Cancer News

ScienceDaily
A new study suggests that sleep problems lead to increased pain and fatigue in cancer patients. The results indicate that interventions aimed at trouble sleeping would be expected to improve both pain and fatigue in this patient population.
Results show that more than half the sample reported having trouble sleeping, with 26 percent reporting moderate or severe trouble sleeping. Compared with patients who reported no trouble sleeping, patients with moderate to severe trouble sleeping reported significantly more fatigue, pain and depressed mood. Using structural equation modeling analysis to evaluate causal relations and directions of effect, the best-fitting model indicates that trouble sleeping led to increased ratings of pain.
According to the authors, the relationship between pain and sleep often has been assumed to be reciprocal. In the present study, however, a model of reciprocal causation could not be fit to the data, and models in which pain caused trouble sleeping did not fit as well as the model in which trouble sleeping caused pain.
“We believed we would find a bi-directional relationship between insomnia and pain, but instead found that trouble sleeping was more likely a cause, rather than a consequence, of pain in patients with cancer,” said lead author Edward J. Stepanski, chief operational officer at the Accelerated Community Oncology Research Network in Memphis, Tenn.
The study included demographic, clinical and patient-reported outcomes data from 11,445 cancer patients undergoing treatment at the West Clinic, a large community oncology practice in Memphis. Participants had an average age of 61.5 years, and 74 percent were female. Breast cancer was the most common form of cancer, and about 25 percent of study subjects had received chemotherapy in the last 30 days. Increases in depressed mood also led to increased ratings of pain.
Younger age and recent administration of chemotherapy were both associated with increased trouble sleeping. According to the authors, younger patients often receive more aggressive chemotherapy than older patients; therefore, younger patients may be exposed to more treatment-related toxicity.
Stepanski stated that several studies have shown that cognitive behavioral therapy (CBT) improves sleep in cancer patients who have insomnia. He believes that this type of intervention may decrease patients’ pain and fatigue by improving their sleep.

Adapted from materials provided by American Academy of Sleep Medicine, via EurekAlert!, a service of AAAS.
Journal Reference:
1.The Relation of Trouble Sleeping, Depressed Mood, Pain, and Fatigue in Patients with Cancer. Journal of Clinical Sleep Medicine, April 15, 2009

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Cancer pain: Relief is possible

From MayoClinic.com
Special to CNN.com

Not everyone with cancer experiences cancer pain, but one of out three does. If you have advanced cancer — cancer that has spread or recurred — your chance of experiencing cancer pain is even higher.

Cancer pain strikes in many ways. Your pain may be dull, aching or sharp. It could be constant, intermittent, mild, moderate or severe. Timothy Moynihan, M.D., a cancer specialist at Mayo Clinic, Rochester, Minn., offers some insight into cancer pain, reasons why people might not get the pain treatment they need and what they can do about it.

What causes cancer pain?

Cancer pain can result from the cancer itself. Cancer can cause pain by growing into or destroying tissue anywhere near the cancer. Cancer pain can come from the primary cancer itself — where the cancer started — or from other areas in the body where the cancer has spread (metastases). As a tumor grows, it may put pressure on nerves, bones or other organs, causing pain.

Recent research has shown that cancer pain may not just be from the physical effect of the cancer on a region of the body, but also due to chemicals that the cancer may secrete in the region of the tumor. Treatment of the cancer can help the pain in these situations.

Cancer treatments — such as chemotherapy, radiation and surgery — are another potential source of cancer pain. Surgery can be painful, and it may take time to recover. Radiation may leave behind a burning sensation or painful scars. And chemotherapy can cause many potentially painful side effects, including mouth sores, diarrhea and nerve damage.

How do you treat cancer pain?

There are many different ways to treat cancer pain. The ideal way is to remove the source of the pain, for example, through surgery, chemotherapy, radiation or some other form of treatment. If that cannot be done, pain medications can usually control the pain. These medications include:

• Analgesics, such as aspirin or acetaminophen (Tylenol, others)
• Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil, Motrin, others)
• Weak opioid (derived from opium) medications, such as codeine
• Strong opioid medications, such as morphine, oxycodone, hydromorphone, fentanyl or methadone

These drugs can often be taken orally, so they’re easy to use. However, it you’re unable to take medications orally, they may also be taken intravenously, rectally or through the skin using a patch.

