Living with ovarian cancer

Anxiety is a common response to a cancer diagnosis, and while it can heighten pain, disrupt sleep, and impact overall quality of life, not everyone will develop an anxiety disorder. It can be challenging to differentiate between normal cancer-related fears and more severe anxiety disorders. Signs of severe anxiety may include panic attacks, avoidance behaviors, intrusive thoughts, and sleep disturbances. It’s important to talk to your doctor if your anxiety symptoms seem severe. Treatment for anxiety will vary depending on the impact it has on your daily life. Your doctor can provide a helpful treatment plan that may include management of uncontrolled symptoms, educational information, counseling, or medication.

Eating well during cancer treatment can be challenging at times, but good nutrition can help decrease hospitalizations and delays in treatment and improve your general well-being. Whether you are currently in cancer treatment at Penn Medicine or have completed your treatment, you may benefit from our nutrition counseling services. For more information about nutrition counseling, speak with your physician or nurse.

Feeling confident in your appearance during cancer treatment isn’t a matter of vanity. Studies show it can boost your energy, resilience, and overall outlook, making the challenges of treatment easier to manage. In partnership with the American Cancer Society, Penn Medicine offers the Look Good, Feel Better workshop. This free program teaches beauty techniques to people undergoing cancer treatment, helping them address the appearance-related effects of radiation and chemotherapy.

Feelings about physical and intimate relationships can change during cancer treatment due to factors like body image, fatigue, anxiety, and stress. These changes can impact your sexual desire. Some people may experience a closer connection with their partner, while others may find sexual activity less important for a time. It’s important to address any concerns by discussing them with a doctor or nurse who can provide you with guidance and resources for navigating these changes.

Penn Medicine offers various support services, including counseling and stress reduction programs, to help you navigate these challenges. If you’re experiencing changes in intimacy or other related concerns, don’t hesitate to contact us for help.

Cancer or cancer treatments can sometimes affect how food tastes or smells. To improve the taste of your meals and reduce unpleasant odors, try these tips:

• Experiment with spices, herbs, and condiments if food tastes bland
• Add mint, orange, or lemon slices to your water
• Practice good oral hygiene to reduce lingering bad tastes
• Suck on hard candies like lemon drops
• If cooking smells are bothersome, ask for help in the kitchen, use a fan, or open a window
• Serve food at room temperature to minimize strong odors

Cancer treatments, medications, or a lack of fiber, fluids, and physical activity can cause constipation. While over-the-counter laxatives, stool softeners, or enemas are effective for treating constipation, be sure to speak to your doctor or nurse before using any of these remedies.

Dehydration is a common but preventable side effect of many cancer treatments and can be caused by nausea, vomiting, diarrhea, or inadequate fluid intake. Sometimes, drinking too much fluid at once can lead to nausea or vomiting. If you think you are not drinking enough fluids or are unable to drink as much as you’d like without experiencing other side effects, try drinking smaller amounts of fluid, chewing ice chips, or eating foods that have a lot of fluid in them, like fruits, soups, and popsicles.

Depression affects about 15 to 25 percent of cancer patients, but caregivers are at risk of depression, too. While sadness and grief are normal responses to a cancer diagnosis, major depression is more than just feeling sad; it is a serious condition that can be diagnosed and treated. Mild depression might be treated with counseling, but more severe or persistent symptoms require intensive treatment. Symptoms of depression can include persistent sadness, loss of interest in activities, changes in appetite or sleep, low energy, and feelings of guilt or worthlessness. If you or your caregiver experience symptoms of depression, it’s important to discuss with your medical team, as some symptoms may be related to the treatment or disease itself rather than depression.

Chemotherapy can lead to memory, concentration, and attention issues. This is referred to as “chemo brain.” Many cancer survivors struggle with focusing, finding the right words, or remembering new things. Researchers are working to better understand why these cognitive issues affect some patients more than others. If you are experiencing memory or concentration problems, or if you suspect a medication or mental health issue like depression or anxiety may be contributing, tell your care team. They can connect you with support groups or professional counseling that may help as you transition from active treatment to survivorship.

Some cancer medications can cause diarrhea, or loose, watery stool. This can be a serious side effect because it can lead to dehydration if it’s not properly managed. Some foods that are helpful for relieving diarrhea, include:

• Bananas
• White rice
• Applesauce
• Tea
• White toast
• Yogurt
• Peanut butter

It’s also important to stay hydrated. You should aim to drink six to eight glasses of liquid each day, including Gatorade or coconut water, to help replace lost minerals. You can also discuss this issue with your doctor to see if you should be taking any medications that can help manage this side effect.

Dry mouth is one of the most common side effects of cancer treatments like radiation therapy. This condition occurs when the salivary glands produce less saliva or when saliva becomes thick and sticky. Dry mouth can increase the risk of cavities and mouth infections, and factors like smoking, chewing tobacco, and alcohol consumption can make the dryness worse.

To manage dry mouth:

• Brush your teeth and drink fluids to keep your mouth clean and moist
• Take small bites when eating and make sure you chew your food thoroughly
• Eat soft or moist foods like tuna salad, hot cereal, and pasta

You can also talk to your care team about nutritional supplements that may help.

