Physical Emotional And Social Effects Of Cancer
Cancer and its treatment may cause physical symptoms and side effects, as well as emotional, social, and financial stress. Managing all of these effects is called palliative care or supportive care. It is an important part of your care that is included along with treatments intended to slow, stop, or eliminate the cancer.
Palliative care focuses on improving how you feel during treatment by managing symptoms and supporting patients and their families with other, non-medical needs. Any person, regardless of age or type and stage of cancer, may receive this type of care. And it often works best when it is started right after a cancer diagnosis. People who receive palliative care along with treatment for cancer often have less severe symptoms, better quality of life, and report that they are more satisfied with treatment.
Palliative treatments vary widely and often include medication, nutritional changes, relaxation techniques, emotional and spiritual support, and other therapies. You may also receive palliative treatments similar to those meant to get rid of the cancer, such as chemotherapy, surgery, or radiation therapy.
Sore Mouth And Throat
This treatment may cause a sore mouth and throat. You may also get mouth ulcers. This can make you more likely to get a mouth or throat infection. Use a soft toothbrush to clean your teeth or dentures in the morning, at night and after meals.
If your mouth or throat is sore:
- tell your nurse or doctor they can give you a mouthwash or medicines to help
- try to drink plenty of fluids
- avoid alcohol, tobacco, and foods that irritate your mouth and throat.
Sucking ice chips may sometimes help relieve mouth or throat pain. But if you are having radiotherapy to the head or neck, do not suck on ice. It can cause damage.
Where You Have Chemotherapy
You usually have treatment into your bloodstream at the cancer day clinic. You might sit in a chair for a few hours so its a good idea to take things in to do. For example, newspapers, books or electronic devices can all help to pass the time. You can usually bring a friend or family member with you.
You have some types of chemotherapy over several days. You might be able to have some drugs through a small portable pump that you take home.
For some types of chemotherapy you have to stay in a hospital ward. This could be overnight or for a couple of days.
Some hospitals may give certain chemotherapy treatments to you at home. Your doctor or nurse can tell you more about this.
Clare Disney : Hello, my name is Clare and this is a cancer day unit.
So when you arrive and youve reported into with the receptionist, one of the nurses will call you through when your treatment is ready, sit you down and go through all the treatment with you.
Morning, Iris. My name is Clare. I am the nurse who is going to be looking after you today. Were going to start by putting a cannula in the back of your hand and giving you some anti sickness medication. And then I am going to come back to you and talk through the chemotherapy with you and the possible side effects you may experience throughout your treatment. Is that okay?
Each chemotherapy is made up for each individual patient, depending on the type of cancer they have and where it is and depending their height, weight and blood results.
Also Check: What To Say To Someone Dying Of Cancer
Ways To Manage Bone Pain Caused By Cancer
This page adheres to our medical and editorial policy and guidelines.
Patients diagnosed with cancer, especially advanced-stage or metastatic disease, often experience bone pain at some point in their cancer journey. Cancer-related bone pain may have many causes, but its not likely caused by primary bone cancer, which is very rare. Many cancers found in the bone are diagnosed as metastatic disease, which occurs when cancer cells break away from a primary tumor and spread to other parts of the body. Bones are a common location to which cancer metastasizes. Some cancers that commonly spread to the bones include breast cancer, lung cancer, prostate cancer, thyroid cancer and kidney cancer.
Cancer cells that spread to the bone disrupt the balance of normal cellular activity of the bones structure, damaging bone tissue, which may cause pain.
Other causes of cancer-related bone pain include:
- Pressure from a tumor pressing on the bone or nerves
- Cancer treatments that may damage or weaken bones
- Infection or inflammation
Unrelieved bone pain may affect your eating, sleeping, activity, mood and concentration. It may also slow your recovery from cancer treatment. Proper pain management may help you feel better so you can continue to participate in activities you enjoy.
High Dose Chemotherapy With Stem Cells
Very rarely you might have more intensive treatment. This is called high dose chemotherapy with stem cell rescue or stem cell transplant. You have this treatment if there is a high risk of your cancer coming back.
