Managing symptoms
The relief of symptoms is one of the main aims of the palliative care team. While it may not be possible to completely eliminate all symptoms, there are many things that can be done to help make you as comfortable as possible.
It may take time to find the most effective treatment – let your palliative care team know if a treatment is not working as they may be able to offer an alternative.
Learn more about managing:
Listen to our podcasts on Managing Cancer Fatigue, Appetite Loss and Nausea, and Managing Cancer Pain
Pain
Whether you have pain will depend on the location of the cancer and its size. Palliative care services are specifically trained in pain management. If you do experience pain, they will help you control it as much as possible.
Some people worry about becoming addicted to pain medicine, but this is unlikely when medicines are taken to relieve pain. Any side effects, such as constipation or drowsiness, can usually be managed. Correctly used doses of opioid medicine, such as morphine, will not shorten life or interfere with your breathing – people often survive for longer when their pain is treated. Talk to a specialist palliative care service if you are having trouble getting the correct dose for your level of pain.
Options for relieving pain
Some of the ways to relieve pain are:
- pain medicines – e.g. non-steroidal anti-inflammatory drugs and paracetamol for mild pain; codeine for moderate pain; or opioids such as morphine, oxycodone and fentanyl for strong pain
- other types of medicine for nerve pain, such as antidepressants, anticonvulsants, or local anaesthetics
- anti-anxiety drugs for muscle spasms
- a nerve block or an infusion of drugs into the spine (intrathecal infusion) for pain that is difficult to manage
- complementary therapies, such as massage or acupuncture
- chemotherapy, radiation therapy or surgery.
| For more information on medical treatment for advanced cancer and managing pain, call 13 11 20 and ask for free copies of Living with Advanced Cancer and Overcoming Cancer Pain, or download them from this page. |
Nausea and vomiting
You may feel sick or have trouble keeping food down either because of the cancer or as a side effect of a medicine you’re taking. Anti-nausea medicines (sometimes called anti-emetics) can be taken as tablets or, if swallowing is difficult, as wafers that dissolve on the tongue, as injections under the skin or as suppositories, which are inserted into the bottom and absorbed through the lining of the rectum.
Finding the right anti-emetic can take time – if you still have nausea or vomiting after using the prescribed medicine, let your palliative care team know so that another type can be tried.
An empty stomach can make your nausea worse – eat small meals and snacks regularly, and eat something soon after getting up in the morning. Avoid fried, greasy, spicy and strong-smelling foods. Try to drink water or other fluids, and consider eating foods with ginger, which can ease nausea.
Loss of appetite
Many people with advanced cancer do not feel like eating. This may be because of the cancer, as a side effect of treatment, or because of anxiety or depression. Food and drinks can help improve your quality of life by maintaining your strength and bodily functions.
Don’t force yourself to eat – this may make you feel uncomfortable, and cause vomiting and stomach pain. Try having small meals or eating your favourite foods more frequently, and relax any dietary restrictions. It is common for your appetite to lessen as the disease progresses – talk to your palliative care team if you are concerned.
Shortness of breath
People with advanced cancer often experience breathlessness (dyspnoea). This may be because of the cancer itself, an infection, a side effect of treatment or an underlying disorder such as asthma or emphysema.
Symptoms of breathlessness include difficulty catching your breath, noisy breathing or very fast, shallow breaths.
Depending on the cause, breathlessness may be managed with medicine (such as low-dose morphine or other opioid medicine), surgery or oxygen therapy. You can also try simple practical measures, such as sitting near an open window, having a fan in the room, adjusting your position in bed or doing relaxation exercises.
Fatigue
Fatigue can be a major problem for people living with advanced cancer. This can be caused by the cancer itself, depression or anxiety, poor sleep, an infection, anaemia, cancer treatment, weight loss or medicines.
Fatigue can be difficult to treat, which can cause you a lot of distress. Your palliative care team may be able to adjust your medicines or treat the infection or anaemia that is causing the fatigue. Your team can also suggest some practical measures. These could include occupational therapy, some gentle aerobic exercise guided by a physiotherapist, or additional equipment to help you conserve your energy.
You may find that the fatigue increases as the disease progresses – counselling may help reduce your distress, and complementary therapies such as meditation and relaxation can also help you cope.
