Managing symptoms and side effects

Your doctors and nurses will ask about any symptoms or side effects you may have. It’s important to talk to them about these so they can give you the right help.

They may refer you to a palliative care team. This is made up of people who are experts in managing symptoms.

Not everyone experiences pain, but if you do, talk to your doctor. There are different medicines and ways of controlling pain. Your doctor or nurse can talk these through with you.

You might notice changes in your eating habits, such as losing your appetite or feeling sick. You can talk to your doctor about these problems. You can also ask about seeing a dietitian, who can help you to eat as well as possible.

Some people find that that they get tired easily. You could try saving your energy for the things that you really want to do and give yourself plenty of time to rest. If you’re having difficulty sleeping, there are different things you can try to help you relax and have a good night’s sleep.

Possible symptoms and side effects

Whether or not you are having treatment to control the cancer, your doctors and nurses will ask you if you are having any symptoms and side effects. Symptoms can happen with some types of cancer, and side effects can be caused by cancer treatments. It is 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 able to control the cancer. In this situation, your doctor may suggest that the aim of treatment changes from trying to shrink the cancer, to managing worrying or upsetting symptoms. This is called supportive or palliative care. It will help you feel better and have the best possible quality of life.

There are palliative care teams based in hospitals and the community. They are experts in helping control symptoms such as pain. Your GP or cancer specialist can refer you to a palliative care team.


Managing pain

Not everyone with advanced cancer has pain. But if you do, it can usually be well controlled with medicines. If you have pain, it is important to let your doctor know so it can be treated.

Mild painkillers like paracetamol may work well for you, but sometimes you may need stronger drugs. 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:

  • radiotherapy
  • steroids
  • bone strengthening drugs, called bisphosphonates
  • nerve blocks
  • painkilling patches.

Some people find complementary therapies, such as acupuncture or hypnotherapy, and relaxation techniques can help relieve pain. There are specialist pain clinics which may offer these methods of pain control.

Your GP or cancer specialist can refer you to a community palliative care team. Or they can refer you to a specialist palliative care or pain clinic.

Managing pain during advanced cancer

Oncologist Sarah Slater explains how painkillers help people with advanced cancer.

About our cancer information videos

Managing pain during advanced cancer

Oncologist Sarah Slater explains how painkillers help people with advanced cancer.

About our cancer information videos


Changes in appetite or eating habits

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 they smell and taste food. Some cancers or treatments also cause particular problems, such as difficulty swallowing or feeling sick.

Even if you are eating well, you may lose weight and muscle. This is because the cancer can change the way your body uses the energy in your food.

If you are concerned about losing weight 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 be concerned if you are eating less, and they may not understand the reasons why. They may feel upset if you are unable to eat food they have prepared for you. You might find it helps if you explain why you find it hard to eat and how they could help you.

Tips to help with eating problems

  • Try having frequent snacks or small meals. These can be more manageable than three large meals a day.
  • If you don’t feel like eating some food you have been given, perhaps you could try it again in a couple of hours.
  • Don’t worry if the food you feel like eating is not always healthy. It is your quality of life that’s important. It is more important to choose foods that you enjoy and ignore those that don’t appeal to you. You can try them again if your appetite improves or your 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 or soup. 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 home help for you.

We have information about eating well when your appetite is poor, as well as a collection of recipes you may find useful.

Chicken, sweetcorn and noodle soup

Tiredness

You may find you become tired easily, and that your body no longer feels as strong. Even after resting and sleeping, you still may feel tired and find you lack energy to do things. This is called fatigue. It may be due to the cancer or the side effects of treatment. If you don’t have much energy, save it for the things you really want to do. You may find it helpful to organise your daily activities so you have some 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 so you can be more independent. Many shopping centres and supermarkets offer electric wheelchairs, but if they don’t you can check what’s available in your local area on the National Federation of Shopmobility’s website.

If you are too tired to cook, there are a number of organisations that deliver ready made meals that can be heated in the microwave. Visit your local council website for details of what is available in your area.


Difficulty sleeping

There are many reasons you may find it difficult to sleep. Sometimes the symptoms of cancer or the side effects of treatment can affect sleep patterns. For example, 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 ways to help, like taking your medications in the morning so you don’t feel wide awake at bedtime.

Tips for a better night’s sleep

  • Go to bed and get up at about the same time every day.
  • Gentle exercise and keeping your mind busy with activities will help you feel naturally tired and ready for sleep. Walking, reading, playing games or doing puzzles may help.
  • Get into a relaxing routine before bed. Having a warm bath or shower, reading or listening to soothing music can help.
  • Make your bedroom a relaxing place to be in. Create an area that is dark, quiet and comfortable.
  • Avoid large meals and stimulants like caffeine or cigarettes in the late evening. Try having a warm, milky drink before bed.

Many people find they can’t sleep because of worry or anxiety. It can help to write down your concerns or talk to someone about them. You may not be able to do anything immediately, but if you note them down you can work through them the next day.

Simple breathing and relaxation exercises may help to reduce anxiety and stress. Almost anyone can learn relaxation techniques. You can learn them at home using a CD, DVD or podcasts.


Other symptoms

Other symptoms you may have that can be treated or relieved include:

Back to Coping with advanced cancer

Decisions about treatment

You may have lots of questions about your treatment options. You can talk to your doctors and nurses about these.

Who can help?

You can get care and support at home, in a hospital or in a hospice. This depends on your needs and preferences.

What is CPR?

Cardiopulmonary resuscitation (CPR) can be used to try to restart the heart and breathing if they have stopped.

Making CPR decisions

You may be asked to make a decision with your family and healthcare team about whether you want cardiopulmonary resuscitation (CPR) to be attempted.