You have stem cells collected and stored until after your high dose chemotherapy. You then have the cells back into a vein so they can start to make new blood cells again.
If your osteosarcoma comes back after initial treatment you are likely to have treatment with:
- ifosfamide and etoposide
If your Ewing sarcoma comes back after treatment you are likely to have treatment with:
- cyclophosphamide and topotecan
- carboplatin and etoposide
We have specific information about each of these drugs on our cancer drugs A to Z list.
Read Also: Stage 4 Liver Cancer Life Expectancy
Types Of Secondary Bone Cancer
Any type of cancer can spread to the bone, causing secondary bone cancer. There are 2 main types of secondary bone cancer:
- Osteolytic this means the bone has become damaged. In some cases, small holes form in the bone, weakening it. This increases the risk of breaking bones and other problems occurring.
- Osteoblastic this means new bone is formed but it does not grow normally, causing the bone to become weak and deformed.
Most people with secondary bone cancer develop either osteolytic or osteoblastic changes but some people have both.
Complications From Bone Metastases
Bone metastases can greatly reduce your quality of life with cancer, yet newer treatments are making a difference for many people. Not only do bone metastases mean a cancer has spread and is no longer curable, but can lead to several complications.
Pain from bone metastases can be very severe and often requires treatment with narcotic pain relievers along with anti-inflammatory medications.
Bone metastases also increase the chance of a fracture in the areas of bone which are weakened by a tumor. When a fracture occurs in bones with metastatic cancer they are referred to as a pathologic fracture. Pathologic fractures may occur with very mild injuries. In addition to predisposing to fractures, bone metastases can make it difficult for fractured bones to heal.
When metastases occur to the lower spine, an emergency condition called spinal cord compression may occur. Cancer in the vertebrae can cause them to collapse and compress the nerves traveling from the spinal cord to the lower half of the body. Symptoms include back pain that radiates down the leg, weakness, and numbness of the legs, and loss of bowel and/or bladder control. Emergent treatment with radiation or surgery can stabilize the spine to avoid permanent disability.
Also Check: Stomach Pain Radiating To Back
Remission And The Chance Of Recurrence
A remission is when cancer cannot be detected in the body and there are no symptoms. This may also be called having no evidence of disease or NED.
A remission may be temporary or permanent. This uncertainty causes many people to worry that the cancer will come back. While many remissions are permanent, it is important to talk with your doctor about the possibility of the cancer returning. Understanding your risk of recurrence and the treatment options may help you feel more prepared if the cancer does return. Learn more about coping with the fear of recurrence.
If the cancer returns after the original treatment, it is called recurrent cancer. It may come back in the same place , nearby , or in another place .
If a recurrence happens, a new cycle of testing will begin again to learn as much as possible about it. After this testing is done, you and your doctor will talk about the treatment options. Often the treatment plan will include the treatments described above, such as surgery, chemotherapy, and radiation therapy, but they may be used in a different combination or given at a different pace. Your doctor may suggest clinical trials that are studying new ways to treat recurrent bone sarcoma. Whichever treatment plan you choose, palliative care will be important for relieving symptoms and side effects.
Causes Of Bone Cancer
Cancer occurs when the cells in a certain area of your body divide and multiply too rapidly. This produces a lump of tissue known as a tumour.
The exact reason why this happens is often not known, but certain things can increase your chance of developing the condition, including:
- other bone conditions, such as Paget’s disease of the bone
- rare genetic conditions, such as Li-Fraumeni syndrome
- a history of certain other conditions, including retinoblastoma and umbilical hernia
Recommended Reading: Long Term Side Effects Of Chemotherapy And Radiation
Drugs That Affect Bone Cells
Denosumab is a drug known as a RANKL inhibitor. The RANKL protein normally tells cells called osteoclasts to break down bone. By binding to RANKL denosumab can block this.
