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Anxiety in cancer patients

Introduction



Anxiety and nervous tension and anxiety and fear, panic and phobias of various kinds, all are different aspects of what might be called the illnesses in general, acute anxiety (Anxiety Disorder) and mental and nervous tension, anxiety is a normal reaction to cancer, and one may suffer from anxiety during the testing and preliminary analysis of cancer, or while waiting for test results, and when you received the news of the diagnosis and when to start treatments or when the expected return of the tumor, and will find cancer patients that their feelings of anxiety and tension increase and decrease at different times, the patient becomes anxious and tense than when the cancer spreads or moves to another position, or while become the processors more intense and stressful, and, of course, vary and are different levels of concern from patient to patient, and patients are to reduce anxiety levels should take all the information on cancer and treatments planned and events during the expected.

On the other hand and for some people, especially those who have suffered in their lives periods punctuated by crises, severe tension before with cancer, may become a concern immersive and overwhelming and disruptive to the processors and the progress towards recovery, the worry in this case may increase the pain, and cause the disruption of sleep, and cause nausea and vomiting, and deeply affects the lifestyle of the patient, and not strange to say that the acute anxiety can even limit the age of the patient if not treated.

And some may suffer from acute anxiety, and more likely to have arisen because of the unsatisfactory pattern of factors and different conditions, and medical studies indicate that rates of acute anxiety among people over the following cases:

Patients with a history of the ills of concern for various reasons, or those with a past trauma or emotional.

Who suffered from acute anxiety during the diagnosis.

Persons deficient in social support, and those with few friends or family members who would be interested about them.

Patients who suffer from severe pain, and physical disabilities.

Patients' tumors do not respond to standard treatments.

On the other hand there are many drugs used in cancer treatment could exacerbate feelings of anxiety, in turn, and contrary to what may one thinks, patients suffer stages of a tumor developed from the concern is not fear of death itself, but rather from other factors, often contain The fear of pain stainless control, or fear of leaving them alone without support, or their sense of need and having to rely on others.








Description and Etiology

Some people may suffer from acute anxiety in the previous conditions are not related to cancer, and may appear again suffering the effects of this and the previous emitted and may worsen after the diagnosis of cancer, and patients may suffer from extreme fear and panic, and become unable to absorb the information related to their illness and instructions for the medical team, and they can not understand, and follow-up through the stages of treatment.

Set of questions in the following form to extract data from the patient about the concern in order to determine the symptoms and levels and thus devised a treatment plan:

Any of the following symptoms since I was diagnosed with cancer and when do they occur (before or during treatment, night or day) and their duration?

Do you feel the tremor and weakness, and that you are unable to stand or feel very Bnrvzh unit and nerves?

Did you feel tense and taut nerves, or felt fear or anticipation of the poor?

Do you believe that you should avoid being in certain places or doing certain jobs because of your fear of them?

Do you ever feel that your heart beats violently or accelerate Ndath?

Do you feel difficulty in breathing when they are nervous?

Did you profuse sweating or trembling without justification?

Do you ever feel knot in the stomach?

Do you ever feel as if there is something Mtkom in the throat?

Do you find yourself going places fast or arguing back and forth?

Do you feel the fear of a blind your eyes at night for fear that you might die while you sleep?

Are you concerned to conduct the following analysis, or the possible outcome of a premature long?

It comes to a sudden sense of fear of losing control or going crazy injury or death?

Do you often feel worried about when he would return and how much pain would be bad?

Do you spend time in bed too much fear of the pain that I got up or went to any place?

Did you feel confusion and confusion recently or lost balance?

And these questions are generally designed to determine which of the patient suffers the ills of concern, which include:

The problem of adaptation and coping bug panic, phobias obsessive obsessive types of forced-traumatic stress bug bug public anxiety and concern resulting from the ills of other public health problems, and the following paragraphs an overview of each of them.










Reason not to adapt and cope with the event



These include illness and the presence of behavior or mood shifts even more extreme than expected, and Ktefaal reaction to the diagnosis of a cancer patient, and symptoms include:

Neurological and willies and very sharp.

Concern and conclude a continuous and narrow.

Inability to perform any action such as going for the job or school.

Isolation and the ability to be present with others.

This reason, and it shows more clearly in the critical times in patients with cancer, such as times of analysis and tests of the disease, diagnosis, and when the media, and when intensive treatments, and when setbacks and the return of the tumor.

And can significantly reduce the problems of this illness in several ways, including:

Development of trust between the patient and the medical team that provides reassurance and, in turn, explains the facts and the feasibility of treatments and options, and increases the patient's mettle to confront the situation and follow medical instructions carefully.

Strengthen aspects of the patient's faith and prayer and urged him to read the Koran and a lot of prayer and lift him up by reminding the extent of remuneration and reward when the disease.

Learn relaxation techniques and positive thinking.

Taking medications for the treatment of this malady under the recommendations of the treating team.

Engage in programs of support and assistance and educational programs for cancer patients, in addition to reading about the historic walk.



Reason for panic

Patients suffer illness panic (Panic Disorder) from acute anxiety and tense, and the many symptoms include: shortness of breath and panting heart rate nausea, profuse sweating and shivering chills tingling sensation and numbness strong sense of fear of losing the mind and madness.

And seizures come fast and may last for minutes or hours, and the usual address some of the medicines, and noted that the mentioned symptoms may mimic symptoms of other ailments.



Phobias

Phobia can be defined (Phobia) that concerns the suffering of the continuous and permanent specific thing or place or situation or event, and People with Balrhab usually of concern and tension sharply to avoid what drives them to terrorize, to places such as the presence Arhabonha, Kalmsaad and confined spaces or heights High-rise, or experiencing any position Arbakhm and scare them away.

And cancer patients may have an intimidating and injection needles, or some of the processors, or exploration and extraction of bone marrow, or they fear and avoid testing in confined spaces, such as magnetic imaging MRI, the patient refuses Balrhab usually lie within such a device.



Obsessive obsessive illness forced

Control the actions of a person with illness obsessive-forced (Obsessive-Compulsive Disorder), and also called the illness obsessive compulsive disorder, ongoing and continuous and controlled, ideas or guesses or gentleness or images imagined acquires it (Khos or obsession) and be accompanied by the behavior of certain ( Do not resist foaming and coercive), and may suffer the most people with this illness suffer from losing the ability to follow through cancer treatment, as they are disabled because of concerns and acquiring them, and behaviors that impede their ability to perform normal.

And of course there are different drugs to treat this illness in addition to psychotherapy, and it should be noted that this illness is rare in patients with cancer who did not suffer them in advance before the diagnosis.








Bug-traumatic stress

Also known illness disorder after trauma or injury (post-traumatic stress), People who lived through and have gone through experiences or incidents of life-threatening in a previous life and were diagnosed with their cancer, may be invoked to have again the pressures and stresses they have experienced after the incidents.

And may suffer cancer patients who have this illness in advance of acute anxiety and excessive Before starting treatments, such as surgery or chemotherapy, or medical procedures that are accompanied by a certain pain, or even just to change the dressings, and deal with this illness is usually psychological treatment.



Reason for concern throughout

Patients affected by this ailment of serious concern and continues to reasons that are not realistic, as an example of being a family and friends who know him and still fear being left alone and can not find anyone cares, or fears the patient's inability to cover the expenses of his treatment with that he is capable material and has insurance or enough social security, or to avoid touching his children for fear of transmission of cancer to them.

And the reason may also arise after the passage of the patient's phase of severe depression or frustration, and some of the symptoms usually appear when the existence of this illness, including:
Irritability and agitation and irritability restlessness and lack of submissiveness and quiet or rest cramps and shortness of breath, rapid heart pocket sweating dizziness and fatigue easily.



Anxiety caused by problems other public health

May suffer cancer patients from acute anxiety, for reasons other health, for example, patients who suffer from severe pain are concerned, which in turn increases the pain, and may be the sudden appearance of concern a symptom of infection, or an indicator of pneumonia, or an imbalance in the chemical body , as he appears before the emergence of heart attacks, blood clots or the emergence of the lung and be accompanied by chest pain and difficulty breathing, and the reduced amount of oxygen carried by blood to make the patient feel as if about to suffocate, which worry him deeply.

And for drugs and its complications, may result in anxiety viewer side directly or indirectly, it is medicine that causes anxiety, which can cause other symptoms such as irritability and boredom and lack of stability and submissiveness, or the intensity of mood and agitation or depression, or trembled and shivering, and it should be noted that some tumors may cause anxiety or symptoms occur or give rise to acute anxiety panic causing a chemical imbalance in the body or shortness of breath.








About treatment



Difficult in many cases the distinction between normal fears associated with cancer, and acute and severe concerns about the radical, which can be classified into the ills of acute anxiety, and Treatment depends on the impact of this concern on the activities of daily life for the patient and interfere with treatment plans.

And address the cause of the primary is usually set the acute anxiety caused by pain, or develop other health, or a certain type of tumor, or the side effects of drugs used in cancer treatment, and treatment is the beginning, and in general, provide the patient with all adequate information relating to cancer, and options for treatment so he could complete understanding and clear vision of the disease, and is not affected by the information is correct medically, and then provide support and moral support, and benefit from medical sources available, and religious bodies, social support, in addition to finding appropriate methods for each patient to raise ambition, and self-raising ability to deal with the illness, such as urging him to consider the disease from the perspective that the problem must be solved, for example, or in terms of patience and thanksgiving, and the pay and reward when the disease.

And of treatment options also make psychotherapy specialist, and group therapy to join a group of other patients, and the dialogue of collective denial of isolation, and share experiences and opinions, as well as family therapy with family links to support the patient, or relaxation exercises that include guided imagery ( focusing on the imagined mental images to help ease the stress).

On the other hand there are some medicines and used in the treatment of acute anxiety, and should not avoid the patient's use of such drugs for fear of addiction, in that, of course, the team will the processor as the amount enough of them to ease and relieve the symptoms, and reduce the dosage or stop as the situation demands.

Depression in cancer patients

Introduction



There are many concepts and misconceptions about cancer and traded common among many people, such as the concept that all cancer patients are frustrated and depressed, or depression in a patient with cancer is inevitable and normal, or he can not handle the depression, probably, of the inevitability of suffering or pain horrible and painful death, and the fact that each person is not suffering from depression was diagnosed with cancer, and especially dangerous levels that could lead to a nervous breakdown.

