Patient Guide to Cancer Care • Tom Baker Cancer Centre
Information and Support Patient Guide to Cancer Care • Tom Baker Cancer Centre • Richmond Road Centre • Peter Lougheed Centre September 2013 Tom Baker Cancer Centre Peter Lougheed Centre Patient Guide Cover.indd 2 Richmond Road Centre Cancer Care 13-09-20 12:29 PM Telephone Directory Tom Baker Cancer Centre – Main Numbers Main Number – Switchboard New Patient Referrals and Follow-up Appointments After Hours – Foothills Hospital Emergency 403-521-3723 403-521-3722 403-944-1110 Only call after hours if you have an urgent concern. Otherwise, wait until the next day. Ask for the right type of cancer doctor – hematologist, radiation oncologist, medical oncologist, gyne oncologist or neuro oncologist, depending on your treatments. Departments Alberta Cancer Foundation Blood and Marrow Transplant Clinic Clinical Research Unit Colposcopy Clinic Library (Knowledge Centre) Medical Day Care (Chemotherapy) Chemotherapy Appointments Chemotherapy Symptoms Toll Free for Out of Town Patients Outpatient Unit Pharmacy Psychosocial Resources (Counselling/Support) Radiation Therapy Alberta Radiosurgery Centre 403-521-3303 403-521-3735 1-866-238-3735 403-521-3740 403-521-3764 403-355-3207 403-521-3771 403-521-3800 Supportive Services Clinical Ethics Service Dietitians (for eating advice and support) Patient Feedback Line Patient Education Specialist Psychosocial Resources (Counselling/Support) Rehabilitation and Lymphedema Program Social Workers Spiritual Care Volunteer Drivers 403-943-2821 403-521-3719 1-855-550-2555 403-476-2445 403-355-3207 403-476-2448 403-355-3207 403-521-3352 1-800-263-6750 Peter Lougheed Centre – Main Numbers Switchboard / Hospital Operator Patient Access / Admitting After Hours – Emergency Department If your doctor is based at Peter Lougheed, call this number for emergencies only. Ask for the hematologist on call. 403-521-3433 403-521-3463 403-521-3140 403-698-8031 403-521-3765 403-943-4555 403-943-4556 403-943-4555 Table of Contents Cancer Care Information The Facts about Cancer in Alberta 1 Tom Baker Cancer Centre ------------------------------------------------------------- 1 Parking at Tom Baker Cancer Centre 2 Other Transportation Options 3 Main Floor – What You Will Find 16 Ground Floor – What You Will Find 19 Basement Floor – What You Will Find 21 Cancer Care at the Richmond Road Centre ------------------------------------- 3 Parking at the Richmond Road Centre 5 Richmond Road Centre – What You Will Find 25 Cancer Care at Peter Lougheed Centre ------------------------------------------- 5 Parking at Peter Lougheed Centre 6 Peter Lougheed Centre – What You Will Find 25 Process of Cancer Care – What You Can Expect ------------------------------ 7 Referral for Cancer Care 7 Orientation for New Patients 7 Consultation 8 Treatment Preparation 9 Treatments 9 Treatment Considerations 14 Continuing Care 15 Covering the Costs of Cancer Care ------------------------------------------------ 27 Other Supportive Services 29 Help Us to Help You – Patient Responsibilities 32 Your Rights – What You Can Expect from Us 34 Taking Control – Your Role in Your Cancer Care Special Section 1 – Eat for Your Life Special Section 2 – Exercise for Your Life Special Section 3 – Sleep Well with Cancer and Beyond 35 38 40 Reliable Cancer Websites ------------------------------------------------------------ 44 Other Important Features Telephone Directory – Floor Plans of Tom Baker Cancer Centre – Map of Provincial Cancer Centres – Tom Baker Cancer Centre Parking Map – Richmond Road Centre Site Map Inside Front Cover Introductory Pages Last Page Outside Back Cover Inside Back Cover Fire Exit Only Main Floor Tom Baker Cancer Centre Stairs Offices Pathology Stairs Beige Elevators Class Room CC121 Offices Department of Oncology Offices Class Room CC109 Stairs Knowledge Centre (Library) Volunteer Services Silver Elevators Auditorium CC104 CHR Social Work Stairs Discharge Lounge Offices Board Room CC105 Offices Personal Well-Being Kiosks Main Reception Patient Advocate Spiritual Care CHR Alberta Cancer Clinical Foundation Nutrition Foothills Pharmacy and Garden Deli Gift Shop Main Entrance Ground Floor Tom Baker Cancer Centre Stairs Offices Offices A Pharmacy Reception Timberline Cafe and Foothills Fire Exit Pamphlets Stairs Fire Exit Offices Outpatient Clinic Reception Offices Counselling and Social Work Reception Outpatient Clinic (Consultations) Blood Lab Pamphlets Blood and Marrow Transplant Clinic X-Ray CT Scan Ultrasound Kitchen Medical Daycare Reception Silver Elevators Stairs Pharmacy C Stairs Beige Elevators Medical Daycare B Unit (Chemotherapy) Exit to Ambulance Bay RT Unit 1 Fire Exit Only Exam Room Basement Entrance Dietitian Radiation Reception RT Unit 8 Class Room CCB20 RT Unit 7 To MRI and Foothills Exam Exam RT Unit 5 Operating Room Ortho Stairs Change Area Silver Elevators Change Area Pamphlets RT 9 Exam Room Exam Room RT Unit 4 Radiosurgery Reception Treatment Planning Nurses' Patient Day Offices Room Offices RT Unit 6 Fire Exit Only PostPreSurgery Surgery Stairs Ex it Medical Physics Exam Room Change Area Stairs RT Unit 3 Radiosurgery Exam Room To RT Unit 10 RT Unit 2 Cast and Mould Beige Elevators Offices Simulator Procedure Room Simulator Procedure Area Change Area Tom Baker Cancer Centre To Clinical Research Basement Floor Fire Exit Only The Facts about Cancer in Alberta Nearly 50,000 Albertans are currently being treated for cancer. Each day, around 44 Albertans are diagnosed with cancer adding up to around 16,000 this year. In Alberta and the rest of Canada, 40% of all women develop cancer and 45% of all men develop cancer sometime during their lives, so nearly every family is affected. There are over 200 different types of cancer. The four most common cancers in Alberta are prostate, breast, lung and colorectal (colon or rectal), and they account for around 55% of all cancer cases in the province. Albertans diagnosed with cancer today have a 67% chance of surviving for more than 5 years, compared to 50% two decades ago. The overall 10 year cancer survival rate in Canada is now around 60%, one of the highest rates in the world. Sources: Alberta Cancer Registry Alberta Cancer Foundation Canadian Cancer Society Tom Baker Cancer Centre Location: 1331 – 29th Street NW, Calgary Main Number – Switchboard o 403-521-3723 New Patient Referrals and Follow-up Appointments o 403-521-3722 After Hours – Foothills Hospital Emergency o 403-944-1110 Tom Baker Cancer Centre in Calgary is one of Alberta’s two main cancer centres, along with the Cross Cancer Institute in Edmonton. We provide advanced medical and supportive cancer care for people who live in southern Alberta, and for some residents of Saskatchewan and British Columbia. We are also focused on providing patient and professional education, and on performing extensive research in the quest for even more effective treatments options. Tom Baker Cancer Centre is located at the Foothills Medical Centre site in northwest Calgary and works in collaboration with the city hospitals, the University of Calgary and other related medical institutions. The Cancer Centre consists of three floors of outpatient care and is attached to the Foothills Hospital where some patients stay as inpatients, when necessary. In addition to the two main Cancer Centres, there are 4 Associate Cancer Centres and 11 Community Cancer Centres in the province. The range of services offered is more limited in the Associate and Community Centres than in the comprehensive Centres in Calgary and Edmonton. All of the treatment centres are integrated in a network known as Alberta Health Services – Cancer Care. See the map of locations near the end of this guide. Parking at Tom Baker Cancer Centre See parking map on back cover There are several parking lots for patients and families at the Foothills Medical Centre. Parking space is always available, but when the main lot near the Cancer Centre fills up, it may be necessary for you to park in a lot farther away. It does cost to park at all lots. The charges are $2.00 per half hour to a maximum of $13 a day in the main patient lots. Parking passes are available and may reduce your cost if you are making frequent visits. Weekly Parking Pass – $41 Monthly Parking Pass – Regular – $85 Monthly Parking Pass – Senior – $68 2 The Parking Office is located in the North Tower, one floor down from the main entrance. You can go there to buy passes or deal with any other parking issues. Handicapped parking spaces are located in the main parking lot, right in front of the Cancer Centre. Two hour free parking is available on Toronto Crescent, not far from the Cancer Centre (see parking map). Be careful not to overstay the two hours or you will most likely receive a ticket. Other Transportation Options Calgary Transit – Call 403-262-1000 for transit information. Calgary Transit routes 20, 40, 91 and 419 will all bring you right to the Foothills Medical Centre. Volunteer Drivers – Call 1-800-263-6750 – The Canadian Cancer Society provides volunteer drivers at no cost to those patients who have difficulty finding other ways to get to the Cancer Centre. Patients do need to sign up for the program and book their trips at least two days in advance. Access Calgary – Call 403-537-777 – Offers special needs taxis and handibus service for those with mobility challenges. Cancer Clinics at the Richmond Road Diagnostic and Treatment Centre Since the space at Tom Baker Cancer Centre is not large enough to accommodate all patient and staff needs, our services have been extended to the old Children’s Hospital which is now called the Richmond Road Diagnostic and Treatment Centre. The services at this site are just an extension of services from the main site. Many staff members spend time working at both the main Tom Baker site and at the Richmond Road Centre. Your cancer treatments will be at Tom Baker Cancer Centre. The Richmond Road Centre has several types of clinics for various health issues. They offer treatments for some of these health issues, but not for cancer. We use this site for consultations but not for cancer treatments. 