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.

This section outlines some symptoms common to people with advanced cancer and offers suggestions on how to cope with them. For more information and support, call Cancer Council 13 11 20.

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. People experience pain in different ways and even people with the same type of cancer can experience different levels of pain. Palliative care services are specifically trained in pain management. If you do have pain, they will help you control it as much as possible.

Many people need a combination of treatments to achieve good pain control.

Ways to relieve pain include:

  • pain medicines, such as non-steroidal anti-inflammatory drugs and paracetamol for mild pain, and opioids including 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
  • interventions such as nerve blocks or spinal procedures such as epidurals for pain that is difficult to manage
  • other treatments, such as physiotherapy, complementary therapies (e.g. massage, acupuncture), and psychological interventions (e.g. relaxation, mindfulness, distraction techniques)
  • surgery, drug therapies or radiation therapy.

Some people worry about becoming addicted to pain medicine, but this is unlikely when it is used to relieve pain. Any side effects, such as constipation or drowsiness, can usually be managed. Correctly used opioid medicine, such as morphine, will not shorten life or interfere with your breathing – people may even live longer with better quality of life 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, and ask your specialist palliative care team or your GP to regularly review your pain management plan.

For more on this, see Pain and cancer.

Ways to manage 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 medicines and what each one is for.
  • Use medicine packs made up by the pharmacist to help you take the correct dose of each drug at the right time.
  • Keep a medicines list to record each medicine, the dose, and when it should be taken. Order a printed NPS MedicineWise list at nps.org.au/order or download the MedicineWise app from the App Store or Google Play.

Problems with eating and drinking

Many people with advanced cancer do not feel like eating. This may be because of the cancer or a side effect of treatment. It may also be caused by anxiety, fatigue or depression. However, food and drinks can help improve your quality of life by maintaining your strength and bodily functions.

It is important not to 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 to feel less hungry as the disease progresses – talk to your palliative care team if you are concerned. They may suggest you drink nutritional supplements.

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. You will probably be given anti-nausea medicine that you can take regularly to relieve symptoms. Finding the right one can take time – if you still have nausea or vomiting after using the prescribed medicine, let your palliative care team know so the dose can be adjusted or another medicine can be tried. Constipation can also cause nausea and appetite issues.

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.

For more on this, see Nutrition and cancer.


Bowel changes

Many people having palliative care experience difficulty passing bowel motions (constipation), often as a side effect of opioids, cancer treatments or other medicines, or because of changes to their diet or physical activity levels. The usual suggestions for managing constipation, such as drinking lots of water, eating a high-fibre diet and exercising, are often not useful for people with advanced cancer who feel unwell. Your treatment team will advise the best way to manage this problem, and may prescribe laxatives and stool softeners.


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, anxiety 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), surgery or oxygen therapy (if your oxygen levels are low). Simple practical measures can also be helpful. These include sitting near an open window, having a fan in the room or using a small handheld fan, adjusting your position in bed, doing breathing exercises, and practising relaxation techniques.

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. You can find these at Palliative Care Australia.

Fatigue

Fatigue is different from tiredness, as it doesn’t always go away with rest or sleep. It can be caused by the cancer itself, cancer treatment, depression or anxiety, poor sleep, an infection, anaemia, weight loss or medicines. Ongoing fatigue can be distressing.

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 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 and your family cope.


Sexuality and palliative care

People with advanced cancer usually experience major physical and psychological changes. These can have an enormous impact on how they feel sexually, but do not mean that intimacy needs to end.

We are all sexual beings, and intimacy can provide comfort and maintain connection. Even if sexual intercourse is no longer possible or desired, you may enjoy physical closeness through cuddling, stroking or massage.

Talk with your partner about your feelings and concerns about the sexual changes in your relationship, and ways to maintain intimacy. If you have concerns about sexual intimacy, talk to your GP, nurse or psychologist.

For more on this, see Sexuality, intimacy and cancer.


Click on the icon below to download a PDF booklet on palliative care.


Printed copies are available for free - Call 13 11 20 to order

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 2019
View who reviewed this content
View our editorial policy

Support services

Coping with cancer?
Speak to a health professional or to someone who has been there, or find a support group or forum

Need legal and financial assistance?
Pro bono services, financial and legal assistance, and no interest loans

Looking for transport, accommodation or home help?
Practical advice and support during and after treatment

Cancer information

Key questions about advanced cancer
Answers to questions people may have when they are first told they have advanced cancer

End of life
Information for people who have been told that the end of life is near

View our publications
Guides and fact sheets for people with cancer, their families and friends

TOP BACK TO TOP