| Our Programs |
After The Diagnosis |
||
When someone gets a cancer diagnosis from the doctor, often there are many emotions that present themselves: confusion, anger, anxiety, fear, and apprehension about the future. This section deals with “what’s next” after the initial diagnosis. Here several topics will be discussed:
Before starting treatment, a patient may want a second pathologist to review the diagnosis, and another specialist to review the treatment plan. Some insurance companies require a second opinion; others may cover a second opinion if the patient requests it. It may take a week or two to arrange for a second opinion. This short delay will not reduce the chance that treatment will be successful. There are a number of ways to get a second opinion:
Choosing A Cancer Care Hospital If the doctors you choose for your cancer care practices at more than one hospital, you may have to decide where you want to be treated. Or, you may first decide to choose a hospital, based on its reputation for providing high quality cancer care, and then select a physician who practices there. When choosing among hospitals for cancer care, you should ask the following questions: Does the Commission on Cancer of the American College of Surgeons approve the hospital's cancer diagnosis and treatment program? Is the hospital approved as a National Cancer Institute (NCI) cancer center? Does the Joint Commission on Accreditation of Healthcare Organizations accredit the hospital? Does the hospital offer the full range of services needed for the diagnosis and treatment of your cancer?
What is the hospital's expertise in treating your particular condition? Other Hospital Questions to Consider:
Regional Cancer Care Centers MASSACHUSETTS Dana-Farber Cancer Institute Dana Farber Cancer Institute provides expert, compassionate care to children and adults with cancer while advancing the understanding, treatment, cure, and prevention of cancer and related diseases. Massachusetts General Hospital Cancer Center The Cancer Center stands at the forefront in the fight against cancer. Their clinicians are experts in specific diseases and work together in teams to ensure that patients receive the best care possible. With state-of-the-art, comprehensive and personalized care, the staff of the MGH Cancer Center strive to improve the quality of patients' lives. NEW YORK Herbert Irving Comprehensive Cancer Center Herbert Irving Comprehensive Cancer Center has as its mission “the eradication of cancer via research, education and patient care.” Memorial Sloan-Kettering Cancer Center Treatment, Research & Education. Since 1884, Memorial Sloan-Kettering has been dedicated to improving the understanding and treatment of cancer. Their dedicated team of professionals is committed to providing the best cancer care anywhere. NYU Cancer Institute The mission of the NYU Cancer Institute is to decrease and eliminate cancer as a significant health problem throughout Roswell Park Cancer Institute Roswell Park Cancer Institute offers the most effective means of diagnosis and treatment while addressing both the physical and emotional needs of the cancer patients it serves. What You Will Need To Disclose
What You Will Need To Provide
In most cases, the experts from different specialties will discuss the case of each patient, and decide on a treatment recommendation. After a brief waiting period of one or two days, the patient, or the patient's caregiver, should receive a report on the findings, diagnosis and recommended treatment from the care team. Interpreting Laboratory Results A laboratory test is a medical procedure in which a sample of blood, urine, or other tissues or substances in the body is checked for certain features. Such tests are often used as part of a routine checkup to identify possible changes in a person’s health before any symptoms appear. Laboratory tests also play an important role in diagnosis when a person has symptoms. In addition, tests may be used to help plan a patient’s treatment, evaluate the response to treatment, or monitor the course of the disease over time. Laboratory test samples are analyzed to determine whether the results fall within normal ranges. They also may be checked for changes from previous tests. Normal test values are usually given as a range, rather than as a specific number, because normal values vary from person to person. What is normal for one person may not be normal for another person. Many factors (including the patient’s sex, age, race, medical history, and general health) can affect test results. Sometimes, test results are affected by specific foods, drugs the patient is taking, and how closely the patient follows pre-test instructions. That is why a patient may be asked not to eat or drink for several hours before a test. It is also common for normal ranges to vary somewhat from laboratory to laboratory. Some laboratory tests are precise, reliable indicators of specific health problems. Others provide more general information that simply gives doctors clues to possible health problems. Information obtained from laboratory tests may help doctors decide whether other tests or procedures are needed to make a diagnosis. The information may also help the doctor develop or revise a patient’s treatment plan. All laboratory test results must be interpreted in the context of the overall health of the patient and are generally used along with other exams or tests. The doctor who is familiar with the patient’s medical history and current condition is in the best position to explain test results and their implications. When a person is diagnosed with cancer, shock and stress are natural reactions. These feelings may make it difficult for people to think of everything they want to ask the doctor. Often, it helps to make a list of questions. Also, to help remember what the doctor says, patients may take notes, or ask whether they may use a tape recorder. Some people also want to have a family member or friend with them when they talk to the doctor: to take part in the discussion, to take notes, or just to listen. Patients should not feel the need to ask all their questions or remember all the answers at one time. They will have other chances to ask the doctor to explain things and to get more information.6 Following are a list of questions one could use in preparing for a visit to the doctor or oncologist. A patient who needs a biopsy may want to ask the doctor some of the following questions:
