Play PodcastPlay Download PodcastDownload

Transcription:

Prakash Chandran (Host):  Cancer treatment is a challenge, physically, logistically and emotionally. There are real life nonmedical challenges and resources for managing them. I’m Prakash Chandran and in this episode of Northfield Hospital and Clinics Podcast series, we’ll talk about managing your real life during cancer treatment.

Here with us to discuss is Patty Kark, a Breastcare Nurse Navigator, Juliana Sayner, an Oncology Nurse Navigator and Valerie Thomas, the Director of Social Services, all of Northfield Hospital and Clinics. It’s really great to have the three of you here. So, Juliana I’d really like to start with you. This is something I’m sure a lot of people ask about but what are some of the best ways to help with the side effects of chemotherapy?

Juliana Sayner, BSN, RN, OCN (Guest):  Of course that’s an excellent question. So, a cancer diagnosis is a life changing event and it really impacts beyond just the individual but their family and their community as well. So, there’s a lot we can do to help support patients. And the Cancer Care Infusion Center is really happy to offer some additional services that holistically support our patients during their cancer treatment. One of the opportunities we have in our cancer center is patients have the option to try aroma therapy during their treatment time. And aroma therapy uses what we call aromatic essential oils and these oils can actually help to boost an individual’s sense of physical or emotional wellbeing. These oils are all natural and they come from different parts of plants and trees.

So, one of the most familiar essential oils is lavender. Many people have probably tried lavender at least heard of lavender. And lavender is understood to have some calming properties. So the aromatherapy that we use in the cancer center comes in patches that you place on your clothing, generally, in your upper chest area below your nose, your chin area. And these particular patches include a blend of five to six different oils and the patches are used in our setting to help people with calming, to help with rest and also to help settle the stomach. Patients seem to appreciate the extra support they get for healing with these patches.

So, we have other services that we provide to support our patients during their care. And that is through our two cancer support groups. I’m the oncology nurse navigator and I co-facilitate a monthly cancer wellness group with the hospice chaplain, Julia Carlson. And this group is available to all of our chemotherapy and radiation therapy patients with any cancer diagnosis.  

We also have our breast cancer support group, and this is facilitated by Patty Kark, the Breastcare Navigator. And both of these groups meet on a monthly schedule at the Northfield Hospital. These two groups really provide a wonderful opportunity for our patients to share their own stories within a supportive and caring small group experience.

Host:  Yeah, it’s so fantastic to know that there are support groups just for patients to understand that they are not alone when they are going through this. So, I think it’s really important that they take advantage of that. So, Patty, I want to shift over to you. I’m curious as to how individuals can find and evaluate good resources for managing symptoms. There’s a ton of information to sort through about cancer treatments so how can they find reliable sources?

Patty Kark RN (Guest):  Well as we all know that we have so much information right at our fingertips now on the web and some of that information that we go to is good and there’s some that’s not so good and so for information about your cancer diagnosis and your treatment; the best place for them to start is with the provider whether it’s the surgeon or oncologist or the cancer nurse navigators or the infusion nurses. And they will provide you with resources that will be beneficial to you and also provide you with good websites to look at. Some of those websites that I refer people to are the American Cancer Society which is a good website for all different types of cancers. Chemocare.com which is for information on medications and treatments that the patient may be put on and also symptom management. And for those with breast cancer, I refer them to the Susan G Komen site or to the breastcancer.org site.

It’s just really important to talk with your providers, your nurses, your nurse navigators to get good resources, reputable resources so that you are provided with the best information.

Host:  Absolutely, not all websites and resources are created equal so definitely talk to the resources at the hospital, the surgeons that you are working with and the nurses. They’ll be able to guide you in the right direction. Juliana, shifting over to you; we know that nutrition is so important during cancer treatment, so what can people do or make at home to facilitate this?

Juliana:  So, this is a very commonly asked question. Patients and their care providers often want to know what the best way is to help out with nutrition during cancer treatment. And there is really so much information that can be discussed on nutrition. It could be a topic in itself for an entire podcast. But starting at this point, it’s really important for people to understand that the nutritional needs of each individual is really going to vary depending on their diagnosis and also the types of treatments they are receiving.

Not everyone that goes through cancer treatments will have challenges with eating. But at the Cancer Care and Infusion Center, the oncology nurses do monitor everyone’s weight with each visit and also check in regularly and address any questions or concerns that people have about eating. So, it’s an ongoing process. An example of some challenges that people may face during cancer treatment is taste changes. Taste changes can happen for a few days or a week or so after treatment. A very common taste change that people experience is that beloved morning coffee that they have may develop for example a metallic aftertaste. Other times, people have a queasy stomach. Some people may notice discomfort when they swallow. All of these are side effects of treatment.

So, involving the caregivers in conversation about eating and nutrition can also be really helpful. Family members and friends often make nutrition a priority when helping at home. For example people like to bring meals by. Therefore, involving other individuals of the care team involved in the conversation on eating can be helpful in supporting the patient for the best outcomes. However, at home there are times when the relationship around food preparation and around eating can become really frustrating and stressful for all involved. Such as if an individual going through cancer treatment loses their desire to eat or starts to skip some meals; this can be really challenging for both the caregiver and the patient.

Even though a few skipped meals can happen, the goal is really to maximize the calorie intake that people get during their cancer treatment. And we do see how hard this disparity can be between the caregiver and the patient relationship. Just in conclusion here, just to give you here are some quick tips for patients and caregivers to help ease some of these eating challenges. So, I mentioned if you have a metallic taste one of the strategies people can try is to use plastic silverware instead of stainless steel. Sometimes that helps. Making sure that people take their anti-nausea medicines that are prescribed by their provider at least 30 minutes to 60 minutes before meals. And for a lot of people as I mentioned, just not having that desire to eat, so when sitting down to a meal, eating smaller serving sizes like snack sized servings on a smaller plate, maybe four to six times a day as opposed to trying to eat two to three bigger meals a day sometimes that makes the challenge of eating a little bit more doable.

