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Specific Illnesses

Cancer

What Is Cancer?
Who Gets Cancer?
Common Symptoms of Cancer
Treatment for Cancer
What You Can Do to Help
Cancer Pain Management
Helpful Cancer Resources

Caring for a loved one with cancer is no easy task. Physical and emotional care can be time-consuming and exhausting. Not only does it require caring for someone you love at home, but it also means facing your own concerns about the diagnosis and eventual outcome of the disease. Practical concerns, such as worries about financial issues and time management, are also common. The goal of this chapter is to address some of these concerns.

Learning more about cancer can strengthen you in your caregiver role. This can be especially true because of the stigma attached to a cancer diagnosis. The idea of cancer cells growing in your loved one's body may conjure thoughts of being attacked by an unknown force that cannot be controlled.

It can be difficult to learn about a disease when you do not know where to start. This section provides general information about cancer, including what caregivers can do to help their loved ones. For more information on specific cancer types, see the additional resources listed at the end of this section.

What Is Cancer?

Cancer refers to a group of illnesses that result from cells in the body growing abnormally. These cells divide and produce new cells in an uncontrolled way that can spread throughout the body and cause damage to essential organs.

When cancer spreads to other parts of the body, this is called metastasis. Metastases can occur when cancer cells enter the bloodstream or lymph system. These systems circulate all over the body and allow the cells to travel.

Tumors are masses (or lumps) that can develop as abnormal cells accumulate. Not all tumors are cancer. Benign (non-cancerous or nonmalignant) tumors do not spread to other parts of the body and are rarely life-threatening.

There are four main types of cancer:

1. Carcinomas cancers of the organs
2. Sarcomas cancers of the muscles, bone, cartilage, and connective tissue
3. Lymphomas cancers of the lymphatic system
4. Leukemias cancers of the blood-making system

Cancer cells vary in how fast they grow and how they spread in the body. Most cancers are defined by stage of growth using a system developed by the American Joint Committee on Cancer for solid tumors (like cancer of the lung, breast or colon). The stage is based on the size of the tumor and on how much the cancer has spread.
Stage I Primary tumor only
Stage II Primary tumor, but larger than in Stage I
Stage III Primary tumor and metastasis to lymph nodes
Stage IV Primary tumor and distant metastasis
(Adapted from Dollinger, M., Rosenbaum, E., and Cable, G. Everyone's Guide to Cancer Therapy. Kansas City: Andrews McMeel Publishing, 1997.)

Who Gets Cancer?

In the United States, half of all men and one-third of all women will get cancer at some time in their life. This statistic includes skin cancers, most of which are easily treated. Millions of people have cancer today or have had it in the past. It affects all races and age groups, although it is more prevalent in the elderly and in certain geographical regions.

Your family members and friends may wonder if they can "catch" cancer from the patient. The disease is not contagious. It cannot be spread from person to person through the air, by contact or via blood transfusions. Rather, the risk of cancer can be inherited. This means that it can be passed through families from parents to children. This is just one of the risk factors for cancer. These risk factors increase the chance of getting cancer. Reducing them can lessen the risk.

Cancer risk factors

Tobacco use
High fat diet and being overweight
Excessive exposure to sunlight
Drinking too much alcohol
X-rays and other sources of radioactivity
Geographic area
Chemicals and other substances in the environment (carcinogens)
Unsafe sexual practices (through acquiring certain infections, such as HIV or genital warts)
Family members who have cancer (certain types of cancer are hereditary)
(Adapted from Dollinger, M., et al., 1997.)

Common Symptoms of Cancer

It is important to know that these symptoms do not mean that the patient has cancer. Only a doctor can make a diagnosis.

Cancer symptoms

Thickening or lump in the body
Cough or hoarseness that does not go away
Obvious change in a wart or mole
Changes in bowel or bladder habits
Unexplained bleeding or discharge
Any sore that does not heal
Unusual upset stomach or difficulty swallowing

Diagnosing cancer

Doctors use various means to make a diagnosis:

Physical examination
Laboratory tests such as blood and urine tests
Imaging x-ray, CT scan, and MRI are examples of imaging
Biopsy

When a biopsy is done, tissue is examined directly to see if it has the characteristics of cancer. Tissue is obtained through a needle or a surgical procedure. Biopsy is a good method for diagnosing cancer with certainty.

