• Mayo Clinic Health Letter: Highlights from the September 2014 Issue

ROCHESTER, Minn. ― Here are highlights from the September issue of Mayo Clinic Health Letter. You may cite this publication as often as you wish. Reprinting is allowed for a fee. Mayo Clinic Health Letter attribution is required. Include the following subscription information as your editorial policies permit: Visit www.HealthLetter.MayoClinic.com or call toll-free for subscription information, 1-800-333-9037, extension 9771. Full newsletter text: Mayo Clinic Health Letter September 2014 (for journalists only).

Medical staff in operating room performing surgeryAfter celebrating, survivors often face anxieties and fear

Adjusting from being a cancer patient to a cancer survivor isn't just about celebration and gratitude. The September issue of Mayo Clinic Health Letter covers why this transition isn’t always smooth or easy. In addition to dealing with fatigue or other side effects of surgery or treatment, patients may be surprised by feelings that can include fear and uncertainty, anxiety, sadness and irritability.

Common areas of distress may include:

Fear that the cancer will return ― Many cancer survivors describe a roller coaster of fear before medical checkups, followed by feeling great after “clear” checkups. Getting support through cancer survivor groups or online communities can help.

Expectations as a survivor ― Some people embrace the role of cancer survivor by participating in public events. Some patients would rather distance themselves from the disease. Survivors needn’t conform to others’ expectations on what it means to be a cancer survivor.

Return to normal activities ― Returning to normal activities can be a relief and frustrating because of lack of energy or focus. The patient’s treatment team can help develop a realistic plan with flexible, achievable goals. Eating a healthy diet, avoiding tobacco, staying active and maintaining a healthy weight all help return to more familiar energy levels.

Return to sexual intimacy ― Fatigue, lingering treatment side effects, anxiety and depression can limit sexual desire. It often takes time, effort and mutual understanding between partners to rekindle sexual intimacy.

Financial difficulties ― Cancer treatment can cause financial hardships, contributing to stress and anxiety or forgoing or delaying medical treatment. If financial barriers are interfering with recommended care, patients should ask their care team about resources that may be available.


Six tips for surgical success

Evidence suggests that actively preparing for surgery ― pre-habilitation ― is helpful to minimize complications and maximize recovery. The September issue of Mayo Clinic Health Letter offers pre-habilitation tips.

Build strength: Increasing fitness before surgery may reduce the length of hospital stay as well as reduce the risk of postoperative complications. In general, people who are able to walk a few blocks or climb several flights of stairs with no problems have fewer complications after surgery than people who aren’t able to do these tasks.

Stop smoking: Smoking is a risk factor for many surgical complications, including problems with the incision, infections, pneumonia and cardiovascular problems. Even ending tobacco use just a few days before surgery may help.

Control blood sugar: For patients with diabetes, getting blood sugar under control can help reduce complications. Surgery and anesthesia create a hormone stress response that increases blood sugar. People who don’t have diabetes can compensate for this by producing more insulin. For patients with diabetes, the body often can’t compensate, resulting in hyperglycemia. In addition, having diabetes increases the post-surgery risks of slow healing, infections, and heart and kidney problems. When blood sugar is well controlled before surgery, these problems can be minimized.

Manage sleep apnea: Sleep apnea increases the risk of post-surgery breathing and blood oxygen problems. Patients with diagnosed sleep apnea should inform the surgery team about ongoing treatment. Patients who snore loudly, experience consistent nasal congestion at night or have other symptoms of sleep apnea should consider a sleep apnea evaluation before surgery. The surgery team may use a different anesthesia approach for patients with sleep apnea.

Improve the diet: Being a healthy weight, rather than being underweight or morbidly obese, is desirable before surgery. Being underweight, especially when there’s been a rapid weight loss, deprives the body of energy reserves and nutrients needed during surgery and recovery. After any type of surgery, obesity increases the risk of a blood clot developing in the legs and traveling to the lungs, a condition that can be fatal.

In general, increasing protein intake ― lean meats, low-fat dairy, fish, nuts, legumes ― and decreasing the amount of fat, sugar and salt consumed are beneficial.

Manage stress: Stress management skills can help with anxiety about surgery and recovery. Techniques such as deep breathing and guided imagery can reduce the need for pain medication, lower blood pressure, enhance immune activities and even improve quality of life.


Understanding and seeking treatment for anxiety disorders

Feeling anxious is a normal, healthy human response to stressful circumstances. But when fears and worries become excessive, disrupting quality of life, it’s wise to consider treatment options, according to the September issue of Mayo Clinic Health Letter. The newsletter covers the common signs of anxiety disorders, types of disorders and why treatment is important.

There are several different types of anxiety disorders, ranging from specific phobias to post-traumatic stress disorder. All types have signs and symptoms that revolve around excessive worry and dread that fall into three categories:

  • Thoughts: Fearful thoughts about what might happen may come to dominate thinking.
  • Physical sensations: There may be physical sensations, such as a pounding heart, sweating, stomach distress and feeling flushed, lightheaded, agitated or jumpy. Some people may misinterpret these sensations as being associated with serious medical conditions. These physical signs and symptoms can exacerbate underlying physical conditions such as migraine or irritable bowel syndrome.
  • Behaviors: People with anxiety disorders might avoid going out because they are afraid of crowds. Or, some people repeat certain activities such as checking and rechecking the lock on a door or calling loved ones several times a day. The behaviors may temporarily decrease anxiety, but over time they usually become part of the problem.

Symptoms of anxiety disorders shouldn’t be overlooked. The first step in reducing anxiety’s impact is to seek help, including a complete evaluation and correct diagnosis. Anxiety is often complicated or overshadowed by illnesses such as depression, heart disease, chronic obstructive pulmonary disease (COPD), diabetes and others. Living with a chronic anxiety disorder may increase the risk of other illnesses including stroke and coronary heart disease.

Treatment might include learning new coping skills, talking to a counselor or therapist, or taking medications.


About Mayo Clinic
Recognizing 150 years of serving humanity in 2014, Mayo Clinic is a nonprofit worldwide leader in medical care, research and education for people from all walks of life. For more information, visit 150years.mayoclinic.orghttp://www.mayoclinic.org and newsnetwork.mayoclinic.org.

MEDIA CONTACT: Brian Kilen, Mayo Clinic Public Affairs, 507-284-5005, newsbureau@mayo.edu

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