And of course going through the person you are diagnosed with cancer several levels of psychological pressure and stress, and emotional fluctuations and emotional, nervous and anxiety and alarm, radical changes in the pattern of life and the fear of death, and physical changes, or change physical shape, and change the perception of self, and the change in location and social status and way of life, as well as financial considerations and functional, all of these issues are very important when a person gets cancer, and a sense of sadness and grief is normal and natural reaction during this crisis, and everyone will feel such that at times, but it is very important to distinguish between the levels of grief and sorrow natural and normal, and with serious depression that needs to be addressed in care plans and treatment, depression Capricorn is not a sad or nervous, and it is the illness itself and the symptoms can be diagnosed, and multi-effects and complications and should be addressed, and according to some medical statistics affects approximately 25% of patients.

And will pass all the people reactions of grief and sorrow at diagnosis and periodically during treatment, and after the escape of cancer, as people often feel when they discover their cancer with disbelief and rejection or despair, and may suffer from sleep difficulties and loss of appetite, and phobias and severe anxiety, and become absorbed in thought Almanmom about the future, and from customary to ease these feelings and concerns and difficulties when adapted to the person with the new situation, and rises to face reality and begin treatments and disease resistance, and the signs of this adjustment is dealing with the status quo, and ability to continue effectively in the activities of daily life, and continue to play a social role as a husband or father or mother, and continue to function or work, and the integration of processors in the routine of daily life.

However, when some people show greater difficulties in coping and adaptation, and while one can adapt to the diagnosis and live with the disease after a long period, and apparently unconscious of the interest in activities as usual, and is Mkthert matters of life task, it may be an indicator of injury depression, frustration, and the need for competent medical advice.

And longer depression interactive or interactive (reactive depression) of more types of depression common in patients with cancer, and is characterized by fluctuations in mood and bile, and the inability to complete activities as usual, and continue its symptoms for longer periods and appear more clearly from the responses of the normal and expected, as well It does not rise to the level of severe cases of depression, and while the impact on the daily life of the patient, such as work, school or household affairs, or interfere with treatment programs, should be treated as if it was sharp style.










Diagnosis of depression



May be difficult to diagnose depression in patients with cancer, given the difficulty of separating symptoms of the problems of the side effects of treatments, and symptoms of cancer itself, and be more difficult particularly when patients undergo intensive therapies, or when the advanced stages of disease.

Include symptoms and signs of severe depression:

A frustrated and depressed mood throughout the day and on most days.

Have the desire or interest to do most activities, and a sense of futility or worthlessness and low self.

Profound changes in eating habits and sleep, and fatigue lasting.

Nervous tension or dullness, weakness, and mental focus.

Inappropriate sense of guilt, and time thinking about death or suicide.

It should be noted that the emergence of these signs and continue for at least two weeks to establish a diagnosis of depression, and in the advanced stages and are considered some of the symptoms, such as guilt, and sense of futility and low self-defense and lost hope, and ideas of the termination of life and the desires of the most important labels useful in the diagnosis of depression.

On the other hand increases the risk of vulnerability to depression in some cancer patients but not others, and although the reason behind the occurrence of depression is not known precisely, but several influential factors increase the possibility of it happening, and include:

A depression when you hear the diagnosis, or the presence of depression Kaalh satisfactory prior to the patient, or suicide attempts in the past.

Treatment is effective for pain, or increased physical disability and weakness.

The family support and social exclusion, or the presence of depression or suicide Kaalh in the history of the patient's family.

The existence of an advanced stage of cancer, or cancer of the pancreas.

Aspects and the presence of other life events increase the pressure and stress, and nervous system, or the presence of illness when the patient's alcoholism or drug abuse.

Loss of sense of hope and despair and a feeling of helplessness and the loss of assistance, or the feeling of self-value and low
Or a sense of futility and guilt.

The presence of other diseases causing depression (such as heart attacks), and the effects of some drugs to tumors.

And add to the effects of some drugs, cancer treatment, there are other medical factors may in turn cause depression in patients with cancer and they include: the presence of untreated pain and the presence of abnormal levels of calcium, sodium or potassium blood anemia, severe shortage of vitamin B-12 fever the presence of abnormal levels of thyroid hormones or steroids in blood.

Useful and commonly used drugs in the treatment of this type of depression more effectively than counseling, especially if you can not change medical factors that cause (such as the inability to change or modify the doses of the drug causes depression.)


On the other hand the following points should be explored carefully and to assess the state of depression in cancer patients:

Look at the patient and his thoughts about his illness.

Patient's medical history and current mental state and physical condition.

Side effects of treatments and complications of the disease.

Any other pressure in the patient's life.

The extent of support available to the patient, whether moral or physical.

And in this regard is the existence of ideas and Discussion about suicide indicator of risk for both the patient or the medical team and family, and varying statements or hints of wanting to die just a hint improvised from a person cranky or frustrated by longer periods of treatment, a gateway (if I had to subjected to explore the bone again Vsaagafz of the window), to the statements predicted for deep despair, like say (no longer able to afford what he is doing this disease all of us, and I will kill myself and to complete the command), and is very important to investigate the seriousness of such thoughts, and of course if it is proven the seriousness of the patient's thinking of ending his life, Viogb ensure his safety and displayed on the psychological specialist doctor without delay.









Treatment of depression



Depression can be treated with a combination of acute joint consultation between the treatment and medications (such as antidepressants), and the physician may prescribe drug treatment of depression, and then turn to present the patient to a psychiatrist who specializes in some cases, such as:

While finding that it is not comfortable to deal with depression (eg, the patient has thoughts of suicide).

Did not improve symptoms of depression after the lapse periods ranging from two to four weeks of starting treatment.

Increased symptoms worse.

