| CARERS AND THE MEDICAL TEAM
As a carer, your efforts must complement that of your loved one’s medical team.
Support the medical team by following all their instructions. If you have doubts, ask for
At times, some carers feel that because they are not medically trained, their efforts are
not as helpful as the medical team. Do not feel this way.
Carers help to ensure that the treatment is effective. Your role is important in the
recovery, well being and comfort of your dear one.
Opening up the communication passageway no matter how hard it can become,
allows both the caregiver and the loved one to process the situation and reach an
understanding. This in return will compliment the medical team’s effort in prescribing
LEARNING ABOUT TESTS & TREATMENTS
The more you know about the tests, treatments and medication
prescribed, the better you can care for your loved one.
You will understand why certain drugs have been prescribed
instead of the others. Or why only certain tests have been
done and not the others.
Ask the medical team to repeat and explain in simpler terms
if required. Even if they have explained to you earlier, they
would understand that you and your loved one may have
been in shock when receiving the information.
You can also refer to authoritative books and the Internet but
make sure you visit only reputable medical sources.
Tests for Cancer
Medical tests are carried out to confirm if a person has cancer.
There are various tests to identify different cancers.
Before any tests are conducted, the doctor will enquire the
patient on their ailments, family history and lifestyle. He will
also look at the patient’s symptoms and complaints.
Based on this information, the doctor will recommend certain
tests to diagnose what cancer the patient could have. Tests
are never done unnecessarily.
The doctor also may run more tests to confirm the result or to
identify other types of cancer. Following are some of the tests
you can expect:
- Full blood count
Conducted to examine the number of red, white and
platelet cells in the blood. The level of red blood cells will
show if the patient is anaemic. White would point to the
person’s immunity level – if they are fighting an infection.
Platelets are checked as they
- Electrolytes (electrolyte estimation)
Used to see if there is an imbalance of salts in the blood,
particularly sodium and potassium. An imbalance indicates
that the patient is unwell.
- Urea & Creatinine
Urea and creatinine levels are measured to check kidney
- Liver Function Tests
The level of protein and certain enzymes are measured to
see if the liver is working correctly and efficiently.
- Special Blood Tests
Performed when certain specific cancers are suspected
such as ovarian and testicular cancer. These tests are also
done to measure how well a cancer patient is responding
A biopsy may be done either to support blood tests or as an
Biopsy means removing tissue from the living body for
During a biopsy, the entire lump (tumour) may be removed
or just a part of it. It may be done during the patient‘s first
visit to the doctor or during subsequent visits. This is done via
a minor surgical operation. The lump is then examined.
Both the timing and size of the lump to be removed will
depend on the patient’s condition and the location of the
lump within the body.
Very simply, this test uses a micro camera attached to fibreoptic
cables which can be inserted into hollow cavities in the body
(the throat, nose, rectum, etc).
It allows the doctor to see inside the patient’s body without having
to perform surgery. The fibreoptic cables can be controlled from
the outside for a more detailed view of the patient’s organs and
tissues as well as extract a tissue sample for biopsy.
The process is slightly invasive, but not painful. Patients are
normally sedated or under anaesthetic during the procedure to
reduce discomfort. This technique has several variations:
To examine the airways leading to and directly from the
lungs. The tube is inserted through the nose.
- Oesophagoscopy / gastroscopy / duodenoscopy
To examine the gastro-intestinal tract (stomach). The tube is
inserted through the mouth into the stomach.
To examine the intestinal tract with the tube inserted through
To examine the bladder (urethra) with the tube inserted via
the bladder itself
X-rays help doctors ‘see’ the tumour in the body, particular those
in the stomach (digestive tract) and the breast. You may hear
the doctor mention tests such as Barium meal, Barium enema
and mammogram (for breasts). These are all X-ray based tests.
Similar to X-rays but scans can give a better picture of the size,
position and shape of lumps in the body. Scans commonly use
either CT scans or MRI scans.
Both require the patient to lie still as they capture images or
data of the patient’s body which is displayed on a computer.
The process is painless.
There is also the ultrasound (ultrasonic) scan. Normally used in
pregnancy, it can also be used to examine organs. It is noninvasive,
harmless and inexpensive.
Treatments for Cancer
Once the doctor diagnoses that a patient has cancer, a treatment
plan is prescribed. Following are some of the treatments that
your loved one may undergo with regard to their cancer.
Surgery is used when the tumour is limited to one area and
there is a good chance that the entire tumour can be removed
completely. If the operation is done early enough, it can be
highly successful in removing tumours and greatly reduce the
chance of it recurring.
The initial reaction from many patients is to opt for surgery
simply because in their panic or fear, they want to remove
the ‘sickness’ from their body as quickly as possible. But if the
cancer has spread too far, the tumour is too advanced or the
patient is too weak, other methods may be recommended.
You may need to counsel your loved one on their
condition and why surgery is not suitable for them.
On the other hand, he/she may be scared of facing
surgery. If so, you can assure them that the procedure
is safe and necessary for their health.
Tips for surgery:
- Arrive on time for all appointments (normally a day before
- Before surgery the patient may undergo blood, urine and
general health tests.
- A consent form will need to be signed either by you or your
loved one before surgery.
- Ensure that no food or drink is consumed several hours
- Based on doctor’s instructions, prepare your home so that
your loved one will be comfortable upon discharge from
- Ensure your patient gets enough rest as per doctor’s orders
and attends all post-surgery appointments.
