Ask CancerCare
December 2007 This Month's Topic: Coping with Treatment Side Effects Featured Expert: Carolyn Messner, DSW, MSW, LCSW-R, ACSW, BCD |
Q. I have been having chemotherapy treatments for the past six months and my memory is not as good as it used to be. Is this because of the chemo? What should I do?
A. During chemotherapy treatments, you may notice memory or thinking changes, sometimes referred to as chemobrain. Chemobrain affects your cognitive or thinking abilities including: memory, attention, concentration, word finding or retrieval, multi-tasking, learning and sense of direction. Researchers are not certain of the exact causes of these difficulties, but they are currently studying this problem in order to find ways to both treat and prevent it.
There are a number of treatable factors that can affect memory, such as low blood counts, hormonal changes, stress, fatigue, sleep disturbances, other health problems, depression and anxiety. Some of your medications could also be affecting your ability to think clearly.
It is important for you to talk with your doctor if you are having trouble with your memory. Your health care team can be very helpful to you in figuring out ways to manage your memory and thinking changes related to chemotherapy. Bring a list of your questions to your doctor and ask if it is OK to tape record your visit. If possible, bring someone with you. It is always helpful to have a second set of ears. Bring a pad and take notes. Get a second opinion if your doctor doesn't take your thinking and memory problems seriously.
Memory tools can help to boost your memory. Write things down in a planner, create a personal memory box to keep your keys and wallet, place reminders around your home and work space of tasks you need to do, and recognize the importance of nutrition, exercise and sleep. Remember you are not alone. Work with your health care team, join a support group, attend workshops on chemobrain, and most importantly be kind to yourself.
CancerCare offers the following fact sheets addressing chemobrain:
- "Cognitive Problems After Chemotherapy"
- "Doctor, Can We Talk About Chemobrain?"
- "Combating Chemobrain: Keeping Your Memory Sharp"
- "Ways to Improve Concentration: Three Key Steps"
Remember that you are not alone. Work with your health care team to address your memory changes, join a support group, attend workshops on chemobrain, and most importantly be kind to yourself.
Q. My dad is an older adult and is scheduled to start treatment for cancer. We are concerned about his ability to tolerate treatment side effects given his age.
A. The single greatest risk factor for cancer is aging. Our population is living longer and cancer is a disease that occurs in older adults. There is no clear data, however, showing that certain cancer treatments, when appropriate, should not be offered on the basis of age. The only exception is when there are pre-existing health problems.
Chronic health problems unrelated to cancer -- such as hypertension, diabetes, heart disease or arthritis -- do need to be considered with regard to cancer treatment and its side effects. For an older adult, it is important that the choice of treatment plan takes into account his or her overall health status, including: other medications being taken and their possible interaction with cancer treatments; the person’s mobility, balance, and memory; any nutritional needs or restrictions; and social supports. Social supports include who will be there to help with daily concerns like grocery shopping, cooking, filling prescriptions and providing transportation to medical appointments.
It is appropriate for you and your dad to expect to control treatment side effects. Before your father starts treatment, make sure his doctor knows about any medications he is currently taking for other health problems, and ask about what treatment side effects he should expect. In many cancer centers, there are health care teams that work with your doctor to help manage treatment side effects. Talk with your dad’s doctor about symptoms you and he are worried about. Don’t be afraid, embarrassed, or hesitate to ask questions, voice your opinion, and seek the care your dad needs and deserves.
The following are helpful CancerCare resources that will provide you with additional information:
- Your Health Care Team: Your Doctor is Only The Beginning (Fact Sheet)
- What Can I Say to a Newly Diagnosed Loved One? (Fact Sheet)
- Coping with Nausea and Vomiting from Chemotherapy (Podcast)
- Nutrition and Cancer: Beyond Calories, Building Lean Body Mass (Podcast)
- Controlling Cancer Pain: What You Need to Know to Get Relief (Connect® Booklet)
- Caregiving for Your Loved One with Cancer (Connect® booklet)
CancerCare’s professionally trained oncology social workers can also help people with cancer, family members and caregivers with the practical and emotional concerns arising from a cancer diagnosis. Contact us online or call 1-800-813-HOPE (4673).
