Physical concerns related to cancer

During or after cancer, you may have physical concerns. To better manage or alleviate them, it is recommended to adopt healthy lifestyle habits, for example:

• move or exercise
• have a healthy, balanced diet
• adopt stress or anxiety management strategies
• have good sleep habits
• consult a health professional

The information in this directory must not be considered medical advice and must not replace a consultation with a doctor, nurse or health professional. If you have any questions about your health, consult a health professional.

Your ability to concentrate may be affected. Your thoughts may be confused, and you may experience memory loss.

To better manage or alleviate impaired concentration or memory, you can:

• practice concentrating, for example, by doing sudoku, a puzzle or crosswords
• use reminders, for example, take notes or use a diary
• consult your doctor

For more information:

• Troubles cognitifs – Content developed by e-IMPAQc (in French only)
• Cognitive problems – Canadian Cancer Society
• Managing fatigue and cognitive challenges – Leukemia & Lymphoma Society of Canada
• Mental Fog or “Chemobrain” – Quebec Breast Cancer Foundation
• Cognitive challenges – Cancer and Work – McGill University Health Centre (MUHC) and BC Cancer
• What to expect after treatment – Managing side effects and their symptoms – Centre intégré universitaire de santé et de services sociaux (CIUSSS) de l’Ouest-de-l’Île-de-Montréal

Short-lived (acute) or persistent (chronic) pain can be the result of the illness. You may experience different types of pain at different times. Pain is perceived in many ways.

Most pain can be controlled. If it is treated as soon as it appears, it will be easier to control. It is easier to relieve it before it gets too intense.

Pain can be caused by:

• a specific intervention such as a biopsy or surgery
• the side effects of chemotherapy, for example, nerve deterioration or bone pain
• the side effects of radiation therapy, for example, irritation of the skin and mucous membranes or inflammation
• another medical cause

Since pain tolerance varies from one person to the next, it can affect people in different ways.

Pain can lead to:

• worry
• stress and anxiety
• irritability or impatience
• annoyance or frustration
• a decreased ability to carry out your daily activities
• difficulties in your social life
• a more negative attitude to life
• a poorer perception of yourself or your health

To relieve pain:

• if you are taking pain medication, be sure to follow the directions and plan well so that you do not miss any
• consult your doctor or pharmacist to prepare a treatment plan
• consult a specialized professional, for example, a physiotherapist, massage therapist or acupuncturist

Whatever is causing the pain, you do not have to tolerate it. You should consult if the pain:

• occurs before your next scheduled dose of pain medication
• interferes with your daily activities
• affects your sleep
• affects your mood

For more information:

• Mieux dans mon corps – Le toucher dans la gestion de la douleur (video) – Association du cancer de l’Est du Québec (in French only)
• Pain relief when you have cancer (video) – Canadian Cancer Society
• Mieux gérer la douleur et l’usage des opioïdes (video) – Centre hospitalier de l’Université de Montréal (CHUM) (in French only)
• Les approches non pharmacologiques en gestion de la douleur (video) – CHUM (in French only)
• L’acupuncture, une alliée complémentaire dans le traitement du cancer (video) – Ordre des acupuncteurs du Québec (in French only)
• Pain – Canadian Cancer Society
• Pain Relief: A guide for people with cancer – Canadian Cancer Society

If you have persistent symptoms, such as constipation, diarrhea or any other gastrointestinal disorder, consult a doctor.

For more information:

• Constipation – Canadian Cancer Society
• Diarrhea – Canadian Cancer Society
• Constipation – Quebec Cancer Foundation
• Constipation – Content developed by e-IMPAQc (in French only)
• Diarrhée – Content developed by e-IMPAQc (in French only)
• Diarrhea related to cancer treatments – CHUM
• Diarrhea – Symptom Management Tip Sheet – Rossy Cancer Network
• Constipation – Symptom Management Tip Sheet – Rossy Cancer Network

Dyspnea is a feeling of breathlessness, of not getting enough air or discomfort while breathing, preventing you from breathing normally.

It is advisable to consult a doctor to find out what is causing the breathing difficulty. Once the cause is known, ways to manage shortness of breath can be proposed.

For more information:

• Dyspnée – Content developed by e-IMPAQc (in French only)
• Shortness of Breath – Symptom Management Tip Sheet – Rossy Cancer Network
• Managing Shortness of Breath For People With Cancer – Cancer Care Ontario

Fatigue is the most common symptom for people with cancer. It is often related to all the physical and psychological effects that cancer and cancer treatment can have. Even if fatigue sometimes lessens after treatment is over, it may take several months for it to diminish or disappear completely. Energy levels may not return to pre-disease levels. Asthenia is abnormal fatigue that continues even after rest and a good night’s sleep.

Fatigue can be caused by:

• cancer and cancer treatment
• stress and anxiety
• lack of sleep and insomnia
• pain
• hormone irregularities
• poor lifestyle habits, for example, physical inactivity, poor diet, alcohol consumption or environmental stimulation
• depression
• sleep apnea
• anemia (lack of energy caused by a problem in the blood)
• a vitamin or mineral deficiency
• medication
• another medical cause

Fatigue can lead to:

• low energy
• stress or anxiety
• insomnia
• impaired concentration and memory
• a decrease in your ability to carry out your daily activities
• sadness or depression
• irritability or impatience
• reduced pain tolerance

To alleviate fatigue caused by cancer, you can:

• relieve pain
• drink enough water
• check if you are taking any medications that may cause sleep problems. If so, talk to your pharmacist to try to solve the problem
• talk to your doctor or pharmacist to check that there are no health problems that are causing your fatigue
• get support from family and friends
• consult a health professional, such as a psychologist, social worker, physiotherapist, massage therapist, acupuncturist or nutritionist

You should consult a health professional when fatigue:

• prevents you from carrying out your activities of daily living, for example, getting dressed, bathing or eating
• affects your mental health
• is accompanied by other symptoms, such as loss of appetite, weight loss or fever
• does not diminish despite good sleep hygiene

For more information:

• Fatigue – Canadian Cancer Society
• Discover the strategies that will help you improve your cancer fatigue – My Cancer Fatigue
• Comprendre et gérer la fatigue liée au cancer – Centre hospitalier universitaire (CHU) de Québec – Université Laval (in French only)
• Coping with fatigue related to cancer and treatments – CHUM
• Fatigue/tiredness – Symptom management tip sheet – Rossy Cancer Network
• Mon plan d’action – Fatigue liée au cancer – My Cancer Fatigue (In French only)

The effects of cancer and cancer treatment can have repercussions on a person’s fertility. For example, the ability to get pregnant and carry a pregnancy to term may be affected.

It is important to consult a health professional or a doctor to discuss the options available before and after cancer treatment

For more information:

• Cancer – Fertility Preservation Women (video) – Rossy Cancer Network
• Cancer – Preserve your fertility – MUHC Reproductive Centre Montreal (video) – Rossy Cancer Network
• La sexualité après le cancer : la fertilité (video) – Centre intégré de santé et de services sociaux (CISSS) de Laval (in French only)
• Side effects – Reproduction and Fertility – Quebec Cancer Foundation
• Fertility problems – Canadian Cancer Society
• Female reproductive system problems – Canadian Cancer Society
• Female Fertility Preservation – MUHC
• Fertility and cancer – Leukemia & Lymphoma Society of Canada

Lymphedema is swelling caused by a build up of lymphatic fluid, generally in the arms, legs or neck.

Lymphedema generally appears as a result of cancer treatment, such as radiation therapy or surgery near lymph nodes or to remove lymph nodes.

For more information about this condition, go to the Lymphedema page.

