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Understanding the Treatment Plan

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Your loved one’s health care team will likely recommend a treatment course based on the specific type of head and neck cancer, disease stage and guidelines based on the best evidence to date from research.1Northouse L, Williams AL, Given B, McCorkle R. Psychosocial care for family caregivers of patients with cancer. J Clin Oncol. 2012 Apr 10;30(11):1227-34. These are not the only factors used to select the best treatment options, so you should ask for as much information as possible to understand the benefits, risks and side effects associated with the treatment plan.

Another essential element of the treatment plan, however, is planning to meet your needs as the caregiver throughout your loved one’s cancer journey. Your well-being will affect the patient’s well-being. If you are able to act as an effective caregiver, then you can influence your loved one to follow treatment recommendations in order to increase your chances of having the best possible outcome.Take the time to make a treatment plan for you as a caregiver during your loved one’s cancer journey.

The types of treatment

As covered in this section, your patient will likely undergo surgery, radiation, chemoradiation or a combination of these therapies during his or her cancer treatment. The more familiar you are with these therapies and their side effects, the better equipped you will be to help your patient endure his or her treatment, deal with side effects and navigate the recovery process.

Meeting your patient’s needs and your own

Treatment is grueling not only for cancer patients but also for their caregivers. Although the proportion of caregivers for people with cancer who experience emotional distress, anxiety or depression varies throughout the course of the cancer journey, up to 40 percent of caregivers experience anxiety and/or depression.2Grunfeld E, Coyle D, Whelan T, et al. Family caregiver burden: results of a longitudinal study of breast cancer patients and their principal caregivers. CMAJ. 2004 Jun 8;170(12):1795-801.

A major factor that negatively impacts a caregiver’s well-being is a limited ability to participate in interests and activities.3, Nijboer C, Tempelaar R, Triemstra M, van den Bos GA, Sanderman R. The role of social and psychologic resources in caregiving of cancer patients. Cancer. 2001 Mar 1;91(5):1029-39.4Cameron JI, Franche RL, Cheung AM, Stewart DE. Lifestyle interference and emotional distress in family caregivers of advanced cancer patients. Cancer. 2002 Jan 15;94(2):521-7.

The following solutions may help you meet both your needs and the needs of your loved one:

  • Researchers found that counseling for a caregiver/cancer patient pair or to the caregiver alone reduced anxiety.5, Northouse LL, Mood DW, Schafenacker A, et al. Randomized clinical trial of a family intervention for prostate cancer patients and their spouses. Cancer. 2007 Dec 15;110(12):2809-18.Moreover, counseling can equip you with improved problem-solving skills or levels of confidence, which will help you in your caregiving duties.Counseling programs provided through the phone were also effective in reducing anxiety and depression, so consider this option if you have limited time or ability to be away from your home.5, Northouse LL, Mood DW, Schafenacker A, et al. Randomized clinical trial of a family intervention for prostate cancer patients and their spouses. Cancer. 2007 Dec 15;110(12):2809-18.6Badger T, Segrin C, Dorros SM, Meek P, Lopez AM. Depression and anxiety in women with breast cancer and their partners. Nurs Res. 2007 Jan-Feb;56(1):44-53.
  • Participate in an exercise program. Exercise programs reduce anxiety and depression in both caregivers and cancer patients.Your loved one may experience cancer-related fatigue; between 70 and 80 percent of people treated with radiation or chemoradiation therapy experience cancer-related fatigue.7, Smets EM, Garssen B, Schuster-Uitterhoeve AL, de Haes JC. Fatigue in cancer patients. Br J Cancer. 1993 Aug;68(2):220-4.8, Vogelzang NJ, Breitbart W, Cella D, et al. Patient, caregiver, and oncologist perceptions of cancer-related fatigue: results of a tripart assessment survey. The Fatigue Coalition. Semin Hematol. 1997 Jul;34(3 Suppl 2):4-12.9, Henry DH, Viswanathan HN, Elkin EP, Traina S, Wade S, Cella D. Symptoms and treatment burden associated with cancer treatment: results from a cross-sectional national survey in the U.S. Support Care Cancer. 2008 Jul;16(7):791-801.10Hofman M, Ryan JL, Figueroa-Moseley CD, Jean-Pierre P, Morrow GR. Cancer-related fatigue: the scale of the problem. Oncologist. 2007;12 Suppl 1:4-10. Researchers have found that exercise reduces cancer-related fatigue.11, Dimeo F, Rumberger BG, Keul J. Aerobic exercise as therapy for cancer fatigue. Med Sci Sports Exerc. 1998 Apr;30(4):475-8.12, Dimeo F, Schwartz S, Wesel N, Voigt A, Theil E.Effects of an endurance and resistance exercise program on persistent cancer-related fatigue after treatment. Ann Oncol. 2008;19(8):1495-1499.13, Curt GA. Like pain, this is a symptom that physicians can and should manage. BMJ. 2001;322:1560.14Rock CL, Doyle C, Demark-Wahnefried W, et al. Nutrition and physical activity guidelines for cancer survivors. CA Cancer J Clin. 2012 Jul-Aug;62(4):243-74. Therefore, if you participate in an exercise program with your loved one, you should both benefit.
  • Both you and your loved one should periodically meet with a psychologist for mental health screening.
  • Build up a caregiving network and occasionally take time off.
There was somebody else there, too—I think that’s so important, if you can get a friend or a family member to go there and pay attention to what’s going on. Because as a patient, you’re just focused on, “Holy cow, I’ve got cancer.” John C. (son of a laryngeal cancer patient)

