Cancer in its terminal stage: Understanding the condition, following routes, and available resources
In the face of a terminal cancer diagnosis, individuals are often confronted with a myriad of emotional and practical challenges. These challenges can range from persistent anxiety, depression, fear, social isolation, and guilt, to managing symptoms and making end-of-life arrangements [1][2][3][4].
Emotional Challenges
One of the key emotional challenges faced by terminal cancer patients is anxiety and fear. Worries about death, the unknown, physical pain, and the wellbeing of family members are common [1][2][3][4]. Depression, with feelings of hopelessness and sadness, is also prevalent, often worsening as the illness progresses [2]. Social isolation can occur due to the emotional burden or physical limitations, leading to loneliness [1][4].
Initial disbelief about the diagnosis (denial) can delay acceptance, and anger may be directed towards loved ones, healthcare providers, or oneself [3]. Guilt might arise from feelings of burdening family members or past lifestyle choices potentially linked to the cancer [3].
Practical Challenges
Practical challenges often stem from the physical symptoms and treatment side effects, such as pain, fatigue, and cognitive or personality changes, which complicate daily functioning and decision-making [4][1]. Patients may struggle with managing emotions while navigating treatment, healthcare systems, and planning for end-of-life care.
Support and Care
Effective support includes mental health assessments, counseling, communication encouragement, and stress management techniques like mindfulness [2][4]. Recognising these emotional and practical challenges is crucial for healthcare providers to deliver holistic care that addresses both the physical and psychological needs of terminal cancer patients [1][4].
Clinical trials may be offered to assess the safety and efficacy of new treatments, although they may involve risks and may not significantly improve a person's health status [5]. Hospice care, a type of care provided to people with terminal illnesses, including terminal cancer, to help manage symptoms and provide emotional support during the final stages of life, is not focused on delaying or hastening the end of a person's life [6].
Hospice care can take place at home or in a special facility, and it is not provided for the entirety of a person's cancer experience alongside other treatments [6]. Life expectancy with terminal cancer varies and depends on several factors, including the type of cancer and a person's functional performance [7]. Doctors may use guidelines like the Karnofsky performance scale and the palliative performance scale (PPS) to estimate life expectancy [7].
Patients experiencing symptoms of depression should contact a doctor to discuss ways to manage and treat these symptoms [4]. Palliative care, a type of care that focuses on treating and preventing cancer symptoms, addressing concerns, and providing emotional support, can involve methods similar to cancer treatment, such as radiation therapy, chemotherapy, or surgery [8].
References
[1] National Cancer Institute. (2021). Cancer: Finding Help for Emotional Distress. https://www.cancer.gov/about-cancer/treatment/supportive-care/caregiving/emotional-distress
[2] American Cancer Society. (2021). Emotional Support and Coping. https://www.cancer.org/treatment/survivorship-during-and-after-treatment/emotional-health/emotional-support-and-coping.html
[3] Mayo Clinic. (2021). Cancer: Helping a loved one cope with a terminal diagnosis. https://www.mayoclinic.org/diseases-conditions/cancer/in-depth/terminal-cancer/art-20047240
[4] National Institute of Mental Health. (2021). Depression. https://www.nimh.nih.gov/health/topics/depression/index.shtml
[5] National Cancer Institute. (2021). Cancer Clinical Trials. https://www.cancer.gov/about-cancer/treatment/clinical-trials
[6] National Hospice and Palliative Care Organization. (2021). What is Hospice Care? https://www.nhpco.org/about-us/what-is-hospice-care/
[7] National Cancer Institute. (2021). Prognosis. https://www.cancer.gov/about-cancer/treatment/prognosis
[8] American Cancer Society. (2021). Palliative Care. https://www.cancer.org/treatment/treatments-and-side-effects/palliative-care.html