To manage the symptoms of lymphedema and prevent complications, you can:

• move or do physical activity to promote blood flow
• do exercises adapted to surgery that may have affected the lymph nodes
• wear compression garments
• do massage and manual lymph drainage
• have good skin hygiene
• maintain a healthy weight
• consult a doctor as soon as the problem appears

For more information:

• Video library of Lymphedema Association of Québec (videos) – Lymphedema Association of Québec
• Thérapie du lymphœdème (video) – CHU de Québec – Université Laval (in French only)
• Program to prevent Musculoskeletal Complications Following Breast Cancer Treatments (video) – Quebec Breast Cancer Foundation and CISSS de la Montérégie‑Centre
• Mieux dans mon corps – Prévenir et gérer le lymphœdème (video) – Association du cancer de l’Est du Québec (in French only)
• Mieux dans mon corps – Lymphœdème – Exercices (video) – Association du cancer de l’Est du Québec (in French only)
• Lymphedema – Cancer and Work – MUHC et BC Cancer
• Lymphedema – Merck Manuel – consumer version
• Lymphœdème – CHUM (in French only)

Some treatments can affect the nerves that control the ability to feel or move (peripheral neuropathy). Neuropathy occurs when nerves are damaged. The first symptoms are usually felt in the fingers and toes.

Neuropathy can lead to:

• numbness, tingling, sensitivity to touch, a burning or electric shock sensation in the hands or feet
• weakness, cramping or muscle pain in the arms and legs, especially in the hands or feet
• loss of sensation, especially in the hands and feet
• joint pain
• difficulty walking or loss of balance that may lead to falls
• difficulty doing up buttons on your clothes, writing, tying your shoelaces
• difficulty recognizing the feel of small objects or picking them up
• constipation or bloating
• erectile dysfunction or difficulty urinating
• dizziness, slightly blurred vision, difficulty hearing or chewing when the nerves in the head are affected
• a different way of sweating

The symptoms usually decrease over time, but some damage may be permanent.

Since sensation is reduced and you may have muscle weakness or difficulty keeping your balance, here are a few tips.

If you have neuropathy in your hands or feet:

• be careful when handling sharp, hot or cold objects
• do not walk barefoot
• wear gloves and socks when it is cold
• check your hands and feet regularly to make sure there are no cuts or wounds

If your muscle strength or balance is affected:

• move slowly and use the handrails when you take the stairs
• get up slowly
• use a grab bar and make sure you have a non-slip mat in the bathroom
• use a cane or walker to help you keep your balance when you walk

If you drive and have neuropathy in your hands and feet, make sure you can feel the steering wheel and pedals of your car.

To help you live better with or alleviate neuropathy, you can do sensory rehabilitation exercises. The aim is to reduce pain related to neuropathy by relearning skin sensation. These exercises require a lot of time and repetition. Neuropathic pain usually decreases within a few weeks or months after starting the exercises if they are repeated frequently.

Medical treatments can help treat the symptoms of neuropathy. However, doing medical treatments at the same time as sensory rehabilitation exercises can help you stay independent and feel better.

If you have neuropathy, you can also consult:

• a doctor as soon as the problem appears
• a pharmacist to find the right painkiller for you
• a professional, for example, a physiotherapist, kinesiologist, occupational therapist, massage therapist or acupuncturist

For more information:

• Peripheral neuropathies induced by chemotherapy (video) – Quebec Breast Cancer Foundation in collaboration with the CISSS de la Montérégie‑Centre
• Peripheral nerve damage (peripheral neuropathy) – Canadian Cancer Society
• Nerve damage – Cancer and Work – MUHC and BC Cancer
• Problèmes aux nerfs liés aux traitements contre le cancer – CHUM (in French only)
• Peripheral Neuropathy – Symptom Management Tip Sheet – Rossy Cancer Network

During treatment various skin problems can develop, including:

• itching
• a burning sensation
• sensitivity
• irritation
• dryness
• peeling skin
• a change in skin colour

Treating these symptoms promptly can help reduce discomfort and the risk of infection.