More about the treatment plan

The articles in this section may help you and your loved one understand the head and neck cancer treatment plan.

Treatment Types

Learn more about the types of treatments your loved one may receive for his or her head and neck cancer.

Long-Term Planning

Help your loved one make a long-term plan for dealing with cancer treatments and side effects that often linger long after treatment is completed.

Staying on Top of the Treatment Plan

Understand how you can help your loved one track and report treatment-related symptoms to the care team.


References

1 Northouse L, Williams AL, Given B, McCorkle R. Psychosocial care for family caregivers of patients with cancer. J Clin Oncol. 2012 Apr 10;30(11):1227-34.

2 Grunfeld E, Coyle D, Whelan T, et al. Family caregiver burden: results of a longitudinal study of breast cancer patients and their principal caregivers. CMAJ. 2004 Jun 8;170(12):1795-801.

3 Nijboer C, Tempelaar R, Triemstra M, van den Bos GA, Sanderman R. The role of social and psychologic resources in caregiving of cancer patients. Cancer. 2001 Mar 1;91(5):1029-39.

4 Cameron JI, Franche RL, Cheung AM, Stewart DE. Lifestyle interference and emotional distress in family caregivers of advanced cancer patients. Cancer. 2002 Jan 15;94(2):521-7.

5 Northouse LL, Mood DW, Schafenacker A, et al. Randomized clinical trial of a family intervention for prostate cancer patients and their spouses. Cancer. 2007 Dec 15;110(12):2809-18.

6 Badger T, Segrin C, Dorros SM, Meek P, Lopez AM. Depression and anxiety in women with breast cancer and their partners. Nurs Res. 2007 Jan-Feb;56(1):44-53.

7 Smets EM, Garssen B, Schuster-Uitterhoeve AL, de Haes JC. Fatigue in cancer patients. Br J Cancer. 1993 Aug;68(2):220-4.

8 Vogelzang NJ, Breitbart W, Cella D, et al. Patient, caregiver, and oncologist perceptions of cancer-related fatigue: results of a tripart assessment survey. The Fatigue Coalition. Semin Hematol. 1997 Jul;34(3 Suppl 2):4-12.

9 Henry DH, Viswanathan HN, Elkin EP, Traina S, Wade S, Cella D. Symptoms and treatment burden associated with cancer treatment: results from a cross-sectional national survey in the U.S. Support Care Cancer. 2008 Jul;16(7):791-801.

10 Hofman M, Ryan JL, Figueroa-Moseley CD, Jean-Pierre P, Morrow GR. Cancer-related fatigue: the scale of the problem. Oncologist. 2007;12 Suppl 1:4-10.

11 Dimeo F, Rumberger BG, Keul J. Aerobic exercise as therapy for cancer fatigue. Med Sci Sports Exerc. 1998 Apr;30(4):475-8.

12 Dimeo F, Schwartz S, Wesel N, Voigt A, Theil E.Effects of an endurance and resistance exercise program on persistent cancer-related fatigue after treatment. Ann Oncol. 2008;19(8):1495-1499.

13 Curt GA. Like pain, this is a symptom that physicians can and should manage. BMJ. 2001;322:1560.

14 Rock CL, Doyle C, Demark-Wahnefried W, et al. Nutrition and physical activity guidelines for cancer survivors. CA Cancer J Clin. 2012 Jul-Aug;62(4):243-74.