Pain >

Symptoms: Burning; aching; tingling or stabbing sensation

Cause: Pain can occur when tumors press on nerves or organs. It can also be caused by radiation, chemotherapy, and surgery that results in nerve damage or other painful side effects

Treatment/Intervention: Opioids [morphine; codeine; OxyContin (oxycodone); Duragesic (fentanyl)]; anticonvulsants [Neurontin (gabapentin)]; antidepressants; nerve blocks; radiation therapy; integrative treatments, such as relaxation techniques, acupuncture, and hypnosis

Fatigue >

Symptoms: Lack of energy; feeling tired even after a good night’s sleep; difficulty concentrating; irritability

Cause: Anemia; depression; thyroid dysfunction; pain; coping difficulties; side effect of chemotherapy, hormone therapy, or biological therapy

Treatment/Intervention: Exercise; stimulants [Ritalin (methylphenidate); Provigil (modafinil)]; antidepressants; sleep therapy; stress management training; medicines or blood transfusions to treat anemia

Neuropathy >

Symptoms: Numbness; tingling or pins-and-needles sensation; muscle weakness; burning; pain in the extremities

Cause: Damage to peripheral nerves can result from cancer, radiation, or chemotherapy, including Taxol (paclitaxel), Oncovin vincristine), and Velcade (bortezomib)

Treatment/Intervention: Anticonvulsants [Neurontin]; antidepressants [nortriptyline; Elavil (amitriptyline)]; Lidoderm (lidocaine patch); drug-free options include transcutaneous electrical nerve stimulation (TENS) and acupuncture

Lymphedema >

Symptoms: Swelling and pain in the affected area

Cause: When lymph nodes are removed or damaged by radiation, anything that causes an increase in lymphatic activity, such as injury, infection, or overuse, can lead to a backup of fluid in the tissues “downstream” from the missing nodes

Treatment/Intervention: Manual lymph drainage [a type of massage]; compression sleeve or device to reduce swelling; keeping the area healthy and free of cuts, infection, burns, or overexertion

Bone Loss >

Symptoms: Bone pain; risk of fractures and breaks

Cause: A change in hormone levels, such as aromatase inhibitor use; chemotherapy; bone metastases, which cause small holes in the bone or a calcium buildup that increases the risk of fractures; and cancer cells, which release factors that stimulate osteoclasts (cells that break down bone tissue)

Treatment/Intervention: Calcium and vitamin D supplements; weight-bearing exercise; bisphosphonates [Actonel (risedronate); Fosamax (alendronate); Aredia (pamidronate); Zometa (zoledronic acid)]; selective estrogen receptor modulators [Evista (raloxifene); tamoxifen]

Sexual Dysfunction >

Symptoms: Loss of sexual desire or libido; erectile dysfunction; vaginal dryness; painful intercourse

Cause: Reduced hormone levels because of treatment; surgery, such as prostatectomy or oophorectomy; depression; onset of premature menopause; body image issues; coping difficulties

Treatment/Intervention: Phosphodiesterase-5 inhibitors [Viagra (sildenafil); Levitra (vardenafil); Cialis (tadalafil)]; penile prosthesis; vacuum erection devices; silicone- or water-based lubricants [K-Y]; vaginal moisturizer [Replens]; counseling

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