Cancer Treatment and Side Effects

Cancer Treatment & Side Effects

When Janet, a school teacher, went through treatment for colon cancer at the age of 57, she experienced very few side effects and resumed her previous activities with little change. 

Amanda, a professional chef, who went through treatment for breast cancer at the age of 39, experienced symptoms that required her to take several months off from her job and left her with serious side effects. 

Cancer encompasses over 100 varying diagnoses with equally varying treatments. People are also very complex. Every person diagnosed with cancer will have a unique experience, depending on factors including the type of cancer and its stage, the type of treatments used and their tolerance to them, as well as other pre-existing conditions and individual issues.

Some of the more common seen symptoms or side effects include those listed below:

Physical Effects of Cancer and Treatment

  • Fatigue – Many treatments and conditions can lead to fatigue, making this side effect very common, especially during chemotherapy and radiation treatments and often times, afterward.
  • Deconditioning – Up to 40% of cancer patients experience a loss of strength due to the effects of cancer and its treatment, as well as lack of activity before, during and after cancer treatment. Severe muscle wasting is called cachexia and is thought to cause death in up to 20% of cancer patients. Nutritional deficiencies and other causes may also lead to cachexia.
  • Decreased range of motion – Cancer itself, the effects of treatment, pain, and a reduction in activity can all lead to decreases in range of motion for people diagnosed with cancer. Surgical patients may experience post-surgical pain and the development of scar tissue (adhesions or cording), which inhibit movement.
  • “Frozen shoulder” – Adhesive capsulitis, a painful condition known as “frozen shoulder” may occur, especially after treatments that limit movement, such breast and lymph node surgery.
  • Hyperkyphosis and Postural issues – Individuals with a cancer diagnosis may experience postural imbalances, including collapsed or hyperkyphotic posture due to cancer and cancer treatment, aging, menopause, osteoporosis, muscle weakness, pain, scarring and cultural tendencies toward sitting and computing. Mental and emotional issues can also affect posture and vice versa.
  • Nausea and loss of appetite – Difficulties with eating and enjoying food can occur, often as a side of effect of chemotherapy or cancers affecting the digestive system.
  • Skin issues – Skin discomfort ranging from that similar to mild or moderate sunburn is common with radiation therapy; clothing and touch can be painful to the skin. Easy bruising can also be a side effect of cancer and its treatment. Rashes and skin sensitivities during and after treatment can be exacerbated by irritating skin care products.
  • Joint pain / Arthralgias – Some joint pain involves pre-existing conditions such as arthritis. However, many cancer survivors report increased joint pain  in particular when taking certain cancer chemo treatments and hormonally-based treatments (such as Arimidex, tamoxifen or Lupron), which are often given for several years after active treatment has ended.
  • General pain – Cancer survivors can experience many types of pain, due to the cancer itself, due to surgeries and treatments, or to unrelated conditions (e.g., fibromyalgia or arthritis). Phantom pain from amputations can also occur. There can be side effects related to medications taken for pain control as well.
  • Peripheral neuropathy – Neuropathy as a side effect of chemotherapy is called Chemo-Induced Peripheral Neuropathy (CIPN). Nerve damage from the toxicity of types of chemotherapy can cause pain, tingling or numbness in the extremities (hands, feet, fingers, toes), which is sometimes permanent. Neuropathy can also cause difficulty in standing, balance or movement. Nerve damage can also occur following surgeries, causing numbness to certain areas.
  • Bone weakening – Mild to significant bone loss/weakening can occur as a side effect of cancer and its treatment, increasing the risk of bone fractures. Chemotherapy, steroids, post-treatment hormonal therapies and other medications can have mild to severe bone weakening effects. Aging and natural or treatment-induced menopause can also accelerate bone loss.
  • Immune system – The immune systems of cancer survivors may be compromised, as either a precursor to cancer itself or as a side effect of its treatment.
  • Reduced blood counts – Neutropenia (low white count) and thrombocytopenia (low platelets) can be a side of effect of cancer and its treatment. Acute cases may require isolation and doctors may direct patients to refrain from activities.
  • Shortness of breath/difficulty breathing – Breathing difficulties may be a part of cancer treatment and the disease process, also secondary to lung involvement or removal. Lung metastasis can spread from nearly any type of cancer, but more common primary cancer sites include breast, ovarian, prostate, and colorectal.
  • Weight gain or loss – Cancer and its treatment often result in weight gain or weight loss, especially due to chemotherapy or medications which interfere with appetite, or those that can cause weight gain, such as steroids.
  • Insomnia – Sleep problems are a major issue for many cancer survivors. Several recent studies have reported a 30-50% incidence of insomnia in cancer patients, compared to 15% in the general population.  In addition, sleep problems tend to last for years after treatment ends.
  • Lymphedema – This condition involves the swelling of a limb or body part with lymph fluid due to the build-up or blockage of lymph glands. In cancer survivors, this is often seen as the swelling of an arm after breast cancer surgery and lymph node removal. Cancer survivors with lymphedema often wear compression garments to prevent further swelling.
  • Abnormal diurnal cortisol rhythms – Many studies now link a “blunted” or “flattened” daily output of the stress hormone cortisol with cancer.  Cortisol should have a steep slope, starting high in the morning and dropping lower at night, but a flattened slope typically shows higher levels of cortisol later in the day.  In addition, studies link flattening of the cortisol rhythm to worse outcomes in cancer and earlier cancer deaths.
  • Heart Conditions – Certain cancer treatments can result in damage to the heart. Chemotherapy-related heart damage is typically related to the type and quantity of the drugs administered. Radiation to the chest and other conditions can increase the risk of heart damage.
  • Hormonal Conditions – Many cancer treatments, both for men and women, affect hormonal balance and result in a wide array of symptoms. These can include sudden onset of menopause, an increase in the symptoms associated with menopause (such as hot flashes) and can affect men who are receiving hormonal therapies as well.

