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) New cases (rate)   Total Female Male Female Male All Cancers 33,734 17,616 16,118 730.2 765.5All Invasive Cancers 27,814 12,819 14,995 537.5 712.5Prostate 3,230 n/a 3,230 n/a 155.9Breast 2,760 2,737 23 123.3 1.1Colon and rectal 2,426 1,029 1,397 41.8 66.2Lung 2,253 946 1,307 39.0 62.0Melanoma skin 899 526 373 22.5 17.5

Deaths for cancer by sex, Ireland , 2010   Deaths (counts) Deaths (rates)   Total Female Male Total Female Male All Cancers 8,316 3,947 4,369 175.2 152.9 206.7All Invasive Cancers 8,135 3,865 4,270 171.7 150.2 202.2Lung 1,693 716 977 36.5 28.6 46.4

Colon and rectal 942 407 535 19.7 15.2 25.3Breast 659 649 10 14.3 26.5 0.5Prostate 533 n/a 533 n/a n/a 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 • 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

• 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-to-date 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/cancer-care/treatments/

symptom-management/integrative-medicine/herbs/

Alert Card

Thispatient isonCYTOTOXICCHEMOTHERAPY

Information forpatients:

YouMUSTcontact your hospital teamURGENTLY if you feel unwell ordevelop:

· chestpainor difficultybreathing· temperaturegreater than38°C(100°F)· shiveringepisodes· flu-likesymptoms· gum / nosebleedsor unusual bruising· mouthulcers that stopyoueating or drinking· vomiting· fouror more bowelmovements or diarrhoea in24hours

®

Information for health care professionals:

· 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 keepthe patient's oncologist, haematologist, or healthcareworker informed pleasecontact these numbers immediately:

Office Hours: Outof Hours:

Oncology Liaison Nurse:

Chart Number: