agnesian cancer care radiation oncology binder

to Agnesian Cancer Care

Welcome

Radiation Oncology

S u r v i v o r S h i p G u i d e

Cancer Care

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


Cancer Care

- 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


Cancer Care

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 QuestionsWe 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.

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Speak Up & Ask Questions


Cancer Care

how to Be An Active Member of Your health Team1. 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.

Speak Up & Ask Questions

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


Cancer Care

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


Cancer Care

Radiation Oncology

Michael Vander Kooy, MDRadiation Oncologist

480 E. Division Street, Fond du Lac | 933 Newbury Street, Ripon | 620 W. Brown Street, Waupun | (920) 926-4100 • (800) 494-2927

Mary L., RNRadiation Oncology Nurse

Tammie L., RNDr. Vander Kooy’s Nurse

Filip T. Troicki, MDRadiation Oncologist

Stacy S., RNDr. Troicki’s Nurse


Cancer Care

Radiation Oncology

Phil B.Dosimetrist

Tim L.Physicist

Brian S., RTTRadiation Therapist

Bonnie D., RTTRadiation Therapist

Noelle B., RTTRadiation Therapist

Ellie B., RTTRadiation Therapist



Cancer Care

Medical Oncology


Joel Lundberg, MDMedical Oncologist

Michael Jones, MDMedical Oncologist

Betsy M., LPNDr. Jones’ Nurse

Sara S., LPNDr. Lundberg’s Nurse

Lisa Michels, APNP Oncology & Women’s Health

Nurse Practitioner


Cancer Care

Medical Oncology

Not pictured:Carrissa R., RN, Chemotherapy Nurse

Kris M., Massage Therapist


Nicki W., RNChemotherapy Nurse

Margo B., RNChemotherapy Nurse

Terri B., RNChemotherapy Nurse

Cindy K., RNChemotherapy Nurse

Travis D., PharmD, RPhPharmacist

Patty S.Pharmacy Technician

Kristin M., RNChemotherapy Nurse

Rachel S., RNChemotherapy Nurse

Kelly H., RNChemotherapy Nurse

Jennifer R., RNChemotherapy Nurse


Cancer Care


Ancillary Associates

Kay G.Breast Care Navigator

Bill DalyOncology Services &

Medical Imaging Director

Juanita H.Receptionist/

Medical Records

Heather B., RTT, MBARadiation Therapy

Supervisor

Ann S., RNNurse 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


Cancer Care

Ancillary Associates

Not pictured:Kari J., American Cancer Society Volunteer Navigator


Patty W. Cancer Registrar

Sheree W.Clinical Trial Data

Manager

Becky S., PTA Exercise Therapist

Kelli L.American Cancer Society

Volunteer Navigator

Kristie M., MSWSocial Worker

Kay H.Cancer Registrar

Sr. Rebecca E., CSAVolunteer

Cheryl M.Cancer Registry


Cancer Care

Thank you for choosing the Agnesian Cancer Center as your healthcare partner during this difficult time in your life. The Agnesian Cancer Center strives to instill courage, provide support, and quality and advanced technology to cancer patients close to home. The advanced technology at the Agnesian Cancer Center provides our physicians with a variety of tools to treat many different cancers.

At the Agnesian Cancer Center, there are two radiation treatment machines, the Trilogy and the Varian 2100EX. This equipment provides state-of-the-art treatment, including IMRT (Intensity Modulated Radiation Therapy) and 3-D treatment planning computers. Your radiation oncologist will determine an individualized plan and select the treatment machine that is appropriate for you and your type of cancer. A multidisciplinary approach is used at the Agnesian Cancer Center to determine the best treatment for your cancer.

As you go through your treatments and build relationships with other patients, please be assured that no two treatments are the same. Other patients may be utilizing different technology than your treatment approach - even for treatments to the same body area. This is because each patient is receiving an optimized custom treatment unique to the individual situation.

Here is a brief summary of some of the technology that the Agnesian Cancer Center has to offer our patients:

Stereotactic radiosurgery (SBrT or SrS) This is a non-surgical, highly-precise form of radiation therapy usually delivered in one to five treatments. SBRT/SRS is only used to treat select cases and is not a treatment option for all cancers. At the Agnesian Cancer Center, we pride ourselves in being the first cancer center in the United States and the world to offer the Protura Robotic Patient Positioning System for stereotactic radiosurgery.

intensity Modulated radiation Therapy (iMrT) An advanced type of treatment planning that uses hundreds of small radiation beams to precisely conform to the tumor and minimize dose to nearby normal tissue. While IMRT is used in many cases, it may not be suitable for some cancers.

image Guided radiation Therapy (iGrT) A radiation treatment guided by imaging equipment, such as CAT Scan (CT) or X-rays, taken in the treatment room just before a treatment is given. During IGRT, the images are used as a final check to ensure accurate placement of the radiation treatment. IGRT does not need to be utilized for all types of cancers and is routinely used for tumors near critical normal structures such as the spinal cord, heart, lung and rectum.

respiratory Gaiting A technique used to account for tumor motion during breathing. This computer system accounts for motion as the patient breathes in and out or holds their breath, helping to target the tumor and protect healthy tissues from receiving unnecessary radiation. The need for respiratory gaiting is very individualized and the radiation oncologist will determine on a case-by-case basis if gaiting should be used for treatment.

3-d Treatment planning A treatment plan that sculpts radiation beams to the shape of a tumor. This is ideal for tumors that have irregular shapes or that lay close to healthy tissues and organs. 3-D treatment is used to treat select types of cancers and is suitable for certain types of cancers.

Welcome to Radiation Oncology


Cancer Care

What to expect When Coming for Simulation (i.e., planning session using CAT scan) Your nurse or radiation therapist will have you sign a consent form and show you where to find gowns/robes and the location of the changing rooms. Be aware that during this planning session you will be marked with permanent marker and tattoo ink. We will remove as much of the markings as possible at the end of the session, but some ink may still stain your undergarments/clothing (a stain remover will usually remove the stains).

The therapists will let you know if you need to remove dentures/partials, hearing aids or jewelry, and explain the procedure you will be having. We will do our best to accommodate your preference for daily treatment times, but may need to periodically adjust an appointment for various reasons. We thank you in advance for your understanding in this matter.

Please let us know of any transportation needs you may have. Before you leave you will be given an appointment card for a “block check.” This will occur on the treatment machine and will involve verification imaging and checking numbers specific to your individualized radiation treatment. The therapist will also inform you of any special instructions, such as having a full bladder or abstaining from deodorant use.

Block Check day or First day of TreatmentRemember to bring your scan card (scan when you enter the building at the reception desk, and scan a second time before entering the treatment room). Please follow any special instructions you were given concerning bladder filling or deodorant use. There will likely be additional marks made on your skin that may stain clothing. The therapists will give you a schedule of your radiation treatments. You will meet with a nurse on your first day of treatment to go over potential side effects and any nursing concerns. A social worker will also meet with you within the first week to address further areas of assistance.

Miscellaneous informationIf you are unable to make an appointment due to inclement weather, illness or an unforeseen conflict, please call (800) 494-2927 or (920) 926-4100. Let the receptionist know if you are missing due to illness and your call will be forwarded to a nurse.

There is always a radiation oncologist on call for night and weekend emergencies. Please call the above phone numbers and the answering service will connect you to the on-call physician.

You may bring your own music CDs to listen to during treatments.

If you prefer, you may bring in your own bathrobe.

There is a water cooler in the back waiting room for your use (blue knob is cold, white knob is room temperature). Also note, there is not a drain underneath the faucets, so please pour excess water in the bathroom sink.

Your family and friends are welcome to visit the treatment room if you would like.

Support groups are available, such as the American Cancer Society’s Look Good...Feel Better program. Call (920) 926-4960 for more information.

Radiation Oncology - What to Expect


Cancer Care

3-d Treatment planning - 3-D conformal radiation is a radiation therapy technique that sculpts radiation beams to the shape of a tumor. This is ideal for tumors that have irregular shapes or that lay close to healthy tissues and organs. This type of external beam radiation therapy combines multiple radiation treatment fields to deliver precise doses of radiation to the affected area. Tailoring each of the radiation beams to focus on the tumor delivers a high dose of radiation to the tumor and avoids nearby healthy tissue.

Accelerator - At the Agnesian Cancer Center, there are two linear accelerators; the Varian 2100EX and the Varian Trilogy. These machines deliver the radiation treatments.

Blocks - Pieces of metal alloy that can be used to shape the radiation beam from a linear accelerator.

Block Check - verification Simulation - Verify proper positioning prior to starting treatment.

Bolus - Additional material placed on the patient’s skin to intentionally pull the radiation dose more superficially.

Boost - An additional dose of radiation delivered after an initial course of radiation. A boost is usually a smaller treatment in volume and is used to enhance tumor control.

CT - CAT Scan / Computed Tomography - An imaging study using X-rays and a computer to create cross-sectional pictures of the body.

Centigray (cGy) - Abbreviated form of centigray, a unit of radiation dose equal to 0.01 gray. Equivalent to rad, the older term for radiation dose.

Chemotherapy - Treatment with drugs to destroy cancer cells. Chemotherapy is often used alone or with surgery or radiation to treat cancer.

Clinical Trials - Studies that test new treatments.

Cone - A linear accelerator attachment for electron beam treatment.

dosimetrist - A member of the radiation oncology team skilled in translating the physician’s radiation therapy prescription into detailed instructions for the radiation therapists treating the patient. Dosimetry work involves extensive calculations and computer modeling to arrive at the optimal treatment plan for the patient. Dosimetrists are certified by the Medical Dosimetrist Certification Board.

electrons - Subatomic particles with mass and negative charge used in radiation therapy to treat superficially located tumors due to their physics properties.

external Beam radiation Therapy - Radiation therapy that uses a machine outside of the body to deliver high-energy rays directed at the cancer or tumor.

Fractions - The number of radiation treatments.

Gray (Gy) - The amount of radiation used in radiation therapy is measured in gray (Gy), and varies depending on the type and stage of cancer being treated.

hormone Therapy - Natural hormones, such as estrogen and testosterone, help some tumors grow. To stop their growth, physicians sometimes prescribe hormone therapy to reduce the amount of hormones produced by the body in order to stop the growth of the cancer.

hyperfractionated radiation Therapy - A type of radiation therapy in which the radiation doses are divided into smaller amounts and patients undergo treatment more than once a day.

Radiation Oncology - Words to Know


Cancer Care

hypofractionated radiation Therapy - A type of radiation therapy in which patients undergo one or just a few treatments.

iGrT - image Guided radiation Therapy - A radiation treatment guided by imaging equipment, such as CT, ultrasound or X-rays, taken in the treatment room just before radiation is given. During IGRT, the images are used as a final check to ensure accurate placement of the radiation treatment. IGRT technology accounts for motion to ensure that the target is in the same position every treatment session. IGRT provides high-resolution, three-dimensional images to pinpoint tumor sites, adjust patient positioning when necessary and complete a treatment.

iMrT - intensity Modulated radiation Therapy - IMRT is a specialized form of external beam therapy that can help improve how the radiation is shaped to fit a tumor. Intensity-modulated radiation therapy (IMRT) is an advanced type of three-dimensional radiation that conforms to the shape of a tumor. It uses hundreds of small radiation beams of varying intensities to precisely radiate a tumor. The radiation intensity of each beam is controlled, and the beam shape changes hundreds of times during each treatment. As a result, the radiation dose bends around healthy tissues in a way not possible with other techniques.

immobilization device - A device that is used to help a patient remain in the same position during every treatment.

involved Field radiation - When your healthcare provider delivers radiation only to the parts of your body known to have disease.

irradiation - Also called radiation therapy or radiotherapy, it is the careful use of various forms of radiation to treat cancer and other diseases.

isocenter - The single point in space where a linear accelerator’s beam is aimed regardless of the orientation of the machine.

lasers - As used in radiation therapy, devices mounted on the walls and ceiling of the treatment room pointing to the treatment machine’s isocenter to allow accurate positioning of the patient.

linear Accelerator or linac - The most common type of machine used to deliver external radiation therapy.

