Navigating physical changes caused by cancer

Cancer and its treatments can cause all sorts of physical changes. Learning how to manage these can hugely improve your quality of life. Whether you've got pain, are navigating menopause hot flushes or are having physical symptoms of anxiety or stress, this guide has you covered.

Pain

Pain is well...a pain. Knowing how to deal with it can make your experience much easier. There are lots of causes throughout treatment and beyond. It’s important to chat to your healthcare team if you’re experiencing pain and the best way to treat it is to find the pain relief that works for you. The earlier you start managing pain, the better.

Most people experience pain at some point in their cancer treatment. There are a few reasons why that might be. Pain can be caused by complications from the cancer itself, surgery, radiotherapy, drug side effects, or late effects of treatment.

Pain caused by the cancer will usually improve once you’ve finished treatment. For most people, pain can be managed with:

• Medicines
• Non-drug treatments
• Complementary therapies
• Self-care

If you get a new pain, it’s common to worry that your cancer has come back. This isn’t always the case. But it’s worth talking to your team about any pain you’re experiencing – they're best placed to advise on treatment.

Fatigue

Fatigue is different to just being a bit tired. It's about feeling exhausted most or all of the time. Many people living life alongside cancer experience fatigue. In fact it’s one of the things we hear about most. 

Fatigue affects everyone differently. How fatigued you are can vary throughout the day, and each day may be different. For most people, fatigue gets better after treatment finishes. But for some it may continue for months or sometimes years.

Fatigue can be caused by:

• The cancer itself
• Treatments 
• Anaemia (a low number of red blood cells, reducing the amount of oxygen your body gets which can make you feel very tired)
• Problems eating
• Pain
• Other health issues
• Feelings like anxiety, depression, stress and tension

There are no medical tests for fatigue, but it’s important that any fatigue is medically assessed so you can get the help you need. Your team might ask you:

• When your fatigue started, if there's anything that makes it better or worse and how long it usually lasts
• How your daily activities are affected by your fatigue
• To give your fatigue a rating on a scale of 1-10

Using a fatigue diary can help you track:

• Your energy levels at different times of the day
• Things that make it better or worse
• Any patterns
• Plan your time for when you have the most energy

Taking care of your SHED (sleep, hydration, exercise and diet) can help manage your fatigue well. There’s loads of evidence that physical activity is good for reducing symptoms of fatigue, while eating well and maintaining a healthy weight can have a positive impact too (check out our exercise programmes). Getting good quality rest is crucial as well. 

Check out our Lifting the Lids on Sleep and Fatigue below.

Hair loss

One of the most recognisable symptoms of cancer treatment is hair loss. If you’re having chemotherapy, radiotherapy or other cancer treatments, your hair may thin or fall out completely. While these things are nearly always temporary, they can still be troubling. 

If you’re worried about losing your hair, talk to the people around you. It can be hard to know how those around you will react but if you tell them how you feel before it happens, it can make it easier for them to understand. Your hairdresser or barber will also likely have had clients who’ve lost their hair as a result of cancer treatment in the past too, so they can also be good to chat to. 

Getting a wig or hats/headwear before your treatment or cutting your hair short can help prepare you for losing your hair. But that doesn’t mean it’s not hard when it happens. 

When your hair starts to fall out, it can be painful so looking after your scalp is important. Wash your scalp every day unless your healthcare team tell you not to, even if you have lost all your hair. This is especially important if you wear a wig, which can make your scalp hot and sweaty. Use a gentle shampoo or a facial wash.

Charities Look Good Feel Better and Cancer Hair Care run a monthly workshop about hair loss and scalp care.

For some, losing their hair is one of the hardest parts of cancer treatment. For others, it’s not as bad as expected. However you feel, know there’s no right or wrong way to feel.

Hair can play a big part in our identity, so losing it can impact your feelings about yourself. Speaking to someone about your feelings and concerns can help you be reassured you’re still the same person, even if you look a little different for a while.

Losing your hair can impact how you feel around other people, relationships, your self-confidence or other aspects of your mood. Being honest about how you’re feeling and speaking to others who’ve been there can help.

In some religions, hair can play a big part in a person’s faith. Many Sikh people, for example, don’t cut their hair or shave, so losing their hair can have impacts on many levels. CancerHairCare are the UK’s no1 hair loss support charity and can offer hair workshops and salon mornings for support. You can also chat to your hairdresser or barber. Macmillan have created their Beauty of Support programme to facilitate conversations around cancer with haircare specialists.

You may also lose your eyebrows and eyelashes. Before you lose your hair, think about buying any products you might need to help you feel more confident and learn how to use them. Some Boots stores have Macmillan Beauty Advisors who can support you here.

Check out our video on drawing on your eyebrows [here].

Trouble sleeping

Difficulty sleeping can be caused by a range of things, including worry and anxiety, pain, medicines, your routine and more. But getting a good night’s sleep is essential for your wellbeing.