During and after cancer treatment, it’s common to feel tired and have less energy. This fatigue can be caused by treatments like chemotherapy, radiation therapy, and surgery, or other factors like infection, poor nutrition, and stress. Fatigue may affect your ability to work, focus, and engage in social activities, and it may be a while before you feel strong again. To help conserve your energy, try to prioritize important activities, delegate less important tasks, take short breaks, get quality sleep, eat small nutritious meals, and ask your doctor about medications that may help, if needed.

It’s natural to feel sad, isolated, or overwhelmed during cancer treatment, even when surrounded by supportive friends and family. It can be comforting to connect with others who understand your experience. Cancer support groups, often free and led by trained professionals, can offer a sense of community, while one-on-one cancer counseling services with Penn Medicine specialists can provide you with more personalized guidance. We offer psychological and spiritual counseling services to help you navigate your cancer treatment journey.

Many cancer survivors go on to lead normal, productive lives, including having children. However, cancer treatments can affect fertility or reproductive health. Penn Fertility Care has been a pioneer and remains a leader in offering innovative solutions to help patients who face infertility due to cancer treatments.

You may experience swelling in the face, hands, feet, or abdomen due to chemotherapy or the fluids you receive during treatment. You should discuss any swelling with your doctor or nurse. You can also manage swelling by limiting your salt intake, avoiding tight clothing, and elevating your feet. If you experience swelling that becomes uncomfortable, if you do not urinate for 12 hours, or if you notice dark or bloody urine, contact your doctor immediately.

Some cancer treatments can impact your blood cell levels. White blood cells are essential for fighting infections, platelets help prevent bleeding and bruising, and red blood cells carry oxygen throughout your body. Low blood counts can be managed, but your treatment options may vary depending on the severity and your individual health history. The symptoms of low blood count vary depending on blood cell type. If you have low white blood cells (neutropenia) after chemotherapy, a fever over 100.5 degrees can be a medical emergency, and other symptoms like chills, cough, mouth sores, painful urination, skin redness, or confusion may indicate an infection. Low platelets (thrombocytopenia) can cause excessive bruising, tiny red spots on the skin, bleeding gums, nosebleeds, prolonged bleeding, dark urine, blood in stool, and unusually heavy or prolonged menstrual bleeding. Low red blood cells (anemia) can cause weakness, fatigue, shortness of breath, a faster heartbeat, or chest pain. If you experience any of these symptoms, you should talk to your doctor to learn about treatment options.

If you’ve been diagnosed with and treated for gynecological cancer, you may be at risk of developing lymphedema or chronic swelling. Lymphedema occurs when fluid accumulates in the soft tissues due to damage to the lymphatic vessels or lymph nodes during surgery or radiation therapy. Symptoms include swelling, tight skin, numbness or tingling, and new aching or heaviness in the abdomen, genitals, buttocks, or legs. To reduce the risk of lymphedema, keep your skin clean and moisturized, avoid pedicures, wear shoes that fit well, and protect yourself from extreme temperatures and insect bites. You should also avoid deep tissue massages in the at-risk area and use sunscreen when outdoors.

Although it can be uncomfortable, lymphedema is not painful or life-threatening. If you notice swelling in an area that feels warm or hot to the touch, is red or covered in a rash, or is accompanied by fever or new pain, please get in touch with your doctor. They may refer you to a specialized physical or occupational therapist for treatment. Penn Medicine also offers lymph node transfer surgery, a new microsurgical procedure that transplants lymph nodes to the affected areas to help restore natural fluid drainage.

Mouth sores are a common and painful side effect of cancer treatments. These sores can form inside the mouth or on the lips, making it difficult to talk, eat, or swallow. While they typically heal on their own within two weeks, there are steps you can take to ease the discomfort.

• Avoid mouthwash that contains alcohol
• Maintain good oral hygiene
• Eat soft foods when mouth sores are present

You may experience different types of nausea during cancer treatment. Anticipatory nausea is a learned response and can be caused by anxiety before treatment. Chemotherapy-induced nausea can start at the beginning of treatment or several hours afterward. Stress-reducing medications or relaxation techniques can be helpful to reduce nausea.

Pain from cancer can come from various sources, including the procedures you undergo during diagnosis and treatment, or from the cancer itself. If left untreated, pain can significantly impact your quality of life, affecting your daily activities, work, and relationships. It’s important to communicate with your care team about any pain you experience so they can provide you with appropriate and effective treatment options. Pain management often involves a combination of methods, including medications, follow-up treatment, anesthetics, massage, heat and cold therapy, relaxation techniques, and exercise. Penn Medicine offers comprehensive pain management programs to help address your needs.

Some ovarian cancer survivors may face a higher risk of developing a small bowel obstruction due to surgical scar tissue or the tumor itself. Symptoms can include cramping, gas, bowel changes, nausea, and vomiting. It’s important to talk to your doctor if you experience more severe signs like increased abdominal pain and vomiting. These symptoms may be an indication of a complete bowel obstruction. You can prevent complete bowel obstruction by adjusting your diet, such as eating smaller, more frequent meals, following a low-fiber diet, avoiding fatty foods, and staying well-hydrated. Be sure to discuss your symptoms with your doctor, who can refer you to a registered dietician for more personalized guidance.

Managing the stress of cancer and its treatment can be overwhelming, with many patients experiencing anxiety and depression. It’s common to feel isolated, hopeless, or struggle with concentration. Speaking with a counselor or practicing relaxation techniques can offer relief, improving sleep and energy, and reducing anxiety. Simple relaxation exercises, such as deep breathing in a quiet space, can also help ease day-to-day stress.