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(12) Cancer Symptoms & Treatment

Different Types Of cancer


Types of Cancer

I have difficulty sleeping at night. What can I do to sleep better and feel more rested?

 Difficulty sleeping is a common problem for many people-either with falling asleep in the evening or with staying asleep through the night. Aside from the distress of lying awake in bed for many hours, not getting enough sleep may cause you to feel irritable and tired during the day and to have difficulty concentrating. Try to determine whether there is a concrete reason you are not sleeping. Are you physically uncomfortable or in pain? Are you having other symptoms, like nausea, vomiting, diarrhea, constipation, itching, mouth sores, or anything else that is preventing sleep? Take medication, as prescribed, to get a restful night’s sleep. If you are taking medication and it is not effective, tell your doctor or nurse.

Aside from physical reasons for not sleeping, are you feeling anxious and worried at night? Are your thoughts racing and keeping you awake at night?

Speak with someone you trust, someone supportive, about your thoughts and feelings; this may provide a significant amount of relief. For some people, medication for anxiety may be helpful.

Do you feel generally restless at night, unable to relax and sleep? A variety of techniques may help:

• Establish a regular schedule, going to bed and waking up at the same times every day.

• Even if you do not sleep well at night, try not to sleep excessively during the day. Naps disrupt your body’s normal cycle. If you are very tired, take a short nap during the day, but not for more than an hour.

• Avoid being in bed at any time except when you are going to sleep. When resting during the day, lay in another room, on a couch or chair. Use your bed only for sleep at night.

• Avoid drinking caffeine or stimulants after dinner.

For some people, these techniques aren’t helpful. If you continue to have difficulty with sleep, ask your doctor to prescribe a sleeping medication. Getting a restful sleep at night is important to feeling energized and capable during the day.

Is there medication I can take to treat my fatigue?

One cause of fatigue is anemia, a low red blood cell count. Red blood cells are produced in the bone marrow and released into the bloodstream, where they carry oxygen from the lungs to all the tissues of the body. The cells use the oxygen to create energy. When the red blood cell count is low, less oxygen is available to the cells, resulting in fatigue. The number of cells in the blood can be measured by testing a blood sample for what is called a complete blood count (CBC). The number of red cells is also reflected in measurements called hematocrit (the percentage of red cells in the blood) and hemoglobin (the substance in red blood cells that binds to oxygen and carries it to the tissues of the body). The normal ranges for these tests vary from laboratory to laboratory, but in general they are as follows:

• Hemoglobin: 12–18 grams per deciliter (g/dl)

• Hematocrit: 36–54%

Of the many causes of fatigue, if the cause is anemia, your doctor will need to determine the reason for it and decide how to treat it. If you are undergoing chemotherapy and your hemoglobin is lower than 10 g/dl, treatment with a medication called epoetin (Procrit, Epogen) or darbepoetin (Aranesp) may be helpful. This medication stimulates your bone marrow to make more red blood cells, raising your blood cell count, delivering more oxygen to the body, and increasing your energy. It is given by injection under the skin using a very small thin needle. It comes in different doses and is commonly given once a week.

Your doctor may also decide to treat your anemia with a blood transfusion. Both treatments have their risks and benefits, and you and your doctor will decide which is best for you. Along with either treatment, you may also be instructed to take an iron supplement. You can obtain additional information about the use of epoetin and darbepoetin on the Internet (www.cancer. net).

 Can I exercise?

Pete’s comment:

Exercise has been an integral part of my life for the last 20 years, and I was concerned that my cancer treatment might cause me to cut back. I was encouraged by my oncology team to ease back into an exercise regimen as quickly as possible. I started with chair aerobics and one-on-one personal training with a clinical nurse specialist. I was eventually able to get back to a full workout routine at my gym, which has given me both a mental and physical lift.

The benefits of exercise are well-known. The American Cancer Society and other organizations recommend exercise for promoting health and for the prevention of many diseases (e.g., heart disease, high blood pressure, cancer). Many studies have shown that exercise may play a role in the prevention of breast, prostate, and colon cancers. Some people believe that they should “conserve their energy” during the diagnosis, treatment, and recovery phases of cancer. However, having a diagnosis of cancer does not mean you have to stop exercising. Studies have shown that people with cancer enjoy many benefits from exercise, including:

• Reduced feelings of anxiety, stress, and depression

• Decreased treatment-related side effects (nausea, constipation, and fatigue)

• Improved appetite and sleep

• Improved bone strength and muscular flexibility

• Improved quality of life and feelings of general well-being

Here are some general guidelines about exercise:

• Before you start or resume exercising, check with your doctor or nurse to see whether you should avoid some types of activity.

• Most people have no limitations on exercise. If exercise was a part of your routine before cancer diagnosis, you should be able to keep up the same routine during diagnosis and treatment.

• After some types of surgery (breast surgery, lung surgery), your doctor or nurse will recommend therapeutic exercises.

• Exercise should not cause pain or discomfort. You should participate in enjoyable activities.

If you have been in bed or have not exercised in a long time, performing everyday activities yourself is a good way to get started. Adding exercise to your daily routine can be as simple as taking a walk outside to get the paper or mail, doing light housekeeping, or shopping for food. In general, it is important to start slowly and increase your exercise level gradually.

Others may enjoy yoga or other structured exercise classes offered at fitness centers. Exercise and yoga videotapes are also available at public libraries for those who want to work out at home. Some people participate in aerobic exercise and weight-training activities. Studies have shown that structured exercise programs helped cancer patients improve endurance, strength, and flexibility, and these patients return to everyday activity faster than those who do not exercise. There may be specific exercise groups in your area for cancer survivors or those who are actively undergoing cancer treatment. Some hospitals and universities have wellness programs (including nutrition and exercise) for people with cancer. Local fitness centers (e.g., the YMCA) may also provide classes for those undergoing cancer treatments.


Hematocrit - The percentage of red cells in the blood.

Hemoglobin - The substance in red blood cells that binds to oxygen and carries it to the tissues of the body.

Try to determine whether there is a concrete reason you are not sleeping.


People with cancer enjoy many benefits from exercise.


If exercise was a part of your routine before cancer diagnosis, you should be able to keep up the same routine during diagnosis and treatment.



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