Clinical support services
A range of clinical support services are available to people living with and beyond cancer. These are services that are available for a specific symptom related to cancer or the side-effects from cancer treatment. This includes emotional support as well as physical support. While some of these services are provided by HSC and are delivered by health care professionals and require referral from a health care professional, there are many others that are available through voluntary and charitable groups.
Clinical support services available are broken down into six sub groups:
- Psychological / Emotional support
Emotional distress is a common and understandable problem amongst people affected by cancer. Problems can range from sadness and worry to more severe symptoms which require support from professional psychology services. Quite often milder symptoms can be dealt with through telephone help lines, self help and support groups which are available through the voluntary or charitable groups. When you contact any of the services listed they will be able to advise you if their service is suitable for your level of need.
- Continence / Stoma care
This is a common problem for many people affected by cancer. A recent patient survey identified that 38% of people with breast, colorectal and prostate cancer experienced bowel or urinary problems following completion of treatment. With early assessment and identification of problems much can be done to help overcome these issues. Stoma care services are provided through the hospitals and can be accessed through health professional referrals.
The physiotherapist aims to reduce some of the effects of the disease or its treatment. It is often possible to improve quality of life and independence, or to gain relief from distressing symptoms. The physiotherapist may use various techniques including:
- Education for patient and carers: e.g. self-care post-surgery and appropriate patient handling skills;
- Exercise therapy to improve flexibility, strength, function and reduce cancer related fatigue;
- Relaxation techniques to reduce levels of anxiety;
- Breathing care; management of shortness of breath, removal of secretions, nebulisers and oxygen management;
- Pain relief via positioning, gentle movement and therapy, acupuncture and electrotherapy;
- Neurological rehabilitation.
- Occupational Therapy
Occupational Therapy aims to help you increase your independence and quality of life by looking at the activities that you do on a daily basis and by finding ways to help you continue with those activities that are important to you.
Occupational Therapists will work with you to develop a treatment programme. This will depend on your individually assessed needs and home/family situation, and may include some of the approaches below:
Finding different techniques to do things;
- Advice and education in relaxation, fatigue and anxiety management;
- Advising on equipment or adaptions for your home;
- You can ask your healthcare team about referring you for an assessment.
- Diet and Nutrition
Treatment for cancer can often change normal eating habits and patterns especially in the earlier stages of recovery. Some people may experience weight gain, others weight loss following treatment. In some cases people will be advised to follow specific diets to ensure they are eating enough of the right things, this information is generally provided by the dietician when they were receiving treatment. However, for many others it may only require a few changes in the type of food they eat or the way in which it is cooked.
The Dietitian can provide individual patients or patient groups with advice on managing dietary problems caused by cancer or cancer treatment support to enable them to make appropiate lifestyle and food choices to reduce future risks of cancer.
- Sexuality and Body Image
Cancer or the effects of treatment can affect a person’s interest in sex or their sexual function. A patient survey showed that 45% of patients with prostate and colorectal cancer experienced erectile problems following cancer treatment. Whilst the potential impact of treatment on sex may be discussed before treatment it is not always discussed after completion of treatment. However, there is information available and support from a number of groups.
For many people cancer and its treatment can affect how they view their bodies. This is not unusual and there are courses and information available on how to deal with any issues you may have with your body image.
The lymphoedema therapist works as part of the multi-disciplinary team to reduce swelling related to failure of the lymphatic system. Lymphoedema can occur due to a variety of reasons including genetic abnormalities, chronic circulatory problems and trauma (including surgery which involves the removal of lymph nodes/ glands). This swelling usually occurs in the arms or legs, but can also be present in the head and neck area, trunk and genital regions. The therapist will help to manage this condition and provide long term support.
Each hospital trust has a lead for this service and any member of the healthcare team can refer you to this team. The lymphoedema network Northern Ireland can be contacted via their website http://lnni.org/.