The HIV-associated cancer treatments result in causing various side effects and changes to the body of the patient. The results of treatment show variations among the patients. Sometimes the same treatment strategy used for a particular disease condition evolves with different effects. Hence, it is difficult to predict the outcome and impact of a specific treatment. Therefore, coping-up strategies are adopted to mitigate the side effects of the treatment. Open communication with the expert regarding new signs or symptoms experienced by the patients helps plan ways to effectively manage and relieve these symptoms and side effects. The patients seek professional therapies to mitigate the adverse emotional impacts during HIV-associated cancer treatment. The general physical side effects of each treatment option for early-stage and locally advanced HIV-associated cancer are addressed by adopting supportive or palliative care provided by the healthcare team.
With the social stigma that is generally associated with the disease, many people fail to openly talk about their concerns. However, it is crucial to communicate any concerns, symptoms, or even financial difficulties with the healthcare team and loved ones. Several services help patients manage such a group of patients treating HIV-associated cancer. Caregivers play an essential role in caring for a person with HIV-associated cancer. Open communication regarding all types of symptoms and side effects of the treatment is essential.
Coping with HIV Associated Cancer Treatment
Cancer has been part of the HIV epidemic since its inception, and initial reports describe cases of Kaposi’s sarcoma associated with opportunistic infections associated with HIV / AIDS. The causes of cancer-related mortality in PLWH (persons living with HIV) are complex and include provider-systemic-and patient-level factors. However, the emotional burden of cancer associated with HIV diagnosis and the potential negative impact on treatment outcomes among patients has received little attention. HIV disproportionately affects people irrespective of sex, color, and ethnicity. HIV and cancer can cause social stigma, emotional turmoil, and guilt among patients. As a result, people with HIV and cancer can simultaneously experience the emotional burden and historical trauma of current stigma, both of which contribute to inequities in well-being and health1.
Coping with Physical side effects of HIV associated cancer
Each treatment option for HIV-associated cancer has many common physical side effects. In addition to this, people with HIV / AIDS have often described the combined or double burden of HIV and cancer with cumulative effects on emotional well-being and health. Many participants who had difficulty adhering to cancer treatment reported increased pain and treatment fatigue over time, including taking part in daily treatment, maintaining treatment adherence, and side effects of treatment. Hence, the side effects of cancer treatment are the most common cause of suffering and a significant contributor to non-compliance with cancer treatment.
All cancer survivors live with the fear that cancer may recur or spread (metastasis). Some may also develop secondary cancer. Regular monitoring, screening, and reporting of symptoms to the doctor can help detect new or metastatic cancer at an early stage. Chemotherapeutic drugs and radiation therapy may increase the risk for long-term dental problems, hypothyroidism, infertility, organ damage, neuropathy, osteoporosis, and diabetes. Cancer treatment may lead to comorbidities associated with endocrine changes such as, memory loss, anemia, decreased muscle mass, depression, weight gain, and loss of body hair.
Coping with Mental/Emotional side effects of HIV associated cancer
People diagnosed with HIV / AIDS can have social and emotional consequences when diagnosed with cancer. This can include overcoming various emotions, such as anxiety, depression, anger, or managing stress levels. Sometimes it is difficult for patients to express their feelings toward their loved ones. Nevertheless, they might find it helpful talking to an oncology counselor, social worker, or fellow cancer patients as it can help develop a more effective coping strategy. The most common psychosocial problems that cancer patients may experience are:
Fear of recurrence
Many survivors worry that cancer may relapse someday. Painful events in the journey of cancer treatment can often cause such feelings. By knowing the body, you can differentiate between normal body changes and more serious symptoms that one needs to report to the doctor.
Grief is the natural outcome of a loss. Moreover, grief can cause other side effects both physically and emotionally such as health, fertility, and physical independence. Counseling and support groups can help solve these problems.
It is estimated that almost 70% of cancer survivors will experience depression at some point in time. One should know the symptoms of depression and seek counselling as well as treatment as soon as possible. Many cancer care providers provide advice and medication to treat depression and anxiety for patients with HIV and cancer.
Cancer survivors who have experienced deformities, amputations, or significant changes in body function due to cancer treatment may suffer from a lack of self-esteem. Negative body image can affect the desire for social interaction and intimacy. And so honest and open communication with loved ones can help reduce negative emotions.
Survivor guilt and Spirituality
Some cancer survivors wonder why they survived cancer while others did not. Therefore, it is often recommended for cancer survivors with a long history of guilt to seek help from a doctor, psychiatrist, or support group. Many AIDS-associated cancer survivors find that living after cancer will take on a new meaning and renew their commitment to spiritual practice. Studies show that spirituality improves the quality of life through stronger social support networks, depression, adaptive coping, and improved physical activity.
After being diagnosed with cancer, patients often find that their friends, family members, and colleagues treat them differently. Due to this, they might often avoid speaking to the patients or discussing with them about cancer. Therefore, it is important to take care of the patients and not make them feel alienated by any chance. While communicating with other similar cancer patients can also help them find solace. As a caretaker, you may also find new relationships with similar people who know what they have been experiencing.
Cancer survivors often think that they cannot communicate with colleagues at their workplace who have never had cancer. The patient may not feel comfortable talking to their colleagues or employer about their cancer treatment because they are afraid of being treated differently. In such cases, cancer survivors should contact the employer to see if they have support groups or resources for cancer patients2.
Coping with Financial burden of HIV/AIDS cancer
“Financial toxicity” has become a well-known term in the discussion of cancer drugs and treatment. Given the high cost of new therapies and treatment classes, it is attracting attention in the literature. The financial burden of cancer treatment among patients and their family members needs to be seen in the context of each circumstance of the patient and the wider experience of diagnosing and treating cancer. Although patients often try to alter their lifestyle to address the financial burden of treatment. Patients often try to change or leave the treatment regime and look out for alternative treatment options. Younger patients and patients from lower-income sections in India are more likely to change treatment1.
- 1.Corrigan K, Knettel B, Suneja G. Inclusive Cancer Care: Rethinking Patients Living with HIV and Cancer. Oncologist. 2020;25(5):361-363. doi:10.1634/theoncologist.2019-0853
- 2.Social & Emotional Impacts of Cancer. MD Anderson Cancer Center. Published 2022. Accessed March 2022. https://www.mdanderson.org/patients-family/life-after-cancer/social-emotional-impacts.html