toAgnesian
CancerCare
Welcome
Medical Oncology
S u r v i v o r s h i p G u i d e
CancerCare
Agnesian HealthCare provides services to individuals regardless
of race, cree...
S u r v i v o r s h i p G u i d e
CancerCare
	 - In addition, the Joint Commission conducts a periodic
review of Agnesian ...
S u r v i v o r s h i p G u i d e
CancerCare
We are Committed to Patient Safety!
Patient safety is part of the Agnesian He...
S u r v i v o r s h i p G u i d e
CancerCare
How to Be An Active Member of Your Health Team
1.	 The single most important ...
Staff only: q Verified identity
Agnesian eHealth Registration Form
Agnesian eHealth
Your on-line health management resourc...
S u r v i v o r s h i p G u i d e
CancerCare
Welcome to the Agnesian Cancer Center.
Choosing a treatment facility for your...
S u r v i v o r s h i p G u i d e
CancerCare
RadiationOncology
480E.DivisionStreet,FondduLac | 933NewburyStreet,Ripon | 62...
S u r v i v o r s h i p G u i d e
CancerCare
RadiationOncology
480E.DivisionStreet,FondduLac | 933NewburyStreet,Ripon | 62...
S u r v i v o r s h i p G u i d e
CancerCare
MedicalOncology
480E.DivisionStreet,FondduLac | 933NewburyStreet,Ripon | 620W...
S u r v i v o r s h i p G u i d e
CancerCare
MedicalOncology
480E.DivisionStreet,FondduLac | 933NewburyStreet,Ripon | 620W...
S u r v i v o r s h i p G u i d e
CancerCare
480E.DivisionStreet,FondduLac | 933NewburyStreet,Ripon | 620W.BrownStreet,Wau...
S u r v i v o r s h i p G u i d e
CancerCare
AncillaryAssociates
480E.DivisionStreet,FondduLac | 933NewburyStreet,Ripon | ...
S u r v i v o r s h i p G u i d e
CancerCare
Medical Oncology is where you will receive your chemotherapy
infusions or inj...
S u r v i v o r s h i p G u i d e
CancerCare
Welcome to Medical Oncology. This is where you will receive your
chemotherapy...
Oral Chemotherapy Prescriptions
agnesian.com
Who
Agnesian Pharmacy Plus
What
Let us fill your oral chemotherapy prescripti...
S u r v i v o r s h i p G u i d e
CancerCare
CancerPainDiary
Date Time Pain Rating
(0 to 10)
Pain Medicine
(name, dose)
Pa...
S u r v i v o r s h i p G u i d e
CancerCare
Cancer Pain Management
Pain can often be a concern for people diagnosed with ...
S u r v i v o r s h i p G u i d e
CancerCare
CancerPainManagement
Your body does not become immune to pain medicine.
• 	 C...
S u r v i v o r s h i p G u i d e
CancerCare
LowPlatelets
Low Platelets (Thrombocytopenia)
Platelets are the blood cells t...
S u r v i v o r s h i p G u i d e
CancerCare
LowRedBloodCells
Low Red Blood Cells (Anemia)
Anemia is an abnormally low lev...
S u r v i v o r s h i p G u i d e
CancerCare
LowWhiteBloodCells
Low White Blood Cells (Neutropenia)
White blood cells dest...
S u r v i v o r s h i p G u i d e
CancerCare
LowWhiteBloodCells
• 	 Loose or liquid stools
• 	 Trouble urinating - increas...
S u r v i v o r s h i p G u i d e
CancerCare
CareatHomeAfterChemotherapy
Care at Home After Your Chemotherapy
The informat...
S u r v i v o r s h i p G u i d e
CancerCare
CareatHomeAfterChemotherapy
• 	 Stay as active as you can. If your physical c...
S u r v i v o r s h i p G u i d e
CancerCare
NutritionDuringCancerTreatment
Why Is Good Nutrition Important?
Good nutritio...
S u r v i v o r s h i p G u i d e
CancerCare
NutritionDuringCancerTreatment
• 	 Allow friends and family to prepare meals ...
S u r v i v o r s h i p G u i d e
CancerCare
CancerExerciseProgram
Exercise and the Cancer Patient
Cancer patients can exp...
S u r v i v o r s h i p G u i d e
CancerCare
ClinicalTrials
About Clinical Trials
Clinical trials are research studies tha...
S u r v i v o r s h i p G u i d e
CancerCare
CancerGeneticRiskAssessmentServices
What are Cancer Genetic Risk Assessment S...
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CancerCare
CancerGeneticRiskAssessmentServices
Am I Required to Have Genetic Testing as ...
S u r v i v o r s h i p G u i d e
CancerCare
SupportServicesAvailable
Our social worker is part of the team of associates ...
S u r v i v o r s h i p G u i d e
CancerCare
SupportServicesAvailable
Journeys: a health resource center
(920) 926-4960
43...
Wig Boutique Services
agnesianhealthshoppe.com
327 Winnebago Drive, Fond du Lac • (920) 926-5277 • Monday through Friday, ...
S u r v i v o r s h i p G u i d e
CancerCare
AmericanCancerSocietyResources
We are fortunate to have a trained volunteer n...
S u r v i v o r s h i p G u i d e
CancerCare
SuggestedInternetResources
www.cancer.net
Cancer Net is the patient informati...
S u r v i v o r s h i p G u i d e
CancerCare
SuggestedInternetResources
Gynecological Cancers (ovarian, cervical)
Gynecolo...
S u r v i v o r s h i p G u i d e
CancerCare
CancerSupportGroup
A Free Program For Individuals with Cancer and Those Who C...
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CancerCare
On-LineCaregiverSupportGroups
Cancer Survivors Network Chat (American Cancer ...
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CancerCare
LookGood...FeelBetter
The Look Good...Feel Better® program is a community-bas...
Guided by volunteer cosmetologists, female cancer patients who
participate in this class will learn how to use make-up and...
S u r v i v o r s h i p G u i d e
CancerCare
AudioVisualEntrainment(AVE)
Do you ever feel tired, anxious, tense or restles...
S u r v i v o r s h i p G u i d e
CancerCare
AcousticalChair
Listening to music with your whole body.
Agnesian HealthCare ...
S u r v i v o r s h i p G u i d e
CancerCare
Labyrinth
A Holy Walk
To walk the labyrinth is to touch God and let God touch...
S u r v i v o r s h i p G u i d e
CancerCare
Labyrinth
You May Want to Walk the Labyrinth Because...
You have a question.
...
Compassion, Knowledge & Respect
agnesianhealthshoppe.com
327 Winnebago Drive, Fond du Lac • (920) 926-5277 • Monday throug...
S u r v i v o r s h i p G u i d e
CancerCare
Thoughts,Feelings&Questions
_________________________________________________...
S u r v i v o r s h i p G u i d e
CancerCare
Completing cancer treatments can be both exciting and scary.
Many patients wo...
Agnesian Cancer Care Medical Oncology Binder
Agnesian Cancer Care Medical Oncology Binder
Agnesian Cancer Care Medical Oncology Binder
Agnesian Cancer Care Medical Oncology Binder
Agnesian Cancer Care Medical Oncology Binder
Agnesian Cancer Care Medical Oncology Binder
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Agnesian Cancer Care Medical Oncology Binder

  1. 1. toAgnesian CancerCare Welcome Medical Oncology
  2. 2. S u r v i v o r s h i p G u i d e CancerCare Agnesian HealthCare provides services to individuals regardless of race, creed, color, national origin, ancestry, religion, sex, sexual orientation, marital status, age, newborn status, disability or source of payment. Each individual is treated with consideration, respect and recognition of their individuality and personal needs, including the need for privacy in treatment. Each individual is entitled to the physical, social, psychological, spiritual and emotional care necessary to meet his or her needs within the framework of our philosophy and standards of care. Individuals have the right to: • Receive healthcare from providers with skills and expertise in areas of care that they request. • Be informed of the physician or healthcare provider that has overall responsibility for their care. • Expect that their own medical care plan and records, including computerized information, will be treated as confidential. • Receive an explanation of their medical treatment in a way or language that they can easily understand. A staff member will access the information in the language that the individual/family requests. • Participate in their treatment plan or plan of care and have cultural issues incorporated into decision making, when applicable. • In the event of a medical dilemma, receive information about appropriate alternatives for healthcare, services or providers. • Gain necessary information to give an informed consent prior to the start of any procedure, treatment (except in emergencies) or transfer to another facility. • The patient or the patient’s legally authorized representative shall give prior informed consent for the patient’s participation in any form of research. • Except in emergencies, the patient may not be transferred to another facility without being given a full explanation for the transfer, without provision being made for continuing care and without acceptance by the receiving institution. • Refuse care or treatment and be informed of the medical consequences. • Obtain information about their healthcare upon leaving the facility. • Request that a healthcare provider discuss their medications with them. • Request information about available financial assistance and explanation of their bill. • Have access to their medical record in accordance with Agnesian HealthCare policies and procedures. • Under the Health Insurance Portability and Accountability Act (HIPAA) of 1996, individuals have specific rights to the use and disclosure of their protected health information. (See the Agnesian HealthCare pamphlet, “Privacy Notice,” on the Health Insurance Portability and Accountability Act.) • Designate who they wish to have visit and who they wish to be informed about their healthcare. • Personal privacy (not a private room) and care in a safe setting which is free from all forms of abuse or harassment. • Have their pain managed through: - Information about pain and pain relief measures. - Staff committed to pain prevention and management. - Health professionals who respond quickly to reports of pain. • Voice concerns about quality of care. - If you or a family member have concerns about any services that you are receiving, discuss them with any associate or contact Patient Relations at (920) 926-8347. You may also contact the Division of Quality Assurance at P.O. Box 2969, Madison, WI, 53701-2969, or call their Hotline at (800) 642- 6552. - If you or a family member have concerns about any services that you are receiving while residing on the St. Agnes Hospital Transitional Care Unit or at St. Francis Home, discuss them with any associate, or contact the Board on Aging and Long Term Care at 1402 Pankratz Street, Suite 111, Madison, WI 53704-4001, or call (800) 815-0015; or the Bureau of Assisted Living, 1325 South Broadway, DePere, WI, 54115, or call (920) 983-3200. - Updates for this information can be received through the Division of Quality Assurance (DQA) newsletter, which is sent out on a regular basis through the DQA listing. Patients’Rights&Responsibilities
  3. 3. S u r v i v o r s h i p G u i d e CancerCare - In addition, the Joint Commission conducts a periodic review of Agnesian HealthCare. Join Commission standards deal with organizational quality of care issues and the safety of the environment in which care is provided. Anyone believing that he or she has pertinent and valid concerns about such matters may contact the Office of Quality Monitoring, Organization Liaison, Joint Commission, One Renaissance Boulevard, Oakbrook Terrace, IL, 60181, or call (800) 994-6610. Individuals have the responsibility to: • Provide accurate and complete information about their health history and cooperate with their treatment. • Request clarification on care or treatment if not understood. • Report changes in their medical condition. • Be respectful of other individuals, staff and property. • Keep appointments reliably and promptly, or notify the appropriate department when unable to do so. • Accept their actions if they refuse treatment or do not follow medical instruction. • Provide an accurate name, date of birth, address, phone number, responsible party and insurance information. • Assure that financial obligations are fulfilled as promptly as possible. • In regard to pain management: - Ask their healthcare provider what to expect in regard to pain and pain management. - Discuss pain relief options with their healthcare provider. - Work with their healthcare provider to develop a pain management plan. - Ask for pain relief when pain first begins. - Inform their healthcare provider if their pain is not relieved. • Tell their healthcare provider about any worries they have about taking medications or following a treatment plan. Patients’Rights&Responsibilities
  4. 4. S u r v i v o r s h i p G u i d e CancerCare We are Committed to Patient Safety! Patient safety is part of the Agnesian HealthCare culture. We address patient safety issues through use of best practices, improved technology and increased patient involvement. Our goal is to make you feel secure about your care. Every one of our associates is dedicated to: • Providing you with a safe, healthy and secure environment. • Performing their jobs carefully and competently. • Using safe and effective practices and technologies. • Responding to your wants and needs in a timely manner. • Ensuring timely communications between caregivers and patients by answering questions about your treatment and your health, providing you with specific information about your care and explaining changes about your treatment. • We promise to be honest with you if a safety-related issue occurs. Plan for Your Questions We want to ensure that all of your questions are answered about your care. Please use this space to write down your questions. Then, when you meet with your healthcare providers, you can discuss each question to ensure that you fully understand your treatment options and get all of your questions answered. __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ SpeakUp&AskQuestions
  5. 5. S u r v i v o r s h i p G u i d e CancerCare How to Be An Active Member of Your Health Team 1. The single most important way you can help prevent errors is to be an active member of your healthcare team. 2. Identify yourself. Make sure all associates check your identity (name and birthdate) before any tests or procedures. 3. Make sure that all of your physicians and other healthcare providers know about all medications or dietary supplements - such as vitamins and herbs - that you are taking. 4. Be sure that your caregivers know about any allergies and/or adverse reactions you have had to medicines. 5. When your physician or other healthcare provider writes a prescription, make sure you can read it. 6. Ask for information about your medications in terms you can understand (both when your medications are prescribed and when you receive them). • What is it for? • How am I supposed to take it and for how long? • What side effects are likely? • What do I do if I have side effects? • Is this medication safe to take with other medicines and dietary supplements I am taking? • What food, drink or activities should I avoid while taking this medicine? 7. Help prevent the spread of infection. • Hand washing is the best way to prevent the spread of infections. • Ask friends and relatives who may have contagious symptoms not to visit you. 8. If you have a test, do not assume that no news is good news. Follow up with your provider. Ask what the results mean for your continued care. 9. Feel free to speak up if you have questions or concerns. It is OK to ask questions and expect answers you can understand. Our goal is to provide safe, quality healthcare the right way, with the best possible results. SpeakUp&AskQuestions
  6. 6. Staff only: q Verified identity Agnesian eHealth Registration Form Agnesian eHealth Your on-line health management resource Benefits of Using Agnesian eHealth Here are some of the benefits of using Agnesian eHealth. You can: • View your medications; allergies; immunizations; surgeries and procedures; and a list of health issues • View your laboratory results • Request appointments • Request a medication refill from your healthcare provider • Manage your health profile How to Register for Agnesian eHealth Upon receiving your registration form, we will enter your information into Agnesian eHealth and set up your account. You will receive a secure e-mail welcome invitation from Agnesian eHealth within two business days. What is Agnesian eHealth? Agnesian eHealth is your personal on-line view into the electronic health record that your Agnesian HealthCare providers use to manage and document your care. It is a free web-based tool that allows you to access your records anytime and anywhere you have an Internet connection. Is Agnesian eHealth Secure? Protecting the privacy of our patients’ health information is very important to us, so we have made this process very secure. Agnesian eHealth is a confidential site that provides individuals with the ability to privately view, store and share health information including medications, allergies, immunizations and select laboratory results. E-mail address:________________________________ Challenge question (please select one and answer below): q What are the last four digits of your social security number? q In what year was your mother born? q In what year did you graduate high school? q In what year did you get married? q In what year were you born? Challenge answer:______________________________ Complete this registration form and give it to a receptionist, nurse or provider. You may also drop it off at any hospital Admitting department or at the Agnesian HealthCare Information Desk on our main campus, 430 E. Division Street, Fond du Lac. Please bring a photo ID when returning the registration form. Patient’s name:__________________________________ Date of birth:____________________________________ Agnesian HealthCare is Sponsored by the Congregation of Sisters of St. Agnes
  7. 7. S u r v i v o r s h i p G u i d e CancerCare Welcome to the Agnesian Cancer Center. Choosing a treatment facility for your cancer care is a serious and thoughtful decision. It means placing your trust in a group of professionals during one of the most challenging and uncertain times in your life. All of us at the Agnesian Cancer Center understand this responsibility. It is one that we take very seriously. That’s why we have spent a great deal of time talking about how we can assure that you will receive the very best cancer care available. To us, the very best cancer care, extraordinary cancer care, means an ongoing commitment to state-of-the-art technology and equipment. It means having access to national and local research studies, and attracting the most talented and compassionate cancer care physicians, specialists and associates available. There is something more...we see our role as a partner in your cancer care. We believe we have the responsibility to provide you with the most accurate, up-to-date and understandable information about cancer. Learning all that you can about your type of cancer is one way to feel a better sense of control during your treatment. That’s part of what this booklet is all about. We’ve collected and organized what we think is valuable information on cancer. Some of it you’ll find helpful and other sections you may never need. As an example, many patients’ treatment plans may or may not include chemotherapy or radiation. Or in some cases, surgery is the only treatment necessary. We invite you to add to the binder. Bring it along to your appointments, write in it...let us know what you like and don’t like or if there is something we’ve missed. In addition to this booklet, we invite you to visit our American Cancer Society (ACS) station in the lobby, and talk with our volunteer coordinator about services and resources the ACS has to offer. Once again, thank you for placing your trust in all of us at the Agnesian Cancer Center. We wish you strength, courage and hope. The Associates and Physicians at the Agnesian Cancer Center. The goal of the Agnesian Cancer Care team is to provide the highest quality compassionate care to all of our patients. Often bonds and relationships form over the course of visits, and patients often become part of the cancer services “family.” At times, patients and their families like to present gifts to staff to express these relationships. We ask that patients and families show their appreciation by verbal or written means instead of physical gifts. There are many patients and so little room! We hope you understand and thank you. Welcome
  8. 8. S u r v i v o r s h i p G u i d e CancerCare RadiationOncology 480E.DivisionStreet,FondduLac | 933NewburyStreet,Ripon | 620W.BrownStreet,Waupun | (920)926-4100•(800)494-2927 Michael Vander Kooy, MD Radiation Oncologist Mary L., RN Radiation Oncology Nurse Tammie L., RN Dr. Vander Kooy’s Nurse Filip T. Troicki, MD Radiation Oncologist Stacy S., RN Dr. Troicki’s Nurse
  9. 9. S u r v i v o r s h i p G u i d e CancerCare RadiationOncology 480E.DivisionStreet,FondduLac | 933NewburyStreet,Ripon | 620W.BrownStreet,Waupun | (920)926-4100•(800)494-2927 Phil B. Dosimetrist Tim L. Physicist Brian S., RTT Radiation Therapist Bonnie D., RTT Radiation Therapist Noelle B., RTT Radiation Therapist Ellie B., RTT Radiation Therapist
  10. 10. S u r v i v o r s h i p G u i d e CancerCare MedicalOncology 480E.DivisionStreet,FondduLac | 933NewburyStreet,Ripon | 620W.BrownStreet,Waupun | (920)926-4100•(800)494-2927 Joel Lundberg, MD Medical Oncologist Michael Jones, MD Medical Oncologist Betsy M., LPN Dr. Jones’ Nurse Sara S., LPN Dr. Lundberg’s Nurse Lisa Michels, APNP Oncology & Women’s Health Nurse Practitioner
  11. 11. S u r v i v o r s h i p G u i d e CancerCare MedicalOncology 480E.DivisionStreet,FondduLac | 933NewburyStreet,Ripon | 620W.BrownStreet,Waupun | (920)926-4100•(800)494-2927 Nicki W., RN Chemotherapy Nurse Margo B., RN Chemotherapy Nurse Terri B., RN Chemotherapy Nurse Cindy K., RN Chemotherapy Nurse Travis D., PharmD, RPh Pharmacist Patty S. Pharmacy Technician Kristin M., RN Chemotherapy Nurse Not pictured: Carrissa R., RN, Chemotherapy Nurse Kris M., Massage Therapist Rachel S., RN Chemotherapy Nurse Kelly H., RN Chemotherapy Nurse Jennifer R., RN Chemotherapy Nurse
  12. 12. S u r v i v o r s h i p G u i d e CancerCare 480E.DivisionStreet,FondduLac | 933NewburyStreet,Ripon | 620W.BrownStreet,Waupun | (920)926-4100•(800)494-2927 AncillaryAssociates Kay G. Breast Care Navigator Bill Daly Oncology Services & Medical Imaging Director Juanita H. Receptionist/ Medical Records Heather B., RTT, MBA Radiation Therapy Supervisor Ann S., RN Nurse Supervisor Nicole S. Radiation Oncology Receptionist Patti D. Breast Care Navigator Stephanie D. Breast Care Navigator Chris B. Oncology Navigator Not pictured: Mindy C., Receptionist/Medical Records Stephanie D., APNP
  13. 13. S u r v i v o r s h i p G u i d e CancerCare AncillaryAssociates 480E.DivisionStreet,FondduLac | 933NewburyStreet,Ripon | 620W.BrownStreet,Waupun | (920)926-4100•(800)494-2927 Patty W. Cancer Registrar Sheree W. Clinical Trial Data Manager Becky S., PTA Exercise Therapist Kelli L. American Cancer Society Volunteer Navigator Kristie M., MSW Social Worker Kay H. Cancer Registrar Sr. Rebecca E., CSA Volunteer Cheryl M. Cancer Registry Not pictured: Kari J., American Cancer Society Volunteer Navigator
  14. 14. S u r v i v o r s h i p G u i d e CancerCare Medical Oncology is where you will receive your chemotherapy infusions or injections. We offer nine chairs and two private rooms. Three beds are available if you need to or prefer to lie down. Your schedule of treatments will be made for you by your nurse the day of your first appointment. Every effort will be made to accommodate your personal schedule, but please understand that there may be times when we need to alter schedules. Prior to receiving chemotherapy, labs will be drawn and vital signs and weight will be recorded. Since chemotherapy doses are based on your height and weight, accurate and current weights are necessary at each appointment. If your treatment is scheduled over the lunch hour, a cup of soup and a sandwich will be provided for you. Feel free to bring in any snacks you might like. A television and portable DVD player is available for use and you may bring in your computer, iPod, etc. Family and friends are welcome to be with you throughout the day. You will meet with your nurse practitioner or registered nurse on or before your first treatment to go over your medications. You will also meet with a social worker within the first few visits. Agnesian HealthCare Spiritual Care Services, Nutrition and Food Services, and complimentary therapies are also available to you. We strive to make your experience at the Agnesian Cancer Center the best. If there is anything further we can do for you, please let us know. If you have any questions or concerns throughout your treatment regimen, call us (920) 926-4100 between 8 a.m. and 4:30 p.m., Monday through Friday, and a nurse will get back to you that same day. If after hours, a physician will return your call. Thank you for the opportunity to serve you. WelcometoMedicalOncology
  15. 15. S u r v i v o r s h i p G u i d e CancerCare Welcome to Medical Oncology. This is where you will receive your chemotherapy treatments. During the course of your treatment, you will hear many terms used by associates. We have provided you with a list of the more frequently used terms so you are better able to understand. Anemia - Low red blood cell count. Antiemetic - Medication used to prevent nausea and vomiting. CBC - A blood test to tell us the number of red cells, white cells and platelets in your blood. Also called a complete blood count. Cancer - General name for the disease where abnormal cells grow out of control. Chemotherapy - Different medication to treat your cancer. Constipation - Difficulty having a bowel movement. Diarrhea - Having four or more loose or watery bowel movements in a 24-hour time period. Nadir - CBC test when we expect your blood counts to be at their lowest after your chemotherapy treatment. This usually occurs 10 to 12 days after chemotherapy. IV - A small plastic catheter inserted into your vein by your nurse to be sued for giving fluids and medications. PICC Line - A short-term (four to six months) IV inserted by specially-trained nurses into the elbow crease of your arm. Port - An access device placed under your skin by a surgeon to be used for taking blood and giving IV fluids and medications. MedicalOncology-WordstoKnow
  16. 16. Oral Chemotherapy Prescriptions agnesian.com Who Agnesian Pharmacy Plus What Let us fill your oral chemotherapy prescriptions along with your other medications. Where The Agnesian Pharmacy Plus is located at the main Agnesian HealthCare campus, 420 E. Division Street, Fond du Lac, (920) 926-8585. When Agnesian Pharmacy Plus hours: Monday through Friday, 8:30 a.m. to 5:30 p.m. How Ask your healthcare provider to send your prescription to the Agnesian Pharmacy Plus! Why • Convenience (located next to the Agnesian Cancer Center) • Free prescription delivery service (Fond du Lac area) • Competitive pricing If you are receiving care in Waupun or Ripon, we can work to coordinate service to an Agnesian Pharmacy more convenient for you - such as the Agnesian Pharmacy Waupun or the Agnesian Pharmacy Markesan. Just let us know! Robert Kritzer, RPh Managing Pharmacist Agnesian Pharmacy Plus AGN-13729 (03/14)
  17. 17. S u r v i v o r s h i p G u i d e CancerCare CancerPainDiary Date Time Pain Rating (0 to 10) Pain Medicine (name, dose) Pain Rating One Hour After Medicine Side Effects 6/8 8 a.m. 6 Oxycodone, 5 mg 2 None
  18. 18. S u r v i v o r s h i p G u i d e CancerCare Cancer Pain Management Pain can often be a concern for people diagnosed with cancer. They are afraid they will have pain and it will not be relieved. Having cancer does not mean that you will have pain. To some people’s surprise, some cancers cause no physical pain at all. Even people with advanced cancers do not always have pain. But for people who do have pain, there are many different kinds of medicines, different ways to take the medicines and non-drug methods to help relieve pain. Talking to Your Doctor or Nurse Proving information about your pain helps your doctors and nurses find the best ways to control your pain. This often includes the use of a pain scale. A rating of 10 reflects the worst pain you could imagine, a rating of five means you feel a moderate amount of pain, and a 0 rating reflects that you are having no pain. Use of this scale is also helpful to identify your goal for pain relief. CancerPainManagement In addition to your pain rating, you will be asked to describe the type of pain you are having, such as throbbing, shooting, aching, burning or pressure. This information will assist your healthcare team in understanding the type of pain you are having and getting you the appropriate type of pain control. Facts About Cancer Pain Treatment Cancer pain can almost always be relieved or lessened. • There are many medicines and methods that can be used to control cancer pain. Your healthcare team will work with you to keep you as comfortable as possible. In some cases, your doctor may need to consult with a pain specialist. Shots are rarely needed to relieve cancer pain. • There are many ways to take pain medicine. Most pain can be controlled by taking medicine by mouth in a liquid, pill or capsule form. Skin patches can also be used to slowly release the medicine. In rare instances, intravenous (IV) medicine is given into a vein. Pain is best relieved when treated early. • It is easier to control pain when it is mild. Do not try to hold off as long as possible between doses. Waiting to take your medication until the pain gets worse may require larger doses to get relief. This may include taking medication before activities that are known to cause pain. Side effects from pain medicines can be managed and often prevented. • Not everyone has side effects from pain medicines, but the most common include constipation, nausea and drowsiness. Constipation can be prevented with stool softeners. Nausea and drowsiness usually improve after a few days as your body adjusts to the medicine. Your doctor and nurse will help you manage any side effects. Sometimes a change is medication is needed.
