Controlling symptoms and side effects
Whether or not you’re having treatment to control the cancer, your doctors and nurses will regularly check whether you’re having any symptoms and side effects.
Some symptoms are only likely to happen with particular types of cancer, and side effects can be caused by cancer treatments. It’s important to let your medical team know about any symptoms or side effects so they can arrange appropriate help and treatment.
For some people, treatment may no longer be controlling the cancer. In this situation, your doctor may suggest that the aim of treatment changes from trying to shrink the cancer, to easing troublesome or distressing symptoms. This will help you feel better and have the best possible quality of life.
Palliative care teams based in hospitals and the community are experts in helping control symptoms such as pain. Your GP or cancer specialist can refer you to a palliative care team.
Not everyone with advanced cancer has pain, but if you do, it can usually be well-controlled with medicines. If you have pain, it’s important to let your doctor know so it can be treated. Mild painkillers like paracetamol may work well for you, but sometimes stronger drugs are needed. Your medical team will work with you to develop the best pain control plan for your situation.
Other treatments can also be used to relieve pain. These include:
transcutaneous electrical nerve stimulation (TENS).
Some people also find complementary therapies help relieve pain, such as acupuncture or hypnotherapy and relaxation techniques.
Specialist pain clinics offer these methods of pain control. Your GP or cancer specialist can refer you to one. Or they could refer you to a community palliative care team. These teams specialise in pain and symptom control.
Many people with advanced cancer notice a change in their eating habits. This may be related to a loss of appetite or to changes in the way you smell and taste food. Some cancers or treatments also cause particular problems, such as difficulty swallowing or feeling sick.
Even if you’re still eating well, you may lose weight and muscle because the cancer can change the way your body uses the energy in your food.
If you’re concerned about weight loss or about changes in your eating habits, talk to your nurse or doctor. They will be able to assess the reason for the change. You can also ask to see a dietitian, who can help you find ways to eat well.
People close to you may have concerns if you’re eating less, and they may not understand the reasons for this. You might find it helps if you explain why you find it hard to eat.
If you’re living with advanced cancer, it’s your quality of life that’s important. Think about what food you enjoy and what you can manage. When you’re struggling to eat, these tips may help:
Try having frequent snacks or small meals. These can be more manageable than three large meals a day.
Choose foods that you enjoy and ignore those that don’t appeal to you. You can try them again after a few weeks if your appetite improves or sense of taste returns.
If you can only manage small amounts, choose foods or drinks that will give you energy and protein so you get the most out of what you eat.
If you can’t face eating, try a nourishing drink. You can make a smoothie by blending or liquidising soft fruits (fresh or frozen) with fortified milk, fruit juice, and ice cream or yoghurt. Your doctor, nurse or dietitian can also prescribe or recommend supplement drinks and puddings for you.
If you feel you need more help at home with cooking or eating, tell your GP or contact the dietitian at your hospital. They may be able to arrange meals on wheels or a home help for you.
We have more information about eating well when you have cancer including a video about healthy diet, a slideshow about poor appetite, recipes and more.
You may find you become tired easily, and that your body no longer feels as strong. This could be because of the cancer or because of the side effects of treatment. If your energy is limited, save it for the things you really want to do. Very often, reorganising your daily activities can be helpful, for example setting aside time to rest every day.
Practical aids can also be useful, such as walking sticks, walking frames or wheelchairs. They may help you move around more than you could on your own. Many shopping centres and supermarkets offer electric wheelchairs. You can check your local area at the National Federation of Shopmobility’s website (shopmobilityuk.org)
Many people find they can’t sleep because of worry or anxiety. It can help to try to offload concerns by either writing them down or talking to someone about them. You may not be able to do anything about them immediately, but if you note them down you can work through them the following day.
Simple breathing and relaxation exercises may be very useful in reducing anxiety and stress. Almost anyone can learn relaxation techniques. You can learn them at home using a CD, DVD or podcasts.
Some medications, such as steroids, can make you feel more alert. If you think medications might be affecting your sleep, speak to your doctor about it. They may be able to suggest things like taking your medications in the morning so you don’t feel wide awake at bedtime.
Other symptoms you may have that can be treated or relieved include:
bowel or bladder problems
a swollen tummy caused by a build-up of fluid (ascites).
Many of these symptoms are discussed in our section, controlling the symptoms of cancer.
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