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CANCER CARE SUPPORT
HOW DOES DRY MOUTH AFFECT CANCER PATIENTS?
Dry mouth is marked by an exceptionally parched mouth, often caused when salivary glands become irritated or damaged, leading them to make less saliva or saliva that is thick or sticky. A cancer patient may experience this side effect, also known as xerostomia when taking certain prescription or over-the-counter medications when undergoing chemotherapy, or after radiation treatments that target the head or neck area. Because saliva serves so many important functions, dry mouth may lead to a range of other symptoms, including increased thirst and hoarseness and an increased risk of oral infection and tooth decay. Other potential complications include altered speech, changes to taste or smell, difficulty swallowing and indigestion. Any of these side effects may impact patients’ overall eating and drinking habits and nourishment.
HOW LIKELY ARE CANCER PATIENTS TO EXPERIENCE DRY MOUTH?
Dry mouth is a common side effect of cancer treatment, especially among patients undergoing targeted radiotherapy to the head and neck. This condition may last for several months, or it may become permanent if the salivary glands are damaged during radiotherapy. Dry mouth is also typical among patients taking certain chemotherapy drugs that are known to thicken saliva and cause dry mouth.
Acupuncturists may help patients who have not found relief from dry mouth with toothpaste and mouthwashes or prescription medications. A 2011 study published in the journal Cancer found that acupuncture “significantly reduced” dry mouth in the head and neck cancer patients studied and improved their quality of life. These providers may also work with other clinicians who approach dry mouth from a dietary, medicinal and oncology rehabilitation standpoint to enhance patients’ overall symptom management.
HOW DO HOT FLASHES AFFECT CANCER PATIENTS?
Most often associated with menopause, hot flashes may also be brought on by certain cancers or treatments, especially those that impact the body’s hormonal balance or ability to regulate temperature. Treatments that trigger early menopause—like chemotherapy to treat breast cancer, for example or surgery to remove the ovaries may also spark hot flashes.
The reaction is often caused when hormone levels drop. That change affects the hypothalamus, the part of the brain that controls body temperature and other functions, causing it to misread the signal as a sign that the body is too hot. Epinephrine, the nervous system’s message carrier, transmits that message instantly throughout the body. Hot flashes are the body’s attempt to get rid of the heat, quickly. The heart starts to pump faster, blood vessels in the skin dilate to release heat, and the skin starts to sweat in an attempt to cool the body off.
The feeling most often comes on suddenly, sometimes starting with an uneasy feeling, followed by intense heat in the face and/or upper body. The warmth may then spread throughout the body. Hot flashes typically last from 30 seconds to 30 minutes and maybe preceded or accompanied by a rapid heartbeat, dizziness, headache, anxiety or nausea. They very often lead to extreme sweating (sometimes called “night sweats” when triggered during sleep) and may leave the body soaked.
Aside from the physical discomfort and stress, it may cause, hot flashes also may lead to difficulty sleeping, which may develop into chronic insomnia, further impacting overall well-being. Patients who experience hot flashes consider it an important detrimental impact on the quality of life, according to the National Cancer Institute (NCI).
HOW LIKELY ARE CANCER PATIENTS TO EXPERIENCE HOT FLASHES?
Hot flashes are common side effects for cancer patients, especially women, but they also impact some men, according to the NCI. The institute estimates that hot flashes impact about two out of three postmenopausal women who have had breast cancer, and 44 percent of them also experience night sweats.
Acupuncture has had some measure of success in reducing the frequency and intensity of hot flashes. For example, a 2014 review by The North American Menopause Society of 104 studies found that menopausal women who underwent acupuncture saw a drop in the severity and frequency of hot flashes for up to three months. The NCI points out, though, that more studies are needed. Acupuncture uses tiny needles inserted gently at certain “acupoints.” Patients seeking relief from hot flashes typically receive weekly acupuncture sessions, including acupressure, electro-acupuncture, laser acupuncture and ear acupuncture. Since results are cumulative, patients may see improvement after successive sessions.
