Tag Archive for: American Cancer Society

How Can Wellness Interventions Aid Patients During and After Treatment?

How can wellness interventions aid cancer patients during and after treatment? Experts Dr. Amy Comander from Massachusetts General Hospital and Nicole Normandin Rueda, LMSW from PEN discuss benefits of different wellness practices, practical wellness strategies, and support resources.

Download Resource Guide

See More from RESTORE

Related Resources:

How Do Wellness Practices Impact Cancer Care Outcomes?

What Is Whole Person Care Exactly?

Why Is It Important to Address Whole Person Care?

Why Is It Important to Address Whole Person Care?

Transcript:

Lisa Hatfield:

How can wellness interventions help patients during and after cancer treatment? And what specific practices might help? I have many questions. I’m getting to the bottom of it in this Patient Empowerment Network RESTORE program.

Dr. Comander, how can wellness interventions help folks like myself during and after treatment? And while there seems to be only pros here, can you also speak to any risks of certain wellness practices during cancer treatment? And how can patients mitigate these risks?

Dr. Amy Comander:

Such an excellent question. And I do think it’s really important for us to focus on things that a patient can do after his or her diagnosis to take control of one’s health. We know there’s nothing scarier than getting a diagnosis of cancer and going through treatment for cancer. So we want to think about practical strategies that people can employ to feel better, tolerate their treatments better, and ultimately improve their health.

So let’s pick one of my favorites, which is exercise. I know for some people that word exercise sounds intimidating, scary. Maybe they’re not someone who ever really practiced exercise on a regular basis and so when their doctor or nurse practitioner or social worker is talking to them about this, they feel kind of intimidated. Well, I will say a new field emerging is actually called exercise oncology. It’s really fascinating. And we’re really learning about what is actually happening in the body when an individual exercises, what is going on at the cellular level that may actually be fighting the cancer.

And this is really interesting and exciting. And I love reading these scientific papers. But we’re not going to get into that right now. Let’s just talk about, when you talk about practical strategies, if you’re someone who really has not been active, just walking to the mailbox to get the mail. Try to do that each day. Maybe taking a walk in your dining room, a few laps around the dining room table, if you have one, just something basic like that, walking your dog, walking a friend’s dog. Like everyone has to start somewhere.

So when we talk to our patients about exercise, we just meet them where they are and help them get started with something. And I know this sounds very intimidating, but organizations such as the American Cancer Society, American College of Sports Medicine, and my organization, American Society of Clinical Oncology, strongly recommend that individuals going through cancer treatment engage in exercise. And so you just have to start somewhere. So why is this important? Exercise has been shown to help patients tolerate their treatment better, reduce side effects, reduce the need for dose reductions, improve the fatigue that is often associated with cancer, and in many cases, reduce risk of recurrence and improve the outcome. So there are so many reasons to do it.

You also ask about risks. And I can understand that many people are fearful of starting an exercise program if this is not something they’ve been doing on a regular basis. So I would encourage patients to talk to their doctor just to address any particular concerns. Certainly, let’s say an individual has cancer involving their bone and they’re worried that they might be at risk for a fall and a fracture. That’s something they should certainly talk about with their doctor.

As a breast oncologist, I care for many women who are concerned about risk for lymphedema. Lymphedema is swelling of the arm, perhaps on the side of the surgery. And my patients are often worried, will that get worse if she starts a strength training program? Actually, it will not, but that’s a good question for her doctor or her physical therapist. So I think it’s really important to think about exercise as the number one wellness intervention that we want to address. 

Lisa Hatfield:

Okay, thank you. And over to you, Nicole, what are some common wellness practices that cancer patients can adopt during treatment? And how can patients be empowered to take an active role in their wellness during and after cancer treatments?

