ONCOLOGY Nurse Edition Vol 22 No 11

The psychological challenges of cancer can become more evident when treatment is complete. The focus on survival and acute symptom management fades and is supplanted by a re-focus on living with the after-effects of diagnosis and treatment. As well described by Drs. Recklitis, Varela and Bober, worry, anxiety, depression, fatigue, and sexual difficulties are some of the most common and yet sometimes intangible issues faced by survivors.

Helping cancer patients to recover and heal goes beyond managing physical consequences of treatment. Mental scars from the cancer experience can run deep. Patients often face profound psychological, spiritual, and emotional challenges as they navigate difficult treatments-and then, if all goes well, move into long-term follow-up.

The person diagnosed with cancer typically is confronted with a variety of difficult challenges. Treatment for cancer can be physically arduous, it generally disrupts patients’ social and work life, and it may even limit their ability to care for themselves or live independently for some period of time. In addition to these physical and functional burdens, cancer patients often face fears of death or disability, and may be prone to feelings of isolation or depression.

Consider the following case study, which illustrates the complex physical and psychosocial care required for the patient developing graft-versus-host disease (GVHD) following an allogeneic hematopoietic stem cell transplantation (HSCT): Mr. SR is a 38-year-old male with a diagnosis of anaplastic large cell non-Hodgkin’s lymphoma (NHL).

Diagnosis and treatment of cancer are potential traumatic stressors.[1,2] Others may include but are not limited to interpersonal violence, military combat, natural and man-made disasters, and displacement.[2] In response to the intense fear, helplessness, terror, and uncertainty that traumatic stressors can provoke, post-trauma symptoms (PTS) classically develop in three clusters: re-experiencing, avoidance/numbing, and hyperarousal.[2]

Sorafenib is indicated for the treatment of patients with advanced renal cell cancer, and patients with unresectable hepatocellular cancer. Sunitinib is indicated for the treatment of patients with advanced renal cell cancer, and patients with gastrointestinal stromal tumor (GIST) after disease progression on imatinib mesylate (Gleevec).

Prophylaxis and management of graft-versus-host disease (GVHD) following a related or unrelated allogeneic hematopoietic stem cell transplant (HSCT) is very complex. The review article written by Barton-Burke and colleagues discusses all of the major components of the clinical manifestations, prophylaxis, and treatment of GVHD.

La fatiga relacionada con el cáncer, un problema común y desconcertante que puede presentarse durante y después del tratamiento del cáncer, puede tener aspectos físicos, mentales y emocionales.

Cancer-related fatigue, a common and upsetting problem that can occur during and after cancer treatment, can have physical, mental, and emotional aspects. It can occur months or even years after cancer treatment ends and is typically more severe than fatigue experienced by people without cancer.