Living With Advanced Cancer

Managing symptoms

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People experience many different symptoms when they have cancer.

Not everyone experiences pain. Those who do may find their pain comes and goes.
Pain depends on the location of the cancer and its size.
You may need to use more than one pain-relieving method.
Regular reviews by pain management experts will help keep the pain under control.

Medications that relieve pain are called analgesics. They may be mild, like aspirin, or relatively strong, like opioids.
Pain medications may be given as tablets, other oral mixtures, suppositories, patches and injections, or self-regulating pumps.
The pain specialists will assess you to work out the right drug and its dose. They will also advise you how to control any side effects that may be caused by the pain medication.

Morphine is an effective opioid drugs used to control moderate to severe cancer pain.
It is very effective and comes in quick-acting and long-acting form.
It can be taken for a long time, in increasing doses if needed.
A person does not become addicted to morphine if they're taking it to relieve pain.
People do experience side effects, such as drowsiness, nausea or constipation, when they take morphine, most of which settle down after a few days.

A nerve block is when the nerves are directly targeted with pain-relieving medication.
A pain specialist or an anaesthetist usually does the procedure.
The nerve is injected with a drug such as a local anaesthetic. The pain relief is usually temporary.
A nerve block is usually used in combination with medications such as analgesics or antidepressants.

For more details, see Cancer Council's information on cancer pain.

Used in advanced cancer to reduce pain, even though they may not be able to cure the cancer.
Chemotherapy treatment can shrink cancer that is causing pain because of its size or location.
Radiotherapy can relieve certain types of pain. The number of treatments varies, but may be fewer than when radiotherapy is used in early-stage cancer.
Surgery may be done to remove an isolated tumour in the soft organs; treat a serious condition like a bowel obstruction that is causing pain; or improve outcomes from chemotherapy and radiotherapy by reducing the size of the cancer.

Some people with advanced cancer experience breathlessness.
Shortness of breath can be caused by fluid around the lungs, infection, the cancer itself, scarring from radiotherapy, pressure from a swollen abdomen, chronic breathing disorders.
Treatment will depend on the cause of the breathlessness.
If breathlessness is ongoing, you may be offered portable oxygen.

Feeling sick in the stomach (nausea) can be caused by chemotherapy or radiotherapy, or the location of the cancer.
Some people have anticipatory nausea, a response when their body realises it is chemotherapy time again.
Tell your doctor or nurse so they can identify the cause of the nausea and give you the right treatment.

For more details, see Cancer Council's information on food and cancer.

Lack of appetite is a common problem.
It can result from illness, treatment, tiredness, an altered sense of taste, pain, lack of activity, depression, nausea or vomiting.
You may go through periods of not wanting to eat. This may last a few days or weeks or it could be ongoing.

Eat small meals and snacks frequently.
Avoid fatty, sugary and heavy food.
Eat moist food, e.g. scrambled eggs or stewed fruit, which is less irritating to a sore mouth.
Add an egg, ice-cream or fruit to a drink to increase calories and nutrients.
Use lemon juice and salt to flavour bland food.
Try sipping clear liquids and then follow these with biscuits or something light.
Let your doctor or nurse know if you have a sore mouth, as this can be treated.
Ask your dietitian if you can use nutrition supplements.

For many people, extreme and constant tiredness (fatigue) can be a major problem.
It can be very distressing for the person experiencing it and for those around them.
Tiredness can be caused by a range of things such as cancer progression, cancer treatment, inadequate nutrition, anxiety, poor sleep, certain drugs, low red blood cell levels (anaemia), or infection.
Tell the doctor or nurse if you think you are becoming weaker or more fatigued as the cause may be something treatable.

Talk about the tiredness with others so it helps them understand how you feel.
Plan to do things at the time of day when your tiredness is least severe.
Research shows that gentle exercise reduces tiredness, helps preserve muscle tone and gives a sense of normality.
Have a short rest during the day. Naps can refresh you without making it hard for you to sleep at night.