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Cancer treatment can be complex. It may involve chemotherapy, radiation, surgery, or a combination of these treatments. Some non-traditional therapies may be used in tandem with these standard treatments. They are called complementary therapies or sometimes CAM, short for complementary and alternative medicine.

Today, many cancer specialists support the use of complementary therapies to augment standard treatment. They recognize the important role that CAM treatments can play in easing symptoms and improving the lives of people with cancer. As a result, some complementary methods are now taught in medical schools and offered by clinics and hospitals.

What are complementary therapies?
The term complementary therapy is applied to a broad range of practices. They are often divided into categories such as:

•Mind-body therapies, which include yoga, meditation, and hypnosis
•Manual therapies, which include many types of massage and hands-on therapies
•Energy therapies, which include acupuncture, tai chi, and qigong
•Biologically based therapies, which include herbs, vitamins, and supplements
Do they work?
Research suggests that some complementary treatments can reduce symptoms of cancer or cancer treatment. For example, studies in people with cancer have shown that:

•Acupuncture can help relieve cancer-related pain, nausea, and vomiting associated with chemotherapy and dry mouth caused by radiation therapy.
•Yoga can improve mood and quality of life and reduce nausea after chemotherapy.
•Manual therapies such as Swedish massage, reflexology, and acupressure can reduce pain, anxiety, distress, and fatigue.
•Hypnosis can help decrease pain, anxiety, nausea, and vomiting. It may also reduce hot flashes in women after breast cancer treatment.
•Energy therapies such as Reiki, therapeutic touch, and qigong may help reduce stress and improve quality of life.
•Relaxation techniques such as guided imagery can reduce stress, pain, anxiety, and side effects from chemotherapy.
Research continues on these and other treatments to improve the lives of people with cancer.

It’s not “either/or”
Some people with cancer are tempted to give up on mainstream medicine and turn to unconventional treatments instead. But there is no evidence that any alternative therapies can halt or slow cancer. Valuable time may be lost if unproven therapies are used in place of proven ones.

Complementary therapies, on the other hand, are used along with standard treatments. They may help you feel better both physically and emotionally as you cope with cancer.

If you are interested in trying a complementary therapy:

•Check with your doctor first to make sure it is safe to use with your prescribed treatments.
•Find a qualified practitioner. Ask your doctor to recommend someone who has experience treating people with cancer.
A word about supplements
Biologically based therapies such as herbs, vitamins, and other supplements are widely used by people with cancer. This may be in part because they are easy to find and relatively cheap. At present, though, there is no evidence to support their use. In some cases, they may actually be dangerous or undermine standard treatments.

Protect your health by being a savvy consumer:

•Be wary of any claims you see or hear about herbs or supplements marketed for cancer.
•Check out any claims on trusted sites such as the National Center for Complementary and Alternative Medicine, National Cancer Institute, and myOptumHealth.com.
•Never take any herbs, vitamins, or other supplements without talking to your doctor first.

Lymphedema is swelling caused by a buildup of lymph fluid. This type of swelling most often occurs in the arms or legs, but it can also affect other parts of the body.

Lymphedema is very common in people who have had cancer. Understanding more about it may help you avoid it or manage it if it occurs.

What causes lymphedema?
Your body has a system of lymph vessels that are something like blood vessels. But instead of blood, the lymph vessels carry lymph fluid throughout your body. Lymph fluid has cells that help fight disease and infection. The lymph system also removes excess fluid and protein from your tissues. Lymph fluid flows through the lymph nodes, which filter out harmful substances.

Lymphedema occurs from damage to the lymph system. Having lymph nodes removed, radiation treatments, or cancer itself can block the flow of lymph fluid. This can cause fluid to build up in your tissues.

You can have lymphedema with any type of cancer, but you are more likely to get it if you’ve had:

•Breast cancer
•Prostate cancer
•Melanoma
•Pelvic area cancers, such as uterine cancer
•Lymphoma
What symptoms should I watch for?
Lymphedema can develop right after cancer treatment or later on. Sometimes it shows up months or even years after treatment. Call your doctor if you notice signs of swelling, such as:

•Arm or leg aches, or heaviness of the arms or legs
•Feelings of tightness of the skin on your arms or legs
•Stiffness in your hands, wrists, or ankles
•Rings, shoes, or sleeves feeling tighter, even though you haven’t gained weight
It’s very important to call your doctor right away if you have swelling and your skin is hot, red, or tender – or you have a fever. These can be signs of a serious infection. Call 9-1-1 if you have sudden weakness in your arm or leg. This could be a sign of a stroke instead of lymphedema.

Can I prevent lymphedema?
You may be able to prevent or reduce lymphedema by taking some precautions.