Side effects of cancer treatments to prevent the patient from eating treatments for depression, or that the symptoms of depression interfere with the patient's ability to continue to cancer and treatments impeded.

And the usual work antidepressants effectively in patients with cancer, and is safe for them in the treatment of depression and its symptoms, but in that, in most cases are not described them, and according to some medical statistics that 25% of patients with depression, prescribed antidepressants for about 2% of them only.

And supports the option of using these drugs on the condition of the patient and the severity of side effects it, and how the presence of allergies or reactions towards them in the past, and to point out that most of the antidepressants give effect during the period ranging from 3 to 6 weeks, and of course the necessary fact-effects side effects before deciding which type will be used, for example, may help to take a drug can cause drowsiness person with concern the sharp stop him from sleep, where the property is soothing and analgesic, and it should be noted that the treatment should continue for periods of at least six months if the antidepressant user effective .

And there are several psychological therapies found useful in the treatment of depression on cancer, and is often used in combination treatment of psychiatric treatment, and what is known as crisis management and ways of thinking associated behaviors, and aimed at treating multiple aspects and aspects, such as screening methods ease the grief and distress in the patient, and raise the vigor and improve problem-solving skills, and raise the spirit of challenge to the disease, and raise the morale and deny negative thoughts about the self, in addition to directing thinking about religious belief and aspects of faith and give a more comprehensive view of life, and create personal links between the patient and strong and a person or persons are understanding of the medical team, and involve the patient in the treatment of other patients or to incorporate social activities involving other patients.

And of the tasks implied by this processor at a broader level:

Help patients and their families at diagnosis, especially answer all questions on the disease and treatments and explain the information adequately, and correct misconceptions about cancer, and to give assurances about the real situation, and develop confidence in the face of the disease.

Help solve problems and develop the capacity of the patient to deal with the disease and Mujahdth, as well as helping his family to find additional capacity, and to investigate the presence of other pressures, such as marital status or changes in lifestyle, and encourage family members to provide support and guidance in this context.

And various social organizations, such as associations to support cancer patients, in turn, are useful in the treatment of depression, especially adolescents, in addition to clubs that combine cancer patients, and social services departments in medical centers, these organizations support the patients and raise their ability to cope with the disease and prevent their isolation, in addition to the patients Atcaflon and share their experiences and moral support.










Depression in children of cancer patients



Most of the children to deal effectively with emotions and successful emotions related to cancer, and adapt well and show growth and positive emotional development, and with that a minority of them suffer from various psychological problems, such as depression and acute anxiety and sleep disturbance, and the emergence of multiple problems in their relationships with others and cooperation during the therapeutic sessions, requiring the need for treatment by a psychiatrist specialized cases of childhood cancer.

And show more symptoms of depression in children who suffer from the effects of acute and delayed for cancer, it usually shows concern xiphoid in young children, while showing depression often when older, and for child survivors of cancer often adapt successfully with cancer and Maagath, and of course case there are problems in adapting to and coping is shown to a small percentage of them.



Diagnosis of depression in children



The term depression to symptoms or sickness or a set of interactions and responses to psychological, and time and severity of the reaction (eg, sadness), show the difference clearly between the symptoms and illness, for example, may be a child is sad, and sadness is a reaction to the bruises or cuts , but this sadness takes a short time, and generally can be identified depression the existence of interaction continues a long time, and associated symptoms such as insomnia and agitation nervous system, and irritability and aggression, and change eating habits, and the emergence of persistent problems with friends or school, and should not be ruled out depression Kaalh present when the continuation of any behavioral problem, it does not refer to temporary moments of sadness, and but rather refers to a bug affecting the growth and interfere with the psychological and physical development of the child.

Include signs of depression in children age school following symptoms:

Inertness not eating activity or hyperactivity, aggressive-looking sad, crying, fear of death to feel the frustration, sadness or despair and self-criticism Alanshidah daydream repeatedly refused to look at low self-school learning problems, slow movement manifestations of anger toward parents, teachers and the attention was unwanted activities previously, and to point out that some of these signs may appear with Ktefaal stages of development and normal growth in children, so it should be identified with any of them linked to depression.

It is necessary to conduct a comprehensive assessment of depression in children to establish an accurate diagnosis and effective treatment for order, and includes a diagnosis of depression in children of inquiry for the following aspects:

Assessment of the overall situation of the child's family, and the level of cognitive and emotional maturity of the child, and its ability to deal with the disease and Maagath, and the age and cognitive level, and how account for himself, and any unsatisfactory experiences of the past.

And focused assessment of the child and assess the conditions of the family health history of the child, and behavioral observations of the child by parents and teachers and the medical team, in addition to interview the child and make an argument, and psychological tests.

And of course different from depression Kaalh satisfactory in children is higher than in adults because of the different aspects of cognition, growth and maturity, and in general can use the margin next to diagnose depression in children:

A sad mood and extinct, (sad expression on the face in children below age six), combined with at least four of the following signs or symptoms, which should continue for a period not less than two weeks:

Changes in appetite.

Lack of sleep or insomnia, or sleep for long periods.

The child is very active or inactive significantly.

The interest in usual activities, and signs of lack of attention to anything (in children below age six).

Fatigue and loss of energy.

A sense of futility or low self-criticism or self or a sense of guilt.

Alanshidah and inability to think and mental focus.

Constantly thinking of death or suicide.