In September 2006 the Food and Drug Administration approved a new form of the opioid fentanyl (Fentora) that dissolves in your mouth. This medication may be particularly effective for intermittent pain episodes, which are sometimes called “incident pain.” These fentanyl tablets dissolve rapidly, and the drug is absorbed through the lining of your mouth.

Specialized treatment, such as nerve blocks, also may be applicable. Nerve blocks are a local anesthetic that is injected around or into a nerve, which prevents pain messages traveling along that nerve pathway from reaching the brain. Other therapies, such as acupuncture, acupressure, massage, physical therapy, relaxation, meditation and humor, may help.

In your experience, what are some reasons for not receiving adequate treatment for cancer pain?

Unfortunately cancer pain is often undertreated. There are many factors behind that, some of which include:

• Physician knowledge. One factor has to do with a physician’s knowledge and ability to treat and recognize pain. Some physicians and other health care professionals may not specifically ask about pain, which should be a normal part of every cancer patient’s visit. Cancer patients should be asked if they are having any pain. If they are, the physician should stop there and deal with the issue. Some doctors don’t know enough about proper pain treatment. If this is the case, your doctor might refer you to a pain specialist.
• Patient reluctance. A second factor might be a patient’s own reluctance. Some people might not want to “bother” their doctors with the information, or they may fear that the pain means that their cancer is getting worse. Some are reluctant to report it or report it as thoroughly as they should because they’re worried about what doctors or other people might think of them if they complain. They might feel that because they have cancer, they’re supposed to have pain and be able to deal with it. That simply isn’t true.
• Fear of addiction. Another factor might be a person’s fear of becoming addicted to the pain medications. This is something that we know doesn’t typically happen if you take medications for pain. If you take them when you’re not in pain or to get high, then, yes, you can get addicted. But the risk of addiction for people who take pain medications in an appropriate fashion — for pain — is very low, so this shouldn’t be a concern.
• Fear of side effects. Some people fear the side effects of pain medications. Many are afraid of being sleepy, unable to communicate with family and friends, acting strangely, or being seen as dependent on medications. People are also sometimes afraid that taking morphine may shorten their life. There is no evidence of any of these happening if the medication is dosed appropriately. And although strong pain medications can cause drowsiness when you first take them, that side effect usually goes away with steady dosing.

What side effects can you expect from cancer pain treatment, and what can you do about them?

Each pain treatment may be accompanied by its own unique side effects. For example, radiation treatments may cause redness and a burning sensation of the skin. And, depending on what part of the body the radiation is applied to, the radiation may cause diarrhea, mouth sores or other problems, such as fatigue. Chemotherapy certainly can cause side effects, such as nausea, fatigue, infection and hair loss, but it can be effective in relieving pain if it shrinks the tumor. There are medications to help with nausea. Relaxation techniques also may help.

Pain medications each have their own unique side effects that should be reviewed with your physician before taking them. One of the common side effects of the stronger pain medicines is constipation — common to opioids. It can be treated with appropriate bowel regimens as prescribed by your doctor, such as adding a stool softener and something to stimulate the bowels. Preventing constipation is much easier than treating it, so anyone who takes these strong pain medications should automatically begin a regimen to keep their bowels moving. Some of the other side effects of the strong pain medications include confusion, lethargy and sleepiness. The severity of these effects varies from person to person and commonly occurs with the first several doses. But once a steady amount of the medicine stays in your body, the side effects usually resolve. Hallucinations and behavior changes are uncommon.

The less potent pain medications actually may have more side effects, which also should be discussed with your physician before taking them. For instance, anti-inflammatory drugs might damage your kidneys, cause ulcers or increase your blood pressure. Aspirin can cause gastrointestinal bleeding, and acetaminophen (Tylenol, others) can cause liver damage if you take too much.

When should you discuss cancer pain with your doctor, and what points should you bring up?

Report any bothersome pain to your physician. If there is a minor pain that goes away, don’t worry about it. But if the pain interferes with your life or is persistent, it needs to be reported and should be treated. Although no one can guarantee that all pain can be completely eliminated, most pain can be lessened to the point where you can be comfortable.

It may help to keep track of your pain by noting how strong it is, where it’s located, what makes it worse, what brings it on, what makes it better and anything else that happens when you have the pain. A pain-rating scale from 0 to 10 — with 0 being no pain and 10 being the worst pain you can imagine — may be helpful in reporting pain to your doctor. In addition, pay attention to what happens when you attempt to relieve your pain. If you take medicine, do you feel any ill effects from it? If it’s a massage or something physical that relieves the pain, those therapies are important to report, too. Note whether they cause any ill effects.

What steps can you take to make sure you’re receiving adequate cancer pain treatment?

First, you need to talk to your doctor or health care provider if you’re having pain. Second, you and your doctor should set a goal for pain management and monitor the success of the treatment against that goal. Your doctor should track the pain with a pain scale, assessing how strong it is. The goal should be to keep the pain at a level with which you’re comfortable. If you aren’t achieving that goal, talk to your physician. If you’re not getting the answers you need, request a referral to a facility more skilled in the care of pain, particularly a major cancer center. All major cancer centers have pain management programs. For the most part, the medications and treatment for pain are covered by standard insurance.

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There are many ways that people develop Fatigue conditions, including Post Viral Fatigue Syndrome (PVFS), Chronic Fatigue Syndrome (CFS), Myalgic Encephalomyelitis (ME) as well as Fibromyalgia (FM). Some of the more common causes are viruses, bacterial infections, operations, vaccinations, etc. The onset can also occur after a stressful incident or a build up of stress. There is one common factor – the system is under stress.

What happens when we are under stress?

As a result of entering this state we produce a cocktail of chemicals – including cortisol, adrenalin and noradrenalin. This powerful group of chemicals is also produced during the fight or flight response – this is the natural process that is triggered in reaction to a threat – either real or perceived.

Physiological changes take place during fight or flight

A number of changes take place, due to activation of the sympathetic nervous system. Additional fuel is directed to the major muscles groups by increasing blood pressure and heart rate. Thyroid and blood sugar levels are affected. Increased energy is needed for emergency systems which causes nonessential functions including digestion and immune system to shut down.

What’s the connection between the stress response and Chronic Fatigue Syndrome?

The initial virus, bug, trauma, vaccination etc. has already under put the system under stress. If there were other stressors present or the person was run-down at the time, the recovery period could be prolonged. If the recovery is slow this can be a cause for concern, which results in more stress. The immune system, which is already challenged becomes depleted, further slowing the process of recovery.

Sufferers Search for Help

Sufferers are typically tested for other ailments by their doctors. After receiving the negative test results, the symptoms persist. People often turn to alternative approaches. Some people get temporary relief, but again the symptoms come back. It’s common for people to lose trust in their body and energy levels. This can help to further entrench the stress – symptom – stress cycle.

The stress response over the long-term

The system becomes depleted when subjected to the stress response over the long-term. The chemistry designed to help us out of danger becomes toxic. The immune system becomes depleted and most other bodily systems are disrupted. Adrenalin levels can become depleted after prolonged activation. The dysregulation of stress chemistry is responsible for more fatigue and physical symptoms.

Is it all in the mind?

Chronic Fatigue Syndrome is certainly not all in the mind. It’s a physical and debilitating illness affecting most bodily systems. However, purely physical approaches to recovery, or those that focus on specific symptoms rarely work. We need to recognize that the mechanisms that trigger these physiological responses are very much a part of the mind. Until these patterns are addressed, full recovery over the long term is unlikely.

Breaking the cycle

It is possible to break free of these cycles and it can be done quickly, given the right tools. Fortunately, the length of time of the illness does not determine the length of the recovery time. What’s needed is an understanding of the mind – body connection and an insight into the damaging unconscious cycles. We can then learn to use new physical and cognitive strategies that influence our health in a positive way.