This drug can be used to treat giant cell tumors of bone that have either come back after surgery or cannot be removed with surgery.
This drug is injected under the skin . Often, the tumor can take months to shrink.
Most side effects are mild and can include body aches, fatigue, diarrhea, and nausea. A rare but very serious side effect of denosumab is damage to the jawbone, called osteonecrosis of the jaw . This can lead to loss of teeth and/or infections of the jaw bone. ONJ can be triggered by having dental work while taking the drug. Maintaining good oral hygiene by flossing, brushing, making sure that dentures fit properly, and having regular dental check-ups may help prevent this. Most doctors recommend that patients have a dental check-up and have any tooth or jaw problems treated before they start taking this drug.
What Are Bone Tumors
Several different kinds of tumors can grow in bones: primary bone tumors, which form from bone tissue and can be malignant or benign , and metastatic tumors . Malignant primary bone tumors are less common than benign primary bone tumors. Both types of primary bone tumors may grow and compress healthy bone tissue, but benign tumors usually do not spread or destroy bone tissue and are rarely a threat to life.
Primary bone cancers are included in the broader category of cancers called sarcomas.
Primary bone cancer is rare. It accounts for much less than 1% of all new cancers diagnosed. In 2018, an estimated 3,450 new cases of primary bone cancer will be diagnosed in the United States .
Cancer that metastasizes to the bones from other parts of the body is called metastatic bone cancer and is referred to by the organ or tissue in which it beganfor example, as breast cancer that has metastasized to the bone. In adults, cancerous tumors that have metastasized to the bone are much more common than primary bone cancer. For example, at the end of 2008, an estimated 280,000 adults ages 1864 years in the United States were living with metastatic cancer in bones .
Although most types of cancer can spread to the bone, bone metastasis is particularly likely with certain cancers, including breast and prostate cancers. Metastatic tumors in the bone can cause fractures, pain, and abnormally high levels of calcium in the blood, a condition called hypercalcemia.
Also Check: Cancer Center Treatment Of America Locations
Side Effects Of Chemotherapy
Chemotherapy can damage healthy cells as well as cancerous cells, which means it often causes a number of side effects.
Common side effects of chemotherapy include:
- feeling sick and being sick
Most side effects associated with chemotherapy should resolve once your treatment has finished.
However, there is a risk you will be permanently infertile. Your care team will provide more detailed information about the specific risk to your fertility.
Read more about the side effects of chemotherapy.
Chemotherapy For Bone Cancer
Chemotherapy uses anti cancer drugs to destroy cancer cells. The drugs circulate throughout the body in the bloodstream.
This page is about cancer that starts in your bone .
If your cancer has spread into bone from another part of the body, it is called secondary or metastatic bone cancer.
Autologous Stem Cell Transplant
In an autologous transplant, a patients own stem cells are removed from their bone marrow or blood. They are frozen and stored while the person gets treatment . In the lab, a process called purging may be used to try to remove any leukemia cells in the samples. The stem cells are then put back into the patients blood after treatment.
Autologous transplants are sometimes used for people with AML who are in remission after initial treatment and who dont have a matched donor for an allogeneic transplant. Some doctors feel that it is better than standard consolidation chemotherapy ) for these people, but not all doctors agree with this.
Autologous transplants are generally easier for patients to tolerate than allogeneic transplants, because they are getting their own cells back, which lowers the risk of some complications. But the high-dose chemo can still cause major side effects. This type of transplant can be done in any otherwise healthy person, although patients who are very old or have other health problems might not be suitable.
One problem with autologous transplants is that its hard to separate normal stem cells from leukemia cells in the bone marrow or blood samples. Even after purging , there is the risk of returning some leukemia cells with the stem cell transplant.
What Are The Symptoms Of Bone Cancer
Pain is the most common symptom of bone cancer, but not all bone cancers cause pain. Persistent or unusual pain or swelling in or near a bone can be caused by cancer or by other conditions. Other symptoms of bone cancer include a lump in the arms, legs, chest, or pelvis unexplained fever and a bone that breaks for no known reason. It is important to see a doctor to determine the cause of any bone symptoms.