Mental/Emotional Effects of Cancer and Treatment

The following provides an overview of the potential emotional, mental and spiritual challenges that may accompany a cancer diagnosis. Caregivers can also experience an array of psychosocial effects from a cancer diagnosis.

  • Stress – The pressures that a cancer diagnosis brings can cause stress levels to skyrocket.  Studies show that the effects of stress are as great on caregivers as on the patients.  Navigating the healthcare system and dealing with many changes add to stress for both groups.
  • Anxiety and fear – The stress of having a serious illness can be very anxiety-provoking. Feelings of fear and helplessness are common. People dealing with a cancer diagnosis may feel “ungrounded,” feeling as though the experience has shaken his or her core beliefs and any sense of security in life.
  • Feeling of “lack of control” – This feeling often accompanies a cancer diagnosis, treatment and facing the unknown. While this may improve as the person diagnosed with cancer moves further out from treatment, it can continue with a fear of recurrence or difficulty transitioning to “the new normal.”
  • Depression and withdrawal – While some sadness is normal with a difficult event or situation, clinical depression can be more serious. Depression is a common side effect of cancer, with studies suggesting that half of breast cancer survivors experience emotional distress that interfered with daily life and more than 10% had major depression, even though many were on anti-depressants. Studies show that depression increases a person’s risk of dying from cancer.
  • Spiritual distress – A cancer diagnosis may lead to a spiritual crisis, a deep sense of questioning one’s previous beliefs or the need to create new or stronger belief system. Many people diagnosed with cancer move through these difficulties to a stronger and more authentic sense of self and spirituality.
  • Issues with body image – People with a cancer diagnosis can experience a negative body image, especially after surgery/treatment.  Some may feel the body has “betrayed” them; that they are not in touch with their bodies, or are not “in” their bodies. These issues are in addition to the pervasive negative body images stemming from today’s perfection-obsessed culture.
  • “Chemo brain” and cognitive impairment – Many people report a fogginess in thinking after chemotherapy, known as “chemo brain”, which may be short-term or which can last for years.  The chemotherapy-induced cognitive impairment symptoms may include memory loss, trouble concentrating and disorganization. Other causes of cancer-related cognitive impairment include the disease progression, other medications and treatments, low blood counts, lack of sleep, hormonal changes, age, and emotional concerns.
  • Anger, guilt, grief and blame – A cancer diagnosis can trigger intense emotional reactions, stemming from the diagnosis and issues such as one’s previous life choices, and the loss of an actual or idealized life or physical body. These emotions are also common in caregivers and those experiencing the loss of a loved one.
  • Isolation and loneliness – People affected by cancer may feel a deep sense of isolation or loneliness, even when they are surrounded by other people, possibly because they do not feel that other people can understand what they are going through.  Many patients are physically isolated as well, lacking an adequate support network.  Isolation can have real consequences; it has been correlated with patients missing meals or doctor’s appointments and not taking their medication properly.

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