Transcript Induction Day Lecture - Bon Secours Hospital

Wellness and Cancer
Oncology Liaison Nurses
Bon Secours Hospital
Kate Murphy & Roisin O’Sullivan
Don’t take statistics at
face value. Everyone's
cancer is different
(www.cancersupportcommunity.org)
•Cancer is not one single disease, but
describes a process that begins with a
series of cell changes
•In Ireland –
•Men - prostate, colorectal and lung
•Women - breast, colorectal and lung
New cases for cancer by sex, Ireland , 2010
New cases (counts)
Total
Female
Male
All Cancers 33,734
17,616
16,118
All Invasive
Cancers
27,814
12,819
14,995
Prostate
3,230
n/a
3,230
Breast
2,760
2,737
23
Colon and
rectal
2,426
1,029
1,397
Lung
2,253
946
1,307
Melanoma
skin
899
526
373
New cases (rate)
Female
Male
730.2
765.5
537.5
n/a
123.3
712.5
155.9
1.1
41.8
39.0
66.2
62.0
22.5
17.5
Deaths for cancer by sex, Ireland , 2010
Deaths (counts)
Deaths (rates)
Total
Female Male
Total
Female
All
Cancers 8,316
3,947
4,369
175.2
152.9
All
Invasive
Cancers 8,135
3,865
4,270
171.7
150.2
Lung
1,693
716
977
36.5
28.6
Male
206.7
202.2
46.4
Colon
and rectal 942
Breast
659
Prostate 533
407
649
n/a
535
10
533
19.7
14.3
n/a
15.2
26.5
n/a
25.3
0.5
25.3
Pancreas 472
228
244
10.0
8.6
11.6
Things to consider before
treatment………
• Dentist
• Flu & Pneumococcal vaccines
• Giving up smoking
– Seek advice about quitting smoking
– HSE Quit team, free phone 1800201203
– Irish Cancer Society information nurses, in Daffodil
Centres, can give advice on quitting smoking.
– www.quit.ie
• Review current medications
• Consider applying for medical card.
Things to consider to stay well
during treatment…………
Medication
• Ask what side-effects you may expect
• Take medication, as prescribed
Rest
• Do not fight the tiredness
• Get plenty of rest, but don’t over do it
• Aim to keep your normal wake up time and
go to bed time
• Take naps earlier in day
• If working, consider reducing working
hours
Exercise
• Exercise shapes feelings of psychological
wellness; exercise stimulates feelings of physical
wellness; and exercise influences social wellness
• Make time daily for some regular physical activity
ie walking
• Take it easy at first, increasing the amount as you
feel stronger
Effect of Low-Intensity Physical Activity and
Moderate-High Intensity Physical
Exercise During Adjuvant Chemotherapy
on Physical Fitness, Fatigue and
Chemotherapy Completion Rates
Hanna van Waart et al (2015)
JCO June 10, 2015 vol 33 no. 17 1918-1927
• 230 breast cancer patients having adjuvant
treatment were assessed before, after
treatment and at 6 month follow-up
• Randomised to aerobic exercise program
versus usual care.
Results
• Exercise program resulted in
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Less decline in cardio respiratory fitness
Better physical functioning
Less nausea and vomiting
Less pain
Improved muscle strength
Improved physical fatigue
Conclusion
• A supervised, moderate to high intensity,
combined resistance and aerobic exercise program
is effective for patients with breast cancer
undergoing adjuvant therapy.
• A home based, low intensity physical activity
program represents a viable alternative for women
who are unable or unwilling to follow the higher
intensity program
Sleep
• Have a bedtime routine
• If having problems with sleeping
– Reduce caffeine
– Relaxing before bedtime
– Maintaining a regular sleep schedule
• Consider taking sleeping tablets
Eating
• Eat small, well-balanced meals
• Ask for help with meal preparation
• Aim to drink, at least 2 litres of fluid per
day
• Don’t diet whilst on treatment
• Wash your hands frequently
Protect Your Skin
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Keep your skin covered up.
Wear a high factor, ≥ 30 SPF
Don’t sunbathe for long periods
Wear a hat
Consider wearing clothes with SPF
protection
Talking
• If feeling worried or anxious, talk to your
close friends or family about concerns
• Talk with your GP
• Community support groups – Arc house
Ask For Help
• Cut down on unnecessary tasks
• Get others to help you around the house, with
shopping, cooking, childcare or travelling to
hospital
• Family and friends can offer a listening ear and
give advice, if needed. Some, may gather up-todate information on cancer to know what to expect
and what patient going through.
Complementary Therapies
• Some can boost your morale, like relaxation,
reflexology
• Can be given alongside conventional treatment
• Help with symptoms ie acupuncture can help
nausea, hot flushes
• Alternative therapies ie St John’s Wort can
interact with chemotherapy
• https://www.mskcc.org/cancercare/treatments/symptommanagement/integrative-medicine/herbs/
Alert Card
This patient is on
CYTOTOXIC CHEMOTHERAPY
®
Information for patients:
You MUST contact your hospital teamURGENTLY if you feel unwell or develop:
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chest pain or difficulty breathing
temperature greater than 38°C (100°F)
shivering episodes
flu-like symptoms
gum / nose bleeds or unusual bruising
mouth ulcers that stop you eating or drinking
vomiting
four or more bowel movements or diarrhoea in 24 hours
Information for health care professionals:
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This patient is at risk of neutropenic sepsis
Take full blood count and cultures
Febrile neutropenic patients require URGENT inpatient treatment with IV
antibiotics according to local clinical guidelines and fluid replacement
Even if afebrile, unwell neutropenic patients should be admitted and treated
as above
For further advice and to keep the patient's oncologist, haematologist, or healthcare
worker informed please contact these numbers immediately:
Office Hours:
Oncology Liaison Nurse:
Chart Number:
Out of Hours: