Booklets

Advanced Cancer/Matepukupuku Maukaha

Breast Cancer/Te Matepukupuku o ngā U

Bowel Cancer/ Matepukupuku Puku Hamuti

Chemotherapy/Hahau

Complementary and Alternative Medicine

Eating Well/Kia Pai te Kai

Got Water?/He Wai?

Melanoma/Tonapuku

Prostate Cancer/Matepukupuku Repeure

Radiation Treatment/Haumanu Iraruke

Secondary Breast Cancer/Matepukupuku Tuarua ā-Ū

Sexuality and Cancer/Hōkakatanga me te Matepukupuku

Understanding Grief/Te Mate Pāmamae

What Do I Tell the Children?/He Aha He Kōrero Maku Ki Āku Tamariki?

Brochures

Being Active When You Have Cancer

Questions You May Wish to Ask

Talking to a Friend With Cancer

When Someone Has Cancer

When You Have Cancer

The beginnings of cancer

Normally, cells grow and multiply in an orderly way. However, damaged genes can cause cells to behave abnormally. These cells may grow into a lump, which is called a tumour. Tumours can be benign (not cancerous) or malignant (cancerous). Benign tumours do not spread to other parts of the body.

The beginnings of cancer

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How cancer spreads

A malignant tumour is made up of cancer cells. When it first develops, a malignant tumour may be confined to its original site: a cancer in situ (or a carcinoma in situ). If these cells are not treated, they may spread into surrounding tissues (also known as malignant or invasive cancer) or to other parts of the body. When these cells reach a new site they may continue to grow and form another tumour at that site. This is called a secondary cancer or metastasis.

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He aha te matepukupuku?

He mate tēnei ka pā ki ngā pūtau o te tinana. He kaha ō tātou tinana ki te mahi pūtau hōu hei whakakapi i ngā pūtau kua kore he kaha, kua kino rānei. I ētahi wā, ka whakapaitia ētahi pūtau kua whara, tērā i te whakakapi. He tino momo irakei te whakahaere i tēnei hātepe: he tohu ēnei e aki ana i ō tātou pūtau me pēhea e tipu, e whano. Ka ahu katoa mai ngā matepukupuku i ngā tūkinotanga ka pā ki ēnei ira. Ka pā ēnei tūkino nei i te roanga atu o tō tātou oranga, engari ka whiwhi ētahi tāngata tokoiti nei i tētahi ira kino mā te heke iho i tētahi o ō rātou mātua.

Te tīmatatanga o te matepukupuku

I te nuinga o te wā, pai noa iho te tipu me te whakarau haere o ngā pūtau. Heoi anō, ka āhua rerekē te whanonga o ngā pūtau nā te kino o ngā ira. Tērā pea ka tipu ēnei hei pukupuku pūtau, ā, kīia ai he puku. He mārire (kāore e puta te matepukupuku) ētahi puku; he marere (he matepukupuku) ētahi atu. Kāore ngā puku mārire e rauroha ki wāhi kē o te tinana.

He pūtau matepukupuku kei roto i te puku marere. Ka puta tuatahi ana, tērā pea ka mau tonu ki te mata o te wāhi puta ai, arā, he matepukupuku o te kiri ā-wāhi.

Tērā pea ka rauroha ēnei pūtau ki ngā whakapaparanga hōhonu o te kikokiko i te wāhi i tīmata ai. Kīia ai tēnei, ko te matepukupuku whakaeke. Tērā pea ka rauroha tauaro ki roto i ngā kikokiko noho pātata ana. Kīia ai tēnei, ko te matepukupuku maukaha wāhi puta. Ki te haere ēnei pūtau mā te tinana ki tētahi wāhi hōu, tērā pea ka tipu tonu ā, ka

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puta anō he puku ake ki taua wāhi. Kīia ai he matepukupuku tuarua (secondary), he metastasis rānei.

Kīia ai tēnei ko te matepukupuku maukaha wāhi puta. Ki te haere ēnei pūtau mā te tinana ki tētahi wāhi hōu, tērā pea ka tipu tonu ā, ka puta anō he puku ake ki taua wāhi. Kīia ai he matepukupuku tuarua, he metastasis rānei.

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The pleura

The pleura are two fibrous sheets of tissue that cover the lungs and help to protect them. Doctors may call these the lining of the lungs. This term may be a bit confusing for non-medical people as they are on the outside of the lungs. The pleura are also sometimes called the pleural membranes. They are about the thickness of plastic food wrap. The inner (visceral) layer is attached to the lungs and the outer (parietal) layer lines the chest wall and diaphragm.

The gap between the pleura is called the pleural space or cavity. The pleura produce a lubricating fluid that fills the gap between them. As we breathe this helps the lungs to move smoothly in the chest when they are inflating and deflating.

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Pleura

Small cell lung cancer

Small cell lung cancer (also called oat cell carcinomas because of the cell shape) account for around 15 percent of lung cancers. This type of lung cancer is strongly associated with cigarette smoking. Unfortunately, it grows rapidly, spreads early and causes few early symptoms. Often it has already spread (metastasized) at the time of diagnosis so surgery is not helpful.

Matepukupuku o te kiri pūtau iti

E 15 ōrau o ngā matepukupuku pūkahukahu e puta ana, e puta ana nā runga i ngā matepukupuku o te kiri pūtau iti. (Ko tētahi ingoa anō, ko te matepukupuku o te kiri pūtau ōti, nā runga i te āhua hanga o te pūtau.) E kaha ana te whai pānga o tēnei momo matepukupuku ki te mahi kai hikareti.

Non-small cell lung cancer

Non-small cell lung cancers include squamous cell carcinoma and adenocarcinoma. Also in this group are rare cancers, such as large cell lung cancer and bronchioloalveolar cell carcinoma.

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The most common types of lung cancers affect the cells that line the main bronchi. As these tumours enlarge they can block off the bronchi and reduce the air flow into parts of the lung. They commonly spread to the local lymph nodes and occasionally may invade the chest wall, causing pain. Squamous cell carcinoma has a lower rate of spread to other parts of the body than other types of lung cancer. If it is discovered early, it may result in a better prognosis following treatment. Adenocarcinoma is a cancer of the glandular cells of the lung.

Matepukupuku o te kiri pūtau kore-iti

Ko ētahi o ngā matepukupuku o te kiri kore-iti, ko te pūtau squamous matepukupuku o te kiri me te adenocarcinoma. Kei roto anō hoki i tēnei rōpū ko ngā matepukupuku puiaki, pērā ki te matepukupuku o te kiri pūtau nui, me te matepukupuku o te kiri pūtau riuhauiti-miruhau.

Mesothelioma

Mesothelioma is not, strictly speaking, a lung cancer. It is a rare cancer of the pleural membranes on the surface of the lungs and is strongly related to asbestos exposure.

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Causes of lung cancer

Smoking is the single main avoidable cause of lung cancer. It is not known why one smoker develops lung cancer and another does not.

Up to 90 percent of lung cancer is caused by smoking. Lung cancer occurs most often in adults between the ages of 40 and 70 who have smoked cigarettes for at least 20 years. They are also likely to have started smoking as teenagers.

Second-hand smoking (passive smoking) may also cause lung cancer.

However, as with many cancers, we do not know the cause in all cases.

Occupational exposure to asbestos is associated with an increased risk of asbestosis, mesothelioma and lung cancer. For people with asbestosis, their risk of developing lung cancer is doubled. If the person also smokes, then the risk is increased.

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Other occupational exposures that, possibly, are associated with lung cancer include contact with the processing of steel, nickel, chrome and coal gas. Exposure to radiation causes an increased risk of all cancers, including lung cancer. Miners of uranium, fluorspar and haematite may be exposed to radiation by breathing air contaminated with radon gas.

Ngā take e puta ai te matepukupuku pūkahukahu

Ko te kai hikareti te take nui puta ai te matepukupuku pūkahukahu. Heoi anō, kāore i te mōhiotia e pā ai te mate ki tētahi e kaipaipa ana, engari kāore e pā ki tētahi atu.

Tērā pea, ka puta anō te matepukupuku pūkahukahu nā runga i te kaipaipa tuarua.

How common is lung cancer?

The latest provisional data (data that have yet to be finalized and subject to change) available from the Ministry of Health records 1,713 new cases of trachea, bronchus and lung cancer in New Zealand in 2008. Lung cancer is the most common cause of death from cancer for New Zealand men, and the second most common for women.

Twice as many men as women die from lung cancer, but the incidence is increasing among women. There is some evidence that women may be particularly sensitive to the cancer-causing effects of cigarette smoke.

Pēhea rawa te kaha pā o te matepukupuku pūkahukahu?

E ai ki ngā raraunga provisional o tēnei wā (he raraunga kāore ano i whakatūtūrihia, ā, tērā pea ka rarekē) mai i ngā pātaka kōrero a te Manatū Hauora, 1,713 ngā putanga hou o ngā matepukupuku trachea, matepukupuku bronchus, matepukupuku pūkahukahu hoki, i te tau 2008. Ko te matepukupuku pūkahukahu te mate kaha rawa atu o ngā matepukupuku e hemo ai ngā tāne o Aotearoa, ā, ko te mate kaha rawa atu tuarua mō ngā wāhine.

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Chest X-ray

An X-ray of the chest can sometimes identify tumours as small as one centimetre in diameter. However, tumours can easily be hidden by surrounding areas of infection and are not always obvious on X-ray.

Sputum cytology

The sputum cytology test is an examination of sputum (phlegm/spit), which you cough up from your lungs, under a microscope to check for abnormal cells.

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You will be asked to collect early-morning samples for several days. To do this you will need to cough deeply to bring up liquid from your lungs. You can do this at home, storing the sample in the fridge before taking it to the laboratory. A negative sputum test does not rule out cancer.

Cytology huare

He whakamātautau o te huare (te tuha) mai i o pūkahukahu te whakamātautau cytology huare, ki raro i te karu whakarahi kia kitea ai mēnā he pūtau rerekē kei roto.

Bronchoscopy

An instrument called a bronchoscope is often used to help diagnose lung cancer or confirm the type. This is a flexible tube that is inserted into the nose or mouth and down the trachea. It acts like a periscope and allows the doctor to look in the bronchi and take a sample of any abnormal looking tissue. The doctor will give you a sedative and a local anaesthetic spray to the back of your throat. If you are still uncomfortable let your doctor know.

Fine-needle aspiration - Tango wai tinana mā te ngira–rauiti

The doctor inserts a needle between the ribs into the tumour. They will use this procedure if you have a suspicious looking lump that cannot be sampled by bronchoscopy. It is usually done in a hospital. You will have a local anaesthetic before the doctor inserts the needle through the chest wall into the tumour and removes some tissue. This is nearly always done with the help of a CT scan in the X-ray department.

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Thoracentesis

This procedure also uses a fine needle. Instead of the doctor sampling the tumour, they will draw fluid from the pleural space to check for cancer cells.

Mediastinoscopy

This is a surgical procedure for examining and taking a biopsy of lymph nodes in the mediastinum. This test requires a general anaesthetic and a short stay in hospital. The doctor inserts the viewing scope through an incision (a cut) made above the sternum (the breast-bone).

Video-assisted thoracoscopic surgery (VAT)

Thoracoscopes are instruments like bronchoscopes and mediastinoscopes. They are inserted into the chest cavity through small incisions in the skin. The doctors can see inside your chest using these instruments, and take tissue samples of anything abnormal.

The doctor can use a very small video camera and is able to guide the instruments by watching the video screen. You may have up to three small cuts made in your chest, one for the camera and two for the surgical instruments. You will have a general anaesthetic and be in hospital for two or three days.

CT scan

A computerised tomography (CT) scan is a special type of X-ray that gives a detailed picture of the organs and other structures in your body.

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A CT scan can be used to more accurately assess the size and position of a tumour than a chest X-ray. It can also assess whether lymph nodes are enlarged, or whether other organs are affected. The scan will usually look at your chest and upper abdomen.

You will have a CT scan at the hospital or radiology service. It usually takes about 30 to 40 minutes to complete this painless test. You will be asked to lie flat on a table while it moves through the CT scanner, which is large and round like a doughnut. A dye may be injected into a vein, probably in your arm, during the scan. This may make you feel flushed and hot for a short time. The dye helps distinguish normal blood vessels from a tumour and lymph nodes. You will be asked not to eat or drink for a while before you have your scan. Most people are able to go home as soon as their scan is over.

Other scans

If lung cancer is confirmed, a bone scan can help show whether lung cancer has spread to the bones. A small amount of radioactive substance is injected into a vein. It travels through the bloodstream and collects in areas of bone damage. An instrument called a scanner measures the radioactivity levels in these areas and records them on X-ray film.

The scanner measures the radioactivity levels in all of the bones in the body and produces digital images. The damaged areas show up brighter than normal bone. Damage from arthritis or fractures and some other non-cancer causes can also appear bright.

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Positron emission tomography (PET)

Positron Emission Tomography (PET) scans are being increasingly used before treatment. Before a PET scan a person is injected with a glucose solution (FDG) containing a very small amount of radioactive material. The scanner can 'see' the radioactive substance. Damaged or cancerous cells may show up as areas where the glucose is being taken up. You may have both a PET scan and a CT scan during your appointment.

Other tests

You may also have blood tests and breathing tests. If your doctor is considering surgery, then it is very important to measure your breathing.

Staging the cancer

The tests described above show whether you have cancer, its size and whether the cancer cells have spread to other parts of your body. This helps your doctors 'stage' the disease so they can work out the best treatment for you. The tests described above show whether you have cancer, and if you do, where the primary is. Your doctors will also consider your general health and personal choices when determining treatment options.

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Non-small cell lung cancer is divided into four stages:

• Stage 1 – small and localised.

• Stage 2 or 3 – has spread into surrounding structures, such as lymph nodes and the chest wall or both.

• Stage 4 – has spread to other parts of the body, such as the liver, bones or brain.

Small-cell lung cancer is divided into two stages:

• Limited disease – the cancer cells can be seen only in one lung, in nearby lymph nodes, or in fluid around the lungs (known as pleural effusion).

• Extensive disease – it is clear that the cancer has spread outside the lung, within the chest area, or to other parts of the body.

Te whakaraupapa i te matepukupuku

Ka whakaatu mai ngā whakamātautau i runga ake nei mehemea kua puta te matepukupuku ki a koe. Mēnā kei a koe, ka whakaatu mai kei whea e noho ana, tēna rahi, mehemea kua rauroha hoki ngā pūtau ki wāhi kē o tō tinana. Ka āwhina tēnei i ō rata ki te 'whakaraupapa' i te mate kia tika ai tā rātou whakarite i te maimoatanga pai rawa atu mōu.

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Surgery

Surgery is the first treatment considered for non-small cell lung cancer.

This is only possible if:

• the cancer has not spread beyond the lung and

• your health (apart from the cancer) is reasonably good and

• your breathing capacity is adequate.

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The most common operation, called a lobectomy, removes the affected part of the lung. Occasionally, the whole lung needs to be removed and this is called a pneumonectomy.

In patients with reduced breathing, smaller parts of the lung may be removed to try to preserve breathing capacity.

Hāparapara

Ko te hāparapara te maimoatanga tuatahi ka whakaarohia mō te matepukupuku pūkahukahu pūtau kore-iti.

Ka taea noa iho tēnei mehemea:

• kāore anō te matepukupuku i rauroha ki tua atu i ngā pūkahukahu

• he āhua pai tonu tō hauora (i tua atu i te matepukupuku)

• he rawaka tō āheinga ki te whakahā.

Chemotherapy

Chemotherapy is the treatment of cancer using anti-cancer (cytotoxic) drugs. The aim is to kill cancer cells while doing as little as possible damage to normal cells. It is the main form of treatment for small cell lung cancer.

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Chemotherapy is usually given in an outpatient clinic, and this treatment is spread over weeks and months. Although most chemotherapy is given as an intravenous (IV) infusion (drip) some types can be given by tablet. Most chemotherapy drugs are available free through the hospital cancer services. A few newer drugs are not subsidised by the government and can be very expensive. Your oncologist should be able to advise you on your best options.

Side effects of chemotherapy

Most of the side effects are usually temporary and go away after treatment or within a few months of stopping. A few people may manage to continue with their normal life at home and work throughout their chemotherapy.

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Problems may include:

• infections – the drugs can lower your ability to fight infections

• easy bruising or bleeding

• sore mouth

• diarrhoea or constipation

• feeling sick or vomiting

• tiredness

• loss of appetite or taste changes

• hair loss

• hearing loss

• pins and needles sensations or numbness

• skin rash.

If you develop a fever (have a temperature of 38 degrees celsius or over), or you feel unwell, even with a normal temperature, don't wait to see what happens. Phone your cancer treatment centre, oncologist, oncology nurse or hospital immediately for advice.

You and your partner should use contraceptives during treatment because the drugs can cause birth defects or miscarriage.

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Radiation treatment

Radiation treatment uses high-energy radiation to destroy cancer cells or prevent them from reproducing. Radiation treatment only affects the part of the body at which the beam(s) are aimed, so is very localised.

About half of all people with cancer need radiation treatment at some point in their illness. For some types of cancer this is the main treatment. It might be used in combination with surgery, chemotherapy or hormone therapy.

Radiation treatment may be given as a single one-off dose, or in a course of up to 30 to 35 treatments, depending on individual circumstances. For longer courses, radiation is usually given daily for four or five days a week, but not usually over weekends. Each treatment session usually lasts 10 to 15 minutes. You will see a doctor once a week during treatment to check on your progress.

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Additional blood tests, X-rays or scans may be required to help with this.

Ask your local Cancer Society for further information on radiation treatment and a copy of the Society's booklet, Radiation Treatment/Haumanu Iraruke, which is available through your local Cancer Society or by downloading it free from our website (www.cancernz.org.nz).

Maimoatanga iraruke

Whakamahi ai te maimoatanga iraruke i te iraruke pūngaokaha hei patu i ngā pūtau matepukupuku kia kore ai e tārua. Ka pā noa iho te maimoatanga iraruke ki ngā wāhanga o te tinana e hāngai ana te aro atu o ngā hihi, nā reira he mea tino noho ā-rohe.

Treatment for symptoms that may occur

Palliative care

The majority of people with lung cancer will not be cured. Palliative care is an approach to caring for people with advanced cancer and their family that focuses on improving their quality of life. It is not just about care at the end of life. This can be offered in a hospital, rest home, at home or by hospice.

Palliative care is co-ordinated care provided by specialist doctors, nurses, social workers and spiritual care workers.

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Palliative care may be used during times when your illness is causing discomfort; for example, for:

• bothersome pain

• shortness of breath

• nausea and vomiting periods

• when your thoughts and feelings are distressing

• occasions when your illness may be affecting other aspects of your life, such as with your partner, children, family/whānau

• difficulties with work or perhaps financial affairs.

In general, palliative care services are free. There may be a charge for hire of some equipment for home care. Palliative care and hospice services are funded by both the government and voluntary donation.

You may also be faced with decisions and choices that are confusing or difficult to make during your illness. The palliative care team may be able to help explain things to you, and help you find answers.

Atawhai taurima

Ko te whāinga o te atawhai taurima he tiaki tangata whai i te matepukupuku me tō rātou whānau, e arotahi ana ki te whakapai ake i tō rātou kounga toiora, kaua ko te aro anake ki te atawhai i mua i te hemonga. Ka whakaratoa tēnei ki te hōhipera, ki tētahi kāinga whakangā, ki te kāinga, ki te hospice rānei.

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Talking with doctors

Before you see the doctor, it may help to write down your questions. See suggested list of questions on page 56-57.

Ask your local Cancer Society or call our Cancer Information Helpline 0800 CANCER (266 237) for a copy of Questions You May Wish to Ask. The booklet has 23 frequently asked questions to ask your health professionals. The questions are designed to help you get information about your cancer and to make treatment decisions with your doctor and family/ whānau.

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A space is provided under each question for you, your support person or doctor to write the answer. The booklet is available in 12 languages (including English).

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Taking notes during the session can also help. It is helpful to take a family member or friend with you to take part in the discussion, take notes or simply listen. Some people find it is helpful to record the discussion.

You may want to see your doctor a few times before making a final decision on treatment. It is often difficult to take everything in, and you may need to ask the same questions more than once. You always have the right to find out what a suggested treatment means for you, and the right to accept or refuse it.

Te kōrero ki ngā rata

I mua i tō haere ki te kite i te rata, tērā pea he pai te tuhi i ō pātai i te tuatahi.

Uiuitia tō Kāhui Matepukupuku ā-Rohe, me waea atu rānei ki Waea āwhina Matepukupuku (Cancer Information Helpline) 0800 CANCER (266 237) mō tētahi kape o 'Ngā Pātai e Hiahia Ana Koe ki te Tuku'. Kei roto ko ngā pātai auau 23 hei whiu ki ngā kaimahi ngaio hauora. I whakaritea ngā pātai hei āwhina i a koe ki te tiki pārongo e pā ana ki tō matepukupuku me te āwhina i ngā whakataunga ka puta ki waenganui i a koe me tō rata, tō whānau hoki. Kua whakaritea he wāhanga mōu, mō tō rata, mō tō whānau rānei, hei tuhi i ngā whakautu. Kei roto te pukapuka i ngā reo 12 (tae noa ki te Ingarihi).

Talking with others

Once you have discussed treatment options with your doctor, you may want to talk them over with someone else, such as family or friends, specialist nurses, your family doctor, the Cancer Society, the hospital social worker or chaplain, your own religious or spiritual adviser or another person who has had an experience of lung cancer.

Talking it over can help you to sort out what course of action is right for you.

Te kōrero ki ētahi atu

Ka mutu ana tō kōrero mō ngā kōwhiringa maimoatanga ki tō rata, tērā pea ka hiahia koe ki te kōrero ki tētahi atu, pērā ki tō whānau, ō hoa rānei, ngā tapuhi mātanga, tō rata ā- whānau, te Kāhui Matepukupuku, te tauwhiro o te hōhipera, te minita rānei, tōu ake minita, tōu ake pou ārahi wairua rānei, tētahi atu tangata kua whai wheako i te matepukupuku pūkahukahu.

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A second opinion

You may want to ask for a second opinion from another specialist. Your specialist or general practitioner can refer you to another specialist and you can ask for your records to be sent to the second doctor.

You may be interested in looking for information about lung cancer on the internet. While there are very good websites, be aware that some websites provide wrong or biased information. We recommend that you begin with the Cancer Society's site (www.cancernz.org.nz) and use our links to other good cancer websites, or see the list of websites on page 60.

Taking part in a clinical trial

Your doctor may suggest that you consider taking part in a clinical trial.

You could also ask if there is a clinical trial for your particular kind of cancer.

Clinical trials are a vital part of the search to find better treatments for cancer, and are conducted to test new or modified treatments and see if they are better than existing treatments.

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Many people all over the world have taken part in clinical trials that have resulted in improvements to cancer treatment. However, the decision to take part in a clinical trial is always yours.

If you are asked to take part in a clinical trial, make sure that you fully understand the reasons for the trial and what it means for your treatment.

Before deciding whether or not to join the trial, you may wish to ask your doctor the following questions:

• What is the standard treatment if I do not participate in the trial?

• What is the potential benefit?

• Which treatments are being tested and why?

• What tests are involved?

• What are the possible risks or side effects?

• How long will the trial last?

• Will I need to go into hospital for treatment?

• What will I do if any problems occur while I am in the trial?

• If the treatment I receive in the trial is successful for my cancer, is there a possibility of carrying on with the treatment after the trial?

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If you decide to join a randomised clinical trial, you will be given either the best existing treatment or a promising new treatment. You will be chosen at random by computer to receive one treatment or the other. Either treatment will be appropriate for your condition. In clinical trials, people's health and progress are carefully monitored.

If you do not want to take part, your doctor will discuss the best current treatment options with you.

Te uru ki tētahi whakamātautau haumanu

Tērā pea ka puta te whakaaro i tō rata mehemea ka hiahia koe ki te uru ki tētahi whakamātautau haumanu.

He nui ngā tāngata, huri noa i te ao, kua uru ki ngā whakamātautau a-haumanu, a, nā tēnei, kua pai ake puta te maimoatanga matepukupuku. Heoi anō, i te mutunga, kei a koe te tikanga mēnā ka uru koe ki ngā whakamātautau ā-haumanu.

I mua i tō whakatau mehemea me whakauru koe ki te whakamātautau, tērā pea ka hiahia koe ki te tuku i ēnei pātai ki tō rata:

• He aha te maimoatanga ka whiwhi au ki te kore au e uru ki roto i te whakamātautau?

• He aha ngā hua tērā pea ka puta?

• Ko ēhea ngā maimoatanga e whakamātauria ana, ā, he aha ai?

• He aha ngā whakamātautau ka puta?

• He aha ngā mea mōrea, ngā papātanga rānei ka puta ki te taha, o ngā whakamātautau?

• Ka pēhea te roa o te whakamātautau?

• Me kuhu au ki te hōhipera mō ngā maimoatanga?

• Ka aha au mehemea ka ara ake he raruraru i te wā kei roto au i te whakamātautau?

• Mehemea he pai te maimoatanga ka whiwhi au i te whakamātautau mō taku matepukupuku ka taea tonu te whai i taua maimoatanga i muri i te whakamātautau?

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Emotional support

People react in different ways when they learn they have lung cancer. Feelings can be muddled and change quickly. This is quite normal and there's no right or wrong way to feel.

It may be helpful to talk about your feelings with your partner, family members, friend, or with a counsellor, social worker, psychologist or your religious/spiritual adviser. Talking to other people with lung cancer may also help.

It is usually best to tell your family and your closest friends about your cancer. Some people worry that older people in the family or children will not cope with the news. But if you do not tell your family, they will know that something is wrong anyway.

Sometimes you may find your friends and family do not know what to say to you: they may have difficulty with their feelings as well. Some people may feel so uncomfortable they avoid you. They may expect you to lead the way and tell them what you need. You may feel able to approach your friends directly and tell them what you need. You may prefer to ask a close family member or friend to talk to other people for you.

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Anyone you tell needs time to take it in and to come back with their questions and fears. You can help them to adjust, just as they can help you. But remember that while you are having treatment your needs should come first. If you do not feel like talking, say so. If there are practical things they can do to help, say so. If you cannot cope with any more visitors, say so. Some friends are better at doing something practical to help than they are at sitting and talking. Some find it so difficult that they may stop visiting for a while. Everyone is different.

Tautoko ā-ngakau

He maha ngā tauhohenga rerekē ka puta inā mōhio ai te tangata kua pā he matepukupuku pūkahukahu ki a ia. Ka pōraru ngā kare ā-roto, ka tere te huri. He āhua tēnei ka puta i te nuinga o te wā, ehara i te mea kua takoto he kōrero mō te tika, mō te hē rānei o te putanga ngākau.

He pai te kōrero mō ō kare ā-roto ki tō hoa moe, tō whānau ō hoa, ki tētahi poutohutohu, tētahi tauwhiro, tētahi kaimātai hinengaro, ki tō pou ārahi hāhi, wairua hoki. Tērā pea, mō te kōrero ki ētahi atu e mate ana i te matepukupuku pūkahukahu, ka āwhina i a koe.

