3. S u r v i v o r s h i p G u i d e
CancerCare
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
4. S u r v i v o r s h i p G u i d e
CancerCare
- 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
5. S u r v i v o r s h i p G u i d e
CancerCare
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 Questions
We 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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SpeakUp&AskQuestions
6. S u r v i v o r s h i p G u i d e
CancerCare
How to Be An Active Member of Your Health Team
1. 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.
SpeakUp&AskQuestions
7. 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
8.
9. S u r v i v o r s h i p G u i d e
CancerCare
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
10.
11. S u r v i v o r s h i p G u i d e
CancerCare
RadiationOncology
Michael Vander Kooy, MD
Radiation Oncologist
480E.DivisionStreet,FondduLac | 933NewburyStreet,Ripon | 620W.BrownStreet,Waupun | (920)926-4100•(800)494-2927
Mary L., RN
Radiation Oncology Nurse
Tammie L., RN
Dr. Vander Kooy’s Nurse
Filip T. Troicki, MD
Radiation Oncologist
Stacy S., RN
Dr. Troicki’s Nurse
12. S u r v i v o r s h i p G u i d e
CancerCare
RadiationOncology
Phil B.
Dosimetrist
Tim L.
Physicist
Brian S., RTT
Radiation Therapist
Bonnie D., RTT
Radiation Therapist
Noelle B., RTT
Radiation Therapist
Ellie B., RTT
Radiation Therapist
480E.DivisionStreet,FondduLac | 933NewburyStreet,Ripon | 620W.BrownStreet,Waupun | (920)926-4100•(800)494-2927
13. S u r v i v o r s h i p G u i d e
CancerCare
MedicalOncology
480E.DivisionStreet,FondduLac | 933NewburyStreet,Ripon | 620W.BrownStreet,Waupun | (920)926-4100•(800)494-2927
Joel Lundberg, MD
Medical Oncologist
Michael Jones, MD
Medical Oncologist
Betsy M., LPN
Dr. Jones’ Nurse
Sara S., LPN
Dr. Lundberg’s Nurse
Lisa Michels, APNP
Oncology & Women’s Health
Nurse Practitioner
14. S u r v i v o r s h i p G u i d e
CancerCare
MedicalOncology
Not pictured:
Carrissa R., RN, Chemotherapy Nurse
Kris M., Massage Therapist
480E.DivisionStreet,FondduLac | 933NewburyStreet,Ripon | 620W.BrownStreet,Waupun | (920)926-4100•(800)494-2927
Nicki W., RN
Chemotherapy Nurse
Margo B., RN
Chemotherapy Nurse
Terri B., RN
Chemotherapy Nurse
Cindy K., RN
Chemotherapy Nurse
Travis D., PharmD, RPh
Pharmacist
Patty S.
Pharmacy Technician
Kristin M., RN
Chemotherapy Nurse
Rachel S., RN
Chemotherapy Nurse
Kelly H., RN
Chemotherapy Nurse
Jennifer R., RN
Chemotherapy Nurse
15. S u r v i v o r s h i p G u i d e
CancerCare
480E.DivisionStreet,FondduLac | 933NewburyStreet,Ripon | 620W.BrownStreet,Waupun | (920)926-4100•(800)494-2927
AncillaryAssociates
Kay G.
Breast Care Navigator
Bill Daly
Oncology Services &
Medical Imaging Director
Juanita H.
Receptionist/
Medical Records
Heather B., RTT, MBA
Radiation Therapy
Supervisor
Ann S., RN
Nurse 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
16. S u r v i v o r s h i p G u i d e
CancerCare
AncillaryAssociates
Not pictured:
Kari J., American Cancer Society Volunteer Navigator
480E.DivisionStreet,FondduLac | 933NewburyStreet,Ripon | 620W.BrownStreet,Waupun | (920)926-4100•(800)494-2927
Patty W.
Cancer Registrar
Sheree W.
Clinical Trial Data
Manager
Becky S., PTA
Exercise Therapist
Kelli L.
American Cancer Society
Volunteer Navigator
Kristie M., MSW
Social Worker
Kay H.
Cancer Registrar
Sr. Rebecca E., CSA
Volunteer
Cheryl M.
Cancer Registry
17. S u r v i v o r s h i p G u i d e
CancerCare
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
18. S u r v i v o r s h i p G u i d e
CancerCare
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 Treatment
Remember 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 Information
If 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.
RadiationOncology-WhattoExpect
19. S u r v i v o r s h i p G u i d e
CancerCare
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.
RadiationOncology-WordstoKnow
20. S u r v i v o r s h i p G u i d e
CancerCare
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.
RadiationOncology-WordstoKnow
21. S u r v i v o r s h i p G u i d e
CancerCare
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.
References
http://rtanswers.org/dictionary/index.aspx
Wikipedia
RadiationOncology-WordstoKnow
22. S u r v i v o r s h i p G u i d e
CancerCare
CancerPainDiary
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
23. S u r v i v o r s h i p G u i d e
CancerCare
Cancer Pain Management
Pain 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 Nurse
Proving 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.
CancerPainManagement
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 Treatment
Cancer 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.
24. S u r v i v o r s h i p G u i d e
CancerCare
CancerPainManagement
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.
25. S u r v i v o r s h i p G u i d e
CancerCare
LowPlatelets
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 Platelets
People 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 Platelets
Certain 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 Platelets
Call 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 Considerations
Along 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.
26. S u r v i v o r s h i p G u i d e
CancerCare
LowRedBloodCells
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 Cells
Most 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 Cells
Low 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 Symptoms
Call 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 Cells
Some 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.
27. S u r v i v o r s h i p G u i d e
CancerCare
LowWhiteBloodCells
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 Cells
When 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 Cells
Certain 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 Methods
If 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 Infection
Call 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
28. S u r v i v o r s h i p G u i d e
CancerCare
LowWhiteBloodCells
• Loose or liquid stools
• Trouble urinating - increased frequency or burning with
urination
• Vaginal drainage or itching
Dietary Restrictions
The 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.
29. S u r v i v o r s h i p G u i d e
CancerCare
NutritionDuringCancerTreatment
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.
30. S u r v i v o r s h i p G u i d e
CancerCare
NutritionDuringCancerTreatment
• 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)
31. S u r v i v o r s h i p G u i d e
CancerCare
CancerExerciseProgram
Exercise and the Cancer Patient
Cancer 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 Program
This 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 Begin
Upon 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 Goals
1. 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.
Charges
The 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 Information
For more information about the cancer exercise program,
contact the Agnesian Cancer Center at (920) 926-4100.
32.
33. S u r v i v o r s h i p G u i d e
CancerCare
ClinicalTrials
About Clinical Trials
Clinical 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 For
New 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.
34. S u r v i v o r s h i p G u i d e
CancerCare
CancerGeneticRiskAssessmentServices
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.
35. S u r v i v o r s h i p G u i d e
CancerCare
CancerGeneticRiskAssessmentServices
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.
36. S u r v i v o r s h i p G u i d e
CancerCare
SupportServicesAvailable
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) 926-5277
327 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) 923-7950
239 Trowbridge Drive, Fond du Lac
Hospice Hope
(920) 923-7950
239 Trowbridge Drive, Fond du Lac
745 South Street, Green Lake
Hospice Home of Hope
(920) 906-1000
400 County Road K, Fond du Lac
Spiritual Care Services
(920) 926-4887
430 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) 926-4673
430 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) 926-4455
430 E. Division Street, Fond du Lac
Financial assistance for medial bills and medication assistance
for those who qualify.
Courtesy Van Transportation
(920) 926-8959
430 E. Division Street, Fond du Lac
Free transportation to and from Agnesian HealthCare services;
appointments based on availability.