Waiting for test results can be difficult for patients and their caregivers. This includes initial diagnostic tests and subsequent tests to identify returning or metastasizing (spreading) disease. It is important that both you and your loved one get support from friends and family members at times like this. Using relaxation techniques to relieve stress may also be helpful. Here is more information on obtaining support, taking care of yourself and using relaxation techniques.

Treatment for Cancer

The good news is that about half of all cancers diagnosed are now curable. Even with cancers that cannot be cured, symptoms are often greatly diminished by treatment. Treatment options, which depend on the stage and type of cancer, include:

Surgery
Radiation therapy
Chemotherapy
Biological therapy
Hormone therapy

Cancer treatments can be almost as frightening as the disease. You might imagine your loved one being "cut" by surgery, "burned" by radiation, or "poisoned" by chemotherapy. Understanding and learning about treatment options can help you and your loved one feel more secure. It is helpful to talk about your fears with health care practitioners, family members, and friends. Here is more information on how and when to effectively communicate with your loved one's health care team.

Surgery

About 60% of people with cancer have some sort of surgery. If the tumor is in one place and can be removed without interfering with body functions, then surgery may be the best approach.

Radiation therapy

Radiation therapy is done to shrink tumors or to make them disappear. This can be done by directing beams of x-rays or other high-energy rays at the tumor site. Radioactive materials can also be placed in or near the tumor.

Receiving radiation therapy is generally not painful but side effects can sometimes occur.

Chemotherapy

Radiation and surgery are often used to treat cancer that is in one part of the body. Chemotherapy may be used to treat cancer that has spread. Treatment can also be a combination of surgery, radiation and/or chemotherapy. Some chemotherapy chemicals can be taken by mouth, others need to be taken intravenously (into the blood through a vein). Chemotherapy can sometimes cause unpleasant side effects.

Be aware of the side effects of radiation and chemotherapy treatment. You can help reduce and prevent them. You can also help by knowing when to contact the health care team. Here is more information on how and when to effectively communicate with the health care team.

Biological therapy

Biological therapy uses treatments that help the immune system do its job of fighting disease in our bodies. This can be an effective treatment for some cancers.

Hormone therapy

For cancers that need hormones to grow, hormonal therapy can be an option. With this therapy, the production of hormones is reduced through surgery or medication.

Clinical trials

Clinical trials are research studies that evaluate new treatments. Those who take part in clinical trials are some of the first to receive and benefit from new approaches to cancer therapy. These treatments have usually been tested with good results. Patients in trials are watched closely by physicians and researchers. For more information on how clinical trials and cancer research might benefit your loved one, contact the National Cancer Institute. Here is more information on this organization and other helpful cancer resources.

Complementary or alternative therapy

Complementary and alternative therapies are treatments that do not use known cancer drugs, or use approaches not common in the medical community. Some (such as relaxation, visualization, and acupuncture) are so commonly used to control symptoms, that they are really mainstream approaches. It is important to research and understand the risks and benefits of these therapies. The National Center for Complementary and Alternative Medicine (NCCAM) Clearinghouse is a good source of information. Here for more information on this organization and other helpful cancer resources.

What You Can Do to Help

Notify your medical practitioner at the first sign of fever or infection.
Ask the patient's medical team about medication for nausea and vomiting.
With nausea, feed the patient as if he/she had the flu:
  - Avoid fatty, fried, or spicy foods.
  - Prepare food for the patient when you can.
  - Serve food at room temperature or cold.
Help keep your loved one's mouth clean; brush teeth at least twice a day.
Encourage the use of relaxation techniques to relieve stress and decrease nausea. Here is more information on relaxation techniques.
Distract the patient with activities he/she enjoys to decrease nausea.
Make sure your loved one gets plenty of rest.
Consider obtaining a wig for the patient before hair starts to fall out.
Remind your loved one that most side effects are not permanent.
Help rate and record the patient's fatigue in a journal.