MlC - Located in the head of the linear accelerator, it is used to shape the radiation beam.

Mri - Magnetic resonance imager - A technique used in radiology to visualize detailed internal structures. An imaging study using a magnetic field and a computer to create cross-sectional pictures of the body.

Mask - An immobilization device fitting over a patient’s head and face to allow accurate repositioning.

Med onc - Medical Oncology/Chemotherapy.

peT Scan - positron emission Tomography - A nuclear medicine imaging technique that produces a three-dimensional image or picture of functional processes in the body. A positron emission tomography scan is an imaging study using a very small dose of a radioactive tracer attached to a sugar that is injected into the patient. Different tissues (including tumors) use the sugar at different rates, a characteristic that may be detected by the scanner to create an image of the body showing areas of tumor activity.

photons - Radiation therapy particle, composed exclusively of energy, with no mass or charge, that is used in radiation therapy. They can be produced in the nucleus of the atom (gamma radiation) or in the superficial shell (X-rays).

port Films - Images created by the radiation beams themselves. They are used to verify the position of the beams to confirm that treatment is accurately delivered to the right place.

primary Tumor - A tumor that is at the original site where it first arose.



Cancer Care

radiation oncologist - A doctor who specializes in treating cancer and other diseases with radiation therapies. The radiation oncologist leads the radiation therapy treatment team.

radiation oncology nurse - A member of the radiation oncology treatment team, the radiation oncology nurse works together with the radiation oncologist and radiation therapists to care for patients and families during radiation treatments.

radiation physicist - A person who makes sure that the radiation machine or implant delivers the right amount of radiation to the correct site in the body. The physicist works with the radiation oncologist to choose the treatment schedule and dose that has the best chance of killing the most cancer cells.

radiation Therapist - A health professional who gives radiation treatment.

radiation Therapy - Also called radiotherapy or irradiation, it is the careful use of various forms of radiation to treat cancer and other diseases.

radioprotector - A type of drug that protects normal tissues in the area being treated.

radioresistant - A term used to describe a tumor that does not respond well to radiation therapy.

radiosensitizer - A type of drug that can make a tumor respond better to radiation therapy.

radiosurgery - A technique that allows the radiation oncologist to precisely focus beams of radiation to destroy certain types of tumors. It is most often called stereotactic radiotherapy.

radiotherapy - Also called radiation therapy or irradiation, it is the careful use of various forms of radiation to treat cancer and other diseases.

respiratory Gaiting - A technique used to account for tumor motion during breathing. The computer system accounts for motion as the patient breathes in and out, helping to target the tumor and protect healthy tissues from receiving unnecessary radiation.

Sim - Simulation/planning session using a non diagnostic CT scan to image the patient in treatment position and then used to plan the treatment doses and angles.

Stereotactic Body radiation Therapy (SBrT) - Refers to one or several stereotactic radiation treatments within the body, excluding the brain or spine.

Stereotactic radiosurgery (SrS) - Refers to a single or several stereotactic radiation treatments of the brain or spine. Stereotactic radiosurgery is a nonsurgical, highly precise form of radiation therapy used to treat cancers of the brain, which require a high degree of precision.

Treatment plan - A radiation oncologist’s prescription describing how a patient should be treated with radiation therapy. The radiation oncology team uses special software to maximize radiation to the tumor while sparing healthy tissue and organs.

vMAT - volumetric Modulated Arc Therapy- A volumetric arc therapy that delivers a precisely sculpted 3D dose distribution with a single or multiple arc rotation of the linear accelerator gantry it improves dose conformity while significantly shortening treatment times. VMAT delivers treatments two to eight times faster.

Wedge - A metal filter of triangular cross-section placed within a radiation beam to intentionally feather the radiation intensity from one side of the beam to the other.

Referenceshttp://rtanswers.org/dictionary/index.aspx Wikipedia



Cancer Care

Cancer Pain Diary

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


Cancer Care

Cancer pain ManagementPain 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 nurseProving 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.

Cancer Pain Management

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 TreatmentCancer 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.