3 Location: 1820 Richmond Road SW, Calgary Cancer Clinics o Go to the Admitting and Information Desk on Level 1 and you will be directed to the right clinic for your appointment Main Number – Use switchboard at Tom Baker Cancer Centre o 403-521-3723 New Patient Referrals and Follow-up Appointments o 403-521-3722 Rehab and Lymphedema Program o 403-476-2448 Parking at the Richmond Road Centre Parking is easy at the Richmond Road Diagnostic and Treatment Centre. As soon as you turn into the Main Entrance, you will see the Public Parking sign for underground parking. Just enter, park and pay for your parking at the machine. The cost is the same as at Tom Baker Cancer Centre. The charges are $2.00 per half hour to a maximum of $13 a day in the main patient lots. Parking passes are available and may reduce your cost if you are making frequent visits. Parking passes will work for both the main Tom Baker site and the Richmond Road Centre. 4 Weekly Parking Pass – $41 Monthly Parking Pass – Regular – $85 Monthly Parking Pass – Senior – $68 Cancer Care at Peter Lougheed Centre Location: 3500-26 Avenue NE, Calgary Switchboard/ Hospital Operator o 403-943-4555 Patient Access / Admitting o 403-943-4556 After Hours – Emergency Department o 403-943-4999 Some patients with blood-related types of cancer receive their consultations and their chemotherapy treatments at Peter Lougheed Centre. Several of the Hematologists (blood specialists) in Calgary work at this Centre. If you are referred to them with cancers such as leukemia, lymphoma or multiple myeloma, you will usually have your first consultation in the Outpatient Specialty Clinic and your treatments in the nearby Treatment Room. These services have been provided for many years independently at Peter Lougheed Centre, but they have recently been integrated with the services of Tom Baker Cancer Centre. So the outpatient chemotherapy treatments at Peter Lougheed are now an extension of the services provided by the main Cancer Centre. Like the other hospitals in Calgary, Peter Lougheed Centre also offers some inpatient services to cancer patients such as surgeries, inpatient chemotherapy and palliative care. Inpatient services are fully managed by the staff at each hospital, not by Tom Baker Cancer Centre. 5 Parking at Peter Lougheed Centre The visitor parking area at Peter Lougheed Centre is located on the west side of the main building. The charges to park there are $2.00 for each half hour to a maximum of $13 a day. If you will be making frequent visits, or staying as an inpatient, there are parking passes available at the Parkade Kiosk. Parking passes work for all Alberta Health Service facilities. Weekly Parking Pass – $41 Monthly Parking Pass – Regular – $85 Monthly Parking Pass – Senior – $68 These fees are subject to change, so you can check any changes on the signs as you enter the parking lots. Free parking at Sunridge Mall is not recommended as you will most likely receive a ticket. The Sunridge C-Train Station is a short walk from the hospital and may be another transportation option for you. 6 Process of Cancer Care – What You Can Expect Referral for Cancer Care For most patients, your cancer is diagnosed and confirmed before you are referred to our cancer care facilities. Diagnosis usually starts with a visit to your family doctor or a medical clinic with some concerns. After certain tests and a biopsy (sample of the tissue), cancer cells have been identified. If your type of cancer can be treated with surgery, you are usually scheduled for surgery in a hospital operating room as soon as possible. As you are recovering from surgery, your surgeon or another specialist will then refer you to Tom Baker Cancer Centre for further assessment and further treatments, if recommended. When we receive your referral and medical records, we review them to make sure we schedule you as quickly as possible, depending on the urgency of your needs. One of our booking clerks then calls you to schedule your Orientation and Consultation appointments. o Some patients with blood-related types of cancer are referred by their family doctors directly to the Hematologists (blood specialists) at Peter Lougheed Centre where tests determine the nature of your cancer. You may begin treatments immediately. Plan to attend the New Patient Orientation at Tom Baker Cancer Centre as soon as you can. See the details below. When you come, tell the instructor that you are from Peter Lougheed. o We also work closely with the Prostate Cancer Centre. Prostate patients are usually seen there first and then may be referred to Tom Baker Cancer Centre for further discussion and possibly treatments. Chemotherapy and radiation therapy are not offered at the Prostate Cancer Centre. Orientation for New Patients The Orientation is the 1st appointment for patients who will receive care at Tom Baker Cancer Centre and at the Richmond Road Diagnostic and Treatment Centre. This session is very important 7 since it prepares you and your family for your consultation and the whole process of your care. Chemotherapy patients at Peter Lougheed Centre are encouraged to attend the Orientation soon after they have started their care at that Centre. This session offers you a detailed understanding of the care process, cancer treatments, supportive services, practical information, and how to cope with cancer. Orientations are held every Tuesday at 9:30 AM and every Thursday at 2:00 PM in the Tom Baker Cancer Centre Auditorium on the Main Floor. The sessions last for two hours. There are no sessions on national or provincial holidays. Patients are scheduled into this session, but you are encouraged to drop in at any session if you have somehow missed it. Your family members are also encouraged to attend. The goal of these Orientation sessions is to empower you with knowledge, to reduce your stress, and to help you actively and effectively participate in your care. Consultation The consultation is the 2nd appointment for most patients, although it may be the 1st appointment for some. Most consultations take place at one of three sites. The booking clerks will make sure you know where to go for your consultation: o At Tom Baker Cancer Centre in the Outpatient Unit o At the Richmond Road Centre in the Cancer Clinics o At Peter Lougheed Centre in the Outpatient Specialty Clinic We will give you an ID card with your file connection information on it. This card is very important. Remember to bring it with you for every appointment, and use the file number on it whenever you telephone or email staff members at the Cancer Centre. At the medical consultation, you meet with your cancer doctor for the first time – Oncologist (cancer specialist) or Hematologist (blood cancer specialist). Cancer doctors review your medical records and may examine you to assess the details of you cancer. If treatment is recommended, the doctor will offer you the best available treatments options, which are based on scientific evidence and the protocols established by the care teams. 8 You will need to make a decision about the treatments options presented. You are encouraged to ask questions to make sure you understand the choices clearly. Our doctors, nurses and other care professionals work together as teams to care for you. So, you may have more than just one doctor or nurse caring for your needs. The members of your team may change during the course of your care, but this change should not cause you to be concerned since they are all working together as a team for you. Treatment Preparation The designated treatment departments are notified of your treatment decisions, and they prepare to offer you the selected treatment or treatments You may have more tests, and possibly diagnostic imaging to gain more information to help the medical team direct your treatments We offer preparation classes for both radiation therapy patients and chemotherapy patients to let you know what to expect, how to prepare, and how to cope well through your treatments. Treatments Most treatments take place at the Tom Baker Cancer Centre location, but we also offer chemotherapy at Peter Lougheed Centre. The main treatments we offer include: Surgery – Most surgeries are not performed at the Cancer Centre, but our doctors and other professionals monitor and influence the surgeries that take place in the hospitals. Many patients are directed to have surgery before they come to the Cancer Centre. Surgeons play an important role in fighting many types of cancer 9 by removing as much of the cancer as possible. Surgery is often a first step in treatment, but it can play a role later on. Sometimes other treatments are recommended before the surgery, and sometimes further surgery is needed. Certain types of day surgeries are performed at Tom Baker Cancer Centre, but most surgeries are performed in the operating rooms of hospitals. The Cancer Centre works in connection with the hospitals for your care. Most patients who have surgery receive additional treatments to try to help destroy as many cancer cells as possible. Radiation Therapy – The most common type of radiation therapy is called external beam radiation therapy. For this procedure, we direct high energy beams of radiation at the cancer site to attack cancer cells. The radiation energy is produced by a machine called a linear accelerator. For most patients, the radiation affects only the treated area, not the whole body, but it is possible to treat the whole body when necessary. The treatments take place in one of the 10 treatment units of the Radiation Therapy Department on the Basement Floor and are set up and controlled by Radiation Therapists. Some patients need only one big treatment, but many short treatments work best for most patients. For these short treatments, you would most likely come to the Cancer Centre 5 days a week for 3 to 8 weeks in a row. But you are only in the treatment room for about 15 minutes each time, and the treatment itself is usually only one to two minutes long. Most patients who have radiation therapy experience some fatigue and also some localized side effects such as sore skin. Most of these side effects are very manageable, and we work with you to help you cope well. You are not radioactive following your external beam treatments, and most patients are able to leave right after their treatments. o Internal radiation therapy, called brachytherapy, is also an option for some patients with prostate, breast, cervical and uterine cancers. In these cases, we place sealed radioactive substances in or near the cancer site in a very controlled way to attack the cancer cells. This technique allows a high dose of radiation to be directed to a concentrated area in a short period of time. 10 o Thyroid cancer patients usually receive systemic radiation therapy where they drink a liquid radioactive substance that travels through the body and works to attack the cancer cells in the thyroid area. Chemotherapy – For chemotherapy treatments, we give you drugs designed to target and attack your cancer cells. Cancer cells tend to divide and multiply more rapidly than normal cells. Most chemotherapy drugs work by attacking these cancer cells when they are dividing because they can most easily be stopped during that process. We give you these drugs by pill or IV, depending on the type of drugs you need and the best way to get them into your system. Chemotherapy is called a systemic therapy since the drugs travel throughout your body to attack the cancer cells. Some of your normal cells, the ones that multiply most rapidly, will also be affected by the chemotherapy drugs, so you can expect to have some side effects for a period of time. We work closely with you to manage these side effects, and most patients cope well through their chemotherapy treatment experience. o At Tom Baker Cancer Centre, our highly trained nurses give you IV treatments in the Medical Day Care Unit on the Ground Floor. o At Peter Lougheed Centre, our nurses provide you with treatments in the Treatment Room on the Main Floor, down the hall from the Outpatient Specialty Clinic. o If you are taking your chemotherapy in pill form, you will pick them up at the Pharmacy at one of two sites – Tom Baker Cancer Centre on the Ground Floor or at the Richmond Road Centre on the 1st Floor. These pharmacies at Tom Baker and at Richmond Road are specific for cancer care drugs. Immunotherapy (Biological Therapy) – Your immunity system not only fights off germs and viruses, but it can also help to fight off cancer cells. For immunotherapy, we may give you vaccines to help prevent some types of cancer, or give you drugs to boost or modify your immunity system to help fight existing cancer. We use this type of therapy for early stage bladder cancer, for selected cases of breast cancer, and sometimes for melanoma skin cancer, 11 kidney cancer and lymphoma. If offered for somebody with cancer, it is usually in combination with other therapies. Hormone Therapy – Some types of breast cancer and most types of prostate cancer are affected by the hormones produced naturally in our bodies. Since the hormones can “feed” the cancer, we often need to reduce the production of hormones, or block the hormones from reaching the cancer cells. For this treatment, we generally give you pills or injections that work to reduce the production of your hormones or block them from reaching the cancer cells. Stem Cell Transplants (Blood and Marrow Transplants) – Stem cell transplants are intensive treatments that we use to treat some patients with cancers of the blood or the lymph systems such as leukemia, multiple myeloma and lymphoma. We use transplants to treat some other cancerous and non-cancerous diseases as well. There are different types of stem cells, but the type we are talking about here are immature (“baby”) blood cells that can form into whatever type of blood cells are needed in your body. Blood-forming stem cells are found mostly in your bone marrow, where they are produced. A transplant replaces the stem cells in your bone marrow after the original ones are damaged or destroyed by treatments to attack your cancer. When we use a patient’s own stem cells, the procedure is called an autologous transplant. If we use a donor’s stem cells, it is called an allogeneic transplant, or syngeneic when the patient’s twin is the donor. The type of transplant is dependent on the type of disease being treated. Mobilizing blood stem cells is a procedure we use to increase the number of stem cells that your marrow produces and then move them into your blood as it circulates. Once a large number of these stems cells have moved into your blood, we can collect them from the blood. In most cases, we gather the needed stem cells from your blood. However, we occasionally harvest some of the bone marrow itself to get the stem cells. There are two main reasons why we use a stem cell transplant. If the bone marrow is producing bad blood, 12 such as in leukemia, we may need to eliminate the patient’s own stem cells from the bone marrow and replace them with donor stem cells to enable the body to produce healthy cells. This is referred to as an allogeneic transplant. To prepare a patient for this transplant, we use strong chemotherapy and/or radiation therapy treatments to destroy the stem cells in the bone marrow, since they are cancerous. When these treatments are completed, the harvested stem cells from the donor are infused into the patient. Once the new stem cells have engrafted into the bone marrow, they start to produce new blood cells. These new blood cells will not only develop your bone marrow so it can keep on producing good stem cells, but they also have an immune effect that can help fight off cancer cells in your blood. Finding a donor involves looking for a related donor from your family, usually a brother or sister. However if there is no sibling match, we begin a search for an unrelated donor in the world-wide registry. We offer an autologous transplant for cancers such as lymphoma and multiple myeloma. For this procedure, we collect stem cells from the patient himself/herself and then freeze the cells (cryopreservation). The patient then receives a very strong dose of chemotherapy to treat the disease. The stem cells are then given back to the patient to “rescue” the bone marrow so it can keep producing these stem cells which later turn into blood cells. This rescue is necessary because the strong chemotherapy may have caused damage to the bone marrow making it unable to fully recover. For all types of stem cell transplantation, patients need to go through extensive conditioning and recovery over a period of several weeks. For the actual treatment, patients generally stay in 13 the hospital for about three weeks. The transplant program we offer here is highly rated and often very successful in treating the cancer. In Alberta, autologous stem cell transplants for all Southern Alberta patients and all allogeneic stem cell transplants in the province are performed in Calgary at Tom Baker Cancer Centre in collaboration with the Foothills Medical Centre. The program here is one of the two biggest programs in Canada for these types of treatments. We assist patients from other parts of Alberta to make arrangements to be in Calgary for several weeks of preparation, treatment and follow-up. We offer some of the preparation and follow up care for stem cell transplant patients in other Cancer Centre locations, such as the Cross Cancer Institute. We do whatever we can to provide patients with the necessary care close to their home, when possible. If you are a candidate for a stem cell transplant, you will receive much more detailed information and instructions from our care providers in the Blood and Marrow Transplant Clinic on the Ground Floor of Tom Baker Cancer Centre. Treatment Considerations Most treatments have side effects, but these can usually be managed well. The care teams work with you to monitor and manage your side effects. More tests, imaging and consultations take place at certain times during your care to monitor the effectiveness of the treatments. Treatments may be modified, or new treatments may be added, depending on your needs. Many patients have a combined therapy of more than one type of treatment. For many patients, the goal of treatments is a cancer cure. If a cure is not expected, we may provide you with treatments to help slow down or contain the cancer as much as possible and/or to control the cancer symptoms. 14 Continuing Care Ideally, the treatments are effective, and you can stop having treatments. For a period of time after the treatments are over, you will return to Tom Baker Cancer Centre, the Richmond Road Centre, the Foothills Hospital or Peter Lougheed Centre for follow up with more tests, imaging and discussions with your care team. If the cancer does not recur, then you will most likely be released from the care of the Cancer Centre into the care and monitoring of your family doctor. If the cancer does recur, then our cancer specialists determine the best additional treatments to offer, and you make decisions about the treatment options offered. Even if cancer recurs, effective control may still be possible with further treatments. Even when the cancer does not recur, some patients continue to have treatments, such as hormone treatments, for several years to help keep the cancer from recurring. For some patients, cancer becomes a chronic condition where it is controlled through ongoing treatments, but it never fully goes away. Many of these patients are able to live actively and fully. In cases where no cure is expected and the cancer will most likely progress, patients are considered palliative. We offer these patients special attention to help them live the best quality life possible under the circumstances. There are many supportive services and facilities in Calgary and Southern Alberta to help patients and families with their specific needs and wishes. 15 Main Floor – Tom Baker Cancer Centre What You Will Find See illustrated floor plan Main Reception 403-521-3723 Welcomes and directs patients This area includes the Department of Health Information Management. This department takes on the following important roles for you: o Collects and keeps track of medical records o Sets up consultation appointments for new patients o Registers new patients and makes red ID cards o Books follow-up appointments (but not treatment appointments which are booked from the treatment areas) Psychosocial Resources 403-355-3207 In this department, you will find help to deal with the emotional, psychological and social stresses of dealing with cancer. Here you will find: o Counselling for patients, couples and families o Help with your finances and other basic needs o Support groups for several types of cancer such as breast, ovarian, lung and colorectal (men’s group) o Programs to help you deal effectively with stress such as mindfulness meditation and stress management 16 The staff of the psychosocial department are trained professionals in social work, psychology and psychiatry. There is no charge for counselling and most programs offered by the Psychosocial Resources department. For more details about the many helpful services of this department, take a brochure called Counselling and Support from one of the many pamphlet racks in the care areas. In addition to their clinical work, psychosocial staff are actively engaged in research and educational activities that promote the development of new knowledge. They then use this new information to develop new practices and programs to benefit patients. Clinical care is therefore guided by the best evidence. Knowledge Centre (Library) 403-521-3765 Specializes in books and journals on cancer care, treatments, research and supportive care. The front area of the Knowledge Centre is specifically for patients and family members. You can check out materials and take them home. Staff can help you search and find specific cancer information in books, journals, and from electronic sources such as the internet. The Knowledge Centre is managed by the University of Calgary. Auditorium Large, theatre-style auditorium where patients attend New Patient Orientation and several other educational presentations and discussions. 17 Alberta Cancer Foundation 403-521-3433 www.albertacancer.ca The Alberta Cancer Foundation is a positive movement of those who know something can be done about cancer and are willing to do it. The Foundation is the fundraising arm of Alberta Health Services – CancerControl, but it is managed independently. Welcomes donations that are directed into patient support programs, cancer prevention, education and research here in Alberta. Coordinates major fundraising events such as the Weekend to End Women’s Cancers, the Underwear Affair and the Ride to Conquer Cancer. Note that the Alberta Cancer Foundation is not connected to the Canadian Cancer Society, which is a separate national organization working to support cancer patients. Funds donated to and raised by the Alberta Cancer Foundation stay in Alberta for cancer support and research here. Volunteer Services 403-944-1336 Central meeting and coordination area for hundreds of volunteers who serve patients at Tom Baker Cancer Centre and the Foothills Medical Centre. Volunteers generously give their time and energy to help patients find their way, to serve them refreshments, to prepare patient information packages, to operate the Gift Shops, as well as hundreds of other necessary tasks. Spiritual Care 403-521-3352 Spiritual Care Professionals coordinate spiritual care support and programs for patients and family members. They consult with patients to help clarify and meet their spiritual needs. Welcome opportunities to talk with patients and support them in whatever belief system they prefer. Perform various types of spiritual services and ceremonies, when requested. 18 Department of Oncology Private work offices of the many Oncologists (Cancer Specialists) who consult with patients and treat them. Most consultations take place in the clinical areas, not in these private offices. Ground Floor – Tom Baker Cancer Centre What You Will Find See illustrated floor plan Outpatient Unit 403-521-3740 Main consultation area at Tom Baker Cancer Centre where patients meet with their cancer doctors and nurses. Treatments do not take place in this area, but doctors consult with patients to determine their treatment needs. If treatments are needed, the doctors then provide treatment options and recommendations. Some appointments to monitor and guide the treatment process take place in this area as well. Laboratory Convenient place to go for your blood and specimen tests, right beside the Outpatient Unit. X-Ray, CT Scan and Ultrasound Tests This imaging centre is next to the beige-coloured elevators. You may be directed here for some of your imaging tests such as x-rays, CT scans and ultrasound tests. MRI imaging is done one floor down, on the Basement Floor. Social Workers – Resource Counsellors 403-355-3207 Social workers, called Resource Counsellors, are here to help patients with their financial and other basic needs. The best way to meet these Resource Counsellors and to get help is to show up at Room CCB 20 on the Basement Floor any Wednesday at 9:30 AM. At that time, they will show you a presentation called “How to Get Help for Your Finances and 19 Other Basic Needs” and then discuss how they can help you specifically. Pharmacy 403-521-3764 This pharmacy is for your main cancer treatment drugs, most of which are covered by your provincial health care insurance. You will need to go to a regular pharmacy to fill your other prescriptions. Specializes in cancer treatment drugs in pill and liquid form. Distributes treatment pills to patients and also prepares the treatment fluids for IV chemotherapy. Prepares information sheets on each type of drug to help patients understand important facts about the drugs and know what side effects are possible. Nurses usually give you these sheets about your drugs shortly before your treatments begin. Medical Day Care Unit (for Chemotherapy Treatments) 403-521-3303 – Appointments and Scheduling for Chemotherapy 403-521-3735 – Chemotherapy Symptoms (8 AM to 4:30 PM) 1-866-238-3735 – Toll Free for Out of Town Patients Provides IV chemotherapy treatment for patients. Provides extensive support for chemotherapy patients to help you manage the side effects you may experience during your treatments. Also includes several consultation rooms where you may meet with your care providers. 20 Provides supplies, drugs, instruction and support for selected patients who take a special chemotherapy pump home where they receive their treatment continuously over a few days. Blood and Marrow Transplant Clinic 403-521-3463 Provides comprehensive before and after transplant care for patients undergoing stem cell transplants. The actual transplants take place on Unit 57 of the Foothills Hospital, located on the 5th floor, above Tom Baker Cancer Centre. Basement Floor – Tom Baker Cancer Centre See illustrated floor plan What You Will Find Radiation Therapy Reception 403-521-3771 Stop and check in here for your first radiation therapy appointment. You will then be directed to the designated area for your care. This reception can also answer your questions about the radiation treatment areas and help you find your way. Simulator Procedure Area Here patients receive advanced imaging tests in preparation for radiation therapy. Radiation Therapists then use this detailed information to plan and provide radiation treatments. Much of the preparation for treatments is then done in the Treatment Planning area by Radiation Therapists using sophisticated computer programs. Cast and Mould Area In this area, Radiation Therapists make customized casts, moulds and mesh positioning devices to help position some radiation therapy patients for treatments. These positioning devices are necessary mainly for patients having treatments in their head or neck area. 21 Radiation Therapy Treatment Units 403-521-3771 10 treatment units provide patients with precise radiation treatments. These units are equipped with radiation treatment machines called linear accelerators and staffed by highly trained Radiation Therapists. We can treat around 250 patients a day here with radiation therapy. Alberta Radiosurgery Centre 403-521-3800 First place in Canada to offer dedicated stereotactic treatments for brain tumours and other body areas requiring extreme precision. In stereotactic radiotherapy, very precise beams of ionizing radiation are directed at a specific point to deliver the radiation treatment. Can be especially effective for cancer that has spread to the brain from another part of the body. Patient Day Room This room is a place where we offer supportive procedures and care after radiation therapy treatments. Radiation Therapy Nurses take care of patient needs in this room. Most radiation therapy patients do not need to use this room, but it is available for anyone who needs special attention. 22 Medical Physics Physicists in this area work very closely with the radiation doctors and therapists to set up and maintain the radiation treatment machines and other related equipment. The physicists also use certain specialized procedures to set up and monitor scientific calculations that are necessary for the procedure to be safe and effective. The physicists are continually testing and researching scientific methods to improve the effectiveness of radiation treatments. Operating Room This operating room is used only for selected day surgical procedures to treat certain types of cancer. Most surgeries are performed in hospitals in Calgary and area. Clinical Research Unit 403-521-3140 The clinical research program is a team of doctors, nurses, pharmacists, therapists and scientists who direct and coordinate around 350 clinical trials now underway at Tom Baker Cancer Centre. There are four main types of clinical trials: o Cancer prevention o Cancer screening o Cancer treatments o Supportive care Some considerations for you: o Participation in a trial is voluntary. o You will not be paid to participate. o You may or may not benefit directly by participating in a trial, but you are making a great contribution to our understanding of the effectiveness of prevention, screening, treatments or supportive care. o You will not be neglected on a trial. You will not receive a placebo if you actually need treatment. You will most likely receive either the regular treatment, or the new treatment to help determine which one works best. But the details of the trial will be explained to you so you can make an informed decision. 23 o If you are interesting in participating, speak to your doctor and nurse at your next appointment. o If you are eligible, you will be directed to the appropriate team of care providers and researchers. This department works with your other care providers to provide you with information about clinical trials and then work closely with those who choose to participate. This team studies the patterns of data from clinical trials in a continual quest to find more effective cancer treatments. Richmond Road Diagnostic and Treatment Centre What You Will Find Cancer Clinics Location: 1820 Richmond Road SW These clinic areas on the 1st and 2nd Floor are where around 70% of new patients come for their initial consultation and follow-up appointments. The others are seen at Tom Baker Cancer Centre. These clinics are primarily an extension of the Outpatient Unit at Tom Baker Cancer Centre and are needed to provide quality space for these important consultations. You will find a Pharmacy for cancer treatment drugs on the 1st Floor of this building. Certain educational classes are held in the meeting rooms at this site. 24 Rehabilitation and Lymphedema Program 403-476-2448 This program provides physiotherapy and occupational therapy for cancer patients o Specializes in lymphedema management o Helps patients with post-surgery range of motion, axillary cording, and pain management o Also helps patients with post-radiation range of motion Peter Lougheed Centre What You Will Find Peter Lougheed Centre provides cancer care for people from Calgary as well as other parts of southern Alberta, British Columbia and Saskatchewan. The outpatient chemotherapy treatments offered here are managed by Tom Baker Cancer Centre. We are committed to providing excellent patient care and are proud of our friendly community atmosphere. The cancer care provided here is mainly for patients with blood related types of cancer. 25 Outpatient Specialty Clinic 403-943-4149 Appointments and Scheduling for Treatment 403-943-4592 This is the main consultation area at the Peter Lougheed Centre where you go to meet with your cancer specialists and nurses. If treatments are required, you will receive them down the hallway from the clinic in the Treatment Room. Laboratory 403-943-4637 Laboratory Services are located on the Main Floor of the Peter Lougheed Centre. You may go to the lab to have blood or other specimen tests. The lab is open 7 AM to 5 PM, Monday to Friday. Diagnostic Imaging 403-943-4570 Located on the main floor at the Peter Lougheed Centre. This area is where you may be directed to go for imaging tests such as CT scan, MRI, X-Ray or ultrasound. Outpatient Pharmacy 403-943-4985 The pharmacy is where you will pick up your prescription medications. The helpful staff members are available to provide you with information about your drugs, cancer treatments, and side effects. The pharmacy is open 8 AM to 5 PM, Monday to Friday and is located down the main hallway from the Specialty Clinics area. Social Work 403-943-2514 Social workers are available to help you with the challenges of cancer care such as illness adjustment, coping, and psychosocial or financial concerns. Spiritual Care Services 403-943-4585 26 The Sacred Space is located on the Main Floor of the Peter Lougheed Centre and provides a space for multidenominational services, meditation, and quiet reflection. It is open 24 hours per day, 7 days a week. Spiritual care coordinators are also available to offer support and clarify spiritual needs. Inpatient Unit 38 403-943-6638 Unit 38 is located on the 3rd floor of the brand new East Tower at the Peter Lougheed Centre. This is where you may be admitted if you require inpatient care. Covering the Costs of Cancer Care If you are an Alberta resident, Alberta Health Care covers the cost of your examinations and most treatments at Tom Baker Cancer Centre, the Foothills Hospital and Peter Lougheed Centre. There is no extra charge for radiation therapy or most drugs used for chemotherapy, immunotherapy or hormone therapy. However, in some cases a doctor may suggest the use of a drug that is not covered by Alberta Health Care at this time. If this is the case with you, and you agree to be treated with the suggested drug, we will work with you to try to find supportive funding, but most of these extra costs would still be your responsibility. Most other provincial health care plans also cover your cancer treatments in Alberta for a period of time. If you are from another province and do not have Alberta Health Care, discuss this issue with staff at Main Reception. They will advise you on the best way to plan your coverage. Alberta Health Care does not cover prescription drugs for such needs as side effects and pain. You should expect that you will need to use 27 some prescription drugs at least for side effects. We strongly advise you to get drug coverage by Alberta Blue Cross, unless you already have other private health insurance. Seniors’ Coverage o Comes into effect for you when you turn 65 years of age in Alberta. o Offers $25,000 worth of coverage for prescription drugs and other types of care. Non-Group Coverage o Only for those people younger than 65 years of age. o Offers good individual coverage, rather than group coverage. o Offers $25,000 worth of coverage for prescription drugs and other types of care. o Can get it even if you already have cancer. o Takes 3 to 4 months to get after you apply, unless you are switching from another Blue Cross plan. o Generally costs $63.50 a month, but you can apply to have this cost reduced if your income is low. Contact Alberta Blue Cross o 403-234-9666 – Calgary and area o 1-800-661-6995 – toll-free o www.ab.bluecross.ca 28 Other Supportive Services for Patients and Family Members Interpretation Services You can request and receive interpretation services during your consultations. We want to make sure that you understand us, and we want to make sure that we understand you. The interpretation services are offered over a special telephone service called Language Line. Professional interpreters are available in over 200 languages at all times of the day and night. Our staff can call and connect to this service at any time. In some cases, we may need to move your consultation to another room since not all exam rooms are set up with the right type of telephone yet. If possible, let us know before your appointment if you would like to have an interpreter. Clinical Ethics Service 403-943-2821 – Provincial Clinical Ethics Service 403-521-3368 – Chair of the Clinical Ethics Committee Clinical Ethicists assist patients, families, clinicians, and administrators in identifying, examining, and resolving a wide range of ethical challenges that arise in health care. The Clinical Ethics Service provides support and guidance for patients, families and clinicians when there is no clear answer regarding the right thing to do. For example, choosing between two treatment options, refusing to be treated, or any other difficult decision that can affect patient care. The Clinical Ethics Service supports the TBCC Clinical Ethics Committee that consists of different healthcare professionals and members of the public. Patients and families can contact either the TBCC Clinical Ethics Committee or the Clinical Ethics Service for advice and consultation. Colposcopy Clinic and Nurse 403-698-8025 – Nurse 403-698-8031 – Colposcopy Appointments A colposcopy is a specialized method of examining the vagina and the cervix, using a colposcope, a high powered microscope. 29 A colposcopy is used to examine women who have had an abnormal pap test to determine if there are any tissue changes that could lead to the development of cancer if left untreated. Being scheduled for one of these tests does not mean that you have cancer. The nurse and care providers are based at Tom Baker Cancer Centre, but they meet patients at the nearby Women’s Health Centre for appointments. Dietitians (Nutrition) 403-521-3719 Offer patients information and support to help them find ways to eat well during their cancer care. Help patients deal with eating challenges. Teach regular classes for patients on nutrition. Patient Education Specialist 403-476-2445 Develops and coordinates educational support for patients and family members to help you actively and effectively participate in your care. Strives to provide you with the right information, at the right time, and in the right way so you are not confused and can make the best decisions. Presents an Orientation for New Patients every Tuesday at 9:30 AM and every Thursday at 2:00 PM in the Tom Baker Cancer Centre Auditorium. If you have missed this presentation, we strongly encourage you to come at any time. Provides you with educational support through printed materials, bulletin boards, classes, multi-media presentations, special education events, and by addressing individual patient requests. 30 Rehabilitation and Lymphedema Program 403-476-2448 Location: 1st Floor of the Richmond Road Centre This program provides physiotherapy and occupational therapy for cancer patients. o Specializes in lymphedema management Lymphedema is a swelling some women develop in their arms after breast cancer treatments, but this swelling can develop from various causes in several parts of our bodies. Come to a class where you will learn about reducing your risk of developing lymphedema and of the many types of support available to those with lymphedema. See the schedule called “Get Your Answers Directly from the Cancer Experts”. o Helps patients with post-surgery range of motion, axillary cording, and pain management. o Also helps patients with post-radiation range of motion. Social Workers – Resource Counsellors 403-355-3207 Social workers, called Resource Counsellors, are here to help patients with their financial and other basic needs. The best way to meet these Resource Counsellors and to get help is to show up at Room CCB 20 on the Basement Floor any Wednesday at 9:30 AM. At that time, they will show you a presentation called “How to Get Help for Your Finances and Other Basic Needs” and then discuss how they can help you specifically. Spiritual Care 403-521-3352 Spiritual Care Professionals coordinate spiritual care support and programs for patients and family members. They consult with patients to help clarify and meet their spiritual needs. Welcome opportunities to talk with patients and support them in whatever belief system they prefer. Perform various types of spiritual services and ceremonies, when requested. 31 Help Us to Help You – Patient Responsibilities Come to All of Your Appointments It is very important for your health and well being to show up for all of your scheduled appointments, education sessions and diagnostic tests. All appointments are designed to help you get the information and medical care that you need. If you cannot come to an appointment because of any reason, please call us as much in advance as possible to reschedule. But we don’t encourage you to change appointments unless it is absolutely necessary. Rescheduling may result in long delays in your care. Make Sure Your Phone Number is Not Blocked When we call you from Tom Baker Cancer Centre, our identity is blocked from your telephone to help ensure your medical privacy at your home setting. If your telephone service blocks phone numbers that are not identified, then we may not be able to reach you with important calls regarding your care. Please check your service and make sure that your telephone does not require an identity from the caller in order to reach you. If You are Sick, Let Us Know Let us know before you come to the Cancer Centre if you have any of the following symptoms: (call your specific care providers or department, when possible) o Fever o Sore Throat o New Rash o Diarrhea o Cold Symptoms o New Cough o Runny Nose Cancer treatments can temporarily weaken the immunity systems making it easier to catch a sickness. If we are not informed about your sickness ahead of time, it may put your health, or the health or others, at much greater risk. We care about you and other patients, especially when you are sick. We want the best care for everyone, so please let us know. 32 Please Don’t Wear Scents Scents such as perfumes and colognes may have a very pleasant smell to some people, but many patients and staff members are allergic to these scents and can have a bad reaction. Please don’t put on scents on the days you are coming to the Cancer Centre. If you forget, then please do your best to wash it off before you come. We appreciate your understanding and help. Be Active in Your Care You are the most important member of your care team, and we encourage you to actively participate in your care. Pay close attention to the process of your care and your discussions with care providers. If some aspect of your care does not seem to be happening the way that you expect, then please discuss your concerns with your care providers. We want to ensure that you are receiving all of the attention and care that you need. Take advantage of the many opportunities at the Cancer Centre to learn from cancer experts and from printed materials. There are many presentations for patients each week where you can learn details on how to eat during treatments, how to manage your tiredness, what complementary therapies may help you, as well as several other topics. Knowledge is power. Take advantage of the many supportive services the Cancer Centre offers for you. You can get financial help, talk with a counsellor about your emotions, get advice from a dietitian, receive spiritual support, and you can access many other services to help you cope well through your cancer journey. Respect the Privacy of Others Be sure to be very considerate in respecting the privacy of other patients and family members. If another patient is talking with a staff member or someone else, allow them to have a private discussion, unless you are invited to participate. Keep a respectful distance from reception desks when other patients are talking with the staff at the desks. Don’t share the identity of other patients with people outside of the cancer centre, unless they give their consent. 33 Your Rights – What You Can Expect From Us As a patient, you have a right to: Be treated with care, dignity and respect. Expect that your medical records be kept confidential Review your health records. Have your diagnosis, treatment options, prognosis and other information explained in clear and understandable terms (with the help of a medical interpreter for another language, when requested). Know the benefits and risks of a procedure or treatment offered to you. Decide whether you wish to be treated or not. If you refuse treatment, you will be informed of the likely medical consequences of your decision. Refuse to sign a consent form if you feel everything has not been clearly explained. You can cross out any part of a consent form that you do not want applied to your care. Change your mind about any treatment or procedure for which you have given your consent. Agree or refuse to take part in medical training and research programs. Change doctors or other care providers, when possible. Voice comments, complaints and concerns regarding the quality of the care and service you receive and know that this will not have a negative effect on your care. If you have a comment, complaint or concern, talk to the Patient Feedback Line at Alberta Health Services at 1-855-550-2555. 34 Taking Control – Your Role in Your Cancer Care Special Section 1 – Eat for Your Life This information is provided for you by our Registered Dietitians Eat Well for Your Healing – You need to eat well to nourish your body during your cancer treatment and recovery. Most cancer patients need more calories during cancer treatment, even if they are less active. Both the cancer and treatments tend to use up extra energy. It may help to think of food as a healing medicine during this time and eat enough to maintain your weight. If possible, follow Canada’s Food Guide to make sure you are getting all of the required nutrients. Experience the Benefits of Eating Well o Increase your energy o Improve your immune function o Prevent muscle wasting and maintain your strength o Lessen the side effects of treatment o Promote healing Prevent Weight Loss – If you are losing weight without trying, you may be losing strength to fight your cancer and heal. It is very important to maintain a healthy weight during your treatment and recovery. Adding extra calories and protein to your diet will help you maintain and/or gain weight and recover strength. You need to eat well even if you do not feel hungry. Try some of the tips below to improve your calorie and protein intake: o Eat more healthy high fat foods such as nuts, eggs and full fat dairy products o If you have trouble eating big meals, try eating several small meals every 2 to 3 hours instead o If you cannot eat enough food, try a nutritional supplement drink such as Boost Plus®, Ensure Plus® or a similar store brand to help meet your nutritional 35 needs. Talk to your dietitian for advice on which one is best for you. If you continue to lose weight, contact your dietitian as soon as possible. She or he will help you think of more ideas to maintain a healthy weight. Prevent Too Much Weight Gain – While extra weight is a factor in causing some types of cancer to develop or recur, it is not recommended to intentionally lose weight during your cancer treatments. If you are on a treatment that is increasing your appetite and you are gaining weight, ask your dietitian to help you with tips for weight maintenance. Limit Your Vitamin Pills – Studies show that too many antioxidants from pills may make your treatments less effective. o It is probably okay, and sometimes recommended, to take a multi-vitamin/mineral supplement. o It is usually not recommended to take single dose antioxidants, such as a vitamin E pill, during your treatments. Expect Some Treatment Side Effects – It is normal to experience some treatment side effects that affect your eating, especially with chemotherapy. They may include some of the following: o Decreased appetite o Taste changes o Dry mouth and thick saliva o Sore mouth and throat o Nausea and vomiting o Diarrhea o Constipation If you are experiencing any of these side effects, ask your nurse and/or dietitian for advice on how to deal with these effects. Get Advice from a Registered Dietitian – We have Registered Dietitians to help you eat well for your treatments and healing. We strongly recommend that you see a Registered Dietitian in at least one of the following ways: 36 o Attend a class called The Power of Nutrition – 1st and 3rd Wednesdays of each month at 10:00 AM in the Tom Baker Cancer Centre Auditorium. No pre-registration is required, so just show up. This class provides advice on eating well and gives you a chance to hear examples and ask questions. o Attend a class called Breast Cancer Nutrition – Soy, Supplements and More! – 2nd and 4th Fridays of most months at 1:30 PM in Room CC105 at Tom Baker Cancer Centre. This class provides specific breast cancer advice and a chance to ask questions. To confirm this class, see the schedule in the pamphlet racks called “Get Your Answers Directly from the Cancer Experts”. o Call a Dietitian at 403-521-3719 to talk on the phone or book a personal consultation. Note of Caution: This advice is general in nature and is not meant to replace the specific advice of your cancer care team. 37 Special Section 2 – Exercise for Your Life This information is provided for you by Dr. Nicole Culos-Reed from the Culos-Reed Health and Wellness Lab in the Faculty of Kinesiology at the University of Calgary. Exercise to Gain Great Benefits – Research shows that exercise provides many benefits to people with cancer, and that exercise is both tolerable and beneficial at all stages of the cancer experience. Exercise may help you cope better throughout your cancer experience and may significantly increase your chances of long-term survival. Experience Many Physical Benefits – Here are some of the benefits of exercising during cancer, as shown through research: o Improved heart and lung health o Improved strength o Improved joint mobility o Improved physical functioning o Improved immune functioning o Decreased fatigue (tiredness) o Decreased hospital time o Reduced treatment side effects o Reduced chronic or late-effects from treatments o Reduced risk of getting other diseases – exercise greatly reduces conditions such as osteoporosis, diabetes and heart disease o Greatly reduced risk of cancer recurrence – studies done so far for breast and colorectal cancer show reduced rates of recurrence by up to 50% for those who went on a brisk 45 to 60 minute walk about 6 days a week. Experience Psychological Benefits – These are some of the psychological benefits of exercise, as indicated by studies: o Improved quality of life o Improved self-esteem and body image o Enhanced coping skills o Reduced stress and anxiety o Reduced depression 38 Incorporate the 3 Types of Exercise to Get the Most Benefit o Aerobic Exercise – We recommend moderate to high intensity, 20 to 60 minutes, on 3 to 6 (most) days of the week. Examples are brisk walking, hiking, jogging, skiing, swimming, cycling and aerobics classes. During active treatment, light to moderate exercise may be more realistic for some patients and still offer benefits. We don’t want you to become exhausted at any time. o Strengthening Activity – We recommend moderate intensity strengthening activities of 8 to 12 repetitions per exercise, 1 to 4 sets, on 2 to 3 days a week. Examples are lifting weights, circuit training, conditioning classes, pilates, and higher levels of yoga. If you are using weights, choose weights that you could still lift again at the completion of the exercise, if you had to, but don’t overtire your muscles. o Flexibility Activity (stretching) – We recommend gentle stretching all days of the week for your upper and lower body, and holding each stretch for at least 30 seconds. Don’t forget to breathe while you stretch, and move into each position slowly until the point of a light pull, not pain. Find Something Enjoyable – Exercise may not sound appealing to many people, but think of it as “fun activity”. Find something you can enjoy doing and work it into your daily life. It often helps to find someone to be active with. Those who don’t have cancer should also exercise regularly since research shows it helps prevent cancer. Do What You Can – Some exercise is better than none, but more is better than some. Do as much as you can without going to any extremes. Studies show there are benefits even to small amounts of exercise. Each person will have different abilities, and this ability may vary from day to day during treatments. The effort put into exercise will be rewarded with benefits. Sit and Be Fit – Some people with cancer have limited mobility. For those who can’t walk much or at all, there is a 39 program on the PBS television station at 12:30 PM weekdays (Spokane based station) showing you how to get your exercise even if you can’t walk. Highly recommended for those who may think they can’t exercise. Other activities, such as swimming, may also be possible. Come to the Exercise Class – Plan to attend the regular exercise class at the Cancer Centre to learn more about the importance of exercise, as supported by research, and to get inspired on what to do and how to do it. This fun and interesting class is taught by a cancer and exercise researcher from the Culos-Reed Health and Wellness Lab in the Faculty of Kinesiology at the University of Calgary who explains and demonstrates what you can easily do. o Exercising for Your Life on the 1st Wednesday of most months at 1:30 PM in the Tom Baker Cancer Centre Auditorium. No pre-registration is required, so just show up. To confirm a class date, see the current class schedule in the pamphlet racks or call 403-476-2445. Note of Caution: Please consult with your doctor before beginning any exercise program, especially if you are receiving active treatment. You need to ensure there are no specific restrictions or considerations for you based on your health condition. Special Section 3 – Sleeping Well with Cancer and Beyond This information is provided for you by Sheila Garland who is a sleep researcher and educator in our Department of Psychosocial Resources. Sleep is Important – The average adult spends one-third of their lifetime sleeping. o Sleep plays a vital role in the restoration and revitalization of brain and body function. 40 Sleep is a Common Problem – Sleep disturbances affect 30 to 50% of people diagnosed with cancer. This figure is three times greater than that of the general population. Cancer CAN Affect Sleep – A diagnosis of cancer can place you at a higher risk for sleep disorders and negatively influence your sleep for the following reasons: o The psychological and emotional consequences of the cancer diagnosis itself. This may include feelings of stress, anxiety, depression, anger, worry and concern for family and friends. Our minds often turn to think about these feelings at night when our bodies are still and no other distracting influences are present. o Treatment-related effects Pain related to surgery or treatments can prevent you from falling asleep and cause frequent awakenings during the night. Chemotherapy treatment can have side effects including nerve and muscle problems, nausea and vomiting, dry mouth and mouth sores, all of which can make falling and staying asleep difficult. The use of steroids, such as prednisone, to combat treatment effects can make you feel energized and disrupt sleep, especially if taken in the evening. Hot flashes related to menopause or hormonal medication can cause frequent awakenings. A frequent need to use the bathroom during the night. Disrupted sleep can worsen your treatment-related daytime fatigue. o Long-term adjustment The disruption of your daily routine while in treatment can make it difficult to return to normal functioning. Residual treatment effects, such as pain and fatigue, may negatively impact your ability to engage in previously enjoyed activities. 