- Constantly check the wound to see if it is healing well.
Radiotherapy uses small quantities of radiation to ‘attack’
the tumours and eliminate them. Like surgery, it targets a
particular area where the tumour is located.
Radiotherapy can be used independently or in combination
with surgery and chemotherapy. Radiotherapy first ‘shrinks’
the tumour so that a less invasive surgery can be done. Or it
can be done as a follow-up to surgery just in case some cancer
Today, modern technology has made radiotherapy more
accurate – attacking the cancerous cells with minimum
damage to healthy tissue. Damaged healthy tissue will grow
Watch out for these post radiotherapy side effects:
- General tiredness
Solution: Get your loved one to rest more after radiotherapy
- Redness of the skin (similar to sunburn)
Solution: Use talcum powder and body lotions as recommended
by the doctor.
- Hair loss (if radiotherapy is aimed at the scalp, armpits
and pubic area).
Solution: Hair will grow after treatment stops.
- A sore or dry mouth (if radiotherapy is applied to the
head or neck)
Solution: Pay special attention to dental hygiene, avoid spicy
food and alcohol.
- Diarrhoea, nausea and vomiting
Solution: Have ready anti-diarrhoea and anti-nausea
medication. Drinks with hydrating salts are also useful.
- Cystitis (temporary burning sensation when urinating)
Solution: Consult your doctor for medication if none is
In chemotherapy, most drugs are intravenously fed into the
patient, which then goes into their body and attacks the
This treatment is used when the cancer has spread throughout
the body or has a good chance of spreading through the
body. It is used to combat many cancers such as leukaemia,
lymphomas, childhood and adult cancers.
Unfortunately, the drugs used (cytotoxic drugs) also attack
normal cells. But with better drugs, the effect on healthy cells
has been reduced while maintaining or increasing the damage
on cancer cells. A complete chemotherapy course can take
from one to several days repeated over 1-4 weeks.
Most patients are unable to continue with their daily
lives during chemotherapy. Your physical and emotional
support is important in helping them complete the
course and reduce the side effects.
The side effects are similar to radiotherapy with some
Things to know about chemotherapy:
- Bone marrow damage
- Fertility reduction
- Pins and needles, numbness or pain in hands or feet
- For each visit, the cancer patient will undergo a pre-therapy
check for possible side effects. Make sure you are aware of
this so you can be better prepared. A blood test will also be
- During the treatment, make sure your loved one avoids
public places. Chemotherapy can cause a weakened immune
system which makes them susceptible to infections.
- Avoid many people visiting your friend or relative during
- If your loved one has a raised temperature or a sore throat,
he/she could be ill.
Targeted cancer therapy uses drugs to destroy cancer cells or
block them from spreading. At the same time, the drugs are
designed to not damage healthy cells.
The drugs work by blocking specific enzymes and proteins
that make the cancer cells grow. This is possible as the drugs
can identify specific markers found only in cancer cells. The
cancer cells are killed while healthy cells are left untouched.
This reduces the impact of side effects on the patient.
Many targeted cancer therapies are being tested and some
have been approved for use.
Consult your doctor on whether your loved one can also
receive targeted therapy if it is available.
Hormone treatment involves controlling levels of certain
hormones in the body to suppress the growth of cancer cells.
It is used mainly to treat cancers of the breast, uterus, ovaries
and the prostate gland.
The type of hormone treatment recommended would depend
on the type or cancer and whether it would respond well to
this kind of treatment.
Clinical trials are research studies that involve people. They
are the final step in a long process that begins with research
in a lab and animal testing. Many treatments used today are
the result of past clinical trials which have proven the benefit
of these treatments.
In cancer research, clinical trials are designed to answer
questions about new ways to:
Clinical trials may be an option for you and your loved one.
Choosing to join a clinical trial is something only your loved
one, you, and your doctors and nurses can decide together.
- Treat cancer
- Find and diagnose cancer
- Prevent cancer
- Manage symptoms of cancer or its treatment
You may want to discuss the benefits and drawbacks with your
loved one and the doctor. Clinical trials offer high-quality cancer
care. However, these new treatments may have side effects that
doctors do not expect or that are worse than those of standard
By looking at the pros and cons of clinical trials and other
treatment choices, allow your loved one to play an active role
in a decision that affects your life together.
Complementary & Alternative Therapy
You may possibly consider certain complementary treatments
to be used with conventional medicine. Acupuncture and
reflexology may be helpful in relieving pain and providing
comfort. Aromatherapy could have soothing effects for the
Alternative therapy (treatment that replaces conventional
medicine) is not recommended. Many of these are not part of
conventional medicine because they have not been scientifically
tested or proven and may produce no results at expensive cost.
By relying solely on these methods, your loved one’s cancer
may reach a more advanced stage, which is harder to treat.
While it is your friend or relative’s decision (and your choice
as well) to consult bomoh, sinsehs and other traditional
practitioners, consider carefully before doing so.
Ensure that any treatment you opt for has a proven track record
of being effective:
- Ask your loved one’s medical team before proceeding.
- Be careful about what pamphlets and other material say.
Verify the information with the medical team.
- Consult the medical team to ensure that the therapy does not
cause complications with prescribed treatment, especially if
they are consuming any traditional medicines.
- Encourage your loved one to continue with his /her doctors’