Cancer Care

Cancer Pain Management

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.


Cancer Care

Low Platelets

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 plateletsPeople 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 plateletsCertain 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 plateletsCall 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 ConsiderationsAlong 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.


Cancer Care

Low Red Blood Cells

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 CellsMost 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 CellsLow 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 SymptomsCall 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 CellsSome 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.


Cancer Care

Low White Blood Cells

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 CellsWhen 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 CellsCertain 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 MethodsIf 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 infectionCall 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


Cancer Care

Low White Blood Cells

• Loose or liquid stools• Trouble urinating - increased frequency or burning with

urination• Vaginal drainage or itching

dietary restrictionsThe 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.


Cancer Care

Nutrition During Cancer Treatment

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.


Cancer Care

Nutrition During Cancer Treatment

• 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)


Cancer Care

Cancer Exercise Program

exercise and the Cancer patientCancer 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 programThis 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 BeginUpon 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 Goals1. 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.

ChargesThe 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 informationFor more information about the cancer exercise program, contact the Agnesian Cancer Center at (920) 926-4100.


Cancer Care

Clinical Trials

About Clinical TrialsClinical 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 ForNew 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.


Cancer Care

Cancer Genetic Risk Assessment Services

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.


Cancer Care

Cancer Genetic Risk Assessment Services

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.


Cancer Care

Support Services Available

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) 926-5277327 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) 923-7950239 Trowbridge Drive, Fond du Lac

hospice hope (920) 923-7950239 Trowbridge Drive, Fond du Lac745 South Street, Green Lake

hospice home of hope (920) 906-1000400 County Road K, Fond du Lac

Spiritual Care Services (920) 926-4887430 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) 926-4673430 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) 926-4455430 E. Division Street, Fond du Lac

Financial assistance for medial bills and medication assistance for those who qualify.

Courtesy van Transportation (920) 926-8959430 E. Division Street, Fond du Lac

Free transportation to and from Agnesian HealthCare services; appointments based on availability.


Cancer Care

Support Services Available

Journeys: a health resource center (920) 926-4960430 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) 926-5370430 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.

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.


Cancer Care

American Cancer Society Resources

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.


Cancer Care

Suggested Internet Resources

www.cancer.netCancer 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.orgThe 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.govThis 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.comThe 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.orgThe 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.orgAgnesian 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.orgThe National Coalition for Cancer Survivorship

www.patientadvocate.orgPatient Advocate Foundation

diAGnoSiS - SpeCiFiC reSourCeS

Bladder Cancer American Bladder Cancer Society - www.bladdercancersupport.org

Brain CancerAmerican Brain Tumor Association - www.abta.org

Breast Cancer www.breastcancer.org

Colorectal CancerColon Cancer Alliance - www.ccalliance.org

Gastrointestinal Cancer - life raft Group www.liferaftgroup.org


Cancer Care

Suggested Internet Resources

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 Cancerwww.livertumor.org

lung Cancerwww.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


Cancer Care

Cancer Support GroupA 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.


Cancer Care

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 networkAre 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

On-Line Caregiver Support Groups

patient & Caregiver Support lineThe 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 Caregivershttp://www.care-givers.com/community/community.html

Family Caregivers Alliancehttp://www.caregiver.org/caregiver/jsp/content_node.jsp?nodeid=347


Cancer Care

Look Good...Feel Better

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.

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 10April 13 October 12June 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 25April 28 October 20June 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


Cancer Care

Audio Visual Entrainment (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.


Cancer Care

Acoustical Chair

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 BodyMusical 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.

MusicMusic with strong base tones is most effective for relaxation. The volume of the music has no effect.


Cancer Care

Labyrinth

A holy WalkTo 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 ToolOur 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 WalkHow 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.


Cancer Care

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 SuggestionsA Prayer WalkUse this time to pray for yourself or someone else; to give thanks or to praise God.

An Intercessory WalkUse this to offer prayer for people or needs. Perhaps pray for a particular person or situation at each turn of the journey.

Compassion, Knowledge & Respect

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Cancer Care

Thoughts, Feelings & Questions

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Cancer Care

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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