Treatment of depression in children



Than usual therapy consultation, whether individual or collective line of treatment given to the child with depression, and is designed to help the child overcome the difficulties facing it, to grow and develop the best possible way, and may use play therapy as a means to explore the look of the child toward himself and toward the disease and treatments, and it should be noted that from the beginning and the child needs to help him understand the cancer diagnosis and treatments used, and according to cognitive level.

And the physician may prescribe some medications, such as antidepressants, for treatment in children, including some species used in adults.

Disruption of sleep in patients with cancer

Introduction



Divided into periods of natural sleep into two stages, the stage of rapid movement of the eye (rapid eye movement REM) and also known as the phase of sleep, the dreamer, and the brain through an active and effective, then the stage (move the eye is rapid), or the stage of hibernation and relax, (non rapid eye movement NREM), and pass the sleeping pattern of these two phases repeatedly and sequentially, followed by the stage of hibernation phase of rapid movement of the eye, in the sessions take about 90 minutes each during the period of 7-8 hours of sleep.

And are classified as disorders that overlap and affect the system of normal sleep usually four types:

Disruption of the inability to sleep soundly, and stay awake in the no insomnia (insomnia).

Imbalance in the mechanism of sleep and then wake up the module.

Imbalances related to the stages of sleep and wakefulness partial (parasomnia).

Disruption of hypersomnia.

And sleep disorders appear when some of the cancer patients, and often suffer from two types of sleep disorders: insomnia and sleep disruption mechanism waking up, and has attributed the reasons for this imbalance to several factors, including the disease itself and the accompanying pain, of course, in addition to the impact of drug treatments, and stress and nervousness, and just being in the hospital.

In total, including the effects of tumors and its processors, which may lead to sleep disorders:

Phobias, anxiety and depression and frustration, and pain, and fever, and cough and breathing problems, and feel the skin and skin, itching, and fatigue, and seizures or epileptic, headache, night sweats, and diarrhea, constipation, nausea , and the inability to control their physical functioning.

Add to exposure of patients to interruption or disturbing sleep for various reasons, such as the Times of receiving treatments or routine of the hospital, or the presence of escorts or other patients in the treatment rooms, or noise, or room temperature, and the patient's age a big impact in the pattern of sleep, and on the other hand can to cause sleep disorders and chronic irritation of the person in the sustainable and continued unity of mood and has the ability to focus, in addition to the emergence of depression and phobias and anxiety, and naturally that the occurrence of such problems sleeping at the hospital the patient's presence makes the follow-up treatments is difficult and cumbersome .








Diagnosis of sleep disorders



In order to diagnose sleep problems, the doctor review the patient's medical history, and finding sleep habits have, in addition to physical examination, may also resort to the use of probe sleep (polysomnogram), and is a device that is which to measure brain waves and eye movement and a sense of muscle during the stages of sleep , in addition to the rates of fast heartbeat and breathing pace, in order to determine the extent of sleep disruption in the patient, in order to arrange appropriate treatment plan.








On the treatment of sleep disorders



Sleep disorder can be treated on the same tumor cancer treatment, and control the side effects of various treatments, and useful recommendations to enhance comfort and treatment of sleep disorders:

The need to evaluate the patient in an environment of low noise and inconvenience to avoid interrupting sleep, and arrange lighting appropriate faint or light switch off altogether, and modify the temperature of the room, and kept clean and dry bed, mattresses and free of wrinkles, and the use of cushions suitable in situations supportive of the body, as well as to urge the patient to wear a soft and loose and comfortable.

Read the Koran, and prayers of praise and repeat the sleep constantly.

Urge the patient to control the vomiting and urination habits to avoid interrupted sleep, such as not drinking, and vomiting before going to sleep, and increased consumption of fluids and fiber-rich foods during the day.

Eating protein-rich snack before going to sleep about two hours, and avoid beverages containing caffeine or stimulants.

The performance of some light physical exercises as possible, which should be completed shortly before bedtime is sufficient.

Urge the patient to maintain adequate sleep habits and conditioning to sleep.

Avoid using the bed for purposes other than sleeping, such as reading, as much as possible.

Doctor may prescribe some medicine to help cancer patients overcome sleep disorders to suit each case, but this should be done in the short term without the continuation of taking the medication for prolonged periods.

Fever and sweating in patients with cancer

Introduction



Follow the normal human body temperature pattern in harmony and rhythm in normal circumstances, are usually relatively low in the morning and higher evening, and maintains the body temperature normal rates of engaging in activities set the balance between the rates of heat production and loss rates, and the resulting rise in the degree of abnormal body temperature, either as a result of what is known as the phenomenon of excessive heat (hyperthermia) or as a result of fever, where the excessive heat created by the failure of thermal control system in the body, while at the fever, this system works well, but the body temperature remains high, while the body works hard to combat micro-organisms exotic, such as bacteria or viruses.

And fever of three stages, in the first phase of the body to raise the heat to a new level that caught the blood vessels to skin, to pay the blood from the surface of the skin into the body, and to assist in the Book of heat, which makes the skin more cooler, and the muscles contract and the body begins to trembling, and generated more heat, and continue efforts in the production of body heat, and set up access to a higher temperature.

Equally in the second stage heat generation rates and rates of loss and stop shaking the body, and maintains the new class, while in the third stage temperature starts to decline, as the body discharge excess heat by dilating the blood vessels to skin, and blood flows from the interior to the surface of the skin, and then starts sweating helps to cool the body.