37. S u r v i v o r s h i p G u i d e
CancerCare
SupportServicesAvailable
Journeys: a health resource center
(920) 926-4960
430 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) 926-5370
430 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.
38. 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.
39. S u r v i v o r s h i p G u i d e
CancerCare
AmericanCancerSocietyResources
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.
40. S u r v i v o r s h i p G u i d e
CancerCare
SuggestedInternetResources
www.cancer.net
Cancer 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.org
The 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.gov
This 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.com
The 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.org
The 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.org
Agnesian 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.org
The National Coalition for Cancer Survivorship
www.patientadvocate.org
Patient Advocate Foundation
Diagnosis - Specific Resources
Bladder Cancer
American Bladder Cancer Society -
www.bladdercancersupport.org
Brain Cancer
American Brain Tumor Association - www.abta.org
Breast Cancer
www.breastcancer.org
Colorectal Cancer
Colon Cancer Alliance - www.ccalliance.org
Gastrointestinal Cancer - Life Raft Group
www.liferaftgroup.org
41. S u r v i v o r s h i p G u i d e
CancerCare
SuggestedInternetResources
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 Cancer
www.livertumor.org
Lung Cancer
www.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
42. S u r v i v o r s h i p G u i d e
CancerCare
CancerSupportGroup
A 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.
43. S u r v i v o r s h i p G u i d e
CancerCare
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 Network
Are 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 Line
The 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 Caregivers
http://www.care-givers.com/community/community.html
Family Caregivers Alliance
http://www.caregiver.org/caregiver/jsp/content_node.
jsp?nodeid=347
44. S u r v i v o r s h i p G u i d e
CancerCare
LookGood...FeelBetter
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.
45. 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 10
April 13 October 12
June 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 25
April 28 October 20
June 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
46. S u r v i v o r s h i p G u i d e
CancerCare
AudioVisualEntrainment(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.
47. S u r v i v o r s h i p G u i d e
CancerCare
AcousticalChair
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 Body
Musical 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.
Music
Music with strong base tones is most effective for relaxation.
The volume of the music has no effect.
48. S u r v i v o r s h i p G u i d e
CancerCare
Labyrinth
A Holy Walk
To 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 Tool
Our 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 Walk
How 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.
49. S u r v i v o r s h i p G u i d e
CancerCare
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 Suggestions
A Prayer Walk
Use this time to pray for yourself or someone else; to give thanks
or to praise God.
An Intercessory Walk
Use this to offer prayer for people or needs. Perhaps pray for a
particular person or situation at each turn of the journey.
50. Compassion, Knowledge & Respect
agnesianhealthshoppe.com
327 Winnebago Drive, Fond du Lac • (920) 926-5277 • Monday through Friday, 8 a.m. to 6 p.m.
Let us help you through this sensitive time with all your postmastectomy needs
in our private, boutique-like setting. Our compassionate, professional associates
will work with you to find the right styles and sizes, and help you to feel fashionable
and feminine again.
Postmastectomy Products
• Head coverings • Swimwear & swim forms
• Scarfs • Camisoles
• Feminine bras • Hats
• Lingerie • Breast forms
• Wigs • Lumpectomy fillers
• Hair enhancements • Custom orders
• Lymphedema garments (including sleeves, gauntlets, gloves
and compression garments)
The Agnesian Health Shoppe has a women’s health consultant
and trained wig specialists on-site. We work in conjunction with
an area licensed beautician to help style, trim and color wigs.
We can also assist with billing and reimbursement.
Let us help you today.
Women’s Health Consultant Carla Witkowski
Through one-on-one consultations and our
private fitting rooms, Carla can assist you
with any of your needs.
51. S u r v i v o r s h i p G u i d e
CancerCare
Thoughts,Feelings&Questions
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53. S u r v i v o r s h i p G u i d e
CancerCare
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?