$Unique_ID{BRK01564}
$Pretitle{Neoplasms, Ill Defined Symptoms and Rare Diseases}
$Title{Is Sleeplessness a Sign That One's Cancer is Getting Worse?}
$Subject{sleep cancer treatment}
$Volume{B-23, N-23}
$Log{}

Copyright (c) 1991   Tribune Media Services, Inc.


Is Sleeplessness a Sign That One's Cancer is Getting Worse?


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QUESTION:  I really need your help, and hope you will reply in your excellent
column.  My husband is currently undergoing treatments for a cancer.  Although
he is making progress in his fight against this disease, he is finding it
increasingly difficult to get a good night's sleep.  Sometimes, he just tosses
and turns the entire night.  Is this a sign that his cancer is getting worse?
What can be done?

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ANSWER:  Insomnia is a frequent complaint of cancer patients.  It is rarely a
sign that the disease is getting worse, but instead a side effect of
treatment, fear of the disease, uncertainty about the future, or pain, which
simply prevents a good night rest.  Pain is a significant problem for about a
third of all cancer patients.  In an attempt to prevent a patient from
becoming drug dependent, overly sedated or constipated with narcotic
medications, physicians are cautions about their prescribing habits.
Sometimes the doses given are insufficient to completely relieve the pain.
Thus pain control becomes difficult to manage, and remains as a disturbing
presence that prevents sleep.
     This problem may be addressed by a variety of techniques.  Pain can be
controlled through relaxation techniques, an electrical nerve stimulation
procedure known as TENS, antidepressant medication, and in severe cases,
intravenous morphine or high doses of methadone.  Another sleep inhibiting
problem affecting cancer patients is dyspnea--shortness of breath or
difficulty in breathing.  Patients with this problem may need apparatus in
their homes that can deliver the needed oxygen.
     Vomiting, nausea, nocturia, fever, and positional discomfort also may
hinder a cancer patient's sleep.
     Medications that may help the victim overcome cancer are themselves
frequent causes of sleep disturbances, while the anxiety which comes with this
dreaded diagnosis may also produce insomnia.
     Patients may be able to stay busy during the day, but at night they focus
on their concerns with the cancer.  Often the patient may think of other
family members or friends who have died of cancer.  They feel restless,
trapped, and feel they have no control of their lives.  Therapy to overcome
this anxiety may include a short course of antianxiety medication, and support
from family or special cancer patient support groups.
     Many cancer victims may stay awake at night because they fear dying in
their sleep.  They often find nighttime activities, household chores and other
things to do to avoid sleep.  This creates an abnormal sleep cycle where the
patient may fall asleep during the daytime, but stay awake all night.  This
pattern is often helped when the patient returns to work, begins an exercise
program which can relieve stress, and learns relaxation techniques.
     Nightmares may also be frequent in the cancer victim.  Fears about the
future are uncovered and addressed.  Severe depression is also a cause of
sleeplessness.
     So you see there are many reasons for your husbands sleep problem, and
few of them indicate a worsening of the course of the disease.  The secret of
success here is to find the cause for the insomnia, and take the necessary
steps to correct them.
ÿ
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The material contained here is "FOR INFORMATION ONLY" and should not replace 
the counsel and advice of your personal physician.  Promptly consulting your 
doctor is the best path to a quick and successful resolution of any medical 
problem.
