Coping With Cancer's Side Effects >>
While cancer treatment is essential, reducing disease and treatment side effects is also important as patients move beyond cancer.
Changes in thinking and emotions
Patients sometimes experience changes in thinking, behavior and emotions caused by cancer or its treatment. In some cases, changes affect a person's ability to work, socialize or do everyday tasks. David Sabsevitz, PhD, Medical College of Wisconsin neuropsychologist, offers the only clinic in the region to focus on cancer-related cognitive and emotional side effects. "The sooner changes are discovered, the sooner we can treat the problems," he said.
“After diagnosis, we establish a baseline by test driving different parts of the brain,” Dr. Sabsevitz said. To see how well the brain functions, he interviews patients and tests memory, processing speed, language and problem-solving skills, comparing results to data from healthy people with similar educational and demographic backgrounds. After treatment, patients are monitored. If there are changes, Dr. Sabsevitz works with the patient and medical team to reduce side effects. “Testing allows us to keep an eye on quality of life and address issues early.”
Overcoming physical limitations Cancer and its treatment may also impact physical capabilities.
David Sabsevitz, PhD, Medical College of Wisconsin neuropsychologist, testing a patient's baseline cognitive functions before cancer treatment.
“Is there anything you can’t do now that you could do before is a question every doctor should ask, even long after remission or a cure,” said Oksana Sayko, MD, Medical College of Wisconsin physical medicine and rehabilitation physician. “A proactive approach to evaluating patients' physical function helps identify limitations early and address them." Dr. Sayko studies long-term effects of cancer and its treatment, and helps patients return to normal activities.
Two-thirds of cancer patients receive radiation and side effects can show up months to years later. Radiation can delay wound healing, affect the brain and peripheral nerves, cause lymphedema (swelling) and soft tissue fibrosis (tightening of connective tissue). Soft tissue fibrosis can decrease joint range of motion in areas previously exposed to radiation, making it difficult to drive, dress and perform other daily activities. Lymphedema might be mild initially, but may progress, increasing risk of skin infections, causing social withdrawal and significantly impacting quality of life. Relief is offered through physical therapy, medication or injections, and education on home exercise.
Oksana Sayko, MD
"Even years after treatment, we continue to assess patients to make sure quality of life issues are addressed," Dr. Sayko said.
Hormone therapy
Hormones are a first-line treatment for men with prostate cancer that’s come back or cancer that has spread to other areas of the body. These medications tell the body to stop making the hormone testosterone, which can promote or stimulate cancer cell growth.
But for some older men, treatment causes serious side effects — from tiredness to becoming more frail and susceptible to falls and even bone fractures. Kathryn Bylow, MD, a Medical College of Wisconsin medical oncologist, and her colleagues are looking at who is at risk for adverse effects and trying to identify which patients should start treatment later, or perhaps not receive hormone therapy at all.
“It depends on how fast a patient's PSA (a protein produced by prostate cells} goes up, aggressiveness of the cancer and their other medical conditions.” Dr. Bylow said.
Dr. Bylow plans to investigate means to counteract muscle loss and weakness, such as taking muscle-building nutritional supplements.
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