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Frankly Speaking About Lung Cancer. Living Well with Lung Cancer: Take Control of Symptoms & Side Effects . Frankly Speaking About Lung Cancer Managing Symptoms & Side Effects. Effective symptom management Requires early identification or prevention Improves quality of life

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Frankly Speaking About Lung Cancer

Living Well with Lung Cancer:

Take Control of Symptoms & Side Effects


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Frankly Speaking About Lung CancerManaging Symptoms & Side Effects

  • Effective symptom management

    • Requires early identification or

      prevention

    • Improves quality of life

    • Optimizes treatment potential

    • Should be a factor when deciding which

      treatment is best


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Frankly Speaking About Lung CancerManaging Symptoms & Side Effects

Common Lung Cancer Signs & Symptoms:

  • Pain

  • Confusion

  • Depression

  • Swelling of neck/face

  • Blood clots

  • Cough or Coughing up

    blood (Hemoptysis)

  • Trouble breathing

  • Loss of appetite/weight

    loss

  • Fatigue/anemia


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Frankly Speaking About Lung CancerManaging Symptoms & Side Effects

Common Side Effects of Treatment:

  • Fatigue

  • Trouble breathing

  • Pain

  • Nausea & Vomiting

  • Peripheral neuropathy

  • Low blood counts

  • Infection

  • Alopecia (hair loss)

  • Diarrhea/constipation

  • Loss of appetite

  • Mouth sores

  • Skin changes

  • Sexual/reproductive

    changes


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Frankly Speaking About Lung CancerManaging Symptoms & Side Effects

“Is it the cancer or something else?”

  • No easy answer.

    GOAL: Take control of the symptoms of the disease & the side-effects of treatment!

    • Be aware

    • Be Patient Active


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Frankly Speaking About Lung CancerManaging Symptoms & Side Effects

FATIGUE

Sustained and overwhelming sense of exhaustion & decreased energy for both mental & physical work

This most common & debilitating symptom

may be related to:

  • The lung cancer itself

  • Effects of treatment (low red blood cells,etc)

  • Emotional distress


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Frankly Speaking About Lung CancerManaging Symptoms & Side Effects

FATIGUE

To manage fatigue:

  • Conserve energy- avoid emotional drains

  • Get uninterrupted relaxation: music, reading, meditation, prayer…

  • Do regular physical activity

  • Minimize unnecessary bed rest

  • Talk with your health care team about medications that treat anemia

Inactivity leads to muscle loss…muscle loss leads to fatigue!


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Frankly Speaking About Lung CancerManaging Symptoms & Side Effects

TROUBLE BREATHING

Air hunger that causes difficulty breathing

May be caused by:

  • the tumor itself

  • anxiety

  • anemia (low rbcs)

  • infection

  • radiation therapy

  • chemotherapy drugs

  • chest surgery


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Frankly Speaking About Lung CancerManaging Symptoms & Side Effects

TROUBLE BREATHING

To manage breathing

  • First-determine underlying cause!

  • Relaxation exercises/controlled breathing

  • Practice “abdominal breathing”

    • Exhale slowly through pursed lips, squeezing abdominal muscles upward and inward. Inhale through nose, abdomen will rise as diaphragm lowers

  • Oxygen use

  • Bronchodilators/ steroids/ inhalers

  • Adjust posture or body position


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Frankly Speaking About Lung CancerManaging Symptoms & Side Effects

  • PAIN

  • Cancer pain may steadily get worse & will not go away without treatment

  • Short or long term: can rob you of your quality of life!

  • May be caused by:

    • post-operative state

    • chemotherapy

    • radiation

    • the cancer itself


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Frankly Speaking About Lung CancerManaging Symptoms & Side Effects

PAIN

Take control of pain:

  • Tell somebody about it!

  • Pain can be controlled

  • You have the RIGHT to be pain-free

  • Find a physician/pain specialist who will help

    you control pain

  • Patients in pain do not get addicted

    to pain medications


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Frankly Speaking About Lung CancerManaging Symptoms & Side Effects

PAIN

  • Pain Management Tools:

    • Medications (short & long acting, tablets,

      liquid, patch, injection)

    • Behavior modification

    • Pain control devices (TENS unit)

    • Heating pad, ice, internal pump

    • Relaxation, meditation, massage…


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Frankly Speaking About Lung CancerManaging Symptoms & Side Effects

NAUSEA & VOMITING

  • Can be effectively controlled. Three types of chemo-induced nausea & vomiting:

  • Acute- Occurs within 24 hrs. of chemo.

  • Delayed- Occurs 24 hrs. after chemo and can last 6-7 days

  • Anticipatory- A learned response to n/v in previous treatments.

