Cancer Patient Information

Did You Know? Information About Fevers

Fevers are a first sign of infection, and a sign to seek help.

• Fever and chills are signs of possible infection.  If you are a cancer patient, your fever is telling you to seek help and find the source of infection. 
• You are very vulnerable to infection after chemotherapy, radiation or while on immunosuppressive medications, and when your white blood counts are low.
• Main causes of a fever are infection and tumors.
• Other signs of infection include fatigue and muscle pain.

Remember: 

• Call for a temperature of 38.3 C or 100.9 F or above by mouth.  When taking an axillary (under the arm) temperature with children or adults, call if the temperature is 37.9 C or 100.3 F.
• Monitor your temperature.
• Call for shaking chills.
• Doctors and nurses need to treat the underlining cause of the fever.

Helpful Suggestions for Fever Management: 

• Contact nurse or doctor if you develop chills or a fever.
• Call your doctor or nurse when you notice symptoms of an infection such as inflammation, redness, soreness, or cold symptoms.

Fatigue - Did You Know?

Fatigue is a very common complaint for cancer patients.
Regular physical activity helps reduce fatigue. 

Helpful Suggestions for Self Care: 
• Conserve energy
• Eat as well as you can
• Eat easy-to-prepare foods
• Take short naps rather than long rest periods
• Organize time to avoid rushing
• Take short walks
• Sit down to bathe and dry off
• Obtain patient safety equipment as needed
• Modify your home environment
• Delegate tasks
• Save your energy for things that are important to you

For Additional suggestions on Fatigue please review the Fatigue Symptom Sheet

Knowledge is Power
SCCA Patient and Family Education Department

Source of information: Oncology Nursing Society

Did You Know? Fatigue

Fatigue is a very common complaint for cancer patients.

Regular physical activity helps reduce fatigue 

Helpful Suggestions for Self Care: 
• Conserve energy
• Eat as well as you can
• Eat easy-to-prepare foods
• Take short naps rather than long rest periods
• Organize time to avoid rushing
• Take short walks
• Sit down to bathe and dry off
• Obtain patient safety equipment as needed
• Modify your home environment
• Delegate tasks
• Save your energy for things that are important to you

For Additional suggestions on Fatigue please review the Fatigue Symptom Sheet

Peripheral Neuropathy - Just the Facts

It is damage to nerves that can span from your fingers to your toes. Peripheral means nerves beyond the brain and spinal cord. Peripheral nerves take information to the muscles, organs, skin, and joints, and then take information back to the brain. Neuro means nerves. Pathy means abnormal. When this occurs it can cause pain and numbness, or a sensation that is similar to burning or tingling.  

In many cases symptoms improve with time. There are many different causes. Some chemotherapy medications can cause this problem. Other causes include: traumatic injury, medical illnesses such as diabetes, infectious conditions, and toxic compounds.

Your Goals:
 Monitor onset of symptoms
 Protect your hands and feet
 Get professional help when needed.

911

Emergency Signs and Symptoms

Call 911 IMMEDIATELY if you are the caregiver and can not wake your patient.

Urgent Signs and Symptoms: 
Call the Clinic or the After Hours Clinic NOW if:
 You are unable to move your legs
 If you have fallen

Important Signs and Symptoms
Report symptoms to your doctor or nurse during clinic hours today if you experience:
 Change in sensation symptoms: Numbness, tingling, tremor, burning, loss of sensation, gait imbalance (unstable walking), sensitivity to touch, weakness, tiredness, and heaviness.

 Movement Symptoms: Lack of muscle control, falling, muscle twitching, cramping, foot drop, and muscle atrophy.

 Autonomic Symptoms:  Failure of the nerves to work correctly can result in abnormal blood pressure, digestive problems such as nausea, blurred vision, and dizziness.

What You Can Do At Home
 You can meet with a physical therapist if you are having problems with your balance. Ask your team to schedule you for a Physical Therapy appointment. Home equipment and/or devices to help you walk independently may be recommended for you if you have mobility problems. Discuss with your doctor, nurse and physical therapist safety measures you should put in place.

