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:

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?

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)

Common Symptoms of Cancer

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

Radiation therapy

Radiation Side Effects Fatigue or tiredness Nausea and vomiting Skin inflammation Appetite loss Dry mouth Changes in sense of taste

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.

Chemotherapy Side Effects Nausea and vomiting Fatigue or tiredness Appetite loss Hair loss Sore mouth Changes in taste Fever and infection

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

Hormone therapy

Clinical trials

Complementary or alternative therapy

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

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

Websites