He mea nui te kōrero ki tō whānau me ō hoa tata mō tō matepukupuku. Ka māharahara ētahi mō ngā kaumātua me ngā tamariki o te whānau, kei kore e pai te rongo i ngā kōrero. Heoi anō rā, ki te kore koe e whakamōhio atu i tō whānau, kāore e kore ka mōhio tonu rātou kei te mate kē koe.

I ētahi wā, tērā pea kāore tō whānau me ō hoa e mōhio he aha he kōrero, hei kōrero ki a koe, tērā pea kei te taumaha hoki ō rātou ngākau. Tērā pea ka nui te manawarau o ētahi, ka huri rātou ki te karo i a koe. Tērā pea kei te tiaki kē rātou kia kōrero kē koe mō ōu hiahia i te tuatahi. Tērā pea ka āhei koe ki te kōrero hāngai atu ki a rātou mō ōu hiahia, ki te kōrero rānei ki tētahi o te whānau, tō hoa rānei, hei kawe kōrero mōu.

Talking with your children

How much you tell children will depend on how old they are. Young children need to know that it is not their fault that you have cancer. They also need to know that you may have to go into hospital. Slightly older children can probably understand a simple explanation of what is wrong. Teenagers understand much more. Children like to know what will happen to them while you are in hospital, who will look after them and how their daily life will be affected.

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Sometimes, children rebel or become quiet. Keep an eye on them or get someone else to, and get help if you need it; for example, from the school counsellor or a social worker.

Contact your local Cancer Society for a copy of the booklet What Do I Tell the Children?/He Aha He Kōrero Maku Ki Āku Tamariki? or phone the Cancer Information Helpline 0800 CANCER (226 237). You can also download it from our website (www.cancernz.org.nz).

Cancer Society information and support services

Your local Cancer Society provides confidential information and support. The Cancer Information Service is a Cancer Society service where you can talk about your concerns and needs with trained nurses. Call your local Cancer Society or phone the Cancer Information Helpline 0800 CANCER (226 237).

Local Cancer Society centres offer a range of services for people with cancer and their family/whānau. These may include:

• volunteer drivers providing transport to treatment

• accommodation

• support and education groups

• volunteer support visitors.

The range of services offered differs in each region so contact your local centre to find out what is available in your area.

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Cancer support groups

Cancer support groups offer mutual support and information to people with cancer and their family/whānau. It can help to talk with others who have gone through the same experience. Support groups can also offer many practical suggestions and ways of coping. Ask your hospital or local Cancer Society for information on cancer support groups in your area.

Home care

Nursing care is available at home through district nursing or your community nursing services. Your doctor or hospital can arrange this. You may be entitled to assistance with household tasks during your treatment. For information, contact a social worker or the District/Community Nursing Service.

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Financial assistance

You may be able to get help for transport and accommodation costs if you are required to travel some distance to your medical and treatment appointments. Your treatment centre or local Cancer Society can advise you about what sort of help is available. Financial help may also be available through your local Work and Income office.

Work and Income (0800 559 009) has pamphlets and information about financial assistance for people who are unable to work. Short-term financial help is available through the Sickness Benefit and longer-term help is provided through the Invalids Benefit. Extra help may be available; for example, accommodation supplements and assistance with medical bills. More information is available on the Ministry of Social Development's website, www.msd.govt.nz or by phoning 0800 559 009.

Interpreting services

New Zealand's Health and Disability Code states that everyone has the right to have an interpreter present during a medical consultation. Family or friends may assist if you and your doctor do not speak the same language, but you can also ask your doctor to provide an interpreter if using family members is inappropriate or not possible.

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Diet and food safety

A balanced nutritious diet will help to keep you as well as possible and cope with any side effects of treatment. The Cancer Society's booklet Eating Well/Kia Pai te Kai gives useful advice and recipes. Phone your local Cancer Society office for a copy of this booklet, call the Cancer Information Helpline 0800 CANCER (226 237) or download the booklet from our website (www.cancernz.org.nz).

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The hospital will also have a dietitian who can help. Food safety is of special concern to cancer patients, especially during treatment, which may suppress immune function. To make food as safe as possible it is recommended that patients follow the guidelines below.

• Wash your hands thoroughly before eating.

• Keep all areas used for food preparation clean, including washing hands before preparing food and washing fruit and vegetables.

• Handle raw meat, fish, poultry and eggs with care and clean thoroughly any surfaces that have been in contact with these foods. Keep raw meats separate from cooked food.

• Cook meat, poultry and fish thoroughly and use pasteurised milk and juices.

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• Refrigerate food promptly to minimise bacterial growth.

• When eating in restaurants avoid foods that may have bacterial contamination, such as salad bars, sushi and raw or undercooked meats, fish, poultry and eggs.

• If you are concerned about the purity of your water - for example, if you have well water or rainwater from your roof - have it checked for bacterial content. If you are concerned about its purity, boil it for two or three minutes.