Nicole Normandin Rueda:

Great question. So just like Dr. Comander said, so physical activity, starting somewhere is going to be of the utmost importance. Nutrition, balanced diet, making sure you’re hydrated, you are following all the recommendations from your medical team regarding what you consume, avoiding anything that you probably shouldn’t be consuming. Stress reduction techniques are all, mindfulness, meditation, deep breathing, the things that help you kind of get back to calm is really critical. We want to make sure patients are aware of their sleep. So the sleep cycle is one of those things that people often complain about, but aren’t really informed on how important it is to your actual overall well-being.

And so if that is an issue, we want to make sure that we are referring them to the appropriate specialist in order to help get that resolved. Social connections, again, huge. We want to make sure people understand that there are organizations and people out there that are here to just serve and help as much as we can. Maintaining the relationships, not just with their immediate family and friends, but also making new connections and new relationships with people that are going to support them throughout this journey is important.

For me as a social worker, empowering patients is what I do…it’s why I’m here. We want patients to have an active role in their wellness, both during and after treatment, because we know, as trained individuals, we know that that is going to overall have a positive impact in their quality of life, in their family’s experience throughout the cancer journey. And that’s important. This is a stressful time for a lot of people. So in order to do that, we always want to make sure we’re providing education and that is first and foremost going to come from the medical providers. Follow up to that would then be everything else, all the ancillary services.

So you have organizations, Patient Empowerment Network. We are very focused on providing evidence-based information in an easy to understand way. And so that is one of those organizations that, as a social worker, I would refer everybody to. But there are others that are doing fantastic things providing education on all sorts of topics, anything that you could possibly want. There are organizations that are doing it well. Now that’s the thing, we want to make sure that we are referring patients to get evidence-based, research-backed information for them to consume and digest at their own pace. Next would be advocacy. If you don’t have a strong advocate in your corner, or if you are not comfortable speaking up or asking questions, this is one of those things that is so incredibly important when it comes to empowering patients to really be involved in their care.

And I can tell you firsthand, my mom was my dad’s biggest advocate. It was kind of embarrassing at times, but in hindsight, thank goodness, because had she not been so ferocious and asked so many questions, there’s a lot of things that we wouldn’t have known as a family going through a cancer diagnosis. So that’s really important. And I know working with medical teams, they want somebody to ask questions, they want to be able to provide as much information as they can. That’s a good backbone for people to understand, that their medical teams are going to want to make sure that they walk out of the room feeling like they have the information they need. 

And so we want to make sure that we are providing as much information, as many resources as we can. And then it is up to the patient and their care partners or their family members to then take that and run with it. But we want to be able to make sure that we’re giving them what they need in order to ask the right questions at the right time to the right people. And if they have the resources that they need to go and make it happen.

Lisa Hatfield:

Okay, thank you so much, Nicole. You heard it here directly from the experts. Thanks for joining this RESTORE Program. I’m your host, Lisa Hatfield.

What Are Colon Cancer Screening Guidelines?

What Are Colon Cancer Screening Guidelines? from Patient Empowerment Network on Vimeo.

What are the guidelines for colon cancer screening? Dr. Suneel Kamath explains the current recommendations, including the appropriate screening age and reviews risk assessment based on factors such as family history and race. 

Dr. Suneel Kamath is a medical oncologist at the Cleveland Clinic Cancer Institute. Learn more about Dr. Kamath.

Download Resource Guide

See More from DETECT Colon Cancer

Related Resources:

Research Advances in Colon Cancer Screening and Detection

Research Advances in Colon Cancer Screening and Detection

What Can Patients Do to Access Better Colon Cancer Care?

What Can Patients Do to Access Better Colon Cancer Care?

What Is the Role of Genetic Testing in Colon Cancer Care?

What Is the Role of Genetic Testing in Colon Cancer Care?


Transcript: 

Katherine:  

It seems like the suggested ages for screening may vary based on gender and race and family history. What are the current screening guidelines?

