Index

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Content

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Introduction to cancer

Causes of cancer

Treatment of cancer

Quality of life

Impact of cancer on quality of life

Physical aspects

4-11

Psychological aspects

12-15

Social aspects

16

Spiritual aspects

17

10

Conclusion

18

11

Key points

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12

Assignment

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Introduction
Human body is composed of many
millions of tiny cells, each a self-contained living
unit. Normal cells in the body grow and divide
for a period of time and then stop growing and
dividing. Cancer occurs when this cellular
reproduction process goes out of control. In
other words, cancer is a disease that is
characterized by uncontrolled, uncoordinated
and undesirable cell division.
Cancer
Cancer is a disease characterized abnormal and
uncontrolled growth of cancer cells.
Causes of cancer
Cancers are primarily an environmental disease with 90-95% of
cases due to lifestyle and environmental factors and 5-10% due to
genetics.
Tobacco use. Cigarette smoking and regular exposure to
tobacco smoke greatly increase lung cancer.
Obesity. High-fat, high cholesterol diets are proven risk factors
for several types of cancer
Ionizing radiation. Radiation comes from radioactive fallout,
radon gas, x-rays, and other sources can cause cell damage that
leads to cancer.
Sexually transmitted HPV-infection. HPV increases your risk
factor for cervical, anal, vulvar and vaginal cancer.

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 Exposure to harmful chemicals (carcinogens). People who

have certain jobs (such as painters, construction workers, and those in
the chemical industry) have an increased risk of cancer.
Heredity. Some gene changes that increase the risk of cancer are
passed from parent to child.

Treatment of cancer
At present, there exists a variety of

acceptable treatments for cancer.

Surgery. It is effective in removing

cancer that is limited to an organ or

area of the body. Surgery is
performed for treatment of cancer,
p a l l i a t i o n , p a i n c o n t ro l a n d
diagnosis.

Surgery

Chemotherapy. Cancer drugs can kill or

stop the growth of your tumor, as well as

cancer cells that may have spread from the
original tumor site.
Radiation therapy. It is the use of high-

energy rays to kill cancer cells. It may be used

alone to try to cure the cancer or to reduce
some of the discomfort created by your
tumor.

Chemotherapy

Hormone therapy. Hormones can

make tumour grow

Radiation therapy

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Quality of life
Under normal circumstances,
most of us would probably define
quality of life as companionship with
family and friends, rewarding work,
the knowledge that we make a
difference in the lives of others, the
freedom to pursue a multitude of
interests, the joy of learning
something new. The list is as varied
as we are.
Under the abnormal circumstance of receiving a cancer
diagnosis and undergoing treatment, these sources of satisfaction and
self-esteem can be severely compromised. Quality of life diminishes

Impact of cancer on quality of life

Cancer affects the quality of life (QOL) of individuals with the
disease and also that of their family members and close friends. This is
significant throughout the trajectory of the illness. Patients progress
through different phases and experience different reactions after
being given the diagnosis of cancer.
The initial phase is the pre treatment phase, the symptoms
experienced by the patients include anxiety, fatigue, and pain.
The second phase is the primary treatment phase, during this
time patient's experience, in addition to the above mentioned
symptoms, other disease-specific symptoms.
The third Phase is the post treatment phase. In this phase,
patients often experience treatment-related symptoms. Decreased
movement, loss of strength, anxiety, and depression...
The fourth phase is the recurrence phase. Shock, disbelief,
anxiety, fear, grief, and a feeling of betrayal and anger are common in
this phase along with loss of appetite and depression.
The fifth and final phase is the end-of-life phase. During this
phase there may be a feeling of alienation or isolation. Fear of
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impending death and concern over the events preceding death.

Aspects of quality of life

In general the quality of life can be categorized into following
aspects.
Physical aspect
Psychological aspect
Social aspect
Spiritual aspect

Physical Aspect
Physical aspect involves a variety of aspects that support
physical well-being.
Physical health is important to your overall well being true to
the old proverb A sound mind in a sound body.
By maintaining good physical health during your course of
cancer treatment helps you better cope with your treatment, boost
your immune system, better nourished and experience improved
quality of life.

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Pain
Cancer pain is a subjective sensation of tissue damage, which

has an adverse influence on multiple domains in an individual's life.

Severe pain is associated with decreased function, increased
interference with daily activities, depression, and anxiety.
Causes of Cancer Pain:
People with cancer can experience

pain from different sources: the tumor

itself can cause pain the treatment too
can cause pain.
Pain needs to be assessed to treat
properly it can be done with the help of
pain scale.

Pain

Pain management methods

F
F
F
F

Hot and cold packs, to relieve painful areas of the body.

