Tag: cancer patient

Someday I am going to have to relearn that one twinge somewhere does not have to mean that imminent doom is upon me.

Cancer related PTSD is real people. Did you realize that one in three cancer patients suffer from cancer-related PTSD? That is over 30 percent. That is actually a huge number. First of all what is PTSD? PTSD stands for post-traumatic stress disorder. Post traumatic stress and post traumatic stress disorder are two different things. Post traumatic stress is a normal response to a stressful event. It’s like getting nervous before a scan or a blood test. Post traumatic stress disorder takes things a step further. This consists of severe stress responses to triggers that last longer than 1 to 3 months. They are responses that are so severe that they can prevent you from going to appointments or even living your life. It can be very disabling. It is nothing to be taken likely.

So, who is at risk? Everyone who has had a specific traumatic experience is at potential risk of this. Some examples would be combat, abuse, assault, violence, mental or physical disasters, severe injury, or illness, like cancer. You are also more at risk if there is any previous history of anxiety or depression or you do not have a good support system.

You have to keep in mind that there is not one single cause of PTSD. It is different in terms of triggers and severity for everybody. The symptoms can range from nightmares and flashbacks or intrusive thoughts. There can be avoidance behaviors of people, places, or things. There can be a general disinterest in participation of any kind. There can be guilt or shame about your particular trauma. There can be insomnia. There can be a feeling of general disconnect. All of these are kind of attempted internal protection mechanisms that our brains come up with. But, none of them are actually helpful.

For me, the biggest trigger is any slight hint that something could be wrong such as a pain or a headache that I cannot explain. It immediately sets my brain off to a path of potential disaster if I don’t put a stop to it right away. I mean, to be fair, it makes sense, my previous headaches and pains led to me being in an unresponsive coma with a head full of brain tumor and mush. I am right to be leery and a little hypervigilant. It is my own hyper-vigilence that has helped save my life more than once. But,I still can’t let it rule my life. I have spent enough time locked up in hospitals and struggling to get people to listen. I can take a break right now. I have fought every fight with valiance. I have all the scans and the tests that prove that I am doing ok, including a scan that looks like an actual tumor-free brain. Win! I am going to admit that it is still a work in progress. It is hard not to jump to the bad news. I am just going to keep doing my best and not beat myself up about my jumping to possible bad conclusions. It is what is is. Every day I get to wake up and see the sunshine out of the window of my own house is a blessing. I just have to keep believing that the worst of days are behind me, and get help when I need it.

Dr. Katz

Why are you still all up in my business chemo?

The overall good news is that we are getting better and better at helping patients survive cancer. Awesome! Whoohoo! The double-edged sword side of this is that as people are surviving longer and longer, we are getting to know more and more about late side effects from chemotherapy.

So, what is a late side effect? A late side effect is a side effect that you experience after treatment is over. These can occur even years later. What?! These late side effects can result from any type of cancer treatment. So far I have experienced significant neuropathy, muscle pain, headache, nausea, severe hypothyroidism, renal dysfunction, “chemo brain”, stomatitis, significant fatigue, cough, shortness of breath and hot flashes. I may be forgetting a few but those are the ones that come immediately to mind. To be honest with you, I am kind of over it. Enough already!

The main types of cancer treatment so far are chemotherapy, hormone therapy, surgery, radiation, targeted therapy and immunotherapy. Let’s look at each one. Now, before I go into this, I want to remind everybody that technically we all get counselled and have to sign a consent form before receiving any kind of cancer treatment in the first place. Some places do it better than others. Most sit down and do a one on one chemo teaching session in which the patient can ask questions and get clarification. This is a great opportunity to really START to appreciate what you are getting yourself into. Unfortunately, after this great teaching session, there is usually still a 20 plus page consent form that you are supposed sign as well. I’ll tell ya, nothing undermines your confidence like thinking you just covered all your bases and then you get this huge document plunked in your lap that you are supposed to pour through to make sure you really get it. I think a lot of us do our best but there is no way to digest all that additional info efficiently in a short amount of time, but we sign it anyway because we really want that cancer gone. This is a tough spot for any patient to be in because you really want that cancer gone, but you don’t fully realize what you possibly consented for in exchange. Yes, I am talking about side effects and other potential cancers. This is what we are going to talk about.

Let’s look at the kind of late side effects that are possible with each type of treatment. First let’s look at chemotherapy. Chemotherapy can cause a multitude of late side effects like early menopause, hearing loss, increased risk of other cancers, lung disease, nerve damage, reduced lung capacity, osteoporosis, and dental problems.

Now let’s look at radiotherapy. Radiation therapy can cause all kinds of late issues as well, such as cavities, tooth decay, increased risk of other cancers, coronary artery disease, increased stroke risk, hypothyroidism, heart and vascular problems, early menopause, intestinal problems, memory problems, osteoporosis, infertility and lymphedema.

Surgery is another mode of targeted cancer treatment. The main side effect of surgery is infection risk, at the time. The main late effect of surgery is lymphedema in the area that was operated on.

Hormone therapy is another type of cancer treatment. With hormone therapy comes the risk of blood clots, hot flashes( for men and women), menopause, sexual side effects, osteoporosis and the risk of other cancers.

The last two main categories of cancer treatment are immunotherapy and targeted therapy. These are still new enough that we don’t know a lot about possible late side effects. Lucky me, I fall into this group. Actually, I fall into the immunotherapy and the chemotherapy group. I’ll keep you posted.

The point I want to make is that it is not all in your head when you are still having symptoms long after chemo. We really don’t know a way to prevent them. If you are having them though, make sure to speak up to your doctor and make sure something else is not going on. Even when your cancer is over, it is still your job to continue to advocate for your health.

Dr. Katz