Advanced Cancer : Anxiety, Fatigue, Nausea and Vomiting, Constipation, Eating

by National Cancer Institute

(Page 5 of 11)

Anxiety

Cancer takes a toll on both your body and your mind. You are coping with many different things now. You may feel overwhelmed. Pain and medicines for pain can also make you feel anxious or depressed. And you may be more likely to feel this way if you have had these feelings before.

Here are some signs of anxiety:

• Feeling very tense and nervous
• Racing heartbeat
• Sweating a lot
• Trouble breathing or catching your breath
• A lump in your throat or a knot in your stomach
• Sudden fear

Feeling anxious can be normal. But if it begins disrupting your daily life, ask for help from the members of your health care team. They can recommend someone for you to talk to. Counseling from a mental health professional has been shown to help many people cope with anxiety. Your doctor can also give you medicines that will help. Some of the complementary and alternative medicine choices for pain may work for your anxiety as well.

Fatigue

Fatigue is more than feeling tired. Fatigue is exhaustion - not being able to do even the small things you used to do. A number of things can cause fatigue. Besides cancer and its treatment, they include anxiety, stress, and changes in your diet or sleeping patterns. If you are having some of these problems, you might want to:

• Tell your health care team at your next visit. Some medicines can help with fatigue.
• Ask about your nutrition needs.
• Plan your daily activities. Do only what you really must do.
• Hand over tasks to others who are willing to help you.
• Include short periods of rest and relaxation every day.
• Take naps (no longer than 15-30 minutes).
• Ask others for help, especially when you are feeling fatigued.
• Do light exercises that are practical for you.

Nausea and Vomiting

Nausea and vomiting may be a problem for cancer patients. Both can make you feel very tired. They can also make it hard to get treatments or to care for yourself. If you feel sick to your stomach or are throwing up, there are many drugs to help you. Ask your health care team which medicines might work best for your nausea and vomiting.

You also may want to:

• Make small changes in your diet. Eat small amounts 5-6 times a day.
• Avoid foods that are sweet, fatty, salty, spicy, or have strong smells. These may make nausea and vomiting worse.
• Drink as much liquid as possible. You'll want to keep your body from getting dried out (dehydrated). Water, broth, juices, clear soft drinks, ice cream, and watermelon are good choices.
• Choose cool foods, which may help more than hot ones.
• Try acupuncture.

Constipation

Constipation is a problem in which stool becomes hard, dry, and difficult to pass, and bowel movements do not happen very often. Other symptoms may include painful bowel movements, and feeling bloated, uncomfortable, and sluggish. Chemotherapy, as well as other medicines (especially those used for pain), can cause constipation. It can also happen when people become less active and spend more time sitting or lying down.

Here are some ways to help manage constipation:

Drink plenty of fluids each day. Many people find that drinking warm or hot fluids helps with bowel movements.

Be active. You can be active by walking, doing water aerobics, or yoga. If you cannot walk, talk with your doctor or nurse about ways you can be active, such as doing exercises in bed or a chair.

Ask your doctor, nurse, or dietitian if you should eat more fiber. He or she may suggest you eat bran, whole wheat bread and cereal, raw or cooked vegetables, fresh and dried fruit, nuts, and popcorn and other high-fiber foods.

Let your doctor or nurse know if you are in pain or discomfort from not having a bowel movement. He or she may suggest you use an enema or take a laxative or stool softener. Check with your doctor or nurse before using any of these.

Ask your doctor about giving you laxatives when you start to take pain medications. Taking a stool softener at the same time you start taking pain drugs may prevent the problem.

Loss of Appetite and Body Changes

Eating and appetite changes are common in the later stages of cancer. As your cancer progresses, your appetite may become poor.

On the other hand, you may be eating enough, but your body can't absorb the nutrients. This can cause you to lose weight, fat, and muscle.

Nutrition goals may become less important at this time. Even if your family members think you should have food, let your body be the judge. The goal should not be weight gain or improving your eating but rather comfort and symptom relief.

Your nurse, dietitian, and other members of your health care team can help. They can help you decide on changes to your diet that may be needed to keep you as healthy as possible. There are also new drugs to improve appetite and get rid of nausea. Ask your health care team about them.

Sleep Problems

Illness, pain, drugs, being in the hospital, and stress can cause sleep problems. Sleep problems may include:

• Having trouble falling asleep
• Sleeping only in short amounts of time
• Waking up in the middle of the night
• Having trouble getting back to sleep

To help with your sleep problem, you may want to try:

• Reducing noise, dimming the lights, making the room warmer or cooler, and using pillows to support your body
• Dressing in soft, loose clothing
• Going to the bathroom before bed
• Eating a high-protein snack 2 hours before bedtime (such as peanut butter, cheese, nuts, or some sliced chicken or turkey)
• Avoiding caffeine (coffee, teas, colas, hot cocoa)
• Keeping regular sleep hours (avoid naps longer than 15-30 minutes)
• Talking with your health care team about drugs to help you sleep. These may give relief on a short-term basis.

About the Author

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