  19. 19. S u r v i v o r s h i p G u i d e CancerCare CancerPainManagement Your body does not become immune to pain medicine. • Cancer pain medications do not stop working. It is important to take pain medication when it is needed so that you are able to enjoy being active, sleep better, spend time with family and friends, eat better and avoid depression. Over time your body may get used to the medication - this is called tolerance - and is seldom a concern in cancer pain treatment. If tolerance does occur, medication types and doses can be adjusted. Addiction is rare when medications are taken for cancer pain. • Addiction is a common fear of people taking pain medicine. Sometimes this fear may even keep some people from taking the pain medicine or it may cause family members to encourage you to hold off from taking the medication. Addiction is rare when cancer pain medications are taken the way your doctor or nurse tells you. Talk to your doctor or nurse about how to take pain medicines safely and about any concerns you may have. Pain can affect all parts of your life. You should never have to accept pain as a normal part of having cancer. Most cancer pain can be controlled or relived. We ask that you partner with your healthcare team to achieve your goals for pain relief by: • Keeping count of your pain medications and contacting the clinic for a new prescription a few days before you run out. • Planning in advance to request and pick up your prescription before weekends and holidays. Your pain medication may require a new printed prescription for refill. Many pain medications cannot be called in to your pharmacy. • Considering use of the pain diary sheets to help identify patterns to your pain and the effects of your medication. • Calling if your pain is not adequately controlled.
  20. 20. S u r v i v o r s h i p G u i d e CancerCare LowPlatelets Low Platelets (Thrombocytopenia) Platelets are the blood cells that stop bleeding by plugging damaged blood vessels and help the blood to clot. Thrombocytopenia (throm-bow-sigh-toe-pee-niah) is a low level of platelets in the blood. Risks Associated with Low Platelets People with low levels of platelets bleed more easily and are prone to bruising. If the risk of bleeding is high a transfusion of platelet cells may be given. Causes of Low Platelets Certain types of chemotherapy can affect the platelets. Low platelets caused by chemotherapy is usually temporary. Non-chemotherapy medications may also lower the number of platelets. Low platelets can also occur when cancer cells, such as leukemia or lymphoma cells, crowd normal bone marrow cells. Although rare, thrombocytopenia can also occur when other cancers, such as prostate or breast cancer, spread to the bone marrow. Signs and Symptoms of Low Platelets Call your doctor or nurse if you experience any of the following symptoms: • Easy bruising • Small purple or red spots under your skin • Bleeding from the nose or gums • Heavier than usual menstrual periods • Black or bloody stools • Blood in your urine • Vomiting blood • Bad headaches or dizziness • Coughing up blood Patient Considerations Along with treatment from your doctor, the following tips will help you avoid concerns if your platelet count is low: • Don’t drink alcohol and avoid medications that contain ibuprofen or aspirin as these worsen bleeding. • Use an extra soft toothbrush and don’t floss if your gums bleed. • Blow your nose gently; apply pressure or ice to the bridge of your nose if your nose bleeds. • Be careful using scissors, knives, needles or tools, and be careful not to burn yourself when cooking. If cuts occur, use a clean cloth to apply pressure to the area for three to five minutes. • Shave with an electric razor. • Prevent constipation. Use stool softeners as needed. Avoid enemas and suppositories. • A water-soluble lubricant should be used during intercourse. Intercourse should be avoided if the platelet count is less than 50,000. No anal intercourse. • Avoid contact sports and other activities that might cause injury.
  21. 21. S u r v i v o r s h i p G u i d e CancerCare LowRedBloodCells Low Red Blood Cells (Anemia) Anemia is an abnormally low level of red blood cells. Red blood cells contain an iron protein that carries oxygen to all parts of the body. Risks Associated with Low Red Blood Cells Most people with anemia feel tired or weak. The fatigue (feeling tired) associated with low red blood cells can affect quality of life and make it more difficult for patients to cope with cancer and treatment. If the level of red blood cells gets too low, a transfusion of red blood cells may be given. Causes of Low Red Blood Cells Low red blood cells are common in patients with cancer, mostly in those receiving chemotherapy. Some chemotherapy drugs decrease the body’s ability to make enough blood cells. Cancers that directly affect the bone marrow (a spongy, fatty tissue found inside larger bones) where blood cells are formed, or cancers that spread to the bone can crowd normal blood cells. Bleeding, as result of surgery or a tumor, or poor nutrition, can also cause low red blood cells. Signs and Symptoms Call your doctor or nurse if you have the following symptoms: • Extreme tiredness or fatigue. • Muscle weakness. • Rapid or irregular heart beat and occasional chest pain. • Difficulty breathing or shortness of breath. • Dizziness or fainting. • Pale skin or lips. • Headaches. • Difficulty concentrating. • Difficulty staying warm. Treatment of Low Red Blood Cells Some people with anemia caused by chemotherapy can be treated with medication called growth factors. These medications work by telling the bone marrow to make more red blood cells and are given as a series of injections that can take several weeks to start working If patients have too many symptoms, a transfusion may be needed. If low red blood cells are caused by low iron, low folic acid or low vitamin B12, other medications will be prescribed.
  22. 22. S u r v i v o r s h i p G u i d e CancerCare LowWhiteBloodCells Low White Blood Cells (Neutropenia) White blood cells destroy germs that enter the body. Neutrophils (new-tro-phil) are white blood cells that fight infection. Neutropenia (New-tro-pee-nee-ah) is the term used when the number of neutrophils is low. Risks Associated with Low White Blood Cells When your white blood cells are low, you have less ability to fight infection. Infections can make you sick and may cause you to miss your next treatment or need a smaller dose of chemotherapy. Not every patient that has low white blood cells will develop an infection. Many patients will recover without any concerns. Causes of Low White Blood Cells Certain kinds of treatment such as chemotherapy can affect your body’s ability to make white blood cells. The term “nadir” is used to describe the lowest point that your blood cells drop. This can occur seven to 14 days after your treatment. There are many factors that can affect your white blood cell count, including the dose and type of chemotherapy and whether or not you have other medical concerns in addition to cancer. What is an Absolute Neutrophil Count? When checking white blood cells, your doctor and nurses rely on a count called the “absolute neutrophil count.” This count is a way to tell how many mature and working neutrophils are present in your blood to fight infection. Prevention Methods If you have low white blood cells, it may not always be possible to prevent infection. However, studies have shown that good hand-washing and hygiene are the most effective methods of prevention. Additional ways to decrease your risk of infection are listed below. • Wash your hands before and after preparing meals, before eating and after using the bathroom, sneezing etc. You may use a waterless cleaner if you do not have access to soap and water. Be sure to wash all sides of your hands - 10 seconds is a good length of time. • Good mouth care is essential - brush your teeth with a soft toothbrush and rinse with a non-irritating solution. If you need dental work be sure to check with your doctor first and let your dentist know that you are receiving treatment. • Keep your body clean; bath or shower regularly. • Avoid people who are ill including those with colds or flu, and chicken pox or shingles. • Avoid large crowds of people until your counts have fully recovered. • Avoid contact with stool or saliva of anyone who has had live vaccine (polio or chicken pox) within the last 30 days and check with your doctor before you receive any. • Avoid handling pet feces including changing cat litter and cleaning fish tanks or bird cages. • Wear gloves if working in the garden or soil. • Prevent constipation; check with your doctor about stool softeners as needed. Avoid enemas and rectal suppositories until your counts have recovered. • A water-soluble lubricant should be used during intercourse and good hygiene should be performed immediately following intercourse. No anal intercourse. Intercourse should be avoided if the white blood cell count is very low. Signs and Symptoms of Infection Call your doctor or nurse if you have any of the following symptoms: • Fever of 100.4ºF or greater • Chills • Sweating • Cough or shortness of breath • Sore throat or sores in your mouth • Redness, swelling or drainage around sores on your skin, catheter or port
  23. 23. S u r v i v o r s h i p G u i d e CancerCare LowWhiteBloodCells • Loose or liquid stools • Trouble urinating - increased frequency or burning with urination • Vaginal drainage or itching Dietary Restrictions The following restrictions should be followed if your nurse tells you that your white blood cell count is very low (absolute neutrophil count less then 1000). No restrictions are needed when your white blood cell count has recovered (about one week). • Clean and cook all foods thoroughly. • Avoid raw fish, raw meats and raw eggs. • Fresh fruits and vegetables should be washed well before eating. • Wash your hands well after preparing any food. • Do not share food utensils.