If you have skin problems, you can:

• use products that are unscented and labelled for sensitive skin for your personal hygiene
• keep your skin moist
• protect yourself from the sun
• move or exercise to promote blood flow
• adopt a healthy, balanced diet
• adopt stress or anxiety management strategies

Consult a health professional if:

• you have redness, a purulent or foul-smelling discharge from a wound
• The pain or burning sensation in the affected skin area worsens
• you suspect a nail infection
• your skin problems prevent you from carrying out your daily activities

For more information:

• Skin problems – Canadian Cancer Society
• Changes in skin and nails – Cancer and Work – MUHC and BC Cancer
• Bleeding problems – Cancer and Work – MUHC and BC Cancer
• Skin Rash – Symptom Management Tip Sheet – Rossy Cancer Network
• Bleeding – Symptom Management Tip Sheet – Rossy Cancer Network
• Hand-foot Syndrome – Cancer Care Ontario

Sleep problems are common in people with cancer. They can also continue after treatment ends. It is normal to sleep poorly or to have a bad night’s sleep because of worries, whether related to cancer or not.

The earlier the problem is identified, the greater the possibility of preventing insomnia from becoming a persistent (chronic) problem. When the problem is resolved, sleep often improves.

Insomnia refers to difficulty falling or staying asleep, preventing restful sleep. It is often frequent and sometimes even chronic.

Insomnia can be caused by:

• a particular worry or problem
• stress or anxiety
• pain
• hormonal irregularities
• poor lifestyle habits such as a poor diet, alcohol consumption or environmental stimuli
• medication

Insomnia can lead to:

• fatigue
• low energy
• stress or anxiety
• impaired concentration and memory
• a decrease in your ability to carry out your daily activities
• sadness or depression
• irritability
• reduced pain tolerance

Drowsiness is felt when the body is ready to go to sleep: yawning is common and the eyes close on their own.

After a bad night when you don’t get enough sleep, there is a greater risk of feeling drowsy. Antidepressants, painkillers and sleeping pills are medications known to cause drowsiness.

Drowsiness during the day can lead to:

• fatigue
• low energy
• stress or anxiety
• impaired concentration and memory
• a decrease in your ability to carry out your daily activities
• reduced productivity
• diminished reflexes
• a safety risk (falling asleep at the wheel)

If you have sleep problems, such as insomnia or drowsiness, you can:

• try to identify what is causing the sleep problem in order to resolve it
• adopt good sleep habits
• relieve pain
• check if you are taking any medications that may cause sleep problems. If so, talk to your pharmacist
• consult your doctor or pharmacist to make sure there is no medical cause
• check if a solution other than medication can be recommended by your doctor or pharmacist

If your doctor suggests that you take medication to help you sleep, note that:

• the sleep medication must be taken every day, but over a predetermined length of time. Under certain medical conditions, your doctor may prescribe it in the longer term
• if you want to stop taking your sleep medication, you must talk to your doctor or pharmacist so that they can supervise you and you do so gradually
• it is important to maintain good sleep hygiene, even if you are taking sleep medication

Consult a health professional if:

• you sleep badly three or more times a week
• your insomnia symptoms get worse, or you develop new ones
• your lack of sleep interferes with your daily activities
• you doze off regularly during the day
• you show signs of sleep apnea. This is characterized by chronic snoring, episodes of choking or gasping during sleep that lead to headaches in the morning and poor concentration during the day
• you have restless legs syndrome which is characterized by a strong urge to move your legs and sometimes your arms. This feeling of discomfort in the limbs can interfere with sleep
• you regularly feel drowsy during the day, that is, for several days

For more information:

• Hygiène du sommeil (video) – CISSS de la Gaspésie (in French only)
• Sleep problems – Canadian Cancer Society
• Insomnie et cancer – CHU de Québec – Université Laval (in French only)
• Sleep disturbances – Cancer and Work – MUHC and BC Cancer
• Changements de sommeil – Fiche d’information sur la gestion des symptômes – Réseau de cancérologie Rossy (In French only)