My adult daughter always seems to be complaining of being in pain or fatigue and generally not feeling well. I don’t think she is trying hard enough.Are her “unseen” symptoms real? If so, what can I do to help her?

21. My adult daughter always seems to be
complaining of being in pain or fatigue and
generally not feeling well. I don’t think she is
trying hard enough.Are her “unseen”
symptoms real? If so, what can I do to help her?

The person with cancer first needs to know that she
has a care partner she can trust, someone who
hears her specific complaints and is working with
her to find solutions.

Yes, most likely her symptoms are real. Listening to
your daughter’s complaints may be making you feel
frustrated and helpless, particularly if this has been
going on for a while and progress has been slow.
Sometimes, in order to reduce their own feelings of
not being able to help, family and friends try to minimize
the situation. However, no one can say how
much pain, fatigue, or distress your daughter feels,
except your daughter herself. It is very important that
you believe what your daughter is saying, particularly
about her pain, because when people in pain think that
no one believes them, this increases their distress. As a
result, they may stop telling others exactly what is happening
with their pain, which then makes the pain
more difficult to control.

Most pain can be relieved to the degree that allows
patients to live a reasonable life, though it may require
patience and persistence to find the right regimen.
Sometimes pain is directly connected with a cancer
tumor, which when treated through surgery, radiation
therapy, and/or chemotherapy, reduces the source of the
pain itself. Medication, including analgesics like acetaminophen
and ibuprofen, as well as more powerful opioid
drugs like morphine and oxycodone, can be used on
a regular basis to prevent pain from beginning, in addition
to keeping it under control. And there is a host of
other measures—from warm baths and hot water bottles
to relaxation exercises and training in guided
imagery—that will not only help to reduce your daughter’s
feelings of pain, but will also help to increase her
sense of control with regard to it.Talking about her pain
in detail and on a regular basis should not be thought of
as “dwelling on it,” but as a necessary way of getting
accurate information to the medical team members so
that they can effectively and promptly treat it.

Psychological distress is common among people in pain.
And, it is also possible that there are other psychological
issues, such as depression and anxiety, which are contributing
to your daughter’s expressions of pain and
fatigue. To support the person with cancer, it is better to
address psychological factors separately from her physical
complaints, at least in the beginning.We’ve outlined elsewhere
in this book how to evaluate emotional distress in
your loved one, ways to gauge the seriousness of the distress,
and options for treatment.

The person with cancer first needs to know that she has a
care partner she can trust, someone who hears her specific
complaints and is working with her to find solutions.
If your daughter’s pain continues, help her communicate
this to her doctor and persist in finding methods
of relief. Since our expertise as social workers does not
focus on the management of physical symptoms and
possible treatment side effects, we suggest that you or
your daughter contact the doctor’s office immediately if
new or unresolved symptoms occur. Furthermore, a
very useful resource on managing physical issues at
home is published by the American Cancer Society and
is available on their Web site