Coping with feelings and challenges

Seek support from family, friends, healthcare professionals or the community to help you through this challenging time. You are not alone!

Emotional support and strategies:

• Talk about it: Join a support group, rope in support from family and friends, talk to your cancer care team or seek professional counselling
• Find ways to ease stress and tension and keep track of your feelings: You can keep a journal of your treatment journey or engage in other enjoyable activities
• Seek spiritual support: Spiritual exercises, religious practices, reflection and meditation have been noted to be helpful and a source of strength and peace for many people with cancer
• Set aside private time and space: Take time to do something you enjoy every day

Practical support and strategies:

• Plan ahead and take charge: Gain more knowledge about the cancer, treatment, what to expect and how to cope. The information will help you to plan ahead (see following sections for more information about what to ask your doctors).
• Learn to accept help: Accept hands-on help from friends and family.

Financial support:

• Work out a budget: Ask your doctor and cancer care team about the estimated cost of cancer treatment, as well as other unexpected expenses for transportation, scans or medical accessories and devices. Knowing what to expect early can help you work out your finances more effectively.
• Seek financial advice: Healthcare providers, case managers or social workers can advise on financial options. More information on the financial aspect of cancer can be found in Cancer and Finances.

Professionals in the cancer care team

This is a rough guide. Depending on your type of cancer and treatment, the healthcare professionals on your cancer care team may differ. Here are some professionals usually involved in a cancer care team:

 

• Doctors/oncologists: Medical oncologist (specializes in diagnosing and treatment cancer with chemotherapy and other drugs), surgeons (specializes in using surgery to treat cancer), radiation oncologist (specializes in using radiation to treat cancer).
  
  
• Nursing team: plays many roles from implementing the treatment and care plan your doctor has for you, administering medications, monitoring side effects to coordinating your care process
  
  
• Social worker: offers guidance if you need help finding community resources and support services, and provides counseling and emotional support
  
  
• Dietitian: helps you make better dietary choices so that you feel better during your cancer treatment. You can also get tips on how to increase your appetite and combat symptoms like nausea and heartburn
  
  
• Rehabilitation specialists: including physical, occupational, speech or recreational therapists help you to recover physically after cancer)
  
  
• Palliative care specialists: doctors, nurses, pain specialists and other healthcare professionals who help you manage distressing symptoms of cancer to improve your quality of life
  
  
• Spiritual care professionals: provides spiritual care and support to help you discover meaning and purpose as part of the healing process regardless of race, culture, belief system or gender
  
  

Treatment options

Your doctor may advise a combination of treatment methods for the best outcome. Advised treatment options depend on the type of cancer and other factors such as if the cancer has spread, your preference, age and general health. This list is non-exhaustive - please consult your doctor if you have any questions about your treatment options and alternatives.

Treatment	Description
Surgery	The doctor may recommend surgery to diagnose cancer, check if the disease has spread or remove the cancerous tissue. Sometimes, surgery is used to prevent or lower the risk of cancer from occurring in the future.
Chemotherapy	This involves the use of potent drugs to destroy cancer cells. Today, more than 100 chemotherapy drugs are available. They are administered through injections into a vein or muscle, or sometimes taken orally as a pill or liquid, placed into the spine, chest, abdomen or rubbed on the skin.
Radiation Therapy	Uses high-energy rays to destroy cancer cells, slow down or shrink cancer growth. Unlike chemotherapy which affects the entire body, radiation therapy is a local treatment that affects only the part of the body being treated. There are lifetime dose limits of radiation.
Targeted Therapy	This type of cancer drugs work by targeting specific mutations in cancer cells. Some drugs work by interrupting pathways that are involved in the growth of cancer. In the process of destroying cancer cells, they are less likely to affect normal cells.
Laser Therapy	A high-intensity beam of light is focused and directed at a specific area. Lasers can be used to burn away tumors or growths, as well as relief symptoms such as bleeding. It is commonly used in the treatment of cancers that are found on the surface of the body, or when the cancer is in the early stages.
Stem Cell Transplant	Also known as a bone marrow transplant, sometimes recommended for people with certain cancers, involves replacing the damaged bone marrow with healthy stem cells.
Immunotherapy	This involves drugs that make use of the body’s natural immune system to fight the cancer.
Photodynamic Therapy	Involves using drugs called light-sensitive agents along with light to kill cancer cells. Activated only by certain types of light, the light-sensitive agent is injected into the blood stream through a vein or placed on the skin. Once the drug is absorbed by the cancer cells, light is directed at the area to destroy them.
Blood Product Donation and Transfusion	People with certain cancers may experience internal bleeding, low blood count and require blood transfusions to help them temporarily replace blood. Blood transfusions are also given to people who have undergone cancer treatments that may lead to blood loss or low blood count.

