Managing symptoms and side effects

The person you are looking after may have symptoms and side effects. This may be due to cancer treatment or because the cancer is advanced. There are lots of ways you can help manage these.

They may have trouble eating. This can be because they have a sore or dry mouth, have constipation, feel sick or are being sick. It may help to ask the person’s GP or district nurse for advice. There are things you can do to help, such as cooking foods they find easier to eat or making small meals they can more easily manage.

The person you are looking after may have some pain and be breathless. There are medicines that can help and things you can do too, such as helping them find a comfortable sitting or lying position.

They may also have difficulty sleeping. You could ask the district nurse about a pressure-relieving mattress. You could help by making sure their room is at a comfortable temperature.

There are health and social care professionals here to support you. Let them know if any side effects and symptoms don’t improve.

A poor appetite and eating difficulties

Some people with symptoms or side effects of treatment can have difficulty eating. Problems like a sore mouth, diarrhoea, constipation, tiredness or feeling sick can affect how well they eat. They may also find chewing or swallowing difficult. Cancer can also change the way the body uses food, so they may lose weight even if they are eating normally.

If the person you are looking after is having trouble eating, it may help to ask the health and social care professionals in charge of their care for advice. You can ask the GP or district nurse, or ask to speak to a dietitian. Dietitians give specialist advice to people who have eating problems or who struggle to maintain a healthy weight. They may give you a supply of supplements or nutritional drinks.


Sore or dry mouth

A sore or dry mouth is a common side effect of cancer treatment or advanced cancer. Mouth ulcers and thrush are common. Tell the GP, specialist palliative care team or district nurse if the mouth of the person you are caring for becomes very sore or has white patches. It is very important these symptoms are treated. There are mouthwashes, tablets, gels or pellets that can help relieve the symptoms.

There are things you can do to help:

  • Encourage them to gently clean their teeth or dentures using a soft-bristled or children’s toothbrush.
  • Suggest they avoid things that are likely to cause discomfort, such as strongly flavoured toothpaste, acidic drinks like orange juice, and spicy or salty foods.
  • Try cooking moist food, as it is often easier to eat.
  • If they cannot manage solid food, try giving them soft foods such as porridge, bananas, custard, soup, yoghurt or rice pudding. You could try liquidised food, or a nourishing drink such as a smoothie.
  • Keep their lips moist by using Vaseline® or a lip balm.
  • Encourage them to drink plenty of fluids, and to avoid alcohol and smoking.
  • If they need dental treatment, ask the dentist if they can do a home visit. They may charge for this.


Constipation

Constipation can be caused by cancer treatments and medicines, such as painkillers and anti-sickness drugs. Not eating enough fibre (roughage) or not drinking enough fluids can also make someone constipated. If the person you are caring for cannot move around much and is less active than usual, they are also more likely to become constipated.

Everyone’s bowel habits are different. But you should tell the GP, district nurse or palliative care nurse if the person you are caring for has a change in their usual bowel habit. They can give you advice about things that can help, such as changes to their diet. They may also prescribe medicines, such as laxatives. A laxative is a medicine that helps people to open their bowel.

There are things you can do to help:

  • If they are managing to eat, add more fruit and high-fibre foods to their diet, such as apricots, prunes, or prune juice.
  • Encourage them to drink plenty of fluids.
  • If they can move around a little, suggest doing some gentle exercise together, such as walking.


Feeling or being sick

Some people with cancer feel sick (nausea) or are sick (vomit). This may be due to the cancer or its treatment.

If the person you are caring for is feeling or being sick, their hospital doctor or GP can prescribe anti-sickness drugs. If symptoms don’t improve, talk to the GP, district nurse or specialist nurse. There are different types of anti-sickness drugs they can try. 

There are things you can do to help:

  • Try making them small meals and snacks regularly, rather than big meals. 
  • Keep tinned foods and frozen meals ready for when they feel able to eat. 
  • Get drinks that can help with sickness, such as ginger beer.
  • Avoid cooking fatty and fried foods – the smell can often make them feel more sick.


Pain

People with cancer are often worried that they are going to be in pain. Not everyone with cancer will have pain, even if the cancer is advanced. If the person you are caring for is in pain, it can usually be well-controlled with painkillers. Sometimes, the pain may be more difficult to control. So a combination of different medicines or other treatments may be needed.

