To Your Health: The many faces of a cancer diagnosis

By Ray Lin, MD, Scripps Health

Few events may be as life-changing as a diagnosis of cancer. Yet thousands of people hear such news every day. In fact, according to the National Cancer Institute, more than 40 percent of men and women born today will be diagnosed with cancer at some point during their lives. For people living with cancer, the challenges may not only be physical, but emotional as well.

After the initial shock wears off, patients may have a variety of reactions. Some may feel overwhelmed by fear, while others may be angry or even deny that the diagnosis is correct. Anxiety is often accompanied by feelings of helplessness, vulnerability or depression, all of which can greatly affect a patient’s quality of life. Moreover, anxiety can also interfere with sleep and lead to problems such as headaches, fatigue and loss of appetite — all of which can make a cancer patient feel worse. In some cases, professional help from a therapist or counselor may be needed to help manage anxiety. Cancer support groups and partnering with a cancer survivor may also help patients understand that they are not alone in their fight against cancer and that they can win.

Similarly, cancer patients may have spiritual struggles, especially if they have strong religious beliefs. Some patients may put their faith in God to determine their fate, while others may feel angry or betrayed. Spiritual beliefs also may affect treatment decisions. For many patients, strong spiritual beliefs may make it easier to cope and help alleviate anxiety.

Many cancer patients experience anxiety about the physical effects of treatment. The most common side effects result from the three primary procedures: surgery, radiation therapy and chemotherapy.

Fortunately, cancer treatments are improving every day, and as a result fewer patients experience severe side effects today versus a decade or two ago.

For example, surgery to remove a tumor once may have required a large incision and a hospital stay. Now, the surgery might be accomplished through minimally invasive surgery, laparoscopically or even in a robotically assisted procedure, all of which result in less pain, bleeding and scarring, as well as a faster recovery time.

Radiation therapy has also improved in the last few years. Newer machines allow treatment to be administered in a more targeted manner, preserving more of the healthy surrounding tissue. Some patients may be able to complete their treatments in a matter of days rather than a matter of weeks.

Many of the most common chemotherapy side effects are related to eating, such as dry mouth, changes in taste, loss of appetite, and difficulty chewing or swallowing. Digestive side effects may include nausea, vomiting, diarrhea or constipation.

The typical side effects of radiation are skin redness and fatigue. Other side effects depend on where the tumor is located in the body. If you are receiving radiation treatment for stomach cancer for example, you may experience diarrhea and nausea.

Because chemotherapy can lower blood cell counts, patients may experience bleeding or clotting problems, as well as anemia. Patients may experience temporary hair loss during treatment, as well as hormonal imbalances. Some patients also experience “chemo brain” — mental confusion and problems with concentration and memory.

However, newer, targeted chemotherapy drugs are less toxic than earlier formulas, and are far better tolerated by patients. Most patients experience only minimal to moderate side effects.

Complementary and integrative treatments can help with both physical and emotional side effects. Evidence indicates that therapies such as acupuncture, guided meditation, yoga and biofeedback —along with counseling and support groups — can significantly ease the challenges of treatment.

In addition, prescription medications may be needed during treatment to address issues such as sleep problems, nausea, anxiety or depression. Patients undergoing cancer treatments should be open with their physicians about their concerns and issues, and not hesitate to ask for help. Far from indicating weakness, working with a physician to address all side effects during treatment is crucial to a patient’s health and quality of life.