Cancer care symptom management

 This post will be continuously updated.

1. Constipation

-types of meds: stool softeners ( docusate), stimulant laxatives ( senna), bulking agents ( psyllium), osmotic laxatives ( milk of magnesia, laculose).

For opiate induced constipation--> stimulants may be needed. Softeners and  bulking agents do not work on their own.

-conside Lubiprostone for chronic IBS associated constipation.

-naltrexone can reverse opiate constipation.

2. Cancer related fatigue:

• Onset and progression:
• Baseline functioning and current interference with ADL:
• Alleviating and aggravating factors:

Assessment:

1. Anemia
2. Sleep: CBT category 1 intervention
3. Anxiety/Depression
4. Endocrine disturbances: thyroid, adrenal insufficiency
5. Alcohol and substance abuse
6. Pain control
7. Physical activity program: category 1, yoga
8. Systems based:

• Liver
• Kidney
• GI
• cardiac
• Neurologic
• Pulmonary

Pharmacologic rx: phase II data for methylphenidate. No convincing evidence for modafinil or ginseng.