And fever affect more on children and the elderly, the control system does not work well when the body temperature of aging, resulting in irregular heartbeat and poor blood flow, in addition to the setbacks and attacks some of the changes of mind, while children between the ages six months and the sixth was subjected to repeated seizures because of the fever.



Etiology



The most important of the main reasons for the emergence of fever in cancer patients:

Tumor itself, of course, and exposure to infection, and allergy medications, allergies or blood transfused blood transfusion, and the emergence vaccinated against the illness when the host bone marrow transplantation or peripheral stem cell periodic, where the transplanted cells attack the tissues of the patient.

And there are some other reasons in addition to that cause fever, such as symptoms of interruption of medicine, and the emergence of blockages in the bladder or intestine or kidney, or the emergence of blockage of human barriers is by particles and throws, and the occurrence of other ailments in sync with cancer, such as clots of blood, or the effects of tissue macrophages, hemorrhage, or central nervous system.








Fever resulting from infection

May show fever in cancer patients as an indicator of exposure to infection, a serious and dangerous, need to be addressed as quickly, and attributable fever is usually a deficiency cells, neutrophil white blood cells (neutropenia) when the patient, where there is sufficient numbers of cells resistant to infection in the blood circulation, and is the onset of fever associated with the state of destitution a strong indicator of an infection life-threatening, and produces about two thirds of cases of fever in patients with cancer from exposure to infection because of the persistence of destitution for long periods, and the fever in this case a painful and debilitating and may be accompanied by trembling and sweating, extreme, where the struggling body to control the temperature, and starts the line of initial treatment is usually with antibiotics, and that used to continue to be addressed for a period of time ranging from five to seven days as long stopped fever and infection, and may begin to address the fungi that the fever persists after week after the start of a course of antibiotics.



Fever caused by tumors

Cause some types of tumors in the mouth, and the onset of fever and the degree of severity may reflect the growth or spread of the tumor, and the usual cause of some tumors, such as fever, particularly tumors of Hodgkin's lymphoma, and types of leukemia and lymphoma, and kidney tumors and bone and thyroid adrenals, while it is unusual to cause some tumors fever only in the event of transmission of the tumor to the liver, including tumors of breast, lung and colon, and on the other hand arise fever as a result of the presence of tumors block the intestinal tract, or stomach, or urinary tract or parts of the respiratory system .

And the usual thing to have a fever in such cases on a regular basis can be determined style, and may appear at certain times of the day, as may occur in periods of non-specific, and may stop for days or weeks, and it should be noted that the researchers do not know on the face of precision how it is working tumors to cause fever.

And the usual stop cycles fever at the start of treatment standard for tumors that cause them and eliminate them, and on the other hand may return the return of these tumors, and from here might be seen as the emergence of fever in some cases, an indication of the return of some tumors (for example, may be considered the continuation of courses fever When cases of acute leukemia after treatment of infection, an indicator of the return of cancer, either to the testicles or meningitis, despite his low bone marrow), and if the treatment used is not effective or not available treatments, it is usual medication non-steroidal and anti-inflammatory to treat fever.








Fever caused by drugs


May arise fever in patients with cancer as a result of interaction of the body towards the abuse of some drug treatment of tumors, and is a drug immunotherapy (or what is known as drug modified to respond to antibiotics), it is common cause of fever, as well as with some antibiotics such as amphotericin (amphotericin), add to some types of chemotherapy drugs, of course, such as real estate Bleomaesen (bleomycin).

And the usual treatment of such conditions, either to stop suspected drug abuse or replace it with ever more feverish, and in the case of drug treatment may be immune to change the control fever immune Property Type the user, or modify the dosage or change the method of approach, and on the other foot can be avoided by eating medicine that causes it; giving the patient acetaminophen (Acetaminophen), or non-steroidal anti-inflammatories, or steroid drugs or antihistamines as the case, and on the other are taking certain medicines to treat tremors associated with fever, such as real estate Mbryden (Meperidine).



Fever resulting from the transfer of blood components

May arise fever in patients with cancer as a result of interaction of the body towards the compounds of blood-borne them, and this usually occurs in response to immune to the white blood cells in blood, transported, and can reduce this interaction to separate white blood cells or treatment of radioactive compounds blood prior to transport, as fever can be treated in such cases took some medicine, such as antihistamines, or acetaminophen (acetaminophen) prior to any transfer of blood components.










Fact fever


To investigate the causes of fever and order of the treatment plan, is investigating the health history of the patient and the previous problems, and the line of treatment that followed, medication intake, in addition to physical examination destruction, especially if the fever is in sync with the case of deficiency of white blood cells, and focused examination on the skin, and holes of various body (mouth, nose, ears and anus and channels urinary), in addition to teeth and gums, tongue and throat, and places stitches needles, and tubes, intravenous or feeding tubes veins, and is a different analysis of blood and urine and saliva to determine the signs of infection.

It should be noted that the usual signs of fever may not appear on some patients when there is a deficiency white blood cells, which requires the need for periodic examinations, and of course should not be neglected fever, which is an indicator of the risk of severe threat to the patient.



Recommendations to alleviate the pain of fever


In parallel with addressing the underlying causes behind the emergence of fever, it can take some steps that would help mitigate the severity and patient convenience, most notably the need to give the patient plenty of fluids because he needs it most, where the body using the fluid and calories more quickly at high temperature , (and lack thereof thus causing additional problems arise when a patient who is already suffering from a lack of nutrients and lack of eating), in addition to the mitigation of spare clothing and blankets or bed sheets, and the use of compresses or showers with lukewarm water or room temperature also helps in patient convenience, and to point out the need not to use cold water compresses or ice packs, or sheets, bedspreads and cooled, compresses or alcohol, and when the emergence of tremors have to change mats wet ones dry, and remove the patient from any air currents, and modify the room temperature .

