Care of a patient with brain cancer metastasis

Care of a patient with brain cancer metastasis is a challenging task for healthcare providers as well as family members.  The mental status of a patient with brain cancer can worsen at any time. However, symptoms vary among patients and depend on tumor size and location. The human brain comprises distinct regions, each of which controls specific body parts and functions.

A patient with a brain tumor or metastasis of cancer can have the following issues and symptoms

Physical symptoms of patients with brain cancer metastasis

Physical symptoms depend on the tumor’s location and size. However, the following symptoms are mostly shared by patients

• Tremors/fits or seizures
• Physical imbalance
• Poor gait
• Muscle weakness
• Lethargy
• Headache/vision problems
• Nausea and Vomiting
• Feeling of fainting / falling due to a misbalance
• Urinary incontinence
• Stool incontinence
• Lack of sleep/disturbed sleep
• Weakness of the upper or lower limbs
• Weight loss and weakness

How to manage physical symptoms of a patient with brain metastasis?

Physical symptoms are very challenging to manage in a patient with brain cancer. The following tips should be followed in managing physical symptoms

Managing nausea and vomiting:

Nausea and vomiting are common complaints in patients with brain tumors. The following tips are beneficial in managing nausea and vomiting

• Do not use sweets or juices in the morning
• Try to offer oily and spicy food
• Avoid fatty foods, as fats take longer to digest; they remain in the stomach for a longer period, which may further cause gastric fullness or pain.
• Try to add more liquids and fruits to the diet
• Always take the medication at least half an hour before food
• Avoid excessive screen use, such as mobile phones or laptops. This may exacerbate nausea and vomiting.
• Avoid travelling if you have motion sickness
• Take small, frequent meals instead of heavy meals

How can fits and convulsions be prevented and managed?

Fits and convulsions are also another risk for patients with brain metastasis, when the tumor puts pressure on surrounding parts of the brain. Therefore, if a patient is at risk of fits, the following care should be taken.

• Do not leave the patient alone.
• Give medication to prevent fits.
• If the patient’s condition permits, maintain the left lateral position to prevent aspiration.
• Do not place anything, including a finger, in the patient’s mouth to prevent tooth injury.
• Keep the airway open by placing an airway if you are well-trained or if a patient is in a hospital setup.
• Do not keep sh. arps, hot utensils, or hot water beside the patient. It could harm the patient physically.
• Keep the bed level on the lowest level.
• Assist the patient while toileting or walking

How to manage physical weakness?

Weakness is another major problem in patients with cancer. Weakness may be due to inadequate nutrition, severe nausea and vomiting, or impaired gastrointestinal function and digestion. However, weakness can be managed by following these tips.

• Provide a diet. that the patient can easily tolerate and digest.
• The diet should be lower in quantity but with high calories.
• Do not bind the patient to bed. It will weaken the muscles
• Keep the patients up and about and make them busy  with household activities
• Take multivitamins such as vitamin D OR B complexes. These supplements will maintain energy and strength and support gut health.
• Multivitamins improve appetite, which further improves diet and nutrition. Also helps nourish skin, nails, and hair, which are damaged by radiation and cytotoxic drugs, such as chemotherapy.

How to take care of skin, especially bony areas:

If a patient with brain cancer is bedbound, there are higher chances of skin damage or breakdown due to poor blood perfusion to the skin, due to low hemoglobin, or pressure exerted by the bone on the skin. This could lead to pressure ulcers, which further cause pain and infection. To avoid this complication, the following measures should be carried out:

• If the patient is bed-bound or has low mobility, apply an air mattress to prevent pressure ulcers.
• Keep changing the position of the patient.
• Massage with a. moisturizer or with any organic oil to prevent friction and improve blood circulation.
• Keep the patient well hydrated.
• Include proteins in the patient’s diet to maintain skin strength and nourishment.

     Cognitive impairment of a patient with brain cancer metastasis

A patient with brain cancer/ brain metastasis has the following mental issues.

Forgetfulness /memory issues: Care of a patient with brain cancer metastasis

Patients with brain involvement exhibit memory impairment, including forgetting the names of family members, places, and objects. In difficult situations, patients may forget to eat and drink, so it is the family member’s or healthcare provider’s responsibility to remind them and ensure they receive their meals on time.

Unable to concentrate / Brain fog:

Unable to communicate the message properly:

 Patients with brain involvement may be unable to communicate effectively; therefore, pay attention and listen carefully to their words and actions to meet their needs.

Irritability/agitation: Care of a patient with brain cancer metastasis

Patients usually get irritated due to many factors, such as their physical dependency on others, being unable to carry out their own activities, and having an altered self-image. If you become irritable, do not argue with them; instead, try to divert their attention.

Change in mood /personality

Confusion

Lack of confidence

Emotional and psychological symptoms:

     Fear of separation

     Fear of death

     Change in perception

     Depression and anxiety

     Mood swings

How to manage emotional symptoms in a patient with brain cancer?

Emotional symptoms are as challenging as physical symptoms. Patients suffering from emotional distress should be managed by following the care tips:

• Be with your loved ones and show them love and care so they feel they are not burdening their loved ones.
• Do a physical massage to make the patient relax.
• Assistance with physical care, including bathing, eating, and other activities of daily living.g
• Sit with the patient and watch a funny movie
• Discuss the events of good times
• Do not discuss stories of life and death in front of a patient with cancer
• Go for an outing with the patient to make them happy and relaxed

Which types of cancer have a higher risk of brain metastasis?

Usually, all types of cancer have a risk for brain involvement, but there are some cancers with a high prevalence of brain metastasis, which are as follows:

Breast cancer

Liver cancer

Blood cancer

Prostate cancer

Lymphoma

Gall bladder cancer

Cancer of the pancreas

Cancer of the stomach

Lung cancer. So, in conclusion,n a patient with brain cancer may be more dependent on family members or healthcare providers. Taking care of such a patient is challenging with multiple physical, psychological, and cognitive issues. Addressing these challenges or symptoms with care is crucial to preventing further complications in the patient.