policy and advocacy community.
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ONLINE COMMUNITIES
AND SUPPORT
If you're facing a cancer diagnosis, connecting with
others who've been through one already can be a

source of comfort and support.
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WHEN YOUR CHILD HAS CANCER The diagnosis of cancer in a child or teenager can be a devastating blow to parents and other family members who love the child. Cancer creates an instant crisis in the family. Here we provide information to help parents of children with cancer know what to expect. We offer suggestions on topics such as coping with the diagnosis, dealing with financial and insurance issues, and nutrition for children with cancer.
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MDJ3243 COMPLEX NURSING

SHANUI SHABAS, DON-FMHS (09NSG MX OF ONCOLOGY CLIENTS 10-12)

SHANUI SHABAS, DON-FMHS (09-10-12 (2-4pm)) 1

SHANUI SHABAS, DON-FMHS (09NSG MX OF ONCOLOGY CLIENTS 10-12)

SHANUI SHABAS, DON-FMHS (09-10-12 (2-4pm)) 2

Signs and Symptoms of Cancer What are signs and symptoms?

Signs and symptoms:

SHANUI SHABAS, DON-FMHS (09-10-12)

SHANUI SHABAS, DON-FMHS (0910-12)

Nsg MX of oncology clients

Signs and Symptoms of Cancer What are signs and symptoms?

SHANUI SHABAS, DON-FMHS (09-10-12) SHANUI SHABAS, DON-FMHS (094 10-12)

Nsg MX of oncology clients

SHANUI SHABAS, DON-FMHS (09-10-12)

SHANUI SHABAS, DON-FMHS (0910-12)

Nsg MX of oncology clients

Signs and Symptoms of Cancer

SHANUI SHABAS, DON-FMHS (09-10-12)

SHANUI SHABAS, DON-FMHS (0910-12)

Nsg MX of oncology clients

SHANUI SHABAS, DON-FMHS (09-10-12)

SHANUI SHABAS, DON-FMHS (0910-12)

Nsg MX of oncology clients

How does cancer cause signs and symptoms?

SHANUI SHABAS, DON-FMHS (09-10-12)

SHANUI SHABAS, DON-FMHS (0910-12)

Nsg MX of oncology clients

How does cancer cause signs and symptoms?

SHANUI SHABAS, DON-FMHS (09-10-12)

SHANUI SHABAS, DON-FMHS (0910-12)

Nsg MX of oncology clients

How does cancer cause signs and symptoms?

SHANUI SHABAS, DON-FMHS (09-10-12)

SHANUI SHABAS, DON-FMHS (0910-12)

Nsg MX of oncology clients

How does cancer cause signs and symptoms?

SHANUI SHABAS, DON-FMHS (0910-12)

Nsg MX of oncology clients

How does cancer cause signs and symptoms?

Sometimes, cancer cells release

SHANUI SHABAS, DON-FMHS (09-10-12)

SHANUI SHABAS, DON-FMHS (0910-12)

Nsg MX of oncology clients

How does cancer cause signs and symptoms?

SHANUI SHABAS, DON-FMHS (09-10-12)

SHANUI SHABAS, DON-FMHS (0910-12)

Nsg MX of oncology clients

How are signs and symptoms helpful?

SHANUI SHABAS, DON-FMHS (09-10-12)

SHANUI SHABAS, DON-FMHS (0910-12)

Nsg MX of oncology clients

How are signs and symptoms helpful?

It can be easy to remove if it has not grown

deep into the skin.

The 5-year survival rate (percentage of

people who live at least 5 years after

diagnosis) at this stage is around 97%.]

Once melanoma has spread to other parts of

the body, the 5-year survival rate drops below

How are signs and symptoms helpful?

SHANUI SHABAS, DON-FMHS (0910-12)

Nsg MX of oncology clients

How are signs and symptoms helpful?