And in order to relieve the symptoms your doctor may prescribe non-steroidal anti-inflammatory, or acetaminophen, or similar products, and to point out that aspirin may be useful in reducing heat, but he needed to take extreme caution when used with most cancer patients, especially patients Hodgkin's tumors, or might have lower rates of blood platelets, for any reason, as he and especially not when prescribed for children fever.










On sweating


Is the secretion of sweat by sweat glands in the skin, and helps sweating to cool the body, and may arise from exposure to disease, or when the environment is warm or when the effort muscle, such as different exercises, or that is associated with fever, or accompanied with so-called donations heat (hot flashes), and most patients suffering breast and prostate cancer donations from the heat, either mild or severe, and although they are not sharp when ordinary women who have reached menopause and the repeated pattern of decline with time, but it continues in patients with breast cancer after healing without the drop in intensity, and the same thing with the men who were surgically treated tumors of the prostate.

And can be attributed causes of sweating in patients with cancer to the tumor itself or therapies different, or conditions other health is not linked to cancer, is also sweating common symptoms in some tumors, such as tumor and Hodgkin's, and tumor cells, chromatin dark (pheochromocytoma), and tumor-related device nervous system and endocrine glands, and causes of sweating also:

The age of menopause in women (normal, due to surgery or removal of the ovaries, or the effects of chemotherapy and radiation or hormone on the ovaries).

Loss of fertility in men, whether surgery will eliminate the testicles or hormone therapy.

The impact of certain drugs such as tamoxifen (tamoxifen) and anti-depressants and steroidal drugs.

The emergence of complexity in the region of the hypothalamus hypothalamus any brain (hypothalamus).



Sweating treatment


Addresses the sweating associated with fever treatment fever itself, and is controlled sweating caused by tumors usually when addressed, and there are several drugs to treat excessive sweating in general in patients with cancer, and on the other hand are advised to always wear loose cotton clothing and wide, and use fans appropriate and practice to relax to reduce the severity of sweating.

And used to be handled donations temperature (Hot flashes) concurrent with the cessation of menstruation (either naturally or because of treatments) replacement estrogen (estrogen replacement), (although it is not possible for many women taking the hormone estrogen, especially patients of breast cancer), and despite the presence of several drugs to treat heat but donations are often ineffective or have intolerable side effects, and relaxation exercises may help in the mitigation.

Skin and skin complications in patients with cancer

Introduction



Contain skin and skin neural network than many other organs and therefore it is possible to complications of skin and skin cancer patients to cause suffering great pains, as they may give rise to serious problems such as infections and infections of different, in addition to that Such complications may seem embarrassing for the patient to their impact on external appearance.

And when the emergence of such complications Ktathirat side effects of treatments, the preventive measures and early treatment is the best means to deal with and overcome, while in other cases, such as the emergence of wounds and abscesses as a result of the emergence of skin cancer or Anbthat cancer cells to the skin from elsewhere, can address these wounds and constant care to reduce the suffering of pain and provide comfort to the patient the best possible picture.

In this article we are exposed to the overall problems of the skin and skin in patients with cancer and particularly focus on the problems of itching due to popularity.



Mange



Is itching and Aklan skin and skin (Pruritus) of the usual symptoms of some types of tumors, as caused by side effects of treatments for various cancers, which may appear in some patients, in particular, and the feeling of burning the skin or Aloclan pay the patient to the itching and scratching, and the symptoms are painful and annoying, and may give rise to skin wound infections result when repeated rubbing.



Etiology

Itching may be due to many reasons, starting from dry skin to a tumor is detected, and prepare people in the following circumstances are more likely to occur with:

Tumors in patients known to cause irritability and recall, for example:
Kaposi' Algarni associated with AIDS (Kaposi's sarcoma), tumor and Hodgkin's and most of the lymphoma, leukemia, and adenomas, and tumors of the stomach and pancreas and lung and colon, and brain and breast and prostate, and from the usual to stop the symptoms of itching, the end of the tumor or lull back and his return.

When you receive chemotherapy, and itching usually subside within 30 to 90 minutes and do not need to be addressed, and is increasing in the patient indicate a particular sensitivity to the drug user.

When you receive radiation therapy, Radiation can destroy skin cells, causing heartburn and Aloclan, and more than itching of the affected skin, especially when the skin starts peeling, increasing the potential for infection, and may be sometimes stop radiation therapy for some time to recover when the cells of the skin.

When you receive a combination of chemotherapy and radiation treatments, overlapping of the impacts, both increase the severity of skin reactions and skin.

When you receive drugs adjusted to respond to the treatment of vital immune system.

Following marrow transplant bone marrow, as usual for patients to show some effects and changes in the skin, including dry and the appearance of some types of skin rashes.

The drugs covered at any time during the treatment of tumors may cause itching, in turn, and may be the reason behind the presence of allergy to a particular drug to the patient, or that the drug interferes with the normal functions of the nerves, and that the presence of pruritus may signal the emergence of an infection, and may produce infection accompanied by irritability of the tumor itself or due to fungi or from wounds or abscesses of the discharge after surgery.

