7.0 WK7 Cancer in the community

Question 1

How many people may get cancer in their lifetime?

Answer 1

1:2

Question 2

Why has survival rates improved?

Answer 2

Earlier detection

Question 3

What impact did Covid have on cancer management?

Answer 3

• 50,000 pts diagnosis missed
  • 650,000 patient had care disrupted
  • Patients moved onto oral therapy to treat at home

Question 4

What are the stages of need based upon their cancer journey?

Answer 4

• Fear phase - Explore
  
  • Investigation phase – Support/Explain
  • Tx phase – Efficacy/Side Effects
  • Recovery

Question 5

What does life look like beyond cancer?

Answer 5

• Hair loss
  
  • Chronic fatigue syndrome
  • Adjusting life to cancer
  • Healthy living advice

Question 6

What are some of the problems a community pharmacist may have to deal with?

Answer 6

• Pain
  
  • Altered body image
  • Tired and fatigue
  • Mental well being.

Question 7

What is a common symptom associated with Cancer?

Answer 7

Pain

Question 8

What are the causes of pain?

Answer 8

• Surgery
  
  • Radiotherapy
  • Chemotherapy
  • Neuropathy
  • Cancer itself

Question 9

How can pain effect people?

Answer 9

• Physical challenges
  
  • Tiered and fatigue
  • Emotional problems
    ○ Fear
    ○ Anger
    ○ Anxiety
    ○ Depression
    ○ Difficulty in coping with pain
    ○ Impact on relationships

Question 10

Why might their be Anger?

Answer 10

• Open referral
  
  • WHO pain ladder
  • Tens machine
  • Pain diary
  • Adjuvant drugs
    ○ Anticonvulsants e.g. gagpentin
    ○ Antidepressants e.g. Duloxetine
    ○ Bisphophonates e.g. Fosamax especially if on Tamoxifen

Question 11

What else can influence the patient?

Answer 11

• Physical changes and body image

Question 12

What is the main causes of physical and body image emotions?

Answer 12

• Mastectomy
  
  • Testicle removal
  • Stoma following colorectal cancer surgery

Question 13

What is the emotional impact

Answer 13

• Low confidence
  
  • Low self esteem
  • Frustration
  • Embarassment
  • Changes in outlook in focus.

Question 14

How can the pharmacist help?

Answer 14

• Specialist stoma advice
  
  • Exercise + DIet = reduced risk of depression and fatigue
  • Encourage them to use the opportunity to do new things.

Question 15

What makes the patient suffer from tiredness and fatigue?

Answer 15

Chemotherapy causes myelosuppression leading to anaemia

Post op pain leads to physical stress and challenges

I have cancer, emotion stress leads to sleep disturbances

Hormonal changes as a result of Drug Tx

Treatment can lead to constant diarrhoea, nausea, vomiting, increased fractures, diabetes

The body needs more to recover, nutrition needs careful attention

Treatment given to lower pain can cause tired and fatigue e.g. amitrypilline drains you, patient choice, more pain less tired, share decision making.

Question 16

What is the role of pharmacist in managing patients in the community

Answer 16

Manage symptoms with non pharmacological advice and pharmacological treatment

Question 17

What can impact a patient mental well being?

Answer 17

• Treatment ends
  
  • Cancer could return or get worse
  • Too much time on their hands with no appointments to attend
  • Missing hospital staff
  • Side effects
  • Changes to their lifestyle during and after treatment
  • Unable to see the future

Question 18

What can this lead to?

Answer 18

• Fear
  
  • Loneliness
  • Anger
  • Lack of confidence
  • Uncertainty
  • Anxiety and depression
  • Post traumatic stress

Question 19

What is Palliative care?

Answer 19

Life limiting illness where the cancer will not go away, how can we help them control symptoms.

Question 20

What is end of life?

Answer 20

• Do you wish this patient to die at home
  
  • Do you wish this patient to die in hospital
  • May stop all meds except pain relief.