If you’re experiencing insomnia, you might find you: 

• Have difficulty falling asleep
• Waking up during the night or wake up earlier than planned
• Struggle to sleep, even in spaces where conditions are good (i.e a darkened room and comfortable bed)
• Struggle concentrating at work, fall asleep during the day or have low mood

When we’re tired, we’re not ourselves – we might be irritable, tearful and have less resilience. Having good sleep habits can help you improve your sleep, so you’re more well resourced to deal with whatever life throws at you.

Things that could help you sleep better include:

• Try to stay active. Doing more physical activity can help you sleep better
• Get into a sleep routine, waking up and going to sleep at the same time each day
• Set your bedroom up for sleep. Make the temperature comfortable, get a comfy bed and make sure your bedroom is for sleeping, not scrolling Instagram
• Avoid tech before you sleep – blue light can make it harder to fall and stay asleep
• Don’t go to bed hungry. If you’re hungry, you’re more likely to wake up in the night
• Work out how naps affect you. You might need to nap in the day – working out if this makes you sleep better or worse. Generally, a short nap after lunch can be helpful
• Getting out of bed if you can’t sleep. Try exercises to empty your mind, meditate or read for a bit. Then try to sleep again.

If worry or anxiety caused by your cancer diagnosis is what’s impacting your sleep, there are ways to try and process your feelings and ease your mind before you try to rest. Writing down your worries so you can tackle them in waking hours might be useful. Using relaxation techniques around breathing can be helpful. Check out Headspace, Insight Timer and Sleepio for tips on where to begin.

If not being able to sleep is impacting your every day, it can be helpful to take a short course of sleeping tablets. Usually these are prescribed for a couple of weeks because they can have tricky side-effects. If you think sleeping tablets might help you, your doctor can advise whether this is suitable. 

Check out our Lifting the Lid on Sleep here.

Menopause

Cancer and its treatments will undoubtedly cause many changes in your life. One change you might not have anticipated at the outset is going through the menopause early.

An early menopause can be distressing and make you feel overwhelmed, isolated or confused about the changes happening to your body.

The good news is - for most women - there are very effective menopause ways available to help you live well, after cancer. This is why it is so important to find out about an early menopause, ask for support when you need it and get the right help as soon as possible. Our top tips for managing menopause?

• Learn about what might happen and why. Forewarned is forearmed and your research will help you be on the lookout for menopause symptoms
• Keep a note of any symptoms you might experience - things like changes to your periods (if you have them), hot flushes, night sweats, mood changes, fatigue and poor sleep, difficulty concentrating, loss of interest in sex, joint pains and muscle aches, skin problems, headaches, urine infections and dryness or soreness around your vagina are all signs of menopause
• See a specialist menopause doctor. The thought of seeing another medical professional might put you off. But getting the right treatments for menopausal symptoms can help you feel the best you can.
• Chat to family and friends - use them for support and be honest about whatever you're experiencing
• Get treatment sooner rather than later
• Look after yourself. Eat a balanced diet that's rich in vitamins, exercise regularly if you can, limit alcohol and cigarettes, get enough vitamin D and make time to relax.

Check out our Lifting the Lid on menopause for more information

Nausea and Vomiting

There are lots of reasons why you might be feeling sick and being sick. Cancer treatments, physical changes in the body and emotional reasons can all play their part. The best approach to treating nausea is to find the cause. Nausea can be caused by:

• Some cancers or cancer symptoms
• Chemotherapy or other cancer treatments
• Some medicines, such as strong painkillers or antibiotics
• Constipation
• Infection
• Liver and kidneys not doing what they should
• Changes to how the stomach works
• Changes that affect your brain
• Anxiety

You may be prescribed anti-sickness drugs to help you with any nausea, but there are also other ways of managing stomach issues.

Eating problems

If feeling sick is putting you off your food, try:

• Avoiding an empty stomach as it can make feelings of nausea worse – even grazing on plain toast, oat cakes or a banana is better than nothing
• Taking your anti-nausea medications at least 30 mins before meals and try to not lie down for at least 30–60 mins after eating
• Avoiding strong cooking smells or avoid the kitchen if you need to
• Cold or room temperature foods. These may be more palatable than hot or strongly flavored meals
• Sipping on ginger tea or sucking on ginger lollies /crystallised ginger. Peppermint tea can also help settle the stomach

Emotional difficulties

Cancer’s an emotional rollercoaster. If you’re struggling with your emotions, you might find you have stomach issues or other physical symptoms of stress. You may also find you experience anticipatory nausea ahead of a situation that reminds you of feeling sick in the past. If you think you may be experiencing nausea due to your feelings, speak to your medical team for help. Our online community might also be a good place to find reassurance. 

You might also benefit from trying a relaxation technique to give your mind some TLC. Check out Headspace and Insight Timer as a starter for 10.

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