 

What to prepare before each appointment

If possible, the patient should appoint a key spokesperson, who should go with the patient to all appointments if possible, and be the key contact to share information to families and friends. Let the clinic know in advance if an interpreter is necessary. Please note that there might be a fee applicable for these services.

Organise your thoughts by writing down key concerns and questions, and speak with other family members to know their concerns as well before the doctor’s appointment.

What to do during the appointment

Let the doctor know that you have questions to ask so he/she can set aside time to answer your questions. Ask the most important questions first.

If you wish to find out more about cancer from the internet, be sure to also countercheck information with your doctor during the appointment as not all content online are reliable.

Some questions you could ask your doctor include:

• What type of cancer do I have and where is it located?
• Has my cancer spread?
• What further tests do I need?
• What are my treatment options?
• What is my prognosis (this refers to the chance of recovery)?
• Will I be able to continue with my normal routine and responsibilities?
• How much medical leave from work is expected?

Write down the doctor’s answers. If you don’t understand something, ask the doctor to explain again or use a different way to help you to understand. As the patient, you have the right to ask questions and ask for assistance in understanding information relating to your condition. Keep your notes in your filing system with other medical information you have gathered.

What to do after the appointment

You can call the clinic to clarify any other matters. The nurses may also be able to answer many of your questions. Other members of your cancer care team such as therapists and dietitians may also be able to assist with some of your queries.

 

How to cope with the side effects

Ask your cancer care team for advice on ways to manage any side effects. It is also important to alert your doctor should you notice any new symptoms or changes in symptoms. For example, chemotherapy drugs may damage normal healthy cells, causing temporary side effects like hair loss, tiredness, nausea and vomiting. High doses of radiation may affect some normal cells near the tumor. You may experience side effects such as skin changes like rashes or redness, loss of appetite or tiredness. Here is a non-exhaustive list of some side effects experienced by cancer patients and tips for coping:

Side effect	Tips
Nausea & Vomiting	Medications may help. Although rarely life-threatening, if prolonged and repeated they could lead to dehydration. Seek medical attention promptly if you have trouble keeping fluids down and cannot take the medications you need.
Fatigue	Change your lifestyle and diet. You may feel better if you reduce your workload, stick to a nutritious diet, get enough sleep, rest and light exercise. Distraction tactics like reading a book or meditation can also help.
Pain	In most cases, cancer pain can be successfully controlled through medications. The best way to control cancer-related pain is to prevent it from developing or becoming worse. Take pain medications as prescribed. Seek medical attention promptly if you find the pain worsening or becoming unbearable. It could be an indication of a more serious condition.
Fertility & Sexuality Issues	If you’re not done with family planning, talk to your doctor about your concerns before you start treatment. Some cancer treatments can affect your ability to have children. Ask your doctor if it is safe for you to continue with sexual intercourse and the safety measures that you should take. You should also have an open talk with your partner. See Sexuality for more information and tips.
Appetite Loss	Managing symptoms like nausea, vomiting, pain and fatigue may help to improve appetite. Try eating several small meals packed with nutrient-dense foods throughout the day, drink less fluids at mealtimes and having your meals in a pleasant environment. A dietitian can also offer advice on how to plan your meals and recommend nutritional supplements if necessary.
Hair Loss	Share your feelings with a trusted family member, friend or counsellor. Consider having a shorter hairstyle before treatment starts so that the transition is less dramatic. You can also opt for hats, wigs or scarves to cover up hair loss. To learn more about practical ways to manage with the physical changes, you may consider joining SCS’ Look Good Feel Better Programme. For more details, call 6499 9132. See Self-Image for more information.
Mouth Dryness	Medications to help boost saliva production and prevent oral infections are available - check with your doctor. Maintaining good oral hygiene is also important. Rinse your mouth every few hours, especially after meals, with a solution made by mixing salt and baking soda in a cup of warm water to prevent infections. Sip water frequently and avoid drinks like coffee and alcohol, which can cause dehydration.
Constipation	Drink more fluids and do some light exercises if possible. Not being physically active can increase your risk of having constipation. Ask your doctor and dietitian for advice. No matter how uncomfortable you feel, never use laxatives or stool softeners without getting clearance from your doctor.