Ways to manage your medicines
Many people having palliative treatment take many different medicines throughout the day. There are some ways to help ensure you don’t forget to take the correct dose of each medicine:
- Ask your palliative care team for a list of the medicines.
- Use medicine packs made up by the pharmacist to assist with taking the right drug at the right time safely.
- Keep a medicines list to record each medicine, the dose, and when it should be taken. You can download a medicines list as a form or smartphone app at nps.org.au.
| Palliative Care Australia provides resources on topics such as what questions to ask your palliative care team; facts about medicines used in palliative care; pain and pain management; and advance care planning. |
Click on the icon below to download a PDF booklet on palliative care.
Instructions for downloading and reading EPUB files
Apple devices
The iBooks application must be installed on your Apple device before you can read the EPUB.
Different ways to download an EPUB file to your Apple device:
- email EPUB files to yourself and transfer the attachment to iBooks.
- copy EPUB files into DropBox (or a similar service) and use the DropBox app to send them to iBooks.
- open EPUB files directly from Mobile Safari and open them in iBooks, where they are saved automatically by downloading the EPUB from the website.
Need more help? Visit: http://support.apple.com/kb/HT4059
Kobo
To download an EPUB file to your Kobo from a Windows computer:
- download and save the EPUB directly onto your desktop.
- connect your Kobo to your computer using the USB cable and tap “Connect” on your eReader.
- select “Open folder to view files” to view the contents of your Kobo.
- navigate to where you have stored your EPUB file in “Finder”, in documents or downloads, and drag and drop it into the Kobo window. You can now disconnect your Kobo to read the eBook.
To download an EPUB to your Kobo from a Mac:
- download and save the EPUB directly onto your desktop.
- connect your Kobo to your computer using the USB cable and tap “Connect” on your eReader.
- open your “Finder” application.
- select “Kobo eReader” from the listed devices to view the contents of your Kobo.
- navigate to where you have stored your EPUB file in “Finder”, probably in documents or downloads, and drag and drop it into the Kobo window. You can now disconnect your Kobo to read the eBook.
Turn on your Kobo and your EPUB will be located in “eBooks”, while a PDF will be located in “Documents”.
Need more information? Visit: http://www.kobo.com/help/koboaura/response/?id=3784&type=3
Sony Reader
To download an EPUB file on your Sony Reader™:
- ensure you have already installed the Reader™ Library for PC/Mac software
- select the eBook you want from our website and click the link to download it.
- connect the Reader™ to your computer.
- open the Reader™ Library software and click “Library” in the left-hand pane and select the eBook to view it.
Need more help? Visit: https://au.readerstore.sony.com/apps_and_devices/
Amazon Kindle 2nd Generation devices
EPUB files can’t be read on the Amazon Kindle™. However, like most eReaders, Kindle™ 2nd Generation devices are able to display PDFs. We recommend that you download the PDF version of this booklet if you would like to read it on a Kindle™.
To transfer a PDF to your Kindle™ via USB cable from your computer or Mac:
- download the PDF directly onto your computer.
- connect the USB cable to your computer’s USB port, and the micro USB end of the cable to your Kindle™. Note: the Kindle™ won’t be available as a reading device while it is connected to your computer until it has been disconnected.
- open the Kindle™ drive and several folders will appear inside. The “Documents” folder is where you will need to copy or drag the PDF to.
- safely eject your Kindle™ from your computer and unplug the USB cable. Your content will appear on the Home Screen.
Kindle also provides a Kindle Personal Documents Service that allows users to send documents as an attachment directly to your eReader. For more information on this service, visit http://www.amazon.com/gp/help/customer/display.html/ref=help_search_1-1?ie=UTF8&nodeId=200767340&qid=1395967989&sr=1-1
For more information on accessing a PDF on your Kindle™, visit www.amazon.com/manageyourkindle, log in to your account and click on Personal Document Settings.
Need more help? Visit https://www.amazon.com/gp/help/customer/display.html?nodeId=200375630
Android and PC
You can also download and open eBooks on Android devices and PCs with appropriate apps or software installed. Suitable eReader apps for Android include Google Play Books, FBReader and Moon+ Reader. Suitable software for PCs include Calibre and Adobe Digital Editions.
This information was last reviewed in April 2017
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