Here is more information on how to treat fatigue, nausea, vomiting, or skin problems.

Pain Management

Your loved one may experience pain related to the cancer, treatment, or other unrelated reasons. Cancer can cause pain as it spreads into soft tissue and bone, or presses onto nerves. Muscle spasms, constipation, and bedsores can also cause pain. You can help by making sure that the patient receives proper treatment for pain when it occurs.

How You Can Help Obtain Treatment for Pain

Find medical practitioners who understand cancer pain.
Ensure regular visits to cancer pain specialists.
Ask questions of doctors and discuss your concerns.
Administer pain medication as prescribed.
Offer to massage sore or painful areas, if the physician approves.
Encourage the use of relaxation techniques to relieve stress and decrease pain. Here is more information on relaxation techniques.
Find ways to avoid and manage stress in the household.
Distract your loved one with activities he/she enjoys.
Watch for signs of pain or other discomfort.
Help the patient rate and record his/her pain in a daily pain journal.
Contact your medical practitioner if pain is not relieved by medication.

Here is more information on pain.

Helpful Cancer Resources

Organizations

The National Cancer Institute's Cancer Information Service
Toll-free: (800) 4-CANCER (800-422-6237)
TTY (for deaf and hard of hearing callers): (800) 332-8615
The National Cancer Institute's (NCI's) Cancer Information Service (CIS) is a national information and education network. The CIS is a free public service of the NCI, the Nation's primary agency for cancer research. The NCI's CIS information specialists answer calls in English and Spanish, Monday - Friday, 9:00 AM - 4:30 PM local time; respond to E-mail inquiries sent to Cancer.gov; and provide live, online assistance in English through the LiveHelp link on the website. NCI's website provides accurate, up-to-date information on many types of cancer, information on clinical trials, resources for people dealing with cancer, and information for researchers and health professionals.

American Cancer Society
(800) ACS-2345
This organization provides a Website with comprehensive information on many types of cancer, day-to-day living concerns, and treatment options. It includes a state-of-the-art cancer profiler, a decision support tool that helps patients make informed decisions about their treatment. The site provides excellent caregiver information (from the home page, click on Living with Cancer and then on Coping with Cancer). The organization also offers other services via their toll free number, including free wigs and some financial support.

Cancer Care, Inc National Office
275 7th Ave
New York, NY 10001
Services: (212) 302-2400
Toll free counseling line: (800) 813-HOPE (4673)
Email: info@cancercare.org
This is one of the few organizations offering financial support to cancer patients. Other services provided include an online database of cancer resources, educational workshops, counseling, and support groups.

National Center for Complementary and Alternative Medicine (NCCAM) Clearinghouse
P.O. Box 8218
Silver Spring, MD 20907-8218
Toll Free: (888) 644-6226
TTY/TDY: (888) 644-6226
FAX: (301) 495-4957
This is the National Institutes of Health organization dedicated to exploring complementary and alternative healing practices.

Websites

MEDLINEplus Health Information
MEDLINE is a service of the National Library of Medicine that provides excellent links to Websites for a variety of topics related to cancer.

Cancer Net (a service of the National Cancer Institute)
An excellent resource, this site is your gateway to the most recent and accurate cancer information from the National Cancer Institute.

OncoLink
This is a comprehensive cancer support Website that offers medical information, including information on symptom management; psychosocial information, including information on support groups and extensive caregiver resources; and recommendations from cancer experts for books about cancer.

CanSearch
The purpose of CanSearch is to use a step-by step process to assist on-line users in finding Internet cancer resources.

Espaol/Spanish Information

PDQ-Sobre Cuidado Mdico-Pacientes: Cese del Hbito de Fumar y Riesgo Persistente en el Paciente de Cncer (National Cancer Institute)

Qu es el Cncer? (American Cancer Society)

 

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