Dr. Kamath:

The current screening guidelines that are unfortunately due this rise, there is now recommendation for starting colon cancer screening at age 45. That’s really for everybody. There are certain people that really should be screened even earlier. We definitely know that the black community is affected at a higher rate. There are some professional societies, like the AGA or ACG, that actually recommend starting even earlier in the black community, maybe even by age 40. 

And then, the other thing I always try to emphasize is with this is the usual screening guidelines that we talk about are for what we call the average risk population. I do think that we overestimate how many people are average risk. One of the things that I think is not talked about as much is that if you have a family history of even polyps – high risk polyps – that also means that your family members should get screened earlier, 10 years earlier, than the age that you were found to have a high-risk polyp.  

But my experience has been most people don’t share with their families that they had those. Let’s say I had a colonoscopy done one day and they found those, they get taken out, and they just say, “Oh, come back in three years,” instead of 10. As far as I’m concerned, that’s where it ends. But actually, the fact that I had those polyps has implications for my siblings, for children, and everything. I don’t think most people are in the habit of disseminating that information. As a result of that, a lot of people are probably at increased risk and they’re really not aware of it.

Katherine:

Yeah. Where can patients find the most up-to-date information regarding screening?

Dr. Kamath:

The best resource, to me, is the American Cancer Society, their websites. They’re highly reliable, they’re easy to understand, and I find that they’re very balanced. They’re not going to be overly pushing one side or the other. But they’re going to be evidence-based. As we all know, there is so much fake news and misinformation out there, especially when it comes to health. I think having a resource you could really trust and understand is key and the American Cancer Society, you find, is an excellent resource.  

Overcoming Small Cell Lung Cancer Care Barriers

Overcoming Small Cell Lung Cancer Care Barriers from Patient Empowerment Network on Vimeo.

How can small cell lung cancer care barriers be overcome? Expert Beth Sandy from Abramson Cancer Center discusses common barriers for patients in remote areas and underrepresented communities, advice for accessing resources and support, and tips to ensure lung cancer stigma doesn’t interfere with care.

[ACT]IVATION TIP

“…work very closely with the social worker in your practice who is very familiar with all of these different resources that are available…I’ll say up front is when providers like doctors or nurses ask you if you’ve ever smoked, that is by no means being something accusatory. It actually helps us understand the trajectory of your disease better… Another thing that we know about both non-small and small cell lung cancer is that patients who have smoked actually often respond better to immunotherapy. So that can help us understand just how your disease may act and what treatments may even work better.”

See More from [ACT]IVATED Small Cell Lung Cancer (SCLC)

Related Resources:

Extensive Stage Small Cell Lung Cancer _ Empowering Symptom Management

When Can Small Cell Lung Cancer Patients Use Palliative Care

Small Cell Lung Cancer Care | Optimizing Team Communication

Small Cell Lung Cancer Care | Optimizing Team Communication


Transcript:

Lisa Hatfield:

So if we can discuss some barriers to getting care for small cell lung cancer. I’ll break it down to three different areas or three different barriers. So if you could discuss or give advice for a person living with small cell lung cancer in a rural area who might not have access to state-of-the-art cancer care. Second area, if you have any advice or specific considerations or recommendations for small cell lung cancer, people dealing with small cell lung cancer from underrepresented communities. And then third, if you need me to remind you of these, I sure will. Third, kind of the elephant in the room, if you can address one of the barriers being the stigma that’s associated with not only small cell lung cancer but with any lung cancer, maybe address that as a barrier and any advice you have for a person dealing with that, we’d appreciate that.

Beth Sandy:

Yeah, so there are a lot of barriers. So let’s talk about the first one. If you’re living in a rural area and having access to state-of-the-art cancer care. I think the one thing that I’ll say here is that small cell lung cancer responds very well and very quickly to frontline treatment, which is chemotherapy and immunotherapy, and these are approved no matter where you live. This is not a clinical trial. You don’t have to go to a fancy hospital to get this.

As a matter of fact, the two chemotherapy drugs we’ve been using for 20 years, so you can get them anywhere. So now the point is about driving. So this is something you have to come back three days in a row for. So is there a place where you can stay close by? So at my institution, we have a charitable organization who turned an old hotel that’s about 30 minutes outside the city into a place for our patients to stay overnight for free. So that is kept up by charitable donations and so if patients live several hours away and they need a three-days-in-a-row treatment, a lot of times they will stay at that location.

So is there something like that that’s available if you’re driving from very far away? But I think the other thing that also concerns me is your blood counts can drop, and you can get sick from this chemotherapy. Most patients do pretty well, but if you’re getting sick, how far are you from the closest hospital? If you have a fever and your white blood cells are probably low, you need to go to the emergency room. So I think those are things to sort of start preparing for ahead of time and thinking, okay, do I maybe need to stay with family members who may be closer to a hospital? Just again, depending on how far away you are.

Where I live, it snows in the winter, so that’s always something that, especially the people in the more mountainous regions are like, what if we get like a foot or two feet of snow overnight and I can’t get out in the morning? How’s that going to affect me? So really thinking about those kinds of things. And are there, again, charitable organizations or money or grant support to help pay for rides or gas money even? Sometimes the American Cancer Society can help with things like that. 

Are there specific considerations or recommendations for small cell lung cancer for patients who are in underrepresented communities? So yeah, I think again, talking about getting back and forth to treatment, it can be really difficult, especially with small cell lung cancer. If you’re on radiation, radiation is daily and chemotherapy is three days in a row, like I’ve said. So it’s a lot of back and forth. Do you have to pay for parking? Do you have the rides?

Again, this is where a lot of times we’ll work with our social workers in both radiation oncology or medical oncology to help with transportation. There are transportation options, especially within many insurance plans. So that’s something to look into. The other thing is that at my institution, you have to pay to park, but we offer free parking for patients who are getting chemotherapy and radiation. So that’s not going to be something that you have to pay for on a daily basis, because that would be very expensive.

Other things like meals, so do you probably not feel like going to the store or cooking or aren’t even able to, especially when you’re receiving such intensive therapy. So there are definitely programs that are available to deliver meal services to patients and so that’s something, again, that we work really closely with social work to get these types of things set up. And again, some of this stuff is actually covered through your insurance, visiting nurses, home health aides to help.

The American Cancer Society, I go back to them because they have a lot of resources here. I work in the State of Pennsylvania, and in the State of Pennsylvania, if you are a caregiver to someone, there are actually financial resources that you can be reimbursed just for being their caregiver, especially if that takes you away from your work. So there are a lot of things that working with the social worker who understands the laws and the grants that are in your local communities can be really helpful.

So hopefully, I was going to say my activation tips for this really is to work very closely with the social worker in your practice who is very familiar with all of these different resources that are available. But then I forgot to address the last one, which is the stigma, and I do want to address this. This is something I could talk about for a long time. There is certainly a stigma associated with lung cancer and for patients who have smoked. And one thing I’ll say up front is when providers like doctors or nurses ask you if you’ve ever smoked, that is by no means being something accusatory. It actually helps us understand the trajectory of your disease better.

For example, if you were diagnosed with small cell lung cancer and you said, “Well, I smoked in my 20s and 30s, but now I’m 70,” we might question the diagnosis a little bit. We may do some further testing to make sure this is the right thing. Another thing that we know about both non-small and small cell lung cancer is that patients who have smoked actually often respond better to immunotherapy. So that can help us understand just how your disease may act and what treatments may even work better.

So when we ask you if you smoked, just be honest because that can change the way we think about your disease, but by no means is that something accusatory. The second concern with the stigma is that people are less likely to get screening for lung cancer or to be worked up early because they feel like, “Well, I did this to myself, so maybe it doesn’t matter.” But that’s not true. Obviously, I don’t want people to smoke. It’s bad for you for a million reasons, not just lung cancer, but cardiac disease and other types of cancers. There’s a lot of reasons that smoking is not good for you.