  24. 24. S u r v i v o r s h i p G u i d e CancerCare CareatHomeAfterChemotherapy Care at Home After Your Chemotherapy The information below may be helpful in caring for yourself at home after chemotherapy. Please discuss any concerns you may have with your doctor or nurse. Eating Nutrition is an important part of your overall cancer care. Eating enough calories and keeping your weight steady can help you feel your best during cancer treatment. Try these tips to help your appetite: • Eat when your appetite is best. For some this may be earlier or later in the day. • Try small frequent meals if you find you become full quickly. • Try to eat foods that contain good sources of: Protein: fish, chicken, meats, eggs, nuts, beans, Carbohydrates: breads, cereals, grains, pasta, fruits Fats: milk, ice cream, peanut butter • If you are unable to eat enough calories, try adding nutritional supplements (Carnation Instant Breakfast®, milkshakes, Ensure®, or Boost ®) between meals. • Use of vitamin and/or herbal supplements during chemotherapy should be discussed with your doctor or nurse. Some treatments require that you avoid grapefruit, grapefruit juice or green tea, and should be discussed with your doctor or nurse. Fluid Intake Drinking plenty of fluids helps your body to “flush the chemotherapy out of your system.” • Your goal for fluid intake should be 64 ounces (about eight glasses) daily during the first 48 hours after your treatment. Although water is one of the best fluids, juice, popsicles, Jell-O, broth and milk are great alternatives. • Drinking fluids that contain caffeine or alcohol can be dehydrating and are best avoided during the first 48 hours after receiving chemotherapy. • If you are unable to consume or keep down food or fluids, call your doctor or nurse. Mouth Care Cancer and cancer treatments can sometimes cause a sore mouth. Try these tips to keep your mouth healthy: • Brush your teeth after meals and before bedtime with a soft-bristle toothbrush. Use a non-irritating toothpaste; toothpastes with strong whiteners may cause irritation. If you wear dentures, remove them and clean them as above; avoid wearing dentures at night. • If you routinely floss your teeth, you may continue; stop flossing if you experience significant bleeding. • Rinse your mouth regularly after brushing with a non-irritating solution, (one teaspoon of table salt in four cups of water or one teaspoon of baking soda in one cup of water) discard and remix solution daily. Avoid using mouthwash that contains alcohol. Keep your lips moist by using lip balm. Nausea Many medicines are available to control nausea (feeling sick to your stomach) and vomiting (throwing up). These medicines are often given before chemotherapy for prevention. If there is a chance that nausea and vomiting could reoccur, you will be given a prescription for medicines and directions on how to take them. If you have nausea and vomiting even though you are taking your medicines, call your doctor or nurse. Fatigue Fatigue (a feeling of tiredness) is a common a side effect of cancer treatment. Knowing ahead of time that fatigue may occur can help you understand your experience and help you make plans is case you begin to feel more tired than usual. There are some things that you can do to help with fatigue: • Rest and sleep are important. If you are having trouble sleeping, talk to your doctor or nurse. Pace your activities and build in rest periods. Limit your day time naps to 45 minutes or less. Too much napping can decrease your energy level and lead to feeling even more tired.
  25. 25. S u r v i v o r s h i p G u i d e CancerCare CareatHomeAfterChemotherapy • Stay as active as you can. If your physical condition allows, exercise several times per week. Set goals for yourself (walking 10 minutes or two blocks), then increase as you are able. • Eat as well as you can. Carbohydrates and proteins are quick energy foods. Chemotherapy Precautions Chemotherapy may be present in your body fluids for 48 hours after your treatment. You will need to take some special steps at home to avoid you and your family from coming in contact with these medicines as they are passed from your body. The following are steps that should be taken for 48 hours after you finish your chemotherapy treatment: • Wash your hands well after using the restroom. • It is safe for your family to use the same toilet, but you should flush the toilet two times after you use it with the lid down. • Hugging and kissing are safe. Refrain from sexual intercourse or use a condom for 48 hours after treatment. • Your caregiver should wear gloves if emptying a bedpan, urinal or commode. Rinse the bedpan or urinal with water after each use and wash with soap and water daily. • If you vomit, your caregiver should wear gloves when emptying the basin. Rinse the basin with water after each use and wash with soap and water daily. • If underwear, towels or linens become soiled, wash these items separate from your family’s laundry using your usual detergent. Blood Counts Blood counts are often checked between chemotherapy treatments. Ibuprofen or aspirin may affect your blood counts, check with your doctor prior to regular use. Your nurse will provide additional instructions if your white blood cells or platelets are low. Infection can be a side effect of treatment and although infection can not be completely prevented, these steps can help to decrease your risk: • Wash your hands before eating and after using the restroom. You may use waterless hand soap if you do not have access to soap and water. Be sure to wash all sides of your hands. • Keep your body clean; bathe or shower regularly. • Avoid people who are ill including children who have the chicken pox or measles or adults who have shingles. • Check your temperature if you feel flushed, warm or have the chills Call your doctor or nurse if you have a fever of 100.4ºF or greater or any other signs of infection. These signs include coughing, sore mouth, burning with urination, loose stools or diarrhea, and redness, soreness or tenderness anywhere on your body especially around a wound, catheter or port. Avoid the use of Tylenol, ibuprofen or aspirin for fever until after you have talked with your doctor or nurse.
  26. 26. S u r v i v o r s h i p G u i d e CancerCare NutritionDuringCancerTreatment Why Is Good Nutrition Important? Good nutrition is always important for staying healthy and preventing disease. However, following a good diet is also key in maintaining health and weight when someone has cancer and is going through treatment. Proper nutrition helps the body fight infections by strengthening the body’s natural defense system, or immune system. People with cancer are often at risk for getting infections because the immune system is weakened by certain medications and treatments. A healthy diet helps people keep their strength by preventing body tissues from breaking down. It also helps repair damaged tissue, which helps patients maintain their weight. Those who eat well during treatments are able to cope better with the side effects of treatment. Side effects may be fewer or less severe when the patient is well nourished. Also, higher doses of radiation and chemotherapy are usually better tolerated. What Foods are Needed for Good Health? Achieving good nutrition status in people with cancer means getting enough calories and protein to prevent weight loss, regain strength and rebuild healthy tissues. The following nutrients are very important for maintaining best health during treatment: Protein • Helps to repair body tissue and maintain a healthy immune system. • People with cancer usually need additional protein, especially following surgery, chemotherapy and radiation therapy. • Good sources of protein include meat, fish, poultry, dairy products, nuts, beans, lentils and soy. Carbohydrates and Fats • Helps to supply the body with the majority of calories it needs, allowing you to feel energized throughout the day. • Good sources include fruits, vegetables, whole grains, pasta, cereals, beans and peas. • Good sources of fat include olive oils, nuts avocados, fatty fish (tuna, salmon). Vitamins and Minerals • Helps to ensure proper growth and development. • Allows the body to use the energy in foods. • Eating a well-balanced diet with enough protein and calories usually contain plenty of vitamins and minerals. Eat a variety! Water • Provides the environment where all other nutrients can function properly. • Drinking plenty of water throughout the day ensures proper hydration and helps you feel your best. Aim to drink at least eight glasses of water each day. General Eating Tips • Choose many different foods that you like to eat, this way you won’t get bored. • Try smaller, more frequent meals. This will give you energy throughout the day. • Keep nutritious, easy-to-make snacks available. Focus on foods that require little to prepare and eat. • Make all calories count. Don’t fill up on items that give you very few calories (broth, coffee, sodas). Choose foods higher in protein and calories. • Take advantage of the “up” times, when you are feeling your best...Eat! Eat foods that agree with you. Eat foods that you enjoy. • Prepare foods in larger quantities and freeze the extras for times when you can’t or don’t feel like cooking.
  27. 27. S u r v i v o r s h i p G u i d e CancerCare NutritionDuringCancerTreatment • Allow friends and family to prepare meals for you. Don’t hesitate to accept their offers of help with shopping and meal preparation. • Give food a chance. What is unappealing one day, may taste good on another. • Be creative, try new recipes. • Discuss any eating concerns with your dietitian, healthcare provide or nurse. They are your best sources of information about your diet. (Handout adapted from ADA Nutrition Care Manual, 11/2011; for use at the Agnesian Cancer Center)
  28. 28. S u r v i v o r s h i p G u i d e CancerCare CancerExerciseProgram Exercise and the Cancer Patient Cancer patients can experience loss of physical strength when they are treated for cancer. In the past, patients were told to rest and not exercise. Today’s research has shown that cancer patients who join exercise programs have improved strength and better success with their treatment. The benefits of regular exercise during and after cancer treatment include: improved balance with less falls; prevention of muscle loss; improved blood flow to the legs; improved self esteem; less anxiety and depression; and decreased symptoms of tiredness, inability to sleep, constipation, vomiting and pain. Exercise, good nutrition and weight control have also been shown to prevent breast cancer reoccurrence. The Agnesian Cancer Center’s cancer exercise program is created to meet each cancer patient’s individual needs. Therefore, each exercise plan is designed for the patient’s type of cancer and treatment program. Cancer Exercise Program This cancer exercise program is for patients currently in treatment and/or following completion of treatment at the Agnesian Cancer Center or within Agnesian HealthCare. An Agnesian HealthCare physical therapy assistant who has completed training and certification as a cancer exercise specialist will teach the exercise program. How to Begin Upon referral (from an Agnesian HealthCare surgeon, medical oncologist or radiation oncologist), the patient will receive an individualized evaluation with the cancer exercise specialist. An exercise plan will be designed based on surgical history and medical limitations. Individuals will meet weekly in a group setting at the Agnesian Cancer Center with other cancer patients. There will be two exercise program groups. One group will be for lower-level activity patients and the other group for medium- level activity patients. The cancer exercise specialist will assign each patient into the appropriate exercise group. After six to eight weeks, participants can begin to exercise at home or in a community exercise program. Program Goals 1. Create a successful exercise program that can eventually continue as a home exercise program. 2. Increase participant’s range of motion and strength. 3. Reduce symptoms of cancer treatment. 4. Decrease recovery time after cancer treatment. 5. Help cancer survivors live an independent lifestyle by working through limitations from surgery, chemotherapy and/or radiation therapy. Charges The cancer exercise program is free for patients receiving cancer care within Agnesian HealthCare. It is part of the many oncology services we provide, which also include nutrition, chaplain and social work services. For More Information For more information about the cancer exercise program, contact the Agnesian Cancer Center at (920) 926-4100.
