How Can I Help My Loved One Going Through Cancer Treatment?
Supporting your loved one through treatment is easier when you have some information about what to expect. A large part of your caregiving will likely involve helping your loved one through cancer symptoms and the side effects of treatment.
Besides providing care, you should know which symptoms or side effects should trigger a call to the doctor’s office and which symptoms require emergency care. Be sure you know the best way to communicate quickly with your doctor’s office—phone or email—and know how and when to contact your doctor after hours. If you do seek emergency care, contact your treating physician’s office to let them know you are seeking emergency care. This way, they can be on hand to advise the emergency medicine personnel, who might not be familiar with the therapies your loved one is receiving.
Side Effects
Each treatment has various possible side effects. You might assess these side effects to determine if and when you need to contact your loved one’s healthcare provider with any concerns.
Surgery
Complications from surgery can include sensory nerve damage, which can lead to localized numbness, a pins and needles sensation, burning, or severe pain, and motor nerve damage, which can result in weakness or paralysis.
Wound infection is also a potential complication of surgery.
Finally, lymphedema (an accumulation of lymph in the soft tissue) is caused by damage to or the removal of lymph nodes/lymphatic channels and can result in swelling. It can occur in patients with nonmelanoma skin cancer who have undergone more extensive surgery and can be present for either the short or long term. If your loved one is suffering from lymphedema, lymphedema therapists can help with massage, skin care, exercises, bandaging, or a compression garment.
If you are helping your loved one after surgery, you’ll be monitoring for surgical complications. Most surgeons provide a list of complications to look for post-surgery, and you should be familiar with that list and know what to do for each complication.
Radiation
Radiation therapy is another possible treatment for nonmelanoma skin cancer. Side effects are usually restricted to the area that has been radiated, although fatigue is a common symptom of radiation. Additional symptoms may include irritation to the skin, ranging from redness to blistering and peeling; changes in skin color; loss of hair in the area of treatment; damage to salivary glands and teeth when treating cancers near the mouth; difficulty swallowing and a less active thyroid gland (associated with radiation therapy to the head and neck).
You can help with homecare to alleviate some of the radiation side effects. For example, you can assist in moisturizing the radiated area after each treatment with a cream or lotion approved by the radiation team. The moisturizer may lessen skin irritation and help soothe the area of redness. Also, be sure your loved one gets plenty of rest, eats a balanced diet, and protects the radiated area from sun, heat, and cold.
Most dermatologists or radiation oncologists will provide a list of side effects to look for after radiation, and you should be familiar with that list and know what to do for each complication.
Systemic Therapy
Immunotherapy
Immunotherapy works by revving up the immune system to recognize cancer cells. Therefore, immunotherapy can cause a range of autoimmune side effects and problems impacting the lungs, liver, skin, neurologic system, cardiac system, and eyes; gastrointestinal inflammation; and hormonal issues affecting glands. If the side effects are too great, immunotherapy is typically stopped and restarted once the immune system has been quieted, generally by prescribing corticosteroids. The drug may be discontinued in severe or life-threatening cases.
You can help assess side effects and alert the healthcare team. Early recognition and reporting of side effects from immunotherapy is important so that the team can intervene to calm the immune system. Sometimes, the early signs of an immune-related side effect are subtle. In fact, many oncology teams tell their patients to report any difference in how they feel to the oncology team—it doesn’t even have to be a known side effect. You can help recognize side effects and make sure they are reported.
Only some medical professionals are familiar with the side effects of immunotherapy. Your loved one should know the name of the immunotherapy drugs s/he is taking, and this information should be presented anytime s/he seeks medical care outside of the oncology office.
Hedgehog-Inhibitor Therapy
Hedgehog inhibitors are medications taken in a pill form and are available for advanced BCC. Currently, there are two hedgehog inhibitor medications approved by the FDA for BCC: vismodegib and sonidegib.
The most common side effects of hedgehog-inhibitor therapy include muscle spasms, taste changes, weight loss or loss of appetite, fatigue, nausea and vomiting, diarrhea, constipation, and joint pain. You and your loved one should have clear instructions on when to call the office and under what circumstances to seek emergency care for hedgehog inhibitor-related side effects. The name of the hedgehog inhibitor, along with any other medication being taken, should be presented to emergency personnel.
Another important side effect of hedgehog inhibitor therapy is embryo-fetal toxicity, which means that these drugs can cause severe birth defects or fetal death. Women need to use birth control while on this therapy and for 20-24 months after therapy ends, depending on the medication prescribed. These drugs can also be detected in semen. Therefore, men should use condoms while receiving treatment and for three to eight months thereafter, again depending on which medication is prescribed.