Massage and physical therapy.
Hypnosis and diversional therapy.
Stretching and range-of-motion exercises, to maintain
strength, flexibility, and mobility.
F Acupuncture is a traditional Chinese medicine, which involves
inserting very tiny needles into the body.

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F Transcutaneous electric nerve stimulation (TENS). This

uses a mild electrical current from a power pack to relieve pain.
F Progressive muscle relaxation (PMR). It is based upon the
simple practice tightening one muscle group at a time followed by a
relaxation phase with release of the tension.
F Guided imagery. It is a technique in which patients use their
imagination to visualize improved health.
Fatigue
Fatigue is a feeling of tiredness or not having enough energy after

rest or a good sleep that can have a negative impact on quality of life.
Fatigue is most common, as well as one of the most debilitating,
side effects experienced by cancer patients.
Fatigue is also a frequent side effect of surgery, radiation,
chemotherapy, or immunotherapy.
Common signs of fatigue include:
Feeling tired even after a good night's sleep
Feeling sleepy throughout the day
Feeling too weak to stand
Finding it difficult to start routine
activities
Needing to stop in the middle of
activities to rest
Not being able to do activities for
long
Difficulty in concentrating
Irritability
Fatigue
How to be free from fatigue?
F Eat a balanced diet. A more nutritious diet may increase your
energy level.
F Delegate activities that someone can do for you.
F Sit if you need to when doing tasks.
F Rest in bed on a very bad day. But, lift your legs, circle your
ankles, and stretch your arms and legs every 2 hours.
F
Use
assistive devices to help you reach. But stretch and reach
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unassisted whenever you can.

F Remember that exercise and moving are ways to lessen fatigue,

the more you move the better you will feel overall.

F Sleep when you are tired. But don't stay in bed all day. Try to get
up and walk a few steps or more.

Sleep disorder
Sleep disorders such as
insomnia, multiple awakenings and
early waking can be attributed to
many side effects of cancer or its
treatments. These include depression,
anxiety, stress, pain, and medication
side effects.
Lack of sleep can undermine
your healing process and your ability
to function.
Sleep disorders can be reduced by following methods
F Go to bed and get up at about the same time every day, even on
the weekends.
F Don't eat or drink large amounts before bedtime.
F Avoid nicotine, caffeine and alcohol in the evening.
F Exercise regularly.
F Make your bedroom cool, dark,
quiet and comfortable.
F Sleep primarily at night avoid
daytime naps.
F Choose a comfortable mattress and
pillow.
F Make sure you have a bed that's
comfortable.
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F Go to bed when you're tired and turn out the lights.

Nutrition
Nausea, loss of appetite and changes in taste perception are
common side effects of cancer and its treatment. These symptoms can
reduce your enjoyment of food, and may result in decreased nutrition.
Diarrhea and constipation also negatively affect your ability to
obtain adequate nutrition.
Good nutrition is an essential part of cancer treatment. A wellbalanced diet also prevents the breakdown of body tissue, helps
rebuild the tissue that cancer may harm, and helps maintain the body's
immune system.

Balanced diet

Healthy eating tips in cancer

F Eat smaller meals more frequently.

F Keep fat levels low. Fat contains a high amount of calories.
F Increasing protein. Protein is important for growth, health
and repair of your body.

F Increasing calories. During illness, treatment or recovery, your

need for calories may be greater than usual.

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F Eat all types of fruits and vegetables a day.

F Drink lots of water.
F Multivitamin tablets.

Foods to avoid in cancer

Foods containing acrylamide, such as french

fries and potato chips.

Trans fats.
Soda.
Processed meats.
Fried foods.
Foods containing the preservatives BHT, BHA.
Smoked and pickled foods.

Exercise
Many patients find that their level of physical activity diminishes
due to their disease, its treatment, or some combination of both.
This is particularly true for patients who are hospitalized or
bedridden. It can also be an issue for all patients suffering from pain,
lethargy, or depression.
One of the best ways to combat these symptoms is to exercise. No
matter how seemingly insignificant, move your body!

With the help of exercise you will be tolerate the side effects of
chemotherapy, radiation, and surgery in a better manner.
Cancer, as well as cancer treatments can increase the risk of blood
clots, exercise will help to prevent clot formation.
Weight-bearing exercises, such as walking and resistive exercises
using weights, help keep your bones strong and healthy and will help to
prevent osteoporosis which is a side effect of steroid therapy

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Exercise for people living with cancer

Warm-up. It is important to warm-up at the start of each
exercise session.
Warming up helps to get you going and reduces your chance of
injury.
A warm-up should include 5-10 minutes of some light
stretching activities.

These are some of the exercise that can be done.

