Saturday, October 16, 2010

WHY GOOD COMMUNICATIONS SKILLS CAN BE CRITICAL IN CANCER TREATMENT

How can you build the support system you need when you are a cancer patient or caregiver of a cancer patient during treatment? Start out on the right foot, even in the middle of the process, and understand that there will be people all along the course of treatment who can help.

APPOINTMENTS
If the cancer patient is easily exhausted, uses a wheelchair or oxygen, or has other physical limitations, work with the scheduler to arrange appointments with the least amount of wait time. Very often, you can book appointments during the less hectic times of the day, when the doctors aren't as rushed and the patients aren't stacked up like planes waiting to land at Logan Airport.

If you or your loved one is still working through cancer treatment, try to schedule so as to avoid conflicts with the work situation. Some people come in first thing in the morning, to be treated, but this can be difficult if there are side effects. Other people try to get the last appointments of the day. That way, it's a matter of only taking off an hour of work or so. With short radiation treatments, it's often possible to schedule for the lunch hour, so no work is missed unless there is an emergency, leaving enough time to grab a quick bite to eat before heading back to the office.

If you know that you or your loved one will be feeling the effects of chemotherapy a day or two after the treatment, schedule the appointment to accommodate this factor. For example, have the treatment on Thursday, so that recuperation takes place on Saturday. Enjoy Sunday, before it's time to head back to work on Monday.

TREATMENTS
There may be noticeable physical, mental, and emotional changes during the course of treatment that can interfere in the quality of life for a cancer patient. At some point in time, it may be necessary to change chemotherapy medicines because of adverse reactions or because it's not effective enough for the cancer. When an oncologist asks if there are any problems, some people might hesitate to answer, thinking that if treatment is stopped temporarily or changed, it will allow the cancer to grow. It's important to be honest with the oncologist about symptoms, concerns, or noticed changes in the body.

Sometimes the oncologist can adjust the medication, in order to better manage the side effects.
Sometimes the oncologist can provide information that can help provide better comfort during treatment. If you or your loved one are having problems handling certain aspects of chemotherapy, such as the neuropathy that often results, let the oncologist know it is interfering with the quality of the cancer patient's life. Not every chemotherapy drug is the right fit for every cancer patient. It doesn't mean there is only one option for treatment.

Without good communication, though, problems can grow. Cancer specialists aren't mind readers, and they can't just look at a patient and instantly know what to do. By talking with them during appointments and providing an honest assessment of the situation, a cancer patient has a much greater chance of success at managing the cancer and its complications.

If you or your loved one have surgery for cancer, and there are resulting issues, such as residual pain or scar tissue, be sure to address your concerns with the surgeon and his or her staff. Today, there are more options in providing relief.

Sometimes patients who have surgery find relief in physical therapy exercises that will help stretch tightened muscles and regain flexibility, after the surgical wounds have healed. Sometimes patients don't understand that it really takes a long time to heal from surgery. Once the wound looks healed on the surface of the skin, the expectation is that the pain should end and life should go on. The human body has its own schedule for healing. It's not uncommon for some surgeries to take up to a year to heal.

There are also times when cancer patients are concerned that the surgery didn't get all of the cancerous tumors, and when pain remains an issue, it's understandable that you or your loved one might fear the cancer has spread. Talk to the surgeon or oncologist about all treatment options, and be sure to communicate your concerns and accurately describe physical symptoms, so that the physicians can make the best decisions about providing the appropriate treatments.

Radiologists today have become adept at using radiology to manage both cancer pain and some cancer symptoms. If you notice persistent pain, discuss it with the cancer team. Sometimes it indicates that the cancer has metastasized. When this happens, it's often possible to target that spot and eliminate most, if not all, of the pain.

Sometimes radiology treatments can produce inflamed tissue. You or your loved one may be instructed to use specific skin treatments to help the healing process. It's important to discuss the complications of the treatment with the radiology team, so that adjustments can be made where necessary. There are topical treatments and pain medications that can help the cancer patient deal with the complications, but unless you and your loved one share this information, the cancer patient is unlikely to benefit from the options.

