coping with treatment related side effects with... · 2016-10-08 · coping with treatment related...
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Coping with Treatment Related Side Effects
Jennifer Porter, NP-C, AOCNP New Mexico Cancer Care/Christus St. Vincent Regional Cancer Center
Santa Fe
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What is an NP?
• A Nurse Practitioner (NP) is a registered nurse (RN) with advanced training in diagnosing and treating illness. Nurse Practitioners prescribe medications, treat illness, and administer physical exams.
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Side Effects of treatment
• Discuss
•Fatigue
•Chemo Brain
•GI
•Sexual Issues
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Treatment related side effects • Depends on the treatment (different treatments for different patients/diseases……)
• “Traditional” chemotherapy
• Appetite loss, N/V/D/C (GI issues), hair loss, neuropathy, blood counts
• Targeted therapies/Immunotherapy
• Rash, blood pressure, GI issues, blood counts
• ‘-itis’
• Radiation
• Local skin irritation, lymphedema
• Surgery
• Body Image, Lymphedema, nerve “weirdness”
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What can you do? • Side effects are often times linked to each
other
• ie: constipation-nausea-decreased appetite-weight loss-fatigue
• Keep track of changes and how you feel
• big things/small things
• Talk to your providers/nurses!!
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The MOST common side effect of all treatments
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What is fatigue?
• Cancer-related fatigue is a distressing, persistent, subjective sense of physical, emotional, and/or cognitive tiredness or exhaustion related to cancer or cancer treatment that is not proportional to recent activity and interferes with usual functioning.
• NCCN Guidelines 2.2015
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• Sleep disturbance • Lack of activity/deconditioning • Other medical problems (COPD, diabetes…)
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Treatment of fatigue depends on contributing factors
• Set priorities (self is #1)
• Conserve energy
• Structure activities
• Delegate
• Plan for fatigue (calendar)
• Rest and activity
• Tell your family and friends how you feel
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Chemo Brain • Cognitive changes, “mental cloudiness”
• Include memory, concentration changes
• Some reports state this happens in up to 80% of patients receiving cancer treatment
• Not completely understood – yet
• Often times lingers after treatment is completed
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Some things that may contribute to chemo brain
• Cancer itself
• Drugs (nausea, pain, anxiety, chemo)
• Low blood counts
• Insomnia
• Fatigue
• Hormone changes
• Co-morbidity (diabetes)
• Poor oral intake (food/water)
• Emotional distress (worry/fear/sadness)
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What to do? • Get plenty of sleep, eat well balanced diet and exercise
• Try and decrease stress • Meditation, relaxation, hypnotherapy
• Make lists/stay organized, use calendar
• Ask for help
• Try to do one thing at a time (no multitasking), limit distractions
• Puzzles – crosswords, Sudoku, simple math problems
• Keep mind active • Take a class, learn a language, play music
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Gastro-intestinal “stuff”
• Taste change
• Mouth sores (ice during infusions)
• Nausea (before, during, after)
• Vomiting
• Heartburn
• Gas/bloating
• Diarrhea
• Constipation
• Appetite
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Different treatments • Taste – use plastic utensils/no metal
• Mouth sores – rinse baking soda/salt
• Heartburn – aloe vera, papaya, meds
• N/V/decreased appetite – prescription/IV/med marijuana
• Constipation – softeners/laxatives
• Diarrhea – over the counter meds, time, dehydration, easy to digest foods, gut rest
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Sexual Issues • Common question –
Sex during treatment
- use barrier device
- low counts
• Body changes
post surgery (colostomy, mastectomy)
port/PICC
• Decreased desire
fatigue
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What to do?
• Intimacy – doesn’t have to be intercourse
• Be creative
• Have fun
• Talk to your partner
• Talk to your provider
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