10 important questions to ask your doctor about cancer:
If chemotherapy is recommended, here are some questions patients may want to ask about you doctor:
If radiation therapy is recommended, here are some questions a patient may want to ask the doctor before receiving radiation therapy:
Side Effects
If surgery is recommended, here are some questions to ask your doctor or surgeon:
The Health Care Team
The National Cancer Institute publishes a great resource book entitled, “Navigating the Healthcare System”. Visit their website at www.cancer.gov. Copies of the book are available through by calling the Healthcare Consortium Cancer Support Services (518) 822-8820. Follow-up
Resources
The Healthcare Consortium Cancer Support Services Program offers cancer support groups throughout Columbia and Greene County for victims of cancer, their families, and friends. These programs offer educational information, and an opportunity to ask questions and share feelings. Each group is lead by a professional facilitator. For location and meeting information call (518) 822-8820. Additional information on local support groups is located in this book, in the next section titled Supportive Care. Side Effects Of Cancer Treatment Because cancer treatment may damage healthy cells and tissues, unwanted side effects are common. Specific side effects depend on many factors, including the type and extent of the treatment. Side effects may not be the same for each person, and they may even change from one treatment session to the next. Before treatment starts, health care providers will explain possible side effects and suggest ways to manage them. Chemotherapy - The side effects of chemotherapy depend mainly on the specific drugs and the dose. In general, anticancer drugs affect cells that divide rapidly, especially leukemia cells. Chemotherapy can also affect other rapidly dividing cells:
Some anticancer drugs can affect a patient’s fertility. Women may have irregular menstrual periods or periods may stop altogether. Women may have symptoms of menopause, such as hot flashes and vaginal dryness. Men may stop producing sperm. Because these changes may be permanent, some men have their sperm frozen and stored before treatment. Most children treated for leukemia appear to have normal fertility when they grow up. However, depending on the drugs and doses used and the age of the patient, some boys and girls may be infertile when they mature. Because targeted therapy (sometimes used for chronic myeloid leukemia) affects only leukemia cells, it causes fewer side effects than most other anticancer drugs. However, Gleevec may cause patients to retain water. This may cause swelling or bloating. Biological therapy - The side effects of biological therapy differ with the types of substances used, and from patient to patient. Rashes or swelling where the biological therapy is injected are common. Flu-like symptoms also may occur. Radiation therapy - Radiation therapy may cause patients to become very tired as treatment continues. Resting is important, but doctors usually advise patients to try to stay as active as they can. In addition, when patients receive radiation therapy, it is common for their skin to become red, dry, and tender in the treated area. Other side effects depend on the area of the body that is treated. If chemotherapy is given at the same time, the side effects may be worse. The doctor can suggest ways to ease these problems. Stem cell transplantation - Patients who have stem cell transplantation face an increased risk of infection, bleeding, and other side effects because of the large doses of chemotherapy and radiation they receive. In addition, graft-versus-host disease (GVHD) may occur in patients who receive stem cells from a donor’s bone marrow. In GVHD, the donated stem cells react against the patient’s tissues. Most often, the liver, skin, or digestive tract is affected. GVHD can be mild or very severe. It can occur any time after the transplant, even years later. Steroids or other drugs may help. Cancer and its treatment can lead to other health problems. Patients receive supportive care to prevent or control these problems and to improve their comfort and quality if life during treatment. Because people undergoing treatments get infections very easily, they may receive antibiotics and other drugs to help protect them from infections. The health care team may advise them to stay away from crowds and from people with colds and other contagious diseases. If an infection develops, it can be serious and should be treated promptly. Patients may need to stay in the hospital for treatment. Anemia and bleeding are other problems that often require supportive care. Patients may need transfusions of red blood cells to help them have more energy. Platelet transfusions can help reduce the risk of serious bleeding. Dental care also is very important. Chemotherapy can make the mouth sensitive, easily infected, and likely to bleed. Doctors often advise patients to have a complete dental exam and, if possible, undergo needed dental care before chemotherapy begins. Dentists show patients how to keep their mouth clean and healthy during treatment. Adapted from the National Cancer Institute, which also provides helpful booklets about cancer treatments and coping with side effects, such as Chemotherapy and You, Radiation Therapy and You, and Eating Hints for Cancer Patients. See the “National Cancer Institute Information Resources” section for other sources of information about side effects. NCI’s web site includes a section called “Coping with Cancer” at www.cancer.gov/cancer information. This section presents information about coping with fatigue, pain, and other problems. Copies of these booklets are also available through the Cancer Support Services Program at the HealthCare Consortium by calling (518) 822-8820. |
||