  29. 29. S u r v i v o r s h i p G u i d e CancerCare ClinicalTrials About Clinical Trials Clinical trials are research studies that evaluate new treatments and help find ways to improve cancer care. Clinical trials play an important role in the battle against the disease and offer another treatment option for patients who qualify. What Clinical Trials are Used For New drugs and therapies are continually being developed in the field of cancer. After they show promise in other studies, providers need to know if they are considered standard of care. Offering clinical trials allows researchers to compare one treatment plan versus another. Clinical trials are offered in four phases. The Agnesian Cancer Center primarily offers Phase III clinical trials, which occur after there is documented promising activity in Phase I and Phase II trials. Patient Benefits • Potential to receive state-of-the-art treatment before it becomes standard of care. • Patients receive the newest treatment. • Patients are closely monitored by a research team that is part of a network of providers. • Eliminates the need to travel out of this area to take part in a clinical trial. The Agnesian Cancer Center is affiliated with the Alliance for Clinical Trials in Oncology. The Alliance for Clinical Trials in Oncology is a combination of three national cancer clinical research cooperative groups: The American College of Surgeons Oncology Group (ACOSOG), Cancer and Leukemia Group B (CALGB) and the North Central Cancer Treatment Group (NCCTG), which are National Cancer Institute (NCI)-funded. The Alliance for Clinical Trials in Oncology provides us with high quality multidisciplinary cancer control, prevention and treatment trials that engage a comprehensive research network. For more information on cancer clinical trials, call the Agnesian Cancer Center at (920) 926-4100 or visit www.cancer.gov/clinicaltrials.
  30. 30. S u r v i v o r s h i p G u i d e CancerCare CancerGeneticRiskAssessmentServices What are Cancer Genetic Risk Assessment Services? Sometimes hereditary or genetic factors can increase your risk for cancer. Agnesian HealthCare’s Cancer Genetic Risk Assessment Services are designed to help you understand more about your personal cancer risks. Agnesian HealthCare offers a comprehensive cancer risk assessment that focuses on personal and family history, environmental and lifestyle factors and genetics. The assessment evaluation, which includes counseling services, is directed toward individuals and families who may be at an increased risk for hereditary cancer. The consultative services are provided by a nurse practitioner (who works in coordination with medical oncologists) with advanced education in cancer genetics, hereditary cancer patterns and genetic testing resources. An initial visit is usually 60 to 90 minutes in length and includes: • Assessment based on personal, medical and/or cancer history. • Risk assessment using computer-generated risk models. • In-depth review of family history of cancer for hereditary patterns. • Identification and coordination of genetic testing services if available and appropriate. • Discussion of cancer genetics research programs if available and appropriate. Additional follow-up visits are usually 30 to 60 minutes in length and include: • Disclosure and discussion of any genetic testing results. • Recommendations for strategies to decrease cancer risk. • Coordination of specialty physician referrals as appropriate. What are the Key Indicators of Hereditary Cancer? Although many cancers occur by chance or through exposure to known cancer causing agents, sometimes hereditary or genetic factors can increase an individual’s risk for cancer. These genes can come from either side of the family and often follow hereditary patterns such as: • Cancer at a younger age than average. • Multiple generations of cancer in a family. • The same type of cancer in two or more close relatives. • More than one type of cancer in the same person. • Cancer that occurs in both paired organs (cancer in both breasts). • Breast and ovarian cancer on same side of family. • Colon and uterine cancer on same side of family. Who Might Benefit From a Cancer Risk Assessment? • Anyone with a family history of cancer that would like to take steps to decrease their risk of developing cancer. • People who have had cancer who would like to learn steps to reduce the risk of their cancer coming back or of developing a new cancer. • Anyone with a known genetic change (mutation) in his/her family. What is Genetic Testing for Cancer Risk? Genetic testing for cancer risk is used to determine if a genetic change (mutation) is present in genes that increase a person’s risk of developing cancer. • Cancer genetic testing is a benefit under many insurance plans including Medicare. • When testing is available, recommendations are based on personal and family cancer history.
  31. 31. S u r v i v o r s h i p G u i d e CancerCare CancerGeneticRiskAssessmentServices Am I Required to Have Genetic Testing as Part of Cancer Risk Assessment? No. When available and recommended, cancer genetic testing is voluntary and only completed following genetic counseling and written informed consent. How Do I Schedule an Appointment? Cancer Genetic Risk Assessment Services are provided at the Agnesian Cancer Center. For more information or to schedule an appointment, call (920) 926-4100. No referral is required.
  32. 32. S u r v i v o r s h i p G u i d e CancerCare SupportServicesAvailable Our social worker is part of the team of associates available to help you and your family along the way as needed. Some of the issues the social worker can assist with include: • Financial and insurance concerns • Medication assistance programs • Supportive counseling • Referrals to counseling and support groups • Health Care Power of Attorney documents • Disability forms through your employer and/or social security • Referrals to county agencies that may provide help to you • Transportation • Durable medical equipment supplies • Locating other resources that may be helpful to you Agnesian HealthCare Resources Agnesian Health Shoppe (920) 926-5277 327 Winnebago Drive, Fond du Lac Items for sale and services available include: • Durable medical equipment such as wheelchairs, walkers, canes, hospital beds, bathtub and toilet safety items • Wigs, scarves, breast prosthetics, mastectomy bras and swimsuits • Home oxygen services • Lifeline emergency alert service Home Care (920) 923-7950 239 Trowbridge Drive, Fond du Lac Hospice Hope (920) 923-7950 239 Trowbridge Drive, Fond du Lac 745 South Street, Green Lake Hospice Home of Hope (920) 906-1000 400 County Road K, Fond du Lac Spiritual Care Services (920) 926-4887 430 E. Division Street, Fond du Lac Chaplains are available for visits at St. Agnes Hospital, the Agnesian Cancer Center and through hospice services. Mobile Meals (920) 926-4673 430 E. Division Street, Fond du Lac Home-delivered meals are available through St. Agnes Hospital for those who are home-bound. Meals are available Monday through Friday. Community Care and Samaritan Health Clinic (920) 926-4455 430 E. Division Street, Fond du Lac Financial assistance for medial bills and medication assistance for those who qualify. Courtesy Van Transportation (920) 926-8959 430 E. Division Street, Fond du Lac Free transportation to and from Agnesian HealthCare services; appointments based on availability.
  33. 33. S u r v i v o r s h i p G u i d e CancerCare SupportServicesAvailable Journeys: a health resource center (920) 926-4960 430 E. Division Street, Fond du Lac Located off the St. Agnes Hospital lobby, Journeys: a health resource center offers classes and programs including Look Good...Feel Better,® a program for female cancer patients designed to teach participants how to use make-up and offer skin care techniques to overcome the appearance-related effects of chemotherapy; meditation and yoga classes; and community education programs. In addition, Journeys offers lending library of health-related information through books, DVDs and the Internet. Lymphedema Therapy Services (920) 926-5370 430 E. Division Street, Fond du Lac Lymphedema is chronic swelling of a body part caused by damage to the lymphatic system from surgery, injury, etc. Specially-trained occupational therapists can provide the therapy and treatment needed to help manage lymphedema. If you are interested in lymphedema therapy, ask your healthcare provider for a referral. This service is provided in St. Agnes Hospital’s Outpatient Therapy department.
