Frankly Speaking About Lung Cancer

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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 Cancer Managing
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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Is it the cancer or something else?
Frankly Speaking About Lung CancerManaging
Symptoms Side Effects

• 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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FATIGUE
Frankly Speaking About Lung CancerManaging
Symptoms Side Effects

• 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 lossmuscle loss leads
to fatigue!
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TROUBLE BREATHING
Frankly Speaking About Lung CancerManaging
Symptoms Side Effects

• 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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TROUBLE BREATHING
Frankly Speaking About Lung CancerManaging
Symptoms Side Effects

• 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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Frankly Speaking About Lung CancerManaging
Symptoms Side Effects
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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DIARRHEA
Frankly Speaking About Lung CancerManaging
Symptoms Side Effects

• 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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DIARRHEA
Frankly Speaking About Lung CancerManaging
Symptoms Side Effects

• 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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DIARRHEA
Frankly Speaking About Lung CancerManaging
Symptoms Side Effects

• 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