It should be noted that the itching is not a disease or diagnosis itself, but rather is a presentation of a reasoned and beyond, and the patient should inform the medical team when he felt Baloclan and itching, which is investigating the situation to determine the origin of the problem and provide appropriate treatment.



Treatment of prurigo



Can alleviate the problems of itching to maintain good skin health and cleanliness, and good care includes proper nutrition and adequate, and increasing rates of perfusion fluid handling in abundance, and protection of the surrounding environment, and hygiene measures and cleansing that do not cause dry skin.



The following suggestions useful in reducing allergy and itching:

The use of pastes and ointments, liquids and soft:
These products have a thin layer on the skin allows Petrtaibha which prevents dehydration, which causes itching, but he should choose the appropriate type for each person, as they may cause some components such as petroleum jelly or lanolin or mineral oil in the emergence of allergies in some people and not others, and topical steroid ointments and although they are good in reducing itching but may cause weakness in the skin, making it more susceptible to scratches and wounds.

Aldhiror and use cornstarch powders and soaps and foam:
And should choose the products carefully, as they may cause some irritation of the skin, and is the cornstarch well in the treatment of itching caused by radiation therapy but it should not be placed on wet surfaces, and sweat glands and the roots of the hair and near mucous membranes, as it allows the growth of fungi when it becomes wet, and should avoid some types of Aldhiror especially those that contain talc powder or aluminum compounds because they cause skin irritation during radiation therapy, and the products that contain alcohol or Almintol (peppermint oil) in turn has caused the allergy.

Helps bathe with warm water for a period of not more than half an hour daily or every two days to alleviate the itching, and it should be noted that the constant bathing aggravates dry skin, and shower with hot water over the severity of itching.

Palliative use of soaps and moderate, which contains a low percentage of detergents that irritate the skin, and can add a little oil to the water at the completion of a shower or fat on the skin before drying.

Presence helps in cold places and moist to prevent the emergence of itching, Heat increases itching, while the skin loses moisture at low humidity room.

Get rid of the remnants of soaps and laundry detergents backward after rinsing clothes, which in turn exacerbates the itching and irritation can be mitigated by adding vinegar to the laundry when the last rinse (one teaspoon per liter of water), or by using detergents for clothes palliative children.

Avoid wearing woolen clothing or textile industry because it increases the severity of itching, and always advised to wear light cotton clothing and wide, as well as the use of cotton sheets for the family.

Can alleviate the itching put a cold towel or ice on the irritated places, or gently patting or pressing it briefly.

In addition to these measures, skin care, comes the role of drugs that can be used both by putting on the skin or taken by mouth, Antibiotics usually relieve the itching caused by the presence of infection, and prescribed antihistamines and painkillers and tranquilizers and antidepressants in turn to help in some cases , while aspirin and although it relieves symptoms in some patients but increases it for others, and the combination with aspirin Alsimitdan drug (cimetidine) may be effective for some cases of Hodgkin's tumors, and the reason for excessive red blood cells (polycythemia vera).



Complications of radiation

Than usual to show the effects of radiation therapy on the skin during periods ranging from one week to two weeks of the start of treatment and stop within weeks after its completion, and the varied reactions of the skin to the radiation from the appearance of redness and slight placement Bhroqat dry skin like the sun, and scaling to severe and Altzlkh the emergence of the rash, and may arise infections can develop into suppuration and Altzlkh coupled fluid-Benz and the appearance of pimples, it is important of course to address the situation in its early stages, and there are various medications and treatments used in this regard, such as the use Aldhiror and topical ointments and creams antibiotics or steroids to reduce inflammation and itching and to speed up the recovery of the skin, and should not use any medication without consulting your physician, and as noted above may be changed or delayed radiation doses at the aggravation of the skin as a result of complications of radiation therapy.



Leakage of chemotherapy drugs injection position (Chemotherapy extravasation)

When the leakage of some chemotherapy drugs to the skin during injection shows burns painful and inflammatory locus of injection or tissue adjacent that the consumer medicine, and to point out that burning sensation or pain during injection is not normal and should inform the doctor immediately when noticing leakage of the drug in a position injection, or when the appearance of any allergies or congestion or redness or pain during injection (or during the days that followed), and should stop the injections and take measures for cleaning, sterilization and treatment in the case, Valmaaljh quickly to prevent such a situation exacerbated the problem.



Wounds Snorts (Necrotic wounds)

Which means that there is dead tissue on wounds or sores, and can not handle such a case, only remove the dead tissue, first, whether surgically or with medication, or both, and then time for medical attention.



Clinical lesions

Any pressure ulcers and friction constant position and one of the body due to stay status fixed for long periods (such as inherent in the bed), and such lesions typically arise disability and the lower part of the spine and Stubs, and to a lesser extent placements where there are layer of fat more intense , and for patients who are forced to remain in bed is very helpful to use water or mattresses filled with air to avoid these sores.



Wounds Almtsrtunh (Malignant wounds)

As mentioned at the emergence of wounds and abscesses due to skin cancer or Anbthat cancer cells to the skin from elsewhere usually bleeding or exit discharge and seepage of large quantities of fluids and blood, in addition to the emergence of the smell is unpleasant with the attendant pain and high risk for the emergence of infections, and medical care as well as permanent for such cases can be overcome by the smell of the wounds using a scented room smells or the use of materials such as granules absorb odors charcoal (charcoal), and may be useful to use coffee as well.
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