You are not broken!

Sufferers of fatigue related conditions can typically feel broken or flawed in some way. Although the physical symptoms can be so severe that it feels as if this is so, this is not the case. Human health is incredibly buoyant, it is just necessary to discover what is in the way. Once we can bring balance to the system, we can create the opportunity for energy to return and physical symptoms to naturally resolve.

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by Gabriel Adams

You often don’t think about your Immune System, however as soon as it fails you are quick to realize how vitally important the Immune System is for your overall health. The Immune System is responsible for preventing all bacteria, germs, viruses, and other microorganisms from entering the body and causing complete destruction.

You may not realize it, but the Immune System works 24 hours a day, every day of your life protecting you from all sorts of sickness, disease, and ultimately death. In fact, as soon as any living organism dies, the Immune System immediately stops functioning and the organism is subject to all manner of parasitic invasion. When you stop to think about it, it is truly amazing how the Immune System functions at not only keeping you alive, but also in perfect health.

The Immune System consists of a number of different organs and components. The main components of the Immune System are the Lymph System, The Thymus, Hormones, Bone Marrow, The Spleen, Leukocytes (White Blood Cells), Antibodies, Complement, Tonsils, and Adenoids. Together these components work together to ensure that the Immune System is working in proper order and defends the body against foreign invaders.

In addition to these components, there is another very important organ that is invaluable to ensuring that the Immune System is working and that is the Skin. Skin is often the body’s first line of defense against foreign invaders such as germs, viruses, and bacteria. Therefore, by keeping the skin clean, frequent hand washing, and treating cuts or wounds to prevent infection you can help the Immune System by preventing many invaders from entering the body.

It is a proven fact that stress negatively impacts the Immune System. Therefore, one of the best strategies that you can implement to ensure that your Immune System is operating in its best capacity is to reduce stress. You should also ensure that you receive plenty of sleep every night, and take a vitamin and mineral supplement. Also, there are many herbs that help strengthen the Immune System, adding these to your diet can have a powerful impact on the overall health of your Immune System.

Learn how glyconutritionals can boost immune system function.

Article Source: http://www.articlesnatch.com

http://www.articlesnatch.com/Article/Your-Immune-System–How-It-Works/173250

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Cologne, 21 August 2008: Many people sleep better when they are on holiday and wish that they could sleep as well all the time. But according to the German Institute for Quality and Efficiency in Health Care (IQWiG), it is not only being free of daily worries that can make a difference to sleep. Good bedtime habits can help people to sleep well all year round. Medication provides short-term relief at best. In information published today on www.informedhealthonline.org the Institute reports about what bedtime habits could help, how well relaxation techniques work, how sleep changes throughout life and that adults do not generally need eight hours sleep a night. Sleep medication is used less nowadays

About 1 out of every 5 adults in industrial countries have problems sleeping at some point in their lives. In order to provide reliable information on this issue, the Institute analysed scientific studies that cover a wide range of research on sleep and insomnia.

Sleeping pills – whether herbal or prescription – are being used less than they used to be in countries like Germany. Although products based on herbs like valerian have long been used, the evidence from trials testing their efficacy is far from convincing.

“Prescription sleeping pills can be important in certain situations, but they can cause a lot of adverse effects and are not a long-term solution. For older people, sleep medication can increase the risk of falling, as well as interfering with other medicines,” warns the Institute’s Director, Professor Peter Sawicki. “Sleeping pills are not the best way to solve underlying problems like depression or painful conditions that are interfering with a good night’s sleep.”

The habits that can help people get a better night’s sleep

Trials have shown that many people could get to sleep a little sooner if they learned relaxation techniques to help them “switch off” when it is time to go to sleep.

Research suggests that a combination of certain habits can help people sleep better. This includes only going to bed when you are tired and ready to go to sleep. Reading and watching TV in bed could actually make it harder to sleep. If people cannot sleep, it is better for them to get out of bed and do something else rather than focusing on trying to sleep.

