Discomfort disfigurement and disability

Treatments for cancer are unpleasant and cause considerable distress. Surgery can be mutilating and may cause losses of function, body image, self-esteem, and libido. Radiotherapy can induce:

Anxiety and depression

♦ Nausea and vomiting

♦ Skin irritation

Chemotherapy probably has the worst reputation for side-effects, in particular:

♦ Neurotoxicity

♦ Cardiotoxicity

♦ Nausea and vomiting

The advent of the 5HT3 antagonists in the past decade has made many toxic treatments more tolerable, but clinicians should be aware of the need to prevent emesis occurring at the beginning of treatment to avoid classically conditioned responses developing. One study of patients successfully treated for lymphoma showed that they continued to experience nausea and vomiting in response to any stimuli associated with the hospital many years after the cessation of treatment.

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