Also Check: Can Non Smokers Get Lung Cancer
How Many Cycles Of Chemo Does It Take For Osteosarcoma
A commonly recommended course of osteosarcoma chemotherapy regimen consists of approximately six five-week cycles, each of which includes: The administration of a combination of osteosarcoma chemotherapy drugs, such as cisplatin and doxorubicin ifosfamide and etoposide or ifosfamide, cisplatin and epirubicin.
How Is Primary Bone Cancer Treated
Treatment options depend on the type, size, location, and stage of the cancer, as well as the persons age and general health. Treatment options for bone cancer include surgery, chemotherapy, radiation therapy, cryosurgery, and targeted therapy.
More information about treatment for specific types of bone cancers can be found in the following PDQ® cancer treatment summaries:
Mirabello L, Curtis RE, Savage SA. Bone Cancers. In: Michael Thun M, Linet MS, Cerhan JR, Haiman CA, Schottenfeld D, editors. Schottenfeld and Fraumeni, Cancer Epidemiology and Prevention. Fourth edition. New York: Oxford University Press, 2018.
Roman E, Lightfoot T, Picton S Kinsey S. Childhood Cancers. In: Michael Thun M, Linet MS, Cerhan JR, Haiman CA, Schottenfeld D, editors. Schottenfeld and Fraumeni, Cancer Epidemiology and Prevention. Fourth edition. New York: Oxford University Press, 2018.
Machiela MJ, Grünewald TGP, Surdez D, et al. Genome-wide association study identifies multiple new loci associated with Ewing sarcoma susceptibility. Nature Communications 2018 9:3184.
Don’t Miss: Breast Cancer In Both Breasts
What Are Common Bone Cancer Symptoms
Some people with bone cancer have no symptoms other than feeling a painless lump. For others, a variety of symptoms can develop. These symptoms may also occur because of other conditions, such as arthritis or Lyme disease, which may delay the diagnosis. The most common signs of bone cancer include:
- Unexplained swelling.
Outline Of Current Chemotherapy Regimens
Chemotherapy for high-grade osteosarcoma is usually administered within prospective clinical trials. Its total duration is generally 612 months. Doxorubicin is an essential component of most regimens, but its use is limited by its potential for cardiotoxicity. Cisplatin, the second most commonly used drug, is included in most protocols, and high-dose methotrexate with leukovorin rescue is the third most commonly used agent in chemotherapy regimens . High-dose methotrexate has the potential to cause severe, life-threatening toxicity, but it is generally well tolerated in young patients, provided that renal function is normal and that hyper-hydration, alkalinisation, close plasma level monitoring and adequate administration of the antidote leucovorine are guaranteed.
The benefit of adding ifosfamide, the fourth agent generally accepted as being active against the disease, to regimens of doxorubicin, cisplatin and high-dose methotrexate remains to be confirmed. The Italian and Scandinavian groups as well as our own COSS-group have used all four drugs together with promising results. However, the addition of ifosfamide did not result in a survival advantage in a large, randomised North American study .
Recommended Reading: What’s The Difference Between Chemo And Radiation
Tests For Bone Cancer
Your doctor will do some tests to check for primary or secondary bone cancer:
- blood tests to check your general health
- x-ray a scan that takes a two-dimensional picture of the inside of the body that can reveal bone damage or the creation of new bone
- bone scan a small amount of radioactive dye is injected into a vein and a scan is then taken that allows doctors to see any abnormal changes in the bones
- computed tomography scan a scan that uses x-rays to take a three-dimensional picture of the inside of the body
- magnetic resonance imaging scan a scan that uses magnetism and radio waves to take pictures of the inside of the body
- positron emission tomography scan a small amount of radioactive glucose solution is injected into a vein and a scan is then taken and any cancerous areas on the scan will be highlighted
- bone biopsy some cells and tissues are removed from the outer part of the affected bone for examination under a microscope.