But that being said, lung cancer can still be a curative disease if we catch it early. So even if you’ve smoked or are currently smoking, you can get lung cancer screening and catch things early and get them taken care of. We are there to help you with whatever illness or addiction to cigarettes that you have, and we’re going to help you, number one, treat that, and help you quit smoking, but also treat your disease as we would treat anyone else’s. So getting that screening for lung cancer or that early workup as soon as you develop symptoms is going to be beneficial.


Share Your Feedback:

Create your own user feedback survey

How Can Prostate Cancer Stigmas and Misconceptions Be Addressed?

How Can Prostate Cancer Stigmas and Misconceptions Be Addressed? from Patient Empowerment Network on Vimeo.

 How can prostate cancer stigmas and misconceptions be addressed? Expert Dr. Yaw Nyame with the University of Washington discusses common concerns and misconceptions, how doctor-patient communication can help, and support resources to aid patients and care partners.

See More from [ACT]IVATED Prostate Cancer

Related Resources:

Understanding Recommended PSA Screening Age and Frequency In Prostate Cancer

Understanding Recommended PSA Screening Age and Frequency In Prostate Cancer 

Emerging Promising Advanced Prostate Cancer Treatments

Emerging Promising Advanced Prostate Cancer Treatments

What Impact Does Advanced Prostate Cancer Have on Lifestyle

What Impact Does Advanced Prostate Cancer Have on Lifestyle?

Transcript:

Lisa Hatfield:

Dr. Nyame, have you encountered any misconceptions or stigmas related to prostate cancer within the underrepresented communities, and how do you address or mitigate these issues with your patients?

Dr. Yaw Nyame:

I think that there are a lot of misconceptions in all communities and stigmas around prostate cancer and its treatments, all the way from the early portion of diagnosis, stigma around maybe the rectal examination if you need one, take me around what may happen if you get a biopsy, misconceptions of biopsy, like will it spread the cancer all around your body, will it affect erectile function. And then through treatments. And so one of the primary jobs I feel like I have as a doctor who specializes in this area, is to take the time to hear patients express these concerns, do not diminish or belittle misconceptions, to really hear them, and then to try and educate and inform people about the realities without over-correcting either.

So someone comes to me and says, “Well, Doc, I hear that if I have surgery, I’m going to have erectile function.” I can’t, I shouldn’t, and I don’t say, Oh, you’re wrong, right? But I might say, “Well, that’s true. If you have poor erections before surgery, a likelihood that they’re going to get better is really low, and they’re likely to go away or diminish, but if you have good erections, that there’s a chance with certain techniques that they can come back and will come back.”And then I usually put something like 50 percent of men who have surgery and/or radiation will have some erectile dysfunction within the five years following their treatment. So it’s important to have a level ground where we share information candidly.

And I think it’s important for patients to come prepared to have these discussions, do your homework by talking to your people in your circles, by looking at trusted resources online from places like the American Cancer Society, Prostate Cancer Foundation, cancer centers produce their own information and be prepared to have these discussions.

My activation tip is the same as before, I think that building a community of survivors to share your concerns with and to get knowledge from is really important because there is no better source of information than the lived experience, and I think those individuals, especially the ones who volunteer to lead support groups and to share their stories, they’re wanting to impart their experience with other folks to empower them and support them, so it’s usually a really fantastic community to support understanding your diagnosis and what your journey is going to be like better and also a place to go to once you’ve experienced some of these things, right? It’s not just about the misconceptions up front and stigmas up front, but post-diagnosis and treatment, there are other concerns that may come up, and having the right network can sometimes help you navigate finding the solutions and the resources that are going to support you best.

[ACT]IVATED Prostate Cancer Post-Program Survey