Coping with side effects

You will find that there are physical changes as well as many emotional changes to cope with. It is important that you and the people around you (this could include your partner, employer and family members) are prepared.

Tiredness

Many women find that tiredness is a major problem. Travelling backwards and forwards to hospitals and clinics for treatment and appointments is very tiring. If you work during the treatment or if you have a home and a family to care for, you will almost certainly be very tired. Some people having cancer treatment say their tiredness is overwhelming and unlike any tiredness (fatigue) they have felt before. Sometimes it cannot even be fully relieved with rest.

Your tiredness may continue for quite a while even after treatment has finished. Some women find that it takes them up to one or two years to feel really well again. It may help to talk with your family and friends about how you feel and discuss ways in which they can help you. You may need to plan your activities during the day so that you get regular periods of rest. The Cancer Society has an Information Sheet titled “Cancer-related Fatigue”. To receive a copy, call the cancer information nurses on the Cancer Information Helpline 0800 CANCER (226 237), contact your local Cancer Society for a copy or view and download a copy on the Cancer Society’s website.

If your fatigue is caused by low levels of red blood cells or the side effects of drugs that you are taking, your doctor may be able to treat this.

Tips that will help relieve your tiredness

Not all of these things will work for everyone but you may be surprised how small changes can help to save your energy.

  • Plan your day. Set small, manageable goals.

  • Don’t be afraid to ask for help: ask a friend to do the shopping or come to clean the house once a week.

  • Try not to rush: leave plenty of time to get to appointments.

  • If you are fit enough and your doctor has said it is okay, get some exercise. This may be the last thing you feel like doing, but research shows that exercise can boost energy levels and make you feel better. Even if you just walk around the garden or block a few times a week, it all helps.

  • Smoking reduces your energy. If you smoke, talk to your doctor or the Quitline on 0800 778 778 about stopping.

  • If you have young children or grandchildren, try to play with them sitting or lying down: board games, puzzles and drawing are good ideas.

  • Eat nutritious meals and snacks throughout the day to keep your energy levels up.

  • Try to take some time out to do things that you enjoy. For example, having a relaxing bath, listening to some music or just being with your pet may help you relax, and for a short time, take your mind off how tired you feel.

  • Use Facebook, an answerphone and emails to update friends and family on how you are.

  • Join a Cancer Support Group or education programme. Talking about your feelings can ease the burden of fatigue, and you can hear how other people in similar situations have managed. To find a group, call the cancer information nurses on the Cancer Information Helpline 0800 CANCER (226 237), or contact your local Cancer Society.

Menopause

Women who go through menopause as a result of cancer treatment will have to adjust to the symptoms and body changes caused by no longer producing large amounts of the female hormones.

Menopause can cause several different symptoms. Not everyone will have them all. They may include:

  • hot flushes and night sweats

  • vaginal dryness

  • mood and memory changes

  • anxiety

  • effects on your sex drive (libido)

  • weight gain

  • fatigue

  • sleep disturbances

  • bladder changes.

Menopause can increase your risk of other health conditions such as osteoporosis (weaker bones leading to a higher risk of breaking a bone).

Symptoms can have little or no impact on some women. For others they can be severe. You can discuss your symptoms with your cancer doctor or GP. The important thing is that you feel you have the medical and emotional support you need to cope. The Cancer Society has an Information Sheet titled “Early Menopause and Cancer”.

To receive a copy, call the cancer information nurses on the Cancer Information Helpline 0800 CANCER (226 237), contact your local Cancer Society for a copy or view and download a copy from the Cancer Society’s website.

Hormone replacement therapy (HRT) can help reduce menopausal symptoms. Using HRT for more than five years increases the risk of some diseases, including some cancers. However, it also decreases the risk of some other diseases and cancers. You will need to discuss with your gynaecological oncologist what the benefits and risks are for you if you take HRT. If you were on HRT when your cancer was diagnosed, you will need to weigh up the risks with your specialist of continuing HRT.

Lifestyle changes can also help relieve some symptoms and allow women to cope better with menopausal symptoms; for example, diet changes to help with weight gain and finding time to relax to help with any emotional changes.

Remember, it is okay to ask for help. Many women find menopause a difficult time. It can help to tell those around you what you are feeling and going through. Having the support and understanding of those close to you will be reassuring and helpful with managing symptoms.

Bladder problems

Bladder sensations or control may change after cancer treatment or surgery. Some women find they need to go to the toilet more often. Others find they need to go in a hurry and sometimes don’t get there in time. Others find that they pass urine when they cough or sneeze. While these problems may improve, even a small loss of bladder control can be distressing.

If bladder control is a problem, you should seek help. Your specialist or GP will be able to suggest ways to help with bladder control. These may include exercises to strengthen the muscles of your pelvic floor. You may be referred to a physiotherapist. For more information, phone the New Zealand Continence Association Helpline number on 0800 650 659. Some hospitals have continence nurses who can help you with bladder problems.

Bowel problems

After surgery or cancer treatments, such as radiation treatment, some women have problems with their bowels.

Some women find that they become constipated or suffer from diarrhoea or wind pain. Talk to your doctor, nurse or dietitian about your symptoms. There may be some simple treatments they can advise. Some women may need to change their diet or take medication.

Lymphoedema

Lymphoedema is swelling of part of the body, usually the legs or the arms. It may occur after treatment for cancer of the uterus if you have had the lymph nodes in your abdomen removed (lymphadenectomy). Removal of the nodes may prevent normal draining of the lymph fluid from the legs. As a result, fluid can build up in one or both legs, causing swelling. This usually does not occur until some time after the original treatment.

It isn’t possible to predict whether you will have problems with lymphoedema. If you have problems seek immediate help as symptoms are better managed if treated early. Seek advice from your specialist or nurse. You may be given special stockings to wear after your operation that can help prevent this problem.

Some hospitals have specialist physiotherapists who can advise you on how you may be able to reduce your risk of developing lymphoedema. They also help you manage if lymphoedema does occur in the future. The Cancer Society has an Information Sheet titled "Managing Lymphoedema" that you might like to read. For more information, call the cancer information nurses on the Cancer Information Helpline 0800 CANCER (226 237).

‘I was up within a couple of days and moving around slowly.

I was preparing meals–it took a lot of time–within about a week. But the whole experience was fatiguing; it took a long time before I got my energy back.’ Miriana

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