And then also some people find it helpful to have either cool or cold foods or room temperature foods so there’s less of an aroma. When you don’t have an appetite, aromatic foods can sometimes even be more of a deterrent to eat. A couple other suggestions to drink your liquids, your fluids between meals instead of with meals. People tend to get less full with their meals that way and then adding gravies, condiments, sauces to food can help if you are having trouble swallowing and can also add much needed calories.

And then one of the most important things is to remember to continue talking to the cancer care team about concerns about eating so that the oncology nurses and the physicians can continue to work with the patient and their family during treatment to support them.

Host:  Well thank you so much for that advice Juliana. Patty I want to move over to you and talk a little bit about cancer rehabilitation. I’m curious as to at what point during or after treatment it starts helping.

Patty:  We refer people to cancer rehabilitation through the whole spectrum of their treatment because it’s a program that focuses on helping people with their cancer and cancer survivors improve their physical wellbeing and their quality of life. The team is comprised of physical, occupational and speech therapists and their goal is to improve the daily function and overall quality of life before, or during or after treatment and this can include years later if you are continuing to deal with symptoms or side effects from the treatments. So, they work together with the patient, the families and the caregivers to create really a unique treatment that best fits them, their lifestyle and their goals.

Host:  And Valerie, I’m curious as to what are some of the life challenges people face with cancer. I’m sure there are so many things and facets that people have to deal with on a day to day basis but maybe you can talk about some of the most common ones.

Valerie Thomas, MSW, LICSW (Guest):  Absolutely.  A cancer diagnosis and treatment often impact many different parts of people’s everyday life including work, relationships with family and friends, finances and hobbies. People are concerned about their ability to continue to fulfill their roles as partners, parents, financial providers and every person’s situation is unique and everyone deserves the opportunity to share their concerns and questions that they might have. And prior to and during cancer treatment, patients and caregivers are given the opportunity to meet with the medical social worker who can assist in sorting through some of those concerns and locating support and resources to assist with this challenging time.

And there are many resources available that patients and caregivers are sometimes unaware of. If someone needs physical assistance in their home, there are attendant care agencies. A home attendant can do the house keeping chores and meal preparations that someone might need at home. They can be hired for a few hours, a few days a week or for up to 24 hours if needed. Then if a patient is unable to drive, there are agencies that can provide transportation. If cooking is a concern, there are agencies that can provide home delivered meals. And if finances are a concern, some agencies provide free food or energy assistance and by accessing these resources, money that would usually be spent on these needs can be redirected towards expenses connected with the cancer treatments. Also there is some nonprofit agencies who have small grants available to people going through cancer treatment to pay for unexpected expenses like childcare during treatment and transportation to and from treatments.

A medical social worker can assist patients and families in thinking creatively through their whole situation and what resources would be helpful to them and the social worker can make initial calls on behalf of the patient and assist in connecting patients and families with these resources.

Host:  Yeah, it’s so wonderful to hear that there are all those resources there for these patients but outside of what you mentioned there’s obviously also the emotional aspect of it and we all know that emotional health is a really important aspect especially when the medical care is intense and prolonged. I’m curious as to how we can actually address that and what are the health benefits of doing so?

Valerie:  Yeah, emotional health is so important as people are facing diagnosis and treatment for cancer. People have different ways of taking care of their emotional health before they are diagnosed which may influence how they take care of themselves once they receive a cancer diagnosis. Some people feel well supported by their family and friends and they may be able to share all the information about their diagnosis and treatment with them and feel comfortable talking openly with anyone about the situation. Other people are more private and prefer to only share with a few close people. Some people have a religious support person or spiritual community that they turn to for prayers and support. And other people feel more comfortable connecting with a private therapist who can help them to navigate through some of the new emotions and concerns they are experiencing.

And some people may want to connect with a cancer support group where they can learn from others and with shared experiences. And for many people being able to continue with hobbies and activities that have brough them joy in their lives is very important during this time. So, thinking creatively about how activities can be adjusted if needed do to physical ability or energy levels during treatment can allow people to continue to participate and find joy in these important activities.

People should be encouraged to do whatever they feel contributes positively to their emotional health and social workers can be of assistance in discussing the patient or caregivers needs and how to access support for emotional health during cancer treatment.

Host:  So, Patty I want to end with you. There’s obviously all of the care and things that go into taking care of the patient but what about the person that’s caring for a loved one with cancer? How might they make it a point to also take care of themselves?

Patty:  Well first and foremost, it would be good for them to make self-care a priority. A lot of people think of self-care as a luxury, but it should be a priority and some examples of that self-care are exercise, healthy eating, having a sleep routine, it could be spending time with friends or journaling. You could take up a hobby. You could join a caregivers support group. Or you ask for help and more importantly, to accept the help. There is something called compassion fatigue and it’s physical and it’s emotional weariness that comes from caring for others and this is very real. So, it’s important that caregivers take care of themselves so that they then can care for their loved ones.

Host:  Well I want to thank you three so much Patty, Juliana and Valerie for educating us on cancer care decisions. It’s just so wonderful that there are so many resources, support groups and people like you available to help make things a little bit easier. Learn more about cancer care at Northfield Hospital and clinics at our website at www.northfieldhospital.org. Once again, that’s www.northfieldhospital.org. My guests today have been Patty Kark, Juliana Sayner and Valerie Thomas. I’m Prakash Chandran. Thanks so much for listening.