Emotional Health - Other

Waiting can add stress to an already uncertain situation. Some people say that waiting for health and treatment information is one of the most stressful aspects of being ill. There’s the frustration of waiting, and for some people there’s also fear of what the test results may be. The waiting period can be equally difficult for family and friends. They have the added frustration of wanting to help, but not knowing what to say or do.

Some tests can take longer than others. Your husband’s physician will want results from all the tests before approaching your husband to discuss them and the possible treatment options. On top of that, the physician may have asked for further testing on some of the samples, or may have asked the opinion of another physician or health care provider in interpreting the test results.

For people who are waiting, even a little bit of information can help. Your husband could call his physician’s office and ask when the test results will be available, so you don’t have to wonder whether every phone call is the news he’s expecting. He may ask how he’ll find out the results: will he be contacted by a cancer specialist (oncologist) or his family physician? Will he get the details over the phone, or does he need to make an appointment? Clarifying these points may help.

There really are no specific words that will alleviate the stress of the situation, but there are things you can do to give your husband some comfort. The best approach generally is to be attentive to him, and let him know you’re there to support him. Often people assume their support is obvious and that they don’t need to say it out loud. Yet it can give a lot of comfort to hear words along these lines: "I love you and I care about you. I don’t like to see you going through this difficult situation. You’re not alone. I’m here for you whenever you need me."

Listening may be the single most helpful thing you can do. It shows your husband he’s important to you, that you’re attentive to his needs and that you’re available to him. It’s okay to ask him if there are particular things he wants to talk about, or if there are things he doesn’t want to discuss.

Several factors are taken into account when deciding whether to continue radiation treatments:

• the wishes of the person who’s ill;
• the amount of radiation already delivered to the target area;
• the overall strength and energy of the person who’s ill.

Patient’s wishes

The main consideration is what the patient wants. If the person doesn’t want further treatments, then other issues are irrelevant.

Amount of radiation already received

The health care team needs to consider how much radiation the target area has already had. There’s a point where more radiation simply causes damage, and the damage can be worse than the problem being treated. Each part of the body can take only so much radiation over a lifetime. A radiation oncologist monitors the amount given, and doesn’t go beyond the lifetime limit. The spine and brain are areas of special concern, as radiation damage to those areas causes loss of nerve function.

Overall strength and energy

Although radiation is given only to a specific area, it takes a toll on the whole body. It usually makes people feel tired and drains overall energy. This is usually temporary, but if someone’s energy reserve is very low, it’s hard to bounce back. There are times when radiation will not cause local damage, as levels are still below the lifetime amount, but the person is too weak to tolerate more treatments. This is a difficult assessment. It’s based on overall strength, independence, and how quickly things are changing.

Sometimes when people are told that they won’t receive more of a particular treatment, they worry that it means there’s nothing more to be done. This is far from true. It’s simply that the focus of care shifts. The person’s comfort becomes more important than the illness. There’s much that can be done to improve comfort and quality of life.

Much of what can be expected during cancer treatment depends on the specific individual. Many treatments place some burden on a person’s body. This is usually temporary, but requires a period of recovery. People who generally are doing fairly well are more resilient and recover more quickly. Those who generally are feeling exhausted and without energy may be more affected by the treatment and have a harder time recovering. It’s important to explore such issues with the health care team, who can offer suggestions that may help in recovery. The health care providers have the information that will help in balancing the burdens and benefits of treatments.

With radiation therapy, treatment can have both local and general (systemic) effects. Local effects are in the area where the radiation is focused; general effects are the impact on the person’s overall condition.

Commonly the local effects of radiation are inflammation or irritation. For throat cancer, the inflammation and irritation can affect the skin on the head and neck, or the lining of the mouth or throat. If the lining of the mouth or throat are affected then the person can experience dry mouth, dental problems, hoarseness and changes to the person’s sense of taste. The radiation therapy team has ways to help with these symptoms. They include skin treatments, mouth rinses, and sometimes painkillers if there’s discomfort.

Radiation therapy for throat cancer can also affect a person’s ability to swallow. The inflammation and irritation in the mouth and throat can cause pain and burning during swallowing. Unfortunately, there can be long-term complications also, such as decreased saliva production and stiffening of the tissues and muscles needed for normal swallowing. Speech-language specialists can assess the ability to swallow and treat any issues that might arise. A nutritionist or dietician can provide advice and suggestions about food texture and other nutritional concerns.

The general effects of radiation therapy can vary. Most commonly, people may feel tired or fatigued. Some people feel nausea, which can be very effectively treated with new antinausea medications.