Getting up at the same time every morning can help too. Napping during the day might make it harder for you to sleep at night if you are struggling with chronic insomnia.

It is also important to avoid drinking caffeinated drinks and alcohol in the evening. “Most people know that coffee, cola or black tea can interfere with their sleep,” says Professor Sawicki . “But many do not realise that alcohol is one of the major causes of a bad night’s sleep.”

Eight hours a night may not be necessary for everyone

The Institute also looked at research on what is a normal night’s sleep. Studies have shown that as we get older, we actually need less sleep on average. While children and teenagers generally need eight or more hours sleep a night, by the time people are 40, they usually only need seven hours a night.

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Source: Institute for Quality and Efficiency in Health Care

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The cells that are usually affected include bone marrow blood cells, cells of hair follicles, cells lining the digestive tract and cells lining the reproductive tract. Looking at this list of the cells that are usually destroyed, one can start to recognize some the ailments that cause so much suffering to people going through chemotherapy treatment. Now you understand exactly why people end up losing their hair for instance. This is as a result of the cells of hair follicles being damaged by chemotherapy.

Bone marrow cells being affected during cancer treatment is one of the most common causes of many of the side effects of chemotherapy. Bone marrow is a thick liquid in the inner part of some bones which usually produces white blood cells. This damage leads to low white blood cell counts or what doctors call neutrophil. The kind of signs and symptoms that follow include fever, sore throat, coughs, shortness of breath, nasal congestion, burning during urination, shaking chills as well as redness, swelling, pain, and warmth at the site of an injury amongst other symptoms.

Usually because of the high risk of infections, doctors may need to delay further chemotherapy doses. These are some of the factors that cause so much suffering amongst cancer patients.

Fortunately new research and clinical trials offers some hope in greatly alleviating problems related to cancer and cancer treatment. For example natural herbal medicines have been used for hundreds of years and now regularly complement mainstream care in managing symptoms, boosting the immune system and greatly enhancing the quality of life. Actually many cancer patients going through chemotherapy have reported impressive results from natural herbal medicine in addressing the side effects of chemotherapy.

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Therapy Pain   by Billy Fischer

Where traditional forms of medicine do not work alternative therapies are resorted to. When there is a combination or integrated medical system that is followed, how to blend both the alternative and the conventional needs expertise. Alternative therapies make available services which are not offered in conventional medicine. These treatments could involve homeopathy, new age healing, faith healing and naturopathy. Some diseases might warrant alternative methods of healing rather than the conventional and more and more people seem to be becoming aware of this.

Not only can alternative health therapies help you to improve the quality of your life and feel better, they can also help you to improve your overall general health in order to provide you with a sense of control. It relaxes you by reducing your anxiety, stress, depression, sleeplessness and tension. They reduce some of the side effects, which are normally noticed in the usual cancer treatments and also help in reducing some of the symptoms like poor appetite, tiredness, pain, sickness, diarrhea, constipation and breathlessness.

Alternative health therapies can be very effective at masking pain, which can sometimes hide a more serious underlying condition and are often used in conjunction with conventional medicine. Some cancer support groups for example, offer these therapies for free or make a small charge and some hospitals and hospices provide as part of cancer care, alongside conventional cancer treatments such as chemotherapy or radiotherapy. Many cancer patients to support themselves in their fight against cancer now use these therapies. These therapies are very valuable in that they identify and support spiritual and emotional characteristics and physical features, but they should not be used as the only alternative line of treatment.

More than billion is spent by the Americans annually on vitamins and herbs which are alternative health products. The recent studies that were conducted by Phillips, Tindle, Eisenberg and Davis, reflected that there was roughly seventy two million adults within the United States that use alternative and complementary therapies. The studies conducted by Herman, Craig and Caspi in 2005 also show an out of pocket spend of about billion annually on these therapies.

It is very essential to find out which treatments offered by alternative health therapies are more effective and at the same time making you feel much better and comfortable. The quality of life for many people has improved especially those who have Motor Neuron Disease. It is always advisable to check with your doctor before starting with any of the alternative health therapies and you should also remember to check whether any such treatment adapted would have adverse effect on any of the treatment programs which are already being undertaken.

