7.0 WK7 Cancer in the community Flashcards
How many people may get cancer in their lifetime?
1:2
Why has survival rates improved?
Earlier detection
What impact did Covid have on cancer management?
- 50,000 pts diagnosis missed
- 650,000 patient had care disrupted
- Patients moved onto oral therapy to treat at home
What are the stages of need based upon their cancer journey?
- Fear phase - Explore
- Investigation phase – Support/Explain
- Tx phase – Efficacy/Side Effects
- Recovery
What does life look like beyond cancer?
- Hair loss
- Chronic fatigue syndrome
- Adjusting life to cancer
- Healthy living advice
What are some of the problems a community pharmacist may have to deal with?
- Pain
- Altered body image
- Tired and fatigue
- Mental well being.
What is a common symptom associated with Cancer?
Pain
What are the causes of pain?
- Surgery
- Radiotherapy
- Chemotherapy
- Neuropathy
- Cancer itself
How can pain effect people?
- Physical challenges
- Tiered and fatigue
- Emotional problems
○ Fear
○ Anger
○ Anxiety
○ Depression
○ Difficulty in coping with pain
○ Impact on relationships
Why might their be Anger?
- 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
What else can influence the patient?
- Physical changes and body image
What is the main causes of physical and body image emotions?
- Mastectomy
- Testicle removal
- Stoma following colorectal cancer surgery
What is the emotional impact
- Low confidence
- Low self esteem
- Frustration
- Embarassment
- Changes in outlook in focus.
How can the pharmacist help?
- Specialist stoma advice
- Exercise + DIet = reduced risk of depression and fatigue
- Encourage them to use the opportunity to do new things.
What makes the patient suffer from tiredness and fatigue?
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.
What is the role of pharmacist in managing patients in the community
Manage symptoms with non pharmacological advice and pharmacological treatment
What can impact a patient mental well being?
- 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
What can this lead to?
- Fear
- Loneliness
- Anger
- Lack of confidence
- Uncertainty
- Anxiety and depression
- Post traumatic stress
What is Palliative care?
Life limiting illness where the cancer will not go away, how can we help them control symptoms.
What is end of life?
- 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.