Protect your skin
The lymph system responds to skin injuries by sending extra fluid to the injured area. So it’s important to protect your skin and prevent injuries and infections:

•Keep your skin clean.
•Use lotion or cream to prevent dry skin.
•Take steps to avoid cuts, bites, and burns. Use sunscreen and insect repellant when outdoors. Use gloves when doing yard work or housework. Use an electric razor. Don’t cut your cuticles.
•Offer your unaffected arm for shots or blood draws.
•For any minor scrapes or cuts, wash with soap and water, apply antibacterial cream, and cover with a clean bandage.
•Check your skin everyday. Treat any injuries right away. Call your doctor if you get a skin infection.
Avoid excess pressure on your arm or leg

•Choose jewelry and clothes that aren’t tight or binding.
•Don’t cross your legs when you’re sitting.
•Have your blood pressure taken on the unaffected arm.
•Don’t stay in one position for more than half an hour. Flex your affected arm or leg often, or get up and walk around.
•If you plan to travel by air, ask your doctor about a compression sleeve or stockings. Also, it is best to avoid alcohol and drink plenty of water when flying.
Exercise carefully
Exercise can help lymph fluid flow better, but overusing your arm or leg can bring on swelling.

•Learn the exercises your doctor or physical therapist prescribes, and do them regularly.
•Find out which exercises and sports to avoid.
•Use your arm or leg normally, but don’t overdo it. Avoid heavy lifting, pulling, or repeated motions.
•If your arm or leg aches, lie down and raise it above chest level.
Treatment for lymphedema
If you have lymphedema, your doctor may prescribe a treatment called complex decongestive therapy (CDT). This is usually done by a physical therapist who has special training. It consists of:

•A type of massage that can help lymph fluid flow better
•Exercises to help the fluid drain
•Bandaging or custom-fit compression sleeves or stockings
•Skin care
Surgery may be done if these treatments don’t work or if you have repeat infections or excessive swelling.

Having the support of family and friends is important if you have cancer, but sometimes nothing beats talking to someone who is in the same boat. Support groups provide an opportunity for people with cancer to share their feelings, talk about their concerns, and learn more about solving problems. Many people with cancer say that support groups provide them with a feeling that they are not alone.

There is evidence that support groups reduce traumatic stress symptoms, reduce other psychological symptoms and distress, help a person cope better, help provide solutions, and improve a person’s quality of life. Support groups are not appropriate for everyone, as some patients do not wish to share their personal thoughts with others. Individual counseling can help.

What kinds of groups are offered?
What kind of support group you attend is up to you. There are different types of groups. They can be open-ended, allowing anyone with cancer or their family members to attend, often for an indefinite period of time. They can be closed, organized for a prescribed period of time just for the same group of people, such as those with the same diagnosis, the same sex, the same stage of disease, or the same type of cancer treatment.

Support groups meet in different settings: a hospital, community agency, family service agency, or a person’s home. There are chat room programs on the Internet for people. Be sure that the chat rooms are from credible sites, such as the American Cancer Society, and that they have moderators.

Some groups are organized by cancer survivors themselves. Professionals, such as oncology social workers, psychologists, psychiatrists, psychiatric or oncology nurses, or clergy, organize others. Professionals should be licensed in their respective fields and be skilled in leading group discussions.

Groups can be organized by topic, meaning different issues will be discussed each week, or there can be a free-flowing agenda during which time participants discuss whatever they like. Some topics that frequently come up in support groups are the impact of the cancer diagnosis, the sense of loss and grief, emotional reactions, relationships with family and friends, and the questioning of the meaning of life.

Regardless of which group you attend, the group leader at your first meeting should discuss confidentiality. You should feel free to discuss your concerns with others and know that what is discussed will remain confidential. Some people feel more comfortable than others, sharing their thoughts and feelings in a group setting.

In addition to support groups, there are other means of support available to people with cancer:

•Home health nursing services
•Social services that provide counseling and financial assistance
•Nutrition services that provide meals or allow you to talk with a registered dietitian
•Rehabilitation services provided by physical and occupational therapists
•Spiritual services from chaplains or religious leaders in the community

In movies about the old west, a cowboy getting a bullet taken out might get a shot of whiskey or a rag to bite down on. Anesthesia has come a long way since then. Doctors now have a wide array of medicines to help prevent pain during medical procedures.

What are the types of anesthesia?

Local anesthesia is used to numb only a small area. It doesn’t put you to sleep. It may be used if you get stitches or have a skin growth removed. It’s usually given as a shot into the area that needs to be numbed.

Conscious sedation uses medicines that relax you and relieve pain. You’re awake, but do not feel pain. You can usually answer questions. Later, you won’t remember what happened.This type of anesthesia is used for procedures such as colon exams (colonoscopy) and vasectomy. Conscious sedationis usually given through an IV line into a vein, but it can also be given as pills or suppositories.

Regional anesthesia numbs a larger area, such as the lower part of your body. As with local anesthesia, you’re awake, but you may also be given conscious sedation to help you relax. Regional anesthesia includes:

•Nerve blocks. These are used to block pain signals from one nerve or group of nerves, such as one supplying a hand, arm, or leg.
•Spinal anesthesia and epidural anesthesia. These are injected into or near the spine to numb the lower part of the body. These types are commonly used for childbirth and prostate surgery.
General anesthesia is used for major surgery. It keeps you still and asleep during the procedure so you won’t feel any pain. It affects your whole body, including your brain and reflexes. You’ll need a breathing tube or mask to keep you breathing properly.

General anesthesia may be given through an IV line or inhaled through a mask. An anesthesia specialist (an anesthesiologist or a nurse anesthetist) will carefully monitor your condition and control the flow of the medicines.

Because of its broad effect on your body, general anesthesia has a higher risk of complications than other types and is more likely to cause side effects.

Is anesthesia risky?
New drugs and better monitoring devices have made anesthesia safer than ever. It can cause side effects, but most of them are minor and temporary. For example, some of the most common side effects of general anesthesia are nausea, vomiting, headache, a sore throat, and bruising at the injection site. More serious complications are possible, but rare. These include an allergic reaction to the medicine, infection, and heart or lung problems.

Your risk will depend on a number of factors. These include your overall health, the type of anesthesia used, and how you respond to the medicines. Your doctor can help you understand your personal risks.

Could I wake up during surgery?
Some people worry that they will wake up while under general anesthesia. This problem is called anesthesia awareness. It is real, but it’s very rare and generally not traumatic.

•Experts estimate the risk is only about 1 in 1,000.
•Those who have anesthesia awareness usually only have a few vague memories. Very few feel pain, although this can happen.
Giving general anesthesia is a delicate balance. The doctor has to keep you asleep so you don’t feel pain, but not too deeply asleep, which could be bad for your brain. Doctors use brain function monitors to measure brain activity and assess the depth of anesthesia. This decreases the chance for brain injury. If you have concerns about anesthesia, discuss them with your doctor or anesthesiologist. Your doctor’s goal is to keep you safe and comfortable.

How can I reduce my risk of problems?
Many factors can affect your response to anesthesia. To plan your care, your doctor will need to know about:

•Any health problems you have
•All the medicines you take, including any herbs, supplements, and over-the-counter drugs
•Any food or drug allergies you have
•Any past reactions to anesthesia
•Whether you smoke, drink alcohol, or use illegal drugs
Your safety depends on your answers. Be honest and thorough with your doctor.

It’s also important to follow any instructions your doctor gives you to prepare for anesthesia. For example, you may be told not to eat or drink anything for several hours before your procedure. If you were not able to do this, be sure to tell your doctor. It may be best to postpone your procedure.

Also, call your doctor if you get sick in the days before you are scheduled for surgery. Depending on the procedure and the type of anesthesia, your surgery may have to be put off until you feel better.

Mouth sores can be a common and bothersome side effect of chemotherapy and some radiation treatments.

Sores (or ulcers) usually appear 5 to 10 days after chemotherapy begins or a couple of weeks after radiation treatments start. The sores can be very painful. Getting proper nutrition may become a concern because eating can make the pain worse. It can also make it hard to talk and swallow.

Why do sores occur?
Cells in the lining of the mouth normally divide, grow, and turn over quickly. These cells can be easily damaged by chemo and radiation. When the cells are damaged, the mouth becomes inflamed and sores develop. This is called mucositis. Then bacteria and fungi can infect the sores and make them worse.

How serious are mouth sores?
Sores make it hard for you to eat and drink, so they can keep you from getting the nutrition you need. If sores are severe, cancer therapy may have to be stopped for a while. For some people, sores may not heal until 2 to 4 weeks after treatment ends. Sometimes people need to go into the hospital to manage pain and prevent dehydration.

What to do?
It’s a good idea to take extra care of your mouth during cancer treatment. The American Dental Association recommends that you:

•See your dentist before you get treatment, especially if you have gum disease or are having any dental pain.
•Continue to brush your teeth twice a day and floss once a day. If this becomes too painful, ask your dentist or doctor about swabs that can be used to clean your teeth.
•Rinse your mouth several times a day with a solution of baking soda and salt. Use 1/4 teaspoon of baking soda and 1/8 teaspoon of salt in 1 cup of warm water.
•Try to stop smoking. Smoking will make mouth sores worse and delay healing.
During cancer treatment, your doctor may recommend that you:

•Suck on ice chips and swish them around in your mouth just before and while you are getting chemotherapy. This can prevent some types of chemotherapy from reaching the mouth and reduce the chances of getting mouth sores.
•Use a rinse that contains a numbing medicine to relieve pain, or take pain medication for discomfort. Your doctor may prescribe other medications to help heal sores.
Other tips to help maintain good nutrition and lessen the pain of eating:

•Eat soft foods that are easy to chew and swallow. Or puree vegetables, fruits, and meats. Warm (not-too-hot or -cold) foods may be less painful.
•Avoid foods that can be irritating (citrus, spicy, acidic, or salty foods, and coarse, dry foods). Coffee and alcohol can also be irritating. Try using a straw to bypass your sore mouth.