Push ups

Chair raise

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Shoulder press

Calf raise

Squat

Shoulder press

Biceps curl

Triceps extension

Sexuality
Sexual problems may be the result of a
physical problem related to either the cancer
itself or its treatment. A decline in erectile
function, common in men with prostate cancer,
can be treated with external penile vacuum
devices, injections, prosthetic penile implants
or prescription medication such as Viagra.
In women, problems include increased or
decreased vaginal discharge caused by chemohormonal therapy drugs or a narrowing of the
vagina due to radiation of the pelvis. Such
conditions can be treated using medical creams, lubricants,
hormone replacement therapy, or vaginal dilations.
If you are experiencing emotional or physical problems with your
sexuality, you can take charge by discussing them with your partner
and/or consulting your physician or a sex therapist.

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Psychological Aspect
A diagnosis of cancer often brings up one of peoples worst
health fears. It affects the complete psychological status of the
patient.
Psychological aspects includes the different aspects related to
the mental status of the patient. Following are the psychological
aspects of quality of life in cancer.

Cognitive functioning
Cancer patients undergoing chemotherapy
or brain radiation experience increased
forgetfulness, a decreased attention span and
problems concentrating.
In most cases, cognitive dysfunction is
minimal and limited to simple forgetfulness or
loss of coordination.
Mental exercises such as doing mind
games, crossword puzzles, playing chess
or other games of strategy can keep the mind
sharp and focused.

Stress
Stress is an inherent component of a

cancer diagnosis for both the patient and the

family and friends. The mind's natural
tendency is to run off in an infinite number of
directions, each with its own stress and fear.
Stress reduction techniques, such as selfhypnosis, yoga, biofeedback, meditation,
and acupuncture, acupressure, healing
massage, or keeping a journal cultivate inner
peace and may even benefit to reduce your
stress.
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Anxiety
Anxiety is a normal reaction to cancer.
Anxiety associated with cancer may
increase feelings of pain, interfere with
one's ability to sleep, cause nausea and
vomiting, and interfere with the patient's
quality of life.

Tips to reduce anxiety

F Whenever possible, lower your risk (for example, avoid

alcohol to relieve symptoms).

F Find a technique that works for you to lower your anxiety & use
it (like slow deep breathing, in & out, 15 times).

F Follow your treatment plan & take your medications exactly

as prescribed.
F Take guidance from doctor or a counselor.
F Keep a diary or journal of how you are feeling once treatment
is started. Let your health care professional know if your
symptoms are getting better or worse.
Depression
Depression is a disabling illness that affects of cancer patients.
It affects men and women with cancer equally.
People who face a diagnosis of cancer will experience different
levels of stress and emotional upset.

Issues in the life causing anxiety in cancer may are

Fear of death.
Interruption of life plans.
Changes in body image and self-esteem.
Changes in social role and lifestyle.
Money and legal concerns.
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Positive thinking
A positive and optimistic outlook

will not only improve your quality of life

but also improve your chances of getting
well.
When you have cancer, it can be
difficult to maintain a positive attitude.
Daily you are confronted with many
obstacles, including the side effects of the
illness and treatment.
One way you can help yourself maintain a positive attitude is by
setting reasonable, achievable goals. Another helpful hint is to put
your energy into activities that bring satisfaction to your life.
Hope
Hope is a force that sustains and regenerates your will to live.
Even if there is only a remote chance for a successful outcome, hope
can still empower the spirit to fight for life.
Hope can be nourished in many ways,
including accomplishing a goal, having
control over your life, feeling appreciated and
useful, experiencing religious faith, and
spending quality time with family and
friends.
Recent advances in cancer therapy are
also a cause for hope. There are over two
hundred new drugs, vaccines, and antigrowth
factors currently being tested in clinical
research. Because of these and other
advances in cancer research, it is wise not to focus on the statistics
concerning your illness. Statistics can give you a general idea of the
odds for getting better or having a recurrence of disease, but they only
represent averages. You are not 40 percent of anything!

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Coping
Coping refers to the attitudes you
develop and the actions you take to maintain
your equilibrium and adjust to the stresses
caused by cancer.
Different people cope in different ways.
It is normal to feel frustrated at times, but how
you cope, and your attitude can make a
difference. By externalizing your frustrations,
you can improve your quality of life.

Some ways of coping that you may find helpful are:

F
F
F
F
F
F
F
F
F

Relying on others for support and assistance.

Sharing your feelings with others.
Seeking professional counseling.
Setting realistic goals and readjusting them when necessary
Controlling fear and anxiety with stress reduction techniques
Adopting a mantra, or a reassuring phrase
Giving yourself time to adjust to and recover from bad news
Accepting your limitations
Recognizing that you still have control
over many aspects of your life
F Moving on from mistakes rather than
letting them debilitate or destroy you
F Alleviating day-to-day stress

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Social Aspect
The society where a person live plays a important role in shaping
the person's perception about the life.
Socializing allows you to share your ideas, believes, values and
provides an equal opportunity to listen to what others have to say and
have a positive attitude towards problems you may face in everyday
life.