  34. 34. Wig Boutique Services agnesianhealthshoppe.com 327 Winnebago Drive, Fond du Lac • (920) 926-5277 • Monday through Friday, 8 a.m. to 6 p.m. The Agnesian Health Shoppe is collaborating with the Agnesian Cancer Center to help female cancer patients enhance their appearance and self-image during chemotherapy and radiation treatments. Their efforts complement those of the Agnesian HealthCare Foundation, which is providing funding for a wig boutique at the Agnesian Cancer Center at no charge for anyone in need. The Agnesian Health Shoppe offers wig fittings in a private room for your convenience. Wigs come in many different colors, styles and lengths. Feminine scarves and hats are also available.
  35. 35. S u r v i v o r s h i p G u i d e CancerCare AmericanCancerSocietyResources We are fortunate to have a trained volunteer navigator through the American Cancer Society (ACS) right here at the Agnesian Cancer Center! Our ACS navigator is here on a regular basis to offer help and information to you and your family as you go through the cancer journey. The navigator can help you link to information on the following? • Coping with cancer • What to expect during chemotherapy and radiation • Dealing with side effects of treatment • Support groups, classes and other programs • Financial resources • Smoking cessation • Decision-making tools • Employee rights information • Transportation resources • Lodging during treatment if needed Our ACS navigator can also help you and your family by being a caring listener in your time of need. She can also help communicate your needs to the rest of your treatment team members at the Agnesian Cancer Center. If you haven’t met with the ACS navigator, please ask any associate to help you get in touch with her. The American Cancer Society has representatives available by phone 24 hours a day, seven days a week. Call (800) 227-2345 or visit the ACS web site at www.cancer.org.
  36. 36. S u r v i v o r s h i p G u i d e CancerCare SuggestedInternetResources www.cancer.net Cancer Net is the patient information web site of the American Society of Clinical Oncology (ASCO). The site provides oncologist-approved information to help patients and families make informed healthcare decisions through disease and symptom-based guides and procedures. www.cancer.org The American Cancer Society’s web site is a important extension of its mission to provide lifesaving information to the public. The site includes an interactive cancer resource center containing in depth information on every major cancer type. Through the resource center, visitors can order American Cancer Society publications, gain access to recent news articles, and find additional on-and off-line resources. www.cancer.gov This is the central web site for the National Cancer Institute (NCI). NCI is a part of the National Institutes of Health, within the United States Department of Health and Human Services. This web site offers free, credible, current and comprehensive online information about cancer prevention, diagnosis, treatment, statistics, research, clinical trials and news, as well as links to other NCI web sites. www.nccn.com The National Comprehensive Cancer Network (NCCN) is an alliance of 20 of the world’s leading cancer centers, working together to develop treatment guidelines for most cancers and dedicated to research that improves the quality, effectiveness and efficiency of cancer care. NCCN offers a number of programs to help you and your family make informed decisions about your health. www.leukemia-lymphoma.org The Leukemia & Lymphoma Society is the world’s largest voluntary health organization dedicated to funding blood cancer research, education and patient services. The society’s mission: Cure leukemia, lymphoma, Hodgkin’s disease and myeloma, and improve the quality of life of patients and their families. www.caringbridge.org Agnesian HealthCare is a sponsor of CaringBridge, a charitable non-profit organization that provides free web sites that connect families and friends when someone is facing a serious health event. CaringBridge makes it easier to share health updates and receive messages of love and support. www.canceradvocacy.org The National Coalition for Cancer Survivorship www.patientadvocate.org Patient Advocate Foundation Diagnosis - Specific Resources Bladder Cancer American Bladder Cancer Society - www.bladdercancersupport.org Brain Cancer American Brain Tumor Association - www.abta.org Breast Cancer www.breastcancer.org Colorectal Cancer Colon Cancer Alliance - www.ccalliance.org Gastrointestinal Cancer - Life Raft Group www.liferaftgroup.org
  37. 37. S u r v i v o r s h i p G u i d e CancerCare SuggestedInternetResources Gynecological Cancers (ovarian, cervical) Gynecologic Cancer Foundation - www.thegf.org Kidney Cancer Kidney Cancer Association - www.kidneycancer.org Leukemia and Lymphoma www.leukemia-lymphoma.org Liver Cancer www.livertumor.org Lung Cancer www.lungcancer.org Oral Head & Neck Cancer www.oralcancerfoundation.org Pancreatic Cancer www.pancan.org Prostate Cancer www.prostatecancerfoundation.org Testicular Cancer The Testicular Cancer Resource Center - www.tcrc.acor.org
  38. 38. S u r v i v o r s h i p G u i d e CancerCare CancerSupportGroup A Free Program For Individuals with Cancer and Those Who Care About Them Individuals and families experiencing a cancer diagnosis, and cancer survivors, are invited to learn more about cancer and meet with others to share their thoughts to help improve their confidence and sense of well-being in the midst of the physical, emotional and spiritual challenges they may be facing. Agnesian HealthCare’s Cancer Support Group meets on the Second Wednesday of each month from 4:30 to 5:30 p.m. in Agnesian HealthCare’s Journeys: a health resource center, 430 E. Division Street, Fond du Lac. Sessions begin with education presentation, followed by time for sharing and discussion. January 8, 2014 July 9, 2014 February 12, 2014 August 13, 2014 March 12, 2014 September 10, 2014 April 9, 2014 October 8, 2014 May 14, 2014 November 12, 2014 June 11, 2014 December 10, 2014 For more information on this free support group, call Kristie Martin, MSW, Agnesian Cancer Center social worker, at (920) 926-4103.
  39. 39. S u r v i v o r s h i p G u i d e CancerCare On-LineCaregiverSupportGroups Cancer Survivors Network Chat (American Cancer Society) http://csn.cancer.org/forum/138 The Living Room An on-line cancer support community where you can connect with others 24/7 and cover a variety of topics. Receive advice, support and offer tips to others going through similar cancer experiences. http://www.cancersupportcommunity.org/MainMenu/Cancer- Support/Online-Support-Groups.html Cancer Compass Trade tips and strategies with other caregivers at this on- line cancer support forum. From dealing with side effects to managing pain, individuals can find a wide variety of information and resources on this site. http://www.cancercompass.com/message-board/caregivers/ tips/1,0,122,86.htm Welcome to Cancer Buddies Network Are you living through cancer and would like to talk to someone who understands exactly how you feel because they’ve been there too? Individuals can chat by private messaging one-to- one and safely right here on the site, or join in a lively forum and talk about the things that only those who have lived through it can really understand. http://www.cancerbuddiesnetwork. org/?gclid=COXKjfTmvq4CFVElKgodpCzjIg Patient & Caregiver Support Line The Anderson Network can match cancer patients with a survivor with the same or a similar diagnosis, treatment or experience. They can also match caregivers. For more information or to be connected with another survivor or caregiver, call (800) 345-6324 or use the on-line contact form. http://www.mdanderson.org/patient-and-cancer-information/ guide-to-md-anderson/patient-and-family-support/anderson- network/support-programs/anderson-network-support- programs-patient-caregiver-support-line.html Empowering Caregivers http://www.care-givers.com/community/community.html Family Caregivers Alliance http://www.caregiver.org/caregiver/jsp/content_node. jsp?nodeid=347
  40. 40. S u r v i v o r s h i p G u i d e CancerCare LookGood...FeelBetter The Look Good...Feel Better® program is a community-based, free service that teaches women beauty techniques to help restore their appearance and self-image during chemotherapy and radiation treatments. This program is a partnership between the American Cancer Society; the Cosmetic, Toiletry and Fragrance Association Foundation; and the National Cosmetology Association. Certified and licensed beauty professionals provide tips on a variety of issues women undergoing cancer treatment face, including: • Makeup • Skin care • Nail care • Head coverings Volunteer beauty professionals lead small groups, usually consisting of six to 10 women, through a practical, hands-on session. You can learn about makeup techniques, skin care, nail care and options related to hair loss such as wigs, turbans and scarves. Each participant receives a free kit of cosmetics for use during and after the workshop. If you are unable to attend a group workshop, a free, one-time, individual salon consultation with a volunteer cosmetologist may be available. These trained beauty experts will help you address your specific skin, hair and related appearance needs. Self-help materials can be obtained free of charge by request through the Look Good...Feel Better® toll-free number (800) 395-LOOK. The materials include a 30-minute video entitled, “Look Good...Feel Better Just for You,” a step-by-step instructional booklet discussing appearance-related side effects of cancer treatment, as well as skin care information. To preregister or obtain information on this program in the Fond du Lac area, call Agnesian HealthCare Journeys: a health resource center at (920) 926-4960.
