What is palliative care?

palliative careWhat’s in a name? The term palliative care is confusing to many. Oftentimes people associate it with end-of-life care, or hospice care. A poll taken in 2011 revealed that more than 75% of the public lacked knowledge regarding this service.

Although hospice and palliative care overlap in their goals of reducing suffering and providing comfort, the main difference is hospice care is typically for patients who are terminal, or within six months of death, and palliative medicine can be received at any time, whether terminal or not.

Individuals in hospice have chosen to end curative or aggressive treatment, and focus on comfort measures and the dying process. Palliative care patients are often in the midst of active treatment, but need care for distressing side effects from treatment or disease.

Sometimes a referral to palliative care can cause fear in patients and their families because of misconceptions regarding the term. Because of this, some cancer centers have chosen to change Continue reading

Chemotherapy and nerve changes

chemotherapy and nerve changesChemotherapy is used to treat many types of cancers and its side effects vary depending on the type of chemotherapy received. Some cancers and some chemotherapy agents may cause nerve changes, which can increase with the more chemotherapy a patient receives.

Nerve changes can lead to pain or problems with movement called peripheral neuropathy.

Examples of drugs that may cause nerve changes:

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Mouth Care: Why it’s Important Before, During and After Cancer Treatment

Chemotherapy and radiation therapy can cause complications like sores in the mouth and changes to the teeth, salivary glands, gums and bone, which makes mouth care important before, during and after cancer treatment.

Before cancer treatment begins:

Problems such as cavities, broken teeth, loose crowns or fillings, and gum disease can get worse or cause problems during cancer treatment. Because bacteria live in the mouth, it may cause an infection when the immune system is not working well or when white blood cell counts are low. If dental problems are treated before cancer treatments begin, there may be fewer or milder oral problems.

Visiting the dentist at least a month before cancer treatment begins allows time for the mouth to heal if any dental work is needed. In addition, a visit to the dentist before treatment starts will help avoid needed dental treatments during cancer treatment.

During cancer treatment:

Paying close attention to oral health during cancer treatment will help prevent complications or allow you to treat them as quickly as possible. Everyday mouth care during cancer treatment should include:

  • Brushing:  Using only a soft-bristle brush 2-3 times a day and at bedtime for 2-3 minutes.
    • Let the toothbrush air-dry between brushings and replace the brush often.
    • Avoid mint flavored or other strong flavored toothpaste or toothpaste with whitening ingredients, which may irritate the mouth. Instead choose a mild flavored fluoride toothpaste.
    • Try brushing using a mixture of 1/4 teaspoon of salt added to 1 cup of warm water if toothpaste seems to irritate.
    • If you wear dentures, they should be cleaned and rinsed every day using a denture cleaner recommended by a dentist. Store the dentures in water or denture solution when not being worn.
    • Rinsing: Avoid commercial mouthwashes and those with alcohol. Use a salt and soda mouth rinse instead.
    • Flossing: Ask the doctor if it’s OK to floss gently once a day
    • Lip care:  Use lip care products to prevent chapped or cracked lips Continue reading

What is Peripheral Neuropathy?

Chemotherapy induced peripheral neuropathy (CIPN) is a set of symptoms caused from damage to the nerves further away from the brain and spinal cord. These distant nerves are called peripheral nerves. They carry sensations (feeling) to the brain and control the movement of our arms and legs. They also control the bladder and bowel, though these nerves are affected by CIPN less often.  Certain chemotherapy drugs are often linked to this side effect.

The symptoms or signs of CIPN depend mostly on which nerves are involved. This side effect can cause numbness, tingling, burning or weakness, particularly in the hands or feet.

Protection and Safety Tips:

  • Protect areas where sensation is decreased. For example, do not walk around without foot wear. Wear thick socks and soft-soled shoes.
  • Wear warm clothing in cold weather.  Protect feet and hands from extreme cold.
  • Use potholders when cooking.
  • Use gloves when washing dishes – or gardening.
  • Inspect skin for cuts, abrasions – and burns daily – especially arms, legs, toes and fingers.
  • Use your pain medicines if you have them.
  • Be sure that you have ways to support yourself if you have problems with stumbling and walking. Hand rails in hallways and bathrooms may help you keep your balance. A walker or cane may give you extra support.
  • Use night lights or flashlights when getting up in the dark.
  • Protect yourself from heat injuries. Set hot water heaters between 105° – 120° degrees to reduce scalding risk while washing your hands.  When taking a bath or shower, do not let the water get too hot.
  • Give yourself extra time to do things. Ask friends for help with tasks you find hard to do.
  • Don’t drink alcohol. It can cause nerve damage on its own, and may make CIPN worse.
  •  If you have diabetes, control your blood sugar. High blood sugar levels can damage nerves.
  • If your neuropathy is permanent, ask your doctor to refer you to an occupational therapist. They are experts who help people lead more normal lives despite physical limits.
  • Report any unusual feeling you may have to your doctor.

Take the Next Step:


When to ask for help: Talking about symptoms is first step in treating them

Larry Stone asked for help with symptoms related to his cancer treatment.

Larry Stone asked for help with symptoms related to his cancer treatment.

Larry Stone joined a clinical trial in fall 2009 to test a medication that offered the possibility of prolonging the effectiveness of the hormone therapy he was taking to stave off prostate cancer. When he started to experience mild numbness in his hands and feet later that spring, he didn’t think too much about it. But by June, pain and swelling sent him to the hospital overnight.

His hospital stay relieved his pain somewhat, but it prompted him to ask his oncology team a question: “Is there a specialist I can see?”

That simple question triggered a referral to the University of Michigan Comprehensive Cancer Center’s Symptom Management and Supportive Care Clinic. Stone met with Susan Urba, M.D. — the clinic’s leader — as well as pharmacist Emily Mackler, Pharm.D. Together, the team mapped out a program to reduce Stone’s discomfort.

“That was the start of a great relationship,” Stone said.

Read more about symptom management in the University of Michigan Comprehensive Cancer Center’s patient publication, Thrive. Or, if you are a U-M patient, call 1-877-907-0859 to make an appointment with the U-M Symptom Management and Supportive Care Clinic.


Cancer-Related Fatigue Awareness Month: Learn how you can fight this side effect of treatment

Cancer-related fatigue is the most common side effect of cancer and cancer treatment, according to the American Cancer Society. Research suggests that anywhere between 70% and 100% of cancer patients getting treatment have fatigue, and about 30% to 50% of cancer survivors have said that their fatigue lasts for months or even years after they finish treatment. Learn more about cancer-related fatigue and how you can fight it at mCancer.org.