 Avoid extreme temperatures. Peripheral neuropathy may make areas of your body more sensitive to hot or cold.

 Wear shoes, slippers, gloves, and other clothing to protect your skin from changes.

 Use extra care when using hot, sharp or potentially harmful objects. You may be more at risk for clumsiness and prone to injury if you have reduced sensations.

 Avoid falls - please review the Fall Prevention Handout.

 Check your feet everyday, looking carefully at the bottom of your feet and toes for any changes.

 For lack of sensation in your hands:

 Check temperatures with your inner forearms to avoid burns.

 Always use protective padding for cooking and rubber gloves for cleaning. 

 Keep finger nails short to avoid tearing. 

 Keep hands moisturized to avoid skin breaks from dryness.

Coping with Peripheral Neuropathy
 Your doctor will try to determine the source of the problem. Ask your doctor questions.

 Let your team know how much the neuropathy is impacting your life.  There are techniques for coping with pain and discomfort.  In many cases, symptoms improve with time.

© Seattle Cancer Care Alliance, 2009

Anxiety, who needs it!

It is very common for a person to feel anxious when facing a new or stressful situation. We all feel worried at times in our day-to-day lives. People may experience anxiety as nervousness, tension, panic, fear, or feeling like something bad is going to happen.

Anxiety can also be experienced as physical symptoms such as upset stomach, sweaty palms, fast heartbeat, shaking, or flushed face.

Although it is normal to feel anxious when facing a life-threatening illness and the intensive treatment there are things that may help decrease the feelings of anxiety. The goal is to reduce anxiety, not eliminate all anxiety.

Your Goals:

• Learn how to cope with anxiety.
• Get professional help when needed.

Important Signs and Symptoms:
Report symptoms to doctor or nurse during clinic hours today.

• Feelings of dread and apprehension for several days.
• Physical symptoms such as sweaty palms, shaking, rapid heartbeat, and so on. Keep in mind that these symptoms can also be caused by side effects of treatment.
• Wide mood swings that you cannot control.

What You Can Do at Home:
Learn how to cope with anxiety.

• Recognize that anxiety during transplantation is normal and so is getting help for it.
• Try to understand what thoughts are triggering the anxiety. For example, if you are anxious about a medical procedure, ask yourself what it is about the procedure that is upsetting. Then ask yourself how you would change the procedure so it doesn’t make you so anxious. Staff may be able to help make those changes so talk with them about it.
• Getting the facts can help. For example, if you are worried about pain or discomfort, you can get information on how to manage pain or discomfort.
• Thinking about doing things that are pleasant and relaxing can help reduce anxiety. Relaxation is a skill that can be used to counteract anxiety. It’s nearly impossible to be relaxed and anxious at the same time.

Get professional help when needed.
If anxiety doesn’t improve despite your efforts to reduce it, discuss it with your nurse, doctor, or social worker.

Be well!
Ann and Sara

Depression, you can handle it.

Dealing with a life-threatening illness causes a roller coaster of emotions.

When the roller coaster plunges downward, feelings such as helplessness, despair, and sadness can be experienced. Most patients experience these feelings at some time during treatment. Symptoms of depression can also include loss of appetite, changes in sleep patterns, energy, and inability to focus. If you have had symptoms of depression or have been on anti-depressants before in your life, be sure to inform the doctor, nurse, or social worker.

Your goals:

• Acknowledge that it is normal to have feelings of sadness at times.
• Allow yourself to feel sad at times.
• Identify when you need help with depression.

Important signs and symptoms:
Report symptoms to doctor or nurse during clinic hours today.

• Feeling sad most of the time for several days.
• Feelings interfere with your ability to care for self.
• You have thoughts about hurting yourself.
• Mood swings that you cannot control.