In case you are thinking of using any alternative health therapy along with your contemporary medication then you must talk to you doctor and find about the pros and cons that are related. You could even find out from your physician if he is qualified to practice any of these therapies. Today doctors are more and more convinced that alternative therapy does have a place in the overall healing of a patient; this gives them the ability to maybe recommend alternative therapy practitioners. For some people, these types of therapies are helpful in coping with effects of conventional treatments, reducing anxiety and giving them back some control over their lives.

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ScienceDaily — A new study from the National Institutes of Health finds that massage therapy may have immediate benefits on pain and mood among patients with advanced cancer. The study appears in the September 16, 2008 issue of Annals of Internal Medicine.

In a randomized trial of 380 advanced cancer patients at 15 U.S. hospices, improvement in pain and mood immediately following treatment was greater with massage than with simple touch.

“When patients near the end of life, the goals of medical care change from trying to cure disease to making the patient as comfortable as possible,” said Jean S. Kutner, MD, MSPH, Associate Professor of Medicine, Division of General Internal Medicine at the University of Colorado Denver School of Medicine. “This study is important because it shows massage is a safe and effective way to provide immediate relief to patients with advanced cancer.”

Pain and depressed mood are common problems for patients with advanced cancer. While drug therapies can reduce symptoms, they don’t always work and often have troublesome side effects. Researchers think that massage may interrupt the cycle of distress, offering brief physical and psychological benefits. Physically, massage may decrease inflammation and edema, increase blood and lymphatic circulation, and relax muscle spasms. Psychologically, massage may promote relaxation, release endorphins, and create a positive experience that distracts temporarily from pain and depression.

Researchers caution that while massage may offer some immediate relief for patients with advanced cancer, the effects do not last over time, demonstrating the need for more effective strategies to manage pain at the end of life.

Adapted from materials provided by American College of Physicians, via EurekAlert!, a service of AAAS.

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ScienceDaily (Sep. 10, 2008) — Pain is one of the most common symptoms of cancer patients, yet many of them do not receive adequate therapy for the pain caused by their disease or treatments, according to a study in the September 1 issue of the International Journal of Radiation Oncology*Biology*Physics, the official journal of the American Society for Therapeutic Radiology and Oncology.

For cancer patients, pain can come from the cancer itself, chronic inflammatory changes or infections. Standard cancer treatments, such as surgery, chemotherapy and radiotherapy can also cause pain, but despite its common occurrence, pain is a frequent source of patient anxiety due to improper management.

Researchers at the University of Pennsylvania Department of Radiation Oncology in Philadelphia and the Radiation Oncology Branch of the National Cancer Institute in Bethesda, Md., sought to determine the main reasons that patients fail to receive optimal pain therapy.

Between November 2005 and April 2006, 106 radiation therapy patients responded to an Internet-based questionnaire that evaluated their medication use, pain control and attitudes toward pain medication, including prescription and over-the-counter pain medications. Fifty-eight percent reported pain from their cancer treatment and 46 percent of patients reported pain directly from their cancer, yet 80 percent of those patients said that they did not use medication to manage their pain.

Most patients said the main reason they did not take pain medication was because their healthcare provider did not recommend it. This reason was followed by a fear of addiction or dependence and the inability to pay. Some patients also reported using alternative therapies for pain relief, including physical therapy, massage and acupuncture.

“To eliminate barriers to optimal pain management for cancer patients, healthcare providers should talk with their patients about pain symptoms and pain medications,” Charles Simone, M.D., a resident at the National Cancer Institute Radiation Oncology Branch in Bethesda, Md. and lead author of the study, said. “At our institution we have taken these steps by transitioning to an electronic medical record system that has been designed to require an evaluation and documentation of patient pain levels and pain medication responses by healthcare providers at each patient encounter.”

Adapted from materials provided by American Society for Therapeutic Radiology and Oncology, via EurekAlert!, a service of AAAS.

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