Kai noho puku me te haumaru kai

Ka āwhina te noho puku whai painga i a koe ki te noho ora tonu, e ai ki tērā ka taea, me te tū pakari ki ngā pānga kino ka puta i te taha nā runga i ngā maimoatanga. Ka whaikiko ngā tohutohu me ngā tohutaka kei roto i te pukapuka a te Kāhui Matepukupuku i tapaina ai ko Eating Well/Kia Pai te Kai. Waea atu ki te tari Kāhui Matepukupuku kei tō rohe mō tētahi kape o tēnei pukapuka, me waea atu rānei ki te Cancer Information Helpline i te nama 0800 (226 237) me tango ake rānei mai i tō mātou paetukutuku www.cancernz.org.nz.

Exercise

Many people find regular exercise helps. People who remain active cope better with their treatment. The problem is that while too much exercise is tiring, too little exercise can also make you tired. Therefore, it is important to find your own level. Discuss with your doctor what is best for you.

Kori tinana

He nui ngā tāngata e kite ana i te pai o te mahi auau i ngā kori tinana. Ka pai ake ngā maimoatanga mō te hunga e noho pakari ana. Ko te raru kē, ki te nui rawa te mahi korikori, ki te iti rawa rānei, tērā pea ka ngenge rawa koe. Nā reira he mea nui te kimi i tōu ake taumata. Kōrero ki tō rata mō ngā mahi kori tinana pai mōu.

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Relaxation techniques

Some people find relaxation or meditation helps them to feel better. The hospital social worker, nurse or Cancer Society will know whether the hospital runs any relaxation programmes, or may be able to advise you on local community programmes.

Seeking advice from health professionals

If you feel uncomfortable or unsure about your treatment, it is important that you discuss any concerns with those involved in your care, including your general practitioner.

Te rapu tohutohu mai i ngā ngaio hauora

Mehemea kei te noho manawarau koe, kei te māharahara rānei koe mō tō maimoatanga, he mea nui te kōrero ki ngā tāngata kei te tiaki i a koe, tae noa ki tō rata.

Complementary and alternative therapies

Complementary therapy is a term used to describe any treatment or therapy that is not part of the conventional treatment of a disease.

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It includes things such as:

• acupuncture

• relaxation therapy and meditation

• yoga

• positive imagery

• spiritual healing/cultural healing

• art

• aromatherapy/massage.

Complementary methods do not cure lung cancer, but they may help control symptoms and improve wellbeing.

Alternative therapy is a term used to describe any treatment or therapy that may be offered as an alternative to conventional treatments. It includes things such as:

• homeopathy

• naturopathy

• Chinese herbs.

Alternative treatments are sometimes promoted as cancer cures. However, they may be unproven, as they may not have been scientifically tested or, if tested, they were found to be ineffective.

It is important to let your doctor know if you are taking any complementary or alternative therapies because they may be harmful if they are taken at the same time as conventional treatments.

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Ngā haumanu rerekē, tautoko hoki

He kupu te haumanu rerekē mō ngā maimoatanga me ngā haumanu kāore i te whai i ngā āhuatanga motuhake mō te maimoatanga o tētahi mate.

I ētahi wā, ka whakatairangatia ngā maimoatanga tautoko hei kaupapa whakaoranga matepukupuku. Heoi anō rā, kāore anō kia tūturu i te mea kāore anō i whakamātauria ā-pūtaiao nei. Mehemea i whakamātauria rānei, kua kitea kētia te kore whai hua.

He mea nui te whakamōhio atu i tō rata mehemea kei te whai koe i tētahi maimoatanga rerekē, tautoko hoki, i te mea, he takakino ētahi mēnā ka whāia i te wā e whai hoki ana koe i tētahi maimoatanga motuhake.

Fertility and contraception

You may become infertile, either temporarily or permanently, during treatment. Talk to your doctor about this before you start treatment.

Despite the possibility of infertility, you should use contraception (if the woman has not gone through menopause) to avoid pregnancy because there is a risk of miscarriage or birth defects for children conceived during treatment.

If you are pregnant now, talk to your doctors about it straight away. You may find the Cancer Society's booklet Sexuality and Cancer/Hōkakatanga me te Matepukupuku helpful. You can obtain it from your local Cancer Society, by phoning the Cancer Information Helpline 0800 CANCER (226 237) or by downloading it from our website (www.cancernz.org.nz).

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Te Kāhui Matepukupuku o Aotearoa

www.cancernz.org.nz

Any Question, Any Cancer

0800 cancer (226 237)

Cancer Information Helpline

End of "Lung Cancer/Matepukupuku Pūkahukahu"