What you can do at home:

• Allow yourself to feel sad at times.
• Talk about these feelings with someone who listens (family member, volunteer).
• Talk with other patients in your situation (ambulatory support groups, phone contact, internet).
• Use spiritual resources.
• Get professional help when needed.

Psychiatrist and Psychologists can provide:

• Evaluation of cause of depression (sometimes medications can cause depression)
• Medication to manage depression
• Counseling.

Ask your doctor, nurse, or, social worker for a referral.

Be well!
Ann and Sara

Did you know -- Are you at risk for the Holiday Blues?

You might be at risk for the Holiday Blues if you are…

• Single
• Coping with a chronic or recently diagnosed disease
• Have a history of loss
• Have been divorced or separated
• Separated from family and friends
• Have a history of depression

Holiday blues affect both men and women, young and old.  The holiday expectations can trigger stress.   The stress may come from being away from family and friends, the financial demands, hosting house guests, and setting un-realistic expectations. 

The good news is that there are a few simple hints to help you cope and manage your expectations during the holiday season.

Helpful Hints to Help you Cope

• Prioritize and minimize
• Acknowledge the way you feel
• Communicate your needs
• Focus on what gives you peace vs obligation
• Realize there is no magic formula
• Reflect on what really matters
• Create new traditions

Questions to Assist you During your Treatment Journey

It's hard to remember everything you want to ask, espcially when questions come up away from the doctor's office. Here is a list of questions you can keep with you when you visit your doctor.

And if you like, here is a Downloadable "Questions for the Treatment Journey" that you can print out.

At Diagnosis:

What test/s do I need to have?
____________________________________________________________________________________________________________________________________
How do I prepare for the test/s?
____________________________________________________________________________________________________________________________________When Will I get results from the test/s?
____________________________________________________________________________________________________________________________________

Initial Treatment:

What are the treatments you recommend I have for this diagnosis and/or problem?
______________________________________________________________________

When am I scheduled for ?
______________________________________________________________________

How long is the treatment?
______________________________________________________________________

Will I have a break in my treatment?
______________________________________________________________________

What are the expected side effects?
_____________________________________________________________________

When should  I call for help?
_________________________________

How do I get help on the weekends and after-hours?
________________________________________________________

After treatment:

When should I have follow-up clinic visits and tests?___________________________________________________________

How long before I feel like myself?
__________________________________________________________

Additional Questions:

Here you can create your own list.

We've provided a Downloadable "Questions for the Treatment Journey" that you can print out.

Wishing you good health,
Ann and Sara

Did You Know? What are the Screening and Diagnostic Tests for Breast Cancer

Screening Tests

Screening tests identify signs of breast cancer that might otherwise go unnoticed. When breast cancer is found and treated early, a woman has more treatment options and a better chance of a cure. The following tests are recommended as a routine part of every woman’s healthcare.

• Breast Self-Examination (BSE) 
• Clinical Breast Examination (CBE)
• Screening Mammogram

Diagnostic Tests
 
Once breast cancer has been suspected, the following diagnostic tests may be used.

• Diagnostic Mammogram
• Ultrasound
• Biopsy
• Fine Needle Biopsy
• Core Biopsy
• Stereotactic Needle Biopsy
• Surgical Biopsy
• Magnetic Resonance Imaging

Did You Know: What shoes are best not to wear?

Shoes are important. Improper footwear is a leading cause of falls and cancer patients are more likely to fall for many  reasons:  

• Fatigue
• Certain chemotherapy drugs that make you dizzy
• Peripheral neuropathy- numbness in feet,  
• Certain medication (blood pressure, pain, steroid)  
• Being connected to IV’s or oxygen.
• When a cancer patient falls they  are more likely to get hurt because:
• Low platelets levels can cause bleeding problems
• Chronic steroid use makes your bones and skin more fragile
• Bone metastases- can make your bone break more easily

In-order to prevent falls, one should begin with a sturdy shoe. Examples are athletic or canvas shoes which are properly fitted, laced, offer support, and good traction.

Avoid flip-flops or open-toed sandals.