The hospital doctor or GP can prescribe painkillers. They are usually taken by mouth as tablets. Some types of painkiller can be given as a patch stuck onto the skin (like a nicotine or hormone replacement patch).

If the person you are caring for is very drowsy or is being sick, they can have painkillers as an injection. Many painkillers can be given by injection, either into a muscle or often just under the skin.

If painkillers don’t seem to be working, contact the person’s GP, district nurse or specialist palliative care nurse. The dose or medicine may need to be changed.

Some painkillers can make people feel drowsy or light-headed at first, but this usually wears off after a day or so. If it doesn’t, tell their GP, district nurse or specialist palliative care nurse. They may be able to change to a painkiller that suits them better.

You may be able to help with their pain and discomfort by:

  • changing their position regularly
  • giving them a heat pad, a hot water bottle, or wheat bags that you can warm in a microwave
  • giving them ice packs
  • massaging the area that is painful
  • distracting them with TV, books or music.

Sometimes just listening to their fears and worries can help them cope better with pain.

If pain or other symptoms are very severe and distressing, a short stay in a hospice may help. The doctors and nurses there will be able to assess the pain and symptoms. They can change the dose of medicines or give new ones. This may help to control symptoms more quickly than if they were at home. Once their symptoms are controlled, they will be able to go home again.

Some types of pain can be controlled with more specialised ways, such as a nerve block. If the hospice doctor thinks this will help, the person you are caring for can be referred to a specialist in pain control.


Breathlessness

The person you are looking after may sometimes be breathless. They may feel short of breath or their chest may feel tight. This can be scary for both of you. If they are breathless, there are treatments that may help. These may include medicines, oxygen treatment and complementary therapies. Treatments may help to:

  • reduce anxiety and panic
  • reduce inflammation in the lungs
  • widen air passages and increase airflow
  • loosen sticky spit (phlegm)
  • reduce fluid in the lungs.

Medicines can be given in different ways, such as tablets, injections and inhalers. Let the doctor or nurse know if the person you are caring for has trouble swallowing, so they can find the best way to give the medicines. Some people may be referred to a special breathlessness service for advice and support.

Breathlessness can be difficult to live with, but there are things you can do to help:

  • Help them use breathing and relaxation techniques. They might find it helpful to listen to our Relax and breathe CD – it explains breathing techniques and describes positions that can help.
  • You could help them record how breathless they get. They could use a Borg scale to note how breathless they are on a scale of 1 to 10. This may help you both know what makes it worse. You can then plan activities to avoid breathlessness as much as possible.
  • Help them find their most comfortable seating and standing positions, where they don’t feel as breathless.
  • Speak to their GP about any medicines that may help them.
  • Have a small handheld fan ready to blow cool air towards their nose and mouth. Sitting in front of an open window may also help.


Sleep problems

The person you are caring for may have problems sleeping at night. If they are in pain, it can be very difficult to sleep well and their pain control may need to be adjusted.

If they are drowsy during the day and cannot sleep at night, ask the GP to check their medicines. They may be able to adjust it or prescribe sleeping tablets.

They may be anxious and find it difficult to relax. Reading, listening to music, meditating, or having a warm, milky drink or herbal tea in the evening may help. They should avoid anything with caffeine in, such as coffee, tea and cola. You can usually get relaxation or mediation CDs from your local library or you may be able to download a free podcast.

Make sure their mattress and pillows are comfortable, especially if they are spending a lot of time in bed. Ask the district nurse or OT if they need a pressure-relieving mattress. You may be able to get a Macmillan Grant to help you buy a new mattress and some pillows.

There are things you can do to help:

  • Make sure their room is at the right temperature – it should be cool with fresh air, but not too cold.
  • Make sure there isn’t too much light – you could think about getting darker curtains or putting up a blind behind the curtains. Light from phones and clocks can also disturb sleep.
  • Think about removing any noise distractions, such as a ticking clock.

Back to Looking after someone with cancer

What is a carer?

A carer is someone who gives unpaid practical and emotional support to a person who could not manage without this help.

Managing everyday needs

You may need to help the person you are caring for with things like medicines. You can get support to help you with this.

Other care options

You may sometimes need a break from caring. Help is available to support you with looking after your loved one.

If you're a carer with cancer

Looking after someone while going through treatment yourself can be challenging. Support is available for carers.