41 Worry about cancer recurrence. Follow These Guidelines to Sleep Well with Cancer… and Beyond o Determine how much sleep you need. Note that this may increase during times of illness and recovery. Sleeping 8 hours per night is not ideal for everyone. It is normal for sleep needs to vary between 6 and 10 hours. Reflect on the past to determine what you regularly achieved before you had difficulty sleeping, or keep a sleep diary to calculate your current sleep ability. o Set a wake up time that you can keep consistent 7 days per week. Your wake up time will help determine what your bedtime will be. For example, if you regularly achieve 7 hours of sleep and you choose 7:00 AM as your wake up time, your bedtime will be 11:30 PM, allowing for some time to fall asleep. o Give yourself a sleep “buffer zone” of at least 90 minutes before your designated bedtime. Your buffer zone should be dedicated to sedentary, pleasant and relaxing activities that can be performed in dim light (light exposure is a very powerful sleep cue!). Some examples include listening to music or relaxation audio, journaling, and reading with a lamp or reading light. The lighting from computer and electronic devices can be especially confusing to the structures of your brain that regulate sleep. Avoid using the computer or any other electronic devices that are backlit, such as iPads, during your buffer zone. It is IMPORTANT that your buffer zone be in a place other than your bedroom. o Try not to go to bed before you are sleepy, regardless of what the clock says. It may take some practice to determine whether you are actually sleepy, versus bored or fatigued. This will prevent the bed/bedroom from being associated with anything other than sleep. o Reserve your bed for sleep and sexual activity only. Engage in activities, such as watching television, in other areas. o If you have difficulty sleeping after about 15 to 20 minutes after going to bed, get out of bed and return to the area 42 you use for your buffer zone. In order to determine whether to get out of bed, ask yourself “Am I more likely to fall asleep now than I was 15 minutes ago?” If the answer is yes, stay in bed; if the answer is no, return to buffer zone activity. Return to bed when sleepy. What about Naps? o Napping is sometimes required in periods of recovery. Try to limit naps to 30 minutes and try not to nap after 3:00 PM. Naps are not disruptive if you are still able to fall asleep at your regular time in the evening. If you have difficulty falling asleep at night, try to eliminate napping. You May Need to See a Sleep Specialist o If you have ever been told that you stop breathing when you sleep, wake up feeling like you are choking, or experience headaches, dry mouth or sore throat upon awakening. o If you experience tingling, twitching or a creepy-crawly sensation in your legs that interferes with falling asleep. o If you unintentionally fall asleep in unsafe situations, like driving a vehicle. o If you experience any other sleep behavior that is concerning to you or your family members. Get Specific Advice on Sleep o For further information about sleep and cancer or to inquire about diagnostic/treatment options, attend a Sleeping Well with Cancer and Beyond class. It is held on the 3rd Thursdays of most months at 10 AM in the Tom Baker Cancer Centre Auditorium. To confirm a class date, see the schedule called “Get Your Answers Directly from the Cancer Experts” in our pamphlet racks or call 403-476-2445. o Contact the Department of Psychosocial Resources at 403-355-3207 to meet individually with one of their team members. Note of Caution: This advice is general in nature and is not meant to replace the specific advice of your cancer care team. 43 Reliable Cancer Websites www.albertahealthservices.ca This extensive website covers a wide range of detailed information about health services in Alberta. It is the official website for our provincial health care facilities and options for care, as well as news, issues and events. To access information about Tom Baker Cancer Centre, type in our name in the Search bar at the top of the home page. You will then be linked to our information. Currently, there is limited information on this site about cancer care in Calgary and area, but we will be continually adding information to this site. myhealth.alberta.ca New patient portal for healthcare in Alberta. Includes extensive information on health. In the future, this site will allow you to access your medical records online. www.cancer.ca The extensive website of the Canadian Cancer Society Offers information on most types of cancer and treatments, as well as supportive information on dealing with cancer. You can see and download brochures and booklets on most cancer topics from this site. Offers information on the many special services of the Canadian Cancer Society that patients may find helpful. On this site, you will find cancer information in many languages. www.cancer.org The award-winning site of the American Cancer Society. Offers information on most types of cancer and treatments and includes helpful information on dealing with cancer. The information is directed primarily to an American audience, but most is relevant to Canadians. www.cancer.gov/cancerinformation Excellent and up to date information from the National Cancer Institute (NCI) in the USA. 44 All medical information is based on current research and is approved by medical experts. Information includes coping with cancer, clinical trials, new cancer drugs, and cautions about unreliable therapies. www.oncolink.org OncoLink – an excellent site from the University of Pennsylvania. Is regularly reviewed by medical experts and has won awards for its high quality medial information. Covers most topics of interest to cancer patients and families. www.cancer.net/portal/site/patient CancerNet for people living with cancer – a very helpful site for patients and family members from the American Society of Clinical Oncology (ASCO). It includes cancer and treatment information, discussion groups and coping strategies. Information on Clinical Trials for Cancer www.canadiancancertrials.ca Here you can find detailed information on clinical trials for cancer being conducted at various locations in Canada. www.clinicaltrials.gov This site lists and gives you information about cancer trials being conducted in the United States and around the world. Here you can find information about a trial’s purpose, who may participate, locations, and contact information for more details. It is best to use this site along with advice from your health care team. A Few Helpful Canadian Cancer-Specific Sites The sites listed above are the best overall sources of information for most types of cancer. These sites below offer additional information and support for some Canadian patients and family members. www.bladdercancercanada.org Bladder Cancer Canada 45 www.braintumour.ca Brain Tumour Foundation of Canada www.colorectal-cancer.ca Colorectal Cancer Association of Canada www.cnetscanada.org Carcinoid and NeuroEndocrine Tumour Society of Canada www.dermatology.ca Canadian Dermatology Association www.kidneycancercanada.ca Kidney Cancer Canada www.lymphoma.ca Lymphoma Canada www.lungcancercanada.ca Lung Cancer Canada www.melanomanetwork.ca Melanoma Network of Canada www.myelomacanada.ca Myeloma Canada www.SouthernAlbertaMyeloma.org Southern Alberta Myeloma Patient Society www.oneball.ca Calgary guys getting together to fight testicular cancer www.ovariancanada.org Ovarian Cancer Canada www.pccncalgary.org Prostate Cancer Canada Network Calgary www.prostatecancercentre.ca Prostate Cancer Centre www.llscanada.org The Leukemia and Lymphoma Society of Canada 46 www.tctca.org The Canadian Testicular Cancer Association www.thryvors.org Canadian Thyroid Cancer Support Group (Thry’vors) Inc. Special Sites for Specific People and Needs www.bcscf.com Breast Cancer Supportive Care Foundation – a Calgary clinic designed to help patients achieve their best health and wellbeing – physically, mentally, emotionally, socially and spiritually Here, specially trained doctors, nurses, psychologists and psychiatrists provide personalized care for breast cancer patients and family members Services are free of charge A doctor’s referral is best, but self-referrals are accepted www.wellspringcalgary.com Wellspring Calgary – A Lifeline to Cancer Support – a big beautiful facility near Tom Baker Cancer Centre where you can go to get free cancer support and make friends. www.youngadultcancer.ca Young Adult Cancer Canada – a great organization helping young cancer patients connect and deal with unique issues. www.cancerbridges.ca How to Live Your Best Life with Cancer and Beyond – a new site about how to survive cancer well – this program is based at Tom Baker Cancer Centre – see helpful videos and get great support information. www.CaringBridge.org This is an internet site that will help you set up your own free, personal, private website that supports and connects you to your loved ones during your cancer experience. Your loved ones can leave messages on it for you too. www.virtualhospice.ca This new site provides very helpful information and support to patients with progressive cancer and their families. 47 Here you can get help for dealing with symptoms, emotional needs, spiritual needs, caregiving, and decision making. Please direct any comments about this booklet or any suggestions for updating it to Loring Gimbel, Patient Education Specialist, at 403-476-2445 or [email protected]. 48 Alberta Health Services Cancer Care Centres Fort McMurray Community Cancer Centre Peace River Community Cancer Centre Fort McMurray Peace River Grande Prairie Cancer Centre Grande Prairie Bonnyville Community Cancer Centre Barrhead Community Cancer Centre Bonnyville Barrhead Hinton Community Cancer Centre Hinton Cross Cancer Institute Drayton Valley Community Cancer Centre Lloydminster Community Cancer Centre Edmonton Camrose Community Camrose Cancer Centre Drayton Valley Lloydminster Central Alberta Cancer Centre Red Deer legend North Zone Edmonton Zone Calgary Zone Central Zone South Zone Community Cancer Centre Associate Cancer Centre Tertiary Cancer Centre Bow Valley Community Cancer Centre Tom Baker Cancer Centre Calgary Canmore Drumheller Community Cancer Centre Drumheller High River Community Cancer Centre High River Margery E. Yuill Cancer Centre Jack Ady Cancer Centre Lethbridge Medicine Hat Richmond Road Diagnostic & Treatment Centre Google Maps Tom Baker Cancer Centre 13th Avenue Enter Here Public Parking Lot 8a S W Tom Baker Cancer Centre Special Services Entrance Building 29th Street N.W. Toronto Crescent Crosswalk Parking Map South Tower Basement Entrance 2 Hour Free Parking Lower Level Entrance North Tower Public Parking Lot 1 N Foothills Hospital Heliport McCaig Tower Public Parking Women's Health Centre Staff Parking Lot 8 E Heliport Public Parking Health Sciences Centre 29th Street N.W. Hospital Drive Staff Parking Lot 7 ital osp Public Parking Lot 6 H 16 . e N.W enu th Av e Driv
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