Symptoms and side effects in someone with cancer and dementia

A person with cancer and dementia may have symptoms or side effects caused by cancer or cancer treatment. These can usually be prevented or well-controlled.

Symptoms or side effects will depend on the type of cancer or treatment. We have more information about the most common side effects.

The person you care for may not be able to tell you if they have symptoms or side effects. You may have to ask them regularly. If they have problems communicating, it can help to look for signs in their body language or facial expressions.

Some symptoms or side effects of cancer may be like the ones caused by dementia. If the person you care for has symptoms you are worried about, talk to the doctor or nurse.

If the person you care for has symptoms of cancer or side effects from treatment, they may find it hard to eat. Problems that can affect eating include:

• having a sore mouth
• difficulty swallowing
• diarrhoea
• constipation
• feeling sick.

If dementia is already affecting a person's appetite, this may be worse.

Some people may struggle to eat enough. Others may eat more than usual, which can lead to weight gain.

If you think the person you care for is not eating well, ask their GP or specialist nurse to refer them to a dietitian. Dietitians can give advice about any changes you can help them make.

If the person is struggling to eat and losing weight, the dietitian may give them food supplements.

Eating a balanced diet and keeping to a healthy weight may help stop problems such as constipation and dehydration. These problems can make confusion worse for people with dementia.

Here are some healthy eating tips to help someone with cancer and dementia:

• Make sure the person you care for does not overeat.
• Encourage them to eat less saturated fat and sugar, such as cakes, crisps and sweets.
• Make sure they eat plenty of fruit, vegetables and high-fibre foods. This will help prevent constipation.
• Encourage them to drink plenty of fluids during the day. About 2 litres (3½ pints) can help prevent constipation and stop them from becoming dehydrated.
• If they find it hard to use cutlery, try foods they can pick up with their fingers.
• Help them look after their teeth with regular dental checks. If they have dentures, make sure they fit properly.

We have more information about:

• eating problems and cancer
• preventing weight loss
• healthy eating and cancer.

We also have recipes for people affected by cancer, which you might find helpful.

Dementia UK has a leaflet on helping someone with dementia look after their teeth and mouth.

People often worry that cancer causes severe pain. But not everyone will have pain, even if the cancer is advanced. If the person you care for is in pain, it can usually be controlled with painkillers.

Some people with dementia may not be able to tell their carers they are in pain. Look for signs of pain in the behaviour of the person you care for. For example, they may:

• become agitated or tearful
• start shouting out
• hold the part of their body that is sore
• change their facial expression or clench their teeth
• become pale or sweaty
• refuse help or care
• become withdrawn.

Doctors and nurses can use a tool to assess if these behaviours are caused by pain or something else. The tool is a checklist of types of behaviour. It looks at how mild or severe the behaviour is. This can help hospital doctors or GPs decide whether to give someone painkillers.

Painkillers are usually tablets, capsules or liquids taken by mouth (orally). The person you care for may have problems swallowing medicines or remembering to take them. If this happens, they can be given painkiller patches that stick to the skin.

You can do some simple things to help with pain and discomfort in the person you care for. You could try:

• changing their position
• using heat pads, hot water bottles or ice packs
• asking if they would like a massage.

You could also offer them over-the-counter or prescribed painkillers regularly. You should only give these exactly as instructed on the packet.

Sometimes the person you care for may need specialist help to assess their pain and symptoms. The doctors and nurses can adjust the dose of medicines or add new ones to control symptoms. Some people may have a short stay in the hospice to do this. Once their symptoms are controlled, they may be able to go home again.

We have more information about pain and ways to manage it.

You may find it useful to note down symptoms in a symptom diary. You can write down any symptoms and what helps. It might be useful to show the diary to a doctor or nurse so they can help.