NEW YORKCoping with cancer and the side effects of treatment
can be difficult and frustrating for caregivers as well as patients.
Frances K. Barg, MEd, Coordinator for Cancer Control Education,
University of Pennsylvania School of Nursing, and Mary Pat Lynch,
CRNP, MSN, AOCN, graduate faculty, Oncology Advanced Practice Nurse
Program, University of Pennsylvania School of Nursing, had some tips
for caregivers and answers to their questions at a Cancer Care, Inc.
teleconference. They reviewed a number of things caregivers can do to
help relieve the most common problems.
Pain. Often people in chronic pain do not look like they are
in pain because they have lived with it for so long. That can make it
hard for other people to believe they are having pain, which can add
to the patients distress. But pain is whatever the patient says
Fatigue. A decrease or lack of energy is not the only sign of
cancer-related fatigue. Fatigue symptoms can include inability to
concentrate, increased irritability, nervousness, anxiety, and
impatience, the speakers said. Do not assume that nothing can be
done. Balance the diet with complex carbohydrates, encourage
exercise, ensure adequate water intake, and ask the physician to
check the patients hemoglobin level.
One caregiver said she worried that she was pushing her husband
beyond his limits when encouraging him to go for walks. Ms. Barg
suggested that she and her husband track when in the day his energy
spurts seemed to occur and take their walks at those times.
Slowly increasing exercise and doing some walking, however
short, is usually going to be helpful to try to build some energy and
stamina, Ms. Barg said.
Mobility problems. Promote the conservation of energy by
spacing activities with rest periods. Encourage the patients
involvement with activities of daily living as much as possible, and
do not do everything for them.
Eating problems. Do not force feed or display anger if the
patient is unable to eat. Caregivers can interpret rejection of food
as a rejection of love. Also when patients change their eating
habits, it can upset family members who fear that the cancer is
Learning more about the reasons for these eating changes and what can
be done about them can give caregivers confidence about their role.
The patient should be encouraged to participate in meal planning and
to choose appealing foods that are high in protein, and caregivers
should ask their physician for help and whether appetite-stimulating
medication would be useful.
When the patient refuses treatment. One caregiver asked what
to do when the patient doesnt want to go back to the doctor.
The woman described her husband as terminally ill with a brain tumor
and partially paralyzed. Its very frustrating to him and
to me, she said.
Even if the treatment isnt making the cancer better,
theres never nothing to do, Ms. Barg answered. We always
have things we can do to make the patient more comfortable and make
the caregiver feel better about how the patient is doing. So I think
it is very important for you to be in touch with the health care
provider so that any symptoms can be addressed. There also may be
services that could come into the home.
It is understandable when patients become very ill from the disease
and its treatment to decide they dont want treatment at this
point, Ms. Lynch added. Thats a very legitimate choice
for someone to make, and hospice care or palliative care may be
indicated, she said.
Communication. The speakers offered suggestions to a caregiver
who said she dealt with a very, very noncommun-icative cancer
If someone wasnt a great communicator before they became
sick, its rare that all of a sudden they are going to start to
talk about their feelings, Ms. Barg noted. She suggested that
the woman try things that made her husband more likely to talk in the past.