Q. I have a full-time job and am wondering how side effects from my chemotherapy might affect my work.
A. Balancing work and treatments is an important skill. Many people are able to continue working during their treatments. Being proactive can make all the difference. The keys are good communication with your health care team, knowing up front what the expected side effects will be and developing a plan with your doctor.
Schedule an appointment with your doctor to talk about your job and its activities. Make sure that your doctor understands the importance of your job as a source of health insurance, income and purpose, and that your employment be considered in any medical decisions. Get details about your treatment side effects and develop a plan that addresses each one. Explore with your doctor options that will make it easier to continue working, such as scheduling treatments on Friday afternoons to minimize their impact on work.
Sometimes, it may be necessary to take time away from work. Once you have spoken with your doctor and know better what to expect, you may want to talk to your supervisor or human resource department about your need for flex time or time off. If you work full time, learn about workplace legal protections and accommodations. Know the provisions of the Americans with Disabilities Act and Family and Medical Leave Act. You may also contact the Equal Employment Opportunity Commission. All are helpful resources for understanding your legal rights in the workplace when you have cancer.
CancerCare also offers several resources on work and cancer:
- Cancer and the Workplace: A Review of Your Legal Protections (podcast)
- Your Guide to the Latest Cancer Research and Treatments (Connect® booklet)
For more about workplace issues, visit the Ask CancerCare archives.
Q. I'm worried about how the side effects from my treatment will affect my holidays. Any suggestions?
A. People view the holidays as a time to celebrate and renew connections with family and friends. However, the season can be stressful if you are living with cancer and trying to manage treatment side effects such as fatigue, weight loss or gain, nausea or nerve damage.
Each person with cancer reacts differently to cancer treatments. Fortunately, doctors have many ways to reduce and even prevent some of these side effects. At CancerCare, we often use the word "coping" to describe how people deal with cancer. People sometimes mistakenly think that coping means just living with a problem, whether you like it or not. But coping actually means managing a problem and finding a new way to take control of it.
You can maximize your enjoyment of the holidays by letting your health care team know now about your holiday plans and ask for their help in taking control of treatment side effects. Make an appointment with your doctor to discuss your concerns and ask for tips on holiday meals, travel, and conserving your energy, as well as rescheduling your treatments, if possible, so that any resulting side effects will not occur on your special holidays.
CancerCare offers numerous resources that can help you better manage your treatment side effects and enjoy the holiday season:
- Coping with Cancer During the Holidays (fact sheet)
- Understanding and Managing Chemotherapy Side Effects (Connect® booklet)
- Coping with Cancer: Tools to Help You Live (Connect® booklet)
- For Caregivers: Coping with A Loved One’s Cancer During the Holidays (podcast)
You can find additional information about treatment side effects through the National Cancer Institute.
CancerCare's social workers are here to help you with practical tips and emotional support. Call 1-800-813-HOPE (4673) or email info@cancercare.org.
Dr. Carolyn Messner, DSW, LCSW-R, is director of education and training at CancerCare. Dr. Messner specializes in the psychosocial impact of cancer on patients, caregivers and families; methods to design educational interventions to ameliorate the distress of cancer; and cancer in the workplace. She pioneered the use of teleconference technology to bring information and support to cancer patients, their families, employers and healthcare professionals.
The questions and answers listed above are from the Decmber 2007 Ask CancerCare feature. New Ask CancerCare topics are introduced every month.
If you have additional questions about coping with treatment side effects, please contact CancerCare directly for information and guidance. CancerCare provides free professional support services, including counseling, education, financial assistance and practical help. These services are provided by professional oncology social workers. If you have a specific concern or question and would like to speak with an oncology social worker, please contact us at info@cancercare.org or 1-800-813-HOPE (4673).
For questions about medical issues, please visit Cancer.net, the patient information website of the American Society of Clinical Oncology (ASCO).
Ask CancerCare Archive (questions and answers from previous months)
| Cancer Types & Specific Populations | Emotional | Medical | Practical |