NAUSEA AND VOMITING
HOW DO NAUSEA AND VOMITING AFFECT CANCER PATIENTS?
Nausea and vomiting affect patients across all cancer types, particularly those who undergo targeted radiation or chemotherapy. They remain among the most dreaded side effects of treatment. Nausea is characterized by an uneasy sensation that comes in waves in the back of the throat and/or stomach. It is often, but not always, accompanied by vomiting. Dry heaves, a reflexive act caused by contracted stomach muscles and movement of the esophagus, may occur after or in addition to vomiting.
Nausea may develop when chemotherapy drugs damage the cells that line the gastrointestinal tract. Certain other triggers, including sights, smells, motion, taste, anxiety or pain, may also stimulate nausea and/or vomiting. Nausea and vomiting may result in other symptoms, such as an escalated heart rate, excess saliva or difficulty swallowing.
When nausea and vomiting are not prevented or controlled, it may lead to more serious health complications, including:
Loss of appetite
Chemical changes in the body
A damaged esophagus
Reopening of surgical incisions or wounds
Patients undergoing cancer treatment are often troubled more by nausea and stomach upset than by vomiting. Despite medical advances designed to alleviate bouts of nausea and vomiting, both are debilitating and serious side effects of cancer treatment that deserve the attention of the patient’s care team.
HOW LIKELY ARE CANCER PATIENTS TO EXPERIENCE NAUSEA AND VOMITING?
Chemotherapy-induced nausea and vomiting occur in up to 80 percent of patients, according to the National Cancer Institute (NCI). Risk factors that may elevate patients’ chances of developing nausea and vomiting include the drug used, its dosage, the treatment schedule and how certain chemotherapy drugs are combined. Some patients also suffer delayed bouts of nausea and vomiting, which may develop 24 hours after treatment, according to the NCI.
Licensed acupuncturists experienced in working with cancer patients can use techniques that target certain acupressure points prior to patients’ chemotherapy. This technique may help patients better tolerate chemotherapy and reduce the severity of chemotherapy-induced nausea and vomiting. This method of “anticipatory acupuncture” incorporates six common acupuncture points.
Typically developing in the feet, legs, arms and hands, peripheral neuropathy may be caused by a number of cancer treatments, including radiation therapy and certain chemotherapy drugs. Tumours that press on nerves can also cause peripheral neuropathy, which occurs when peripheral nerves send disruptive sensations to the area of the brain that controls limb movement.
Signs of peripheral neuropathy vary depending on the nerves involved. Symptoms include:
Shooting or stabbing pain
Loss of fine-motor skills
Difficulty picking up small objects
Constant or random pain
Sensitivity to cold or heat
Lack of mobility
HOW LIKELY ARE CANCER PATIENTS TO EXPERIENCE PERIPHERAL NEUROPATHY?
The Leukemia & Lymphoma Society estimates that peripheral neuropathy affects 10 percent to 20 percent of cancers patients.
A 2014 study published in the Journal of Hematology-Oncology Pharmacy found that up to 70 percent of patients experience some level of peripheral neuropathy after chemotherapy. A 2014 study published by the Journal of Clinical Oncology concluded that the signs and symptoms of peripheral neuropathy may continue to develop and progress for two to six months after treatment—a protracted reaction known as “coasting.”
The wide range of therapies used in oncology rehabilitation may help patients with peripheral neuropathy. Physiotherapy and acupuncture techniques that promote mobility, stability and range of motion, may counteract symptoms and improve patients’ ability to perform everyday tasks. Oncology rehabilitation may help patients understand limitations that may result from their condition, employing safety techniques that protect them from hot surfaces, sharp objects or loss of balance, for example. physiotherapy’s balance training exercises train patients on three levels: visual, vestibular (equilibrium) and proprioceptive (sensory perception). Recommendations for adaptive equipment, such as the use of a walker, cane or shower chair, may offer additional benefits.