  41. 41. Guided by volunteer cosmetologists, female cancer patients who participate in this class will learn how to use make-up and skin care techniques to overcome the appearance-related effects of chemotherapy and radiation. Class Dates Second Monday of every other month from 9 to 10 a.m. Waupun Memorial Hospital St. Francis Room 620 W. Brown Street, Waupun February 9 August 10 April 13 October 12 June 8 December 14 Fourth Tuesday of every other month from 6 to 8 p.m. (except October) Agnesian HealthCare Journeys a health resource center 430 E. Division Street, Fond du Lac February 24 August 25 April 28 October 20 June 23 December 29 For more information or to register for this free program, contact the American Cancer Society at (800) 227-2345 or Journeys at (920) 926-4960. Brought to you by the American Cancer Society and Agnesian HealthCare. Look Good…Feel Better agnesian.com 2 0 1 5 C O M M u n i T y S u p p O R T G R O u p
  42. 42. S u r v i v o r s h i p G u i d e CancerCare AudioVisualEntrainment(AVE) Do you ever feel tired, anxious, tense or restless? Or maybe you would like a little extra relaxation. If you answered yes to the above, ask your physician, nurse or therapist about Audio Visual Entrainment (AVE). AVE is a complimentary service offered to oncology patients at the Agnesian Cancer Center. What is AVE? AVE means audio visual entrainment. Lights flashing in the eyes, relaxation or hypnosis music and/or tones pulsing in the ears at different frequencies from one to 25 Hz, have an influence on brainwave activity. The brain responds to or resonates (mirrors) to the stimuli, being able to speed up or slow down with the stimuli. What Are Brain Waves? Our brains produce “sweeping” electrical charges. These charges create a rhythm known as brainwave patterns. These patterns are observable through electroencephalograph (EEG) instruments. EEGs record and measure large amounts of neurons firing in unison. Brainwave patterns are commonly grouped into four different categories: beta, alpha, theta and delta. Each of these brainwave patterns are associated with various states of mind. What Happens During AVE? AVE sessions can last from 15 to 30 minutes and can be done before or after treatment. Some sessions can be done during your radiation therapy treatment. First you choose a relaxation CD of your choice. The session involves wearing a special pair of glasses that emit flashing lights set to a specific frequency as well as earphones to listen to the pre-selected relaxation CD. The sessions are intended to provide a sense of relaxation, rejuvenation, calmness and less discomfort. Each patient responds differently to the session. If you like the sessions you can continue with them as often as you like, and the relaxation CD is yours to keep and listen to at home.
  43. 43. S u r v i v o r s h i p G u i d e CancerCare AcousticalChair Listening to music with your whole body. Agnesian HealthCare invites and encourages you to use our relaxation chair, primarily located in the St. Agnes Chapel near the Emergency Department. The chair and chapel are available for associates, individuals and families of any faith to use during their healing and relaxation journey. This relaxation or “acoustical” chair is designed to relax the body, mind and spirit. The chair is easy to use and wonderful to experience. Acoustical Chair Uses • Stress reduction • Pain management • Clinical trials: decreases anxiety, blood pressure and restlessness; improves range of motion Effect on Body Musical sound waves vibrate at a unique speed. A high-pitched tone has a fast vibrational speed. The higher the pitch, the faster the speed of the vibration; the lower the tone, the slower the vibration of the sound wave. The acoustical chair contains multiple frequencies which provide an experience more powerful than a single vibration. As the sound moves from speaker to speaker throughout the chair, you feel a ripple effect. The body feels the musical vibrations. Soothing vibrations relax tight muscles and stimulate circulation throughout the back, spine and legs, which results in relief of muscle tension and deep relaxation. Music Music with strong base tones is most effective for relaxation. The volume of the music has no effect.
  44. 44. S u r v i v o r s h i p G u i d e CancerCare Labyrinth A Holy Walk To walk the labyrinth is to touch God and let God touch us. It is a matter of presence and response. The labyrinth does nothing to make God more present...for God is always present. The labyrinth can make us aware of the presence of God in our lives. So be silent. Walk. Listen. Wonder. Receive God’s gifts. Go in peace on your journey. What is a Labyrinth? The presence of a labyrinth in a Christian church may be new to many people, even though it is an ancient sacred symbol. Historically, pilgrims walked them as a symbolic journey to Jerusalem. They were designed in many forms, and by the ninth century a circuitous path had developed to represent our own journeys. Our labyrinth is a copy of the most well-known labyrinth of the Middle Ages found in the Cathedral of Notre Dame de Chartres. It is composed of 11 circuits and divided into four quadrants clearly defined by a cross. At the center there is a rose-shaped area that serves as the place to stop, pray, meditate and reflect on what has been “received” on this first part of the journey. The Labyrinth is a Spiritual Tool Our lives are sacred journeys in which we encounter joy, sorrow, growth, defeat, grief, celebration and all the other experiences that challenge and transform our understanding of life. The labyrinth functions as a meditation or prayer tool to help us focus and encounter the sacredness of our changing life. The labyrinth has no dead ends or puzzles to be solved. The path in is the same path out. Walking the labyrinth is not a task, but an invitation to use our gifts of creativity, imagination and receptiveness to the holy presence in our life. The journey takes us inward to our center and then back out into the world with new insight into ourselves and God’s presence. It is not magic; it is like prayer in motion through which we may receive guidance, new questions, or simply silence and peace. Beginning Your Walk How do I walk? This is a common question. Just as prayer is individual, so is walking the labyrinth. There is no right or wrong way. Remember, this is not a task to be accomplished, but a time of reflection and openness. You may want to remove your shoes before starting, as some people like to feel the “grounding” it brings them. As you stand at the entrance, take a deep breath and allow yourself to feel surrounded by God’s presence. Relax and take the first step. The full journey may take 20 minutes or more than an hour. You may meet people on the way - let your spirits move together as you step sideways to pass. If you smile or laugh, consider it a blessing. When you reach the center, you may want to sit or stand for a while, again opening to insights that may have come. On your journey back out, you may feel very different or that nothing has changed.
  45. 45. S u r v i v o r s h i p G u i d e CancerCare Labyrinth You May Want to Walk the Labyrinth Because... You have a question. Take a few moments to center yourself and bring your question to mind. Where are you focusing right now? Are you questioning your work, your relationships, a loss, a major life change or your faith? As you walk the labyrinth, listen for wisdom. Be aware that it may not come as concretely as you expect. You seek inner peace. Again, take time to center yourself and bring to mind what is troubling you. Pay attention to your breathing as you inhale peace and exhale that which may be causing your frustration, anger or bitterness. You might try timing a blessing with your breathing - inhale peace then exhale a blessing on yourself, someone else or a particular situation. You want a way to commune more closely with God. Try this three-step meditation. On your journey to the center, let go of all that distracts you. Open to God’s presence and receive what comes with an open heart and mind. At the center of the labyrinth, stop and pay attention to what you have felt so far and receive it gladly. Let your spirit determine the time to leave. On your way out, know that God walks your life’s journey with you. A Few Other Suggestions A Prayer Walk Use this time to pray for yourself or someone else; to give thanks or to praise God. An Intercessory Walk Use this to offer prayer for people or needs. Perhaps pray for a particular person or situation at each turn of the journey.
  46. 46. Compassion, Knowledge & Respect agnesianhealthshoppe.com 327 Winnebago Drive, Fond du Lac • (920) 926-5277 • Monday through Friday, 8 a.m. to 6 p.m. Let us help you through this sensitive time with all your postmastectomy needs in our private, boutique-like setting. Our compassionate, professional associates will work with you to find the right styles and sizes, and help you to feel fashionable and feminine again. Postmastectomy Products • Head coverings • Swimwear & swim forms • Scarfs • Camisoles • Feminine bras • Hats • Lingerie • Breast forms • Wigs • Lumpectomy fillers • Hair enhancements • Custom orders • Lymphedema garments (including sleeves, gauntlets, gloves and compression garments) The Agnesian Health Shoppe has a women’s health consultant and trained wig specialists on-site. We work in conjunction with an area licensed beautician to help style, trim and color wigs. We can also assist with billing and reimbursement. Let us help you today. Women’s Health Consultant Carla Witkowski Through one-on-one consultations and our private fitting rooms, Carla can assist you with any of your needs. AGN-13399 (10/13)
  47. 47. S u r v i v o r s h i p G u i d e CancerCare Thoughts,Feelings&Questions __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________
  48. 48. S u r v i v o r s h i p G u i d e CancerCare Completing cancer treatments can be both exciting and scary. Many patients wonder where they now fit into the spectrum of physician visits and who is responsible for their ongoing care after treatments are done. Agnesian HealthCare offers survivorship appointments to help bridge these gaps, and define a plan for current needs and future care. Agnesian HealthCare’s cancer survivorship program is based on the premise that each survivor has a unique, individualized appointment set up with the oncology nurse practitioner. How is this different from when I see my cancer doctor? The survivorship appointment is different from a follow-up appointment with your oncologist or surgeon in the following ways: • Personalized questionnaire to address your specific needs or concerns • Customized summary of the cancer treatments you received • Recommendations for follow-up care based on your cancer diagnosis and treatments • Discussion of lifestyle recommendations and modifications Survivorship assessment and services include: • Psychological • Diet and nutrition • Exercise • Sexual health • Fatigue and sleep needs • Rehabilitation • Spiritual Survivorship appointments are available to patients at the completion of their cancer treatments. An Agnesian HealthCare associate will contact you to set up an appointment, or you may call us at any time to arrange your survivorship appointment. If you have further questions about survivorship, please call the Agnesian Cancer Center at (800) 494-2927. Survivorship: What Now?

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