  • May be caused by:

  • treatments such as chemotherapy, radiation, surgery

  • anesthesia

  • constipation, etc.


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Frankly Speaking About Lung CancerManaging Symptoms & Side Effects

NAUSEA & VOMITING

Take control of N/V with medication:

  • Premedicate for chemo/radiation with an

    antiemetic regimen + steroid= improved QOL

  • Antiemetic medications (given orally and/or IV)

    such as Zofran,Kytril, Anzemet

  • Zofran: only antiemetic FDA-approved for

    prevention of N/V day 1 & 2 after chemo/xrt


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Frankly Speaking About Lung CancerManaging Symptoms & Side Effects

NAUSEA & VOMITING

Take control of N/V through diet:

  • Small, frequent, bland meals

  • Avoid fried, fatty, & sweet foods

  • Eat & drink slowly, chew food well

  • Suck on ice cubes, mints, or tart candies

  • Eat foods served at room temperature

  • Relax, breath deeply

  • Drink peppermint or ginger tea


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Frankly Speaking About Lung CancerManaging Symptoms & Side Effects

PERIPHERAL NEUROPATHY

Burning, tingling, weakness, pain, or numbness in hands or feet that can make it difficult to walk, hold objects, use your fingers…

  • May be caused by:

  • nerve changes as result of certain types of chemo.

  • tumor pressing on nerves


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Frankly Speaking About Lung CancerManaging Symptoms & Side Effects

PERIPHERAL NEUROPATHY

Take control of PN:

  • Notify your MD of the first indication!

  • Be aware of limitations

    Muscle weakness, decreased sensitivity to hot/cold & sharp objects

  • Prevent falls

    • use handrails

    • always wear shoes or hard-sole slippers

    • remove throw rugs

  • Avoid extreme hot/cold


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Frankly Speaking About Lung CancerManaging Symptoms & Side Effects

THROMBOCYTOPENIA

Known as “Low Platelet Count”: Results in tendency to bleed and bruise easily

  • May be caused by:

  • chemotherapy destroying healthy cells and/or

    platelets


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Frankly Speaking About Lung CancerManaging Symptoms & Side Effects

THROMBOCYTOPENIA

Take control of low platelet counts:

  • Keep track of CBC results

  • Ask MD or nurse if low platelets may occur with your type of treatment

  • Report unusual bleeding/bruising

  • Use soft bristle toothbrush

  • Avoid contact sports

  • Use electric razor for shaving

  • Avoid enemas, rectal suppositories


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INFECTION

The presence and growth of a microorganism that damages tissue. Potentially life threatening complication!

  • May be caused by:

  • chemotherapy destroying white blood cells/

    Neutrophils

  • exposure to bacteria

  • complication with surgery or radiation

  • bronchoscopy


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Frankly Speaking About Lung CancerManaging Symptoms & Side Effects

INFECTION

Take control of infection:

  • Talk with your doctor about treatment to reduce the duration of low wbc counts

  • Wash hands regularly

  • Avoid people with cold and flu

  • Check blood counts

  • Avoid tobacco smoke

    Prevention and close monitoring is critical!


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Frankly Speaking About Lung CancerManaging Symptoms & Side Effects

INFECTION

Immediately notify your MD if symptoms arise:

  • Fever, 100.5 or higher

  • Burning with urination

  • Severe chills

  • Redness, pain, swelling or pus at central line site or an incision line

  • Trouble breathing or productive cough

  • Mental confusion


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Frankly Speaking About Lung CancerManaging Symptoms & Side Effects

ALOPECIA

Hair loss -usually begins 3-4 weeks after chemo starts. Can be extremely traumatic

  • May be caused by:

  • Chemotherapy --Death of rapidly dividing cells hair

    follicles): Will grow back. (Not all chemotherapy

    causes hair loss)

  • Radiation to head --Permanent damage to hair

    follicles: Usually does not grow back


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Frankly Speaking About Lung CancerManaging Symptoms & Side Effects

ALOPECIA

Take control of hair loss:

  • Cut hair or shave head before hair loss starts

  • Buy a wig or hairpiece before hair loss starts

  • Use mild shampoos & soft hairbrushes

  • Avoid hair dyes & permanent waves

  • Use sunscreen on scalp


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Frankly Speaking About Lung CancerManaging Symptoms & Side Effects

DIARRHEA

Increase in the liquidity & frequency of stool resulting from irritation of the intestines

May be caused by:

  • certain chemotherapy drugs

  • infection

  • drug reactions

  • diet alterations


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Frankly Speaking About Lung CancerManaging Symptoms & Side Effects

DIARRHEA

Take control of diarrhea:

  • Call your MD immediately if:

    • diarrhea is severe for 24 hours or more

    • it is combined with fever, blood in stool, or severe pain

  • Call your MD before using OTC drugs


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Frankly Speaking About Lung CancerManaging Symptoms & Side Effects

DIARRHEA

Manage diet:

  • Eat small frequent meals

  • Eat potassium-rich foods (banana, apricot)

  • Drink plenty of fluids (enough to replace loss)

  • Avoid the following:

    • High-fiber foods

    • Fried, greasy, or spicy foods

    • Caffeinated products: coffee, tea, soda

    • Milk and milk products


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Frankly Speaking About Lung CancerManaging Symptoms & Side Effects

CONSTIPATION

Decrease in frequency and/or passage of hard, dry stools

  • May be caused by:

  • pain medications

  • certain chemotherapy drugs

  • inactivity & fatigue

  • diet alterations


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Frankly Speaking About Lung CancerManaging Symptoms & Side Effects

CONSTIPATION

Take control of constipation (especially if on pain medicine):

  • Drink plenty of fluids (warm/hot)

  • Eat high-fiber foods (bran, whole wheat breads, cereals, veggies, popcorn)

  • Increase your physical activity (walk, stretching exercises, yoga, Tai Chi, etc.)

  • Stool softeners & laxatives only with MD ok


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Frankly Speaking About Lung CancerManaging Symptoms & Side Effects

WEIGHT LOSS

Unexpected loss of, or diminished appetite. Can lead to anorexia

May be caused by:

  • the lung cancer disease process

  • chemotherapy

  • radiation therapy

  • constipation

  • nausea

  • depression & anxiety


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Frankly Speaking About Lung CancerManaging Symptoms & Side Effects

WEIGHT LOSS

Take control of food intake:

  • Eat small, frequent meals/snacks

  • Try new foods or high protein/calorie nutritional

    supplements (Boost/ Power Bars/ etc..)

  • Light exercise may make you hungry

  • Arrange nice surroundings for eating

  • Eat whatever sounds & tastes good to you!

  • Eat whatever & whenever you want!

    Adequate nutrition is essential to recovery!


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Frankly Speaking About Lung CancerManaging Symptoms & Side Effects

MOUTH SORES

Can occur 2-5 days after chemo, and 1-2 weeks after radiation starts. Can last for up to 2 weeks. Can range from mild to severe (open bleeding) sores in mouth & throat


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Frankly Speaking About Lung CancerManaging Symptoms & Side Effects

MOUTH SORES

Take control of mouth sores:

  • Have an oral exam, cleaning, etc. before treatment

  • Brush teeth gently with soft bristle brush & toothpaste with mild abrasives

  • Rinse mouth with salt water (1t. Salt to 1qt. water)

  • Avoid salty, acidic, spicy foods

  • Drink through straw

  • Limit/eliminate tobacco & alcohol

  • Notify MD of mouth sores. Take pain meds, antibiotics, anti-fungals as prescribed


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Frankly Speaking About Lung CancerManaging Symptoms & Side Effects

RADIATION FIBROSIS

The formation of scar tissue in lung following radiation treatment. May be temporary & could develop months or years following radiation therapy. May affect your breathing & comfort

Symptoms:

  • Dry mouth or sore throat

  • Difficulty breathing or swallowing


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Frankly Speaking About Lung CancerManaging Symptoms & Side Effects

SKIN CHANGES

Can include pain, redness, scaling, dryness, sun sensitivity, hives. Radiation skin changes only occur at site to which RT was delivered

May be caused by:

  • can be from chemo drugs

  • radiation treatments

  • sun exposure


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Frankly Speaking About Lung CancerManaging Symptoms & Side Effects

SKIN CHANGES

To manage skin changes:

  • If receiving radiotherapy, talk to

    MD/nurse about special skin care

  • Use skin lotions containing aloe or

    lanolin- apply frequently

  • Take cool or warm baths/showers

  • Gently towel dry the sensitive area


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Frankly Speaking About Lung CancerManaging Symptoms & Side Effects

CONCLUSIONS

  • The key to is to take control of symptoms & treatment side effects

    • Maintain open communication with your health care team

    • Take side effects into account when making decisions about which treatment to have– You do have choices!


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Frankly Speaking About Lung CancerManaging Symptoms & Side Effects

CONCLUSIONS cont.

  • Clinical trials are looking at more effective methods to manage side effects & symptoms

  • Newer treatments may offer better efficacy & fewer side effects

  • Treatment can make your symptoms better & improve your QOL!

  • Being involved in treatment decisions up front may allow you to take better control of side effects


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Frankly Speaking About Lung Cancer

Living Well With Lung Cancer:

Take Control of Symptoms & Side Effects

Questions & Answers


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