NUTRITION
A lot of cancer patients lose a lot of weight prior to being diagnosed with cancer, and this can continue during treatment. It's often critical to insure that patients regain weight. Chemotherapy and radiation treatments can pack a wallop, and if a patient is physically weak, he or she might not be able to withstand the rigors of cancer treatment. That's when you really need to speak with the cancer center nutritionist or dietitian. These people can be lifesavers. They can help you set up a diet that can pack a lot of beneficial calories iin ways you wouldn't expect. Did you know that it's often tiring for cancer patients to chew food? Or that sometimes cancer patients have better appetites in the middle of the day, when they haven't used up all their energy? Did you know that it's sometimes easier to eat little meals throughout the day and to add high calorie snacks to build up the weight? By understanding how cancer treatment can affect the dietary needs of the patient, nutritionists and dietitians can provide helpful tips that can make the body better able to endure cancer treatment. If you or your loved one have special needs, like diabetes, this can be a complication for some cancer treatments, and addressing nutritional needs is critical.

The bottom line is that cancer patients usually need to maintain or gain weight during cancer treatment, and failing to do this can affect the success of the treatment. Cancer centers and major hospitals almost always have nutritionists and dietitians available to patients and their families. They can help the family cook to make meals that will entice the cancer patient to eat. They can also provide insight into how and when to use supplemental nutritional aids, like Ensure and Boost. Some patients develop a strong dislike for these products, because they tend to be overly sweet. But if a cancer patient understands that taking a nutritional supplement drink is like taking a prescription drug, and that it can improve the chances of surviving cancer and cancer treatment, it's a lot easier to swallow.

STRESS
It's hard not to feel stress as a cancer patient and as a caregiver. You and your loved one are facing the great unknown. Sometimes the best stress reducer is to honestly communicate the fear to the cancer treatment team. It's often the perception of what is happening that creates the greatest stress. Sometimes the fear builds up. Sometimes it's the guilt. A lot of people feel responsible for getting cancer. Or they are angry that this cancer occurred. You and your loved one have to understand that cancer is a disease that happens to the best people, often for reasons we still don't fully understand. Is there an environmental cause? Is there a genetic cause? Is there a human cause? We don't really know what creates cancer, and that's a big part of the stress during treatment, and often afterwards. With other illnesses and diseases, there is better understanding of how it goes. Heart disease, for example, is often easier to manage because the disease and its symptoms are charted territory. New treatments allow heart patients to survive longer. Diabetes, as another example, can be managed, measured, and the needs can be addressed through diet, pills, and insulin shots, so that the prognosis for this is better than it was ten or twenty years ago. But cancer is a tricky disease. It can show up anywhere in the body, and it can migrate to other organs. That's part of what makes cancer so scary. Understanding it can help reduce the dread you and your loved one can feel. Over the years, some cancer patients become so adept at paying attention to their physical symptoms, they can tell when their cancer is spreading, and they immediately get treated. This allows them to manage cancer for a decade or more. It can improve the quality of life for a cancer patient when the new cancer is nipped in the bud.

But some people are afraid to find out if the cancer is spreading. They prefer to remain in the dark about their own situation. That can actually cause more problems and more pain. The better able you and your loved one are to communicate what is going on with the patient's cancer treatment, the better able the physicians will be to manage the cancer. If you are caring for a cancer patient, it's important for you to pay attention to symptoms you notice and to share your concerns or observations. Sometimes what appears to be a huge problem is really a minor one. And sometimes a mole hill turns out to be a mountain. Talk to the cancer treatment team. Work with them to find the best solutions for the cancer patient.

But sometimes the best stress reducer for cancer patients is to forget about it for a while. Get out in the world and have some fun. Leave the cancer at home for a few hours. You'll have plenty of time to get back to it. In the meantime, take a walk on a nice day, or have a picnic in the park. Stroll on a beach or take a drive. Life is here and now. Don't put off living until tomorrow. Tomorrow is promised to no one.

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