Family/Friends
The support of family and friends is an essential part of
maintaining your quality of life.
Family and friends provide you with
emotional support, physical comfort,
spiritual guidance, a welcome diversion and
assistance.
Spending quality time with your friends
and family will enrich your life. Share a meal,
play a game, or look through an old photograph
album together.
Writing an ethical will - or your
philosophy of life - is another way to share
important beliefs with your family.

Support group

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Support groups provide patients with an

opportunity to see the problems they are
confronting through the eyes of others. This can
give patients a new perspective on their situation,
reduce the inappropriate guilt felt by some, and
help patients to recognize that their problems are
the result of the cancer, rather than some personal
failing. Questions such as "Why me?" take on a
new meaning in a group of people wondering the same thing.

Spiritual Aspect
Being spiritual helps in more than one way. It is good to keep
your faith on supreme being whom you trust.
Trust on spiritual being channels your energy to your creator. No
matter what is your religion, faith in your creator can bring you peace,
good health and all other blessing.

Spirituality, Faith and Religion

At times of extreme vulnerability, we all tend to pay more
attention to our innate spirituality and seek to restore a feeling of
being connected with the universe or a spiritual idea beyond
ourselves.
We may seek this liaison through
prayer and a renewed devotion to
God. In the event of treatment failure
and progressive disease, spirituality
can help ease the pain of separation
from loved ones and the things of this
world.
Spirituality also plays a role in
end-of-life care, helping patients
utilize their remaining time to achieve
a sense of peace and purpose, even in
their final weeks, days or hours. Spiritual practices can strengthen
feelings of hope or give meaning to life prior to death
Some religion's way to increase one's feeling of being in control
Collaborative religious coping- Seeking control in solving
problems through a partnership with God.
Active religious surrender- Turning control over to God after
all else has failed.
Pleading for direct intercession- Seeking control indirectly
by praying for a miracle or divine intercession
Passive religious deferral- Waiting for God to control the
situation
Self-directing religious coping- Believing that God gives 17
individuals the tools and resources to solve problems

Leaving instructions to loved ones

Therefore, this is the time to leave clear instructions as to
whether you want to be resuscitated or treated, if you have no chance
of regaining a reasonable quality of life.
You will also want to leave written
instructions for your family and friends,
if death occurs, telling them how you
want your remains handled and type of
funeral service.
If you don't have a will for the
disposition of your estate, this is a good
time to get that out of the way as well.
You can always change it later. The act of leaving instructions on these
matters is a gift to those you love.

Conclusion
Health professionals today believe that a combination of medical
therapy and supportive care offers the best chance to maintain a
patient's quality of life.
Satisfaction of these diverse needs demonstrates the powerful
connection between mind and body and improves quality of life.
Cancer - because it can have an impact on every aspect of your
life, from your faith and the quality of your relationships to your
physical being and your career is an assault on your life. Yet, as we have
seen with so many of our patients, it need not destroy the quality of
your life.

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Steps for Improving Your Quality of Life

F Conserve your energy for essential or pleasurable activities.

F Work collaboratively with your medical team so that you can get
F
F
F
F
F
F
F
F
F
F
F
F
F

the best possible medical and supportive care.

Set realistic, achievable goals.
Don't let mistakes debilitate or destroy you. Move on.
Avoid negative thinking and self-destructive behavior.
Make end-of-life decisions, including writing legal and medical
wills, and an Advanced Directive.
Take control. Even when your prognosis is not good, you still
have choices.
Try to maintain your hope, endurance, faith, and courage.
Seek spiritual guidance from your faith, community, religious
or inspirational readings, or other sources.
Acknowledge your need for psychological support and seek
assistance from a professional counselor, pastor, social worker,
or a wise friend or family member.
Learn new techniques to promote relaxation, such as yoga and
meditation.
Engage in pleasurable diversions, such as art, music, hobbies,
social events and physical activities.
Give of yourself to others.
Strengthen your relationships by spending more quality time
with family members and friends.
Recognize the sources of your anger and use techniques of
forgiveness and mindful meditation to move on.
Try not to let your illness dominate your life. Be willing to make
the necessary compromises as you go through treatment.

Assignment
1. Cancer is the abnormal and uncontrolled __________ of cancer cells.
2. Surgery removes___________tissues from the body.
3. _________is the use of high-engergy rays to kill cancer cells.
4. Cancer diagnosis and treatment diminishes the_________ of life.
5.Quality of life can be categorized into_______,_______,_______&______ aspects

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