The Importance of Mental Healthcare during Cancer TreatmentBy Pal Chris, USA When I was diagnosed with cancer in 2004 I assembled a team of professionals to help me stay healthy and fight hard. Unfortunately, I forgot to include an important team member. Now, seven years, later I’m realizing the need for one particular critical member of that team. I was diagnosed on Christmas Eve 2004 with Mucinous Adenocarcinoma of the Appendix. I soon discovered the PMP Pals’ Network and found a wealth of resources including surgeons and oncologists. I was introduced to Pal Mentors to help me through the process of preparing for medical treatment. Being a young man, I didn’t seriously take the need to include a mental health professional on my team. Looking back, it’s obvious that, with my wife being pregnant and me having such an aggressive upcoming surgery, that I would need to set aside time to talk to someone about my fears. My strategy in the past has always been to buckle down and do what needs to be done to get through challenges. But cancer is a challenge like no other! Successfully navigating these waters requires as much sage counsel as you can get! I was able to navigate significant chemo and HIPEC surgery and today am blessed to remain free of disease. However, after my medical treatment was completed I never properly dealt with my fears and I wasn’t thinking clearly. My unresolved feelings led me to make poor decisions, causing my wife and I to grow further and further apart. Five years later, we were nearly divorced. At the end of my rope, I finally sought counseling from my church and psychological professionals. It was only through this help that I began to see how much work my family needed emotionally. Thus began a new journey to bring emotional health to me and my family. My wife and I now continue to see a therapist once a week. I’ve found good men in my church to provide wise insight; their advice is helpful, as our family has grown to include two daughters, now ages 7 and 4. My family continues to make progress, as we work on strengthening our emotional health daily. I urge anyone beginning the journey of cancer treatment to immediately include a professional counselor on their healthcare team. A psychologist can be a sounding board, listen to your fears, provide advice and help you address the challenges of balancing family life with cancer treatment. We are fortunate to have Pal psychologist, Dr. Larry Lachmanon the PMP Pals’ Network team. Consider consulting with him, or another licensed professional counselor in your hometown. It’s hard to think clearly when you’re fighting for your life. Invest in obtaining professional counseling. Your family is worth this investment! Articles posted in PMP Pals and on www.pmppals.org are written from the perspectives of patients and their families and are not intended to substitute for licensed, professional legal or medical advice. Each patient is unique and should seek specific counsel from their own licensed healthcare professional. Copyright © 2012 by the PMP Pals’ Network. All rights reserved. Derechos de PMP Pals Network@2012. Todos los derechos reservados.
Is it worth it to have Appendix Cancer Surgery? CL from the USA asks: “I am scheduled for CRS and HIPEC this summer. I am scared to death about this surgery. What I've read on the “support group” message boards makes it seem pretty scary. Is it worth it to have this surgery?” PMP Pals responds: “We understand your concerns, as nearly every patient participant *in the PMP Pals’ Network is a “veteran” of the medical procedure that has been scheduled for you. We also understand your hesitancy after reading postings from online “forums” and “blogs.” The PMP Pals’ Network neither hosts nor endorses any of these online “support group.” While “veteran” Pal participants fully understand the challenges of preparing for and recuperating from surgery, we embrace the philosophy that recuperation is a temporary challenge and one that will be overcome during the coming weeks and months. We choose to promote a positive attitude towards modern medical treatment, as is evidenced by the legions of smiling faces posted throughout www.pmppals.org In effect, through surgery, you will be exchanging a few weeks of discomfort, in exchange for years of improved health. This has been the experience of the overwhelming majority of our fellow Pal Patients! Our Pal Mentors (as we describe those veteran patients who have successfully recuperated and have been trained and specifically selected to assist you based on your common needs and demographics) will all communicate with you directly via your personal email, telephone calls and visits. Your personal questions and concerns will not be “broadcasted” throughout the internet. Our blog articles reflect the optimism and encouragement of our international cadre of Pal Blog authors. Our program participants are diverse and include patients in 50 countries; therefore, it is possible to “connect” with others with whom you truly have something in common besides a rare diagnosis! Please refer to the following Pal Photo Galleriesfor examples of Pal participants who say “yes, it is worth it to have this surgery!” Appendix Cancer Survivors HIPEC Patient Profiles Pals’ Family Support Services
Articles posted in PMP Pals and on www.pmppals.org are written from the perspectives of patients and their families and are not intended to substitute for licensed, professional legal or medical advice. Each patient is unique and should seek specific counsel from their own licensed healthcare professional. Copyright © 2012 by the PMP Pals’ Network. All rights reserved. *Pal members also include family and friends of Pal Patients; they are referred to as “Pal Caregivers.”
How to Select a Surgeon, Part III: Meet the “Charge Nurse”
While most patients take the time to interview their surgeon prior to scheduling CRS and HIPEC, few take the time to tour the floor of the hospital where recuperation will take place following surgery.
Typically, Pals spend 24 to 48 hours in ICU, immediately following surgery, before being released to the surgery recovery floor for the duration of their hospitalized recuperation.
The “charge nurse” is responsible for supervising the floor/unit where you will recuperate. S/he assigns nurses to specific patients, and monitors the unit to be staffed adequately to meet the needs of the patients. Charge nurses may also provide direct patient care when needed and may serve as liaisons between patients and the nursing staff. Charge nurses may be rotated throughout the week, therefore, the charge nurse may change from day to day. In some hospitals, charge nurses maintain that position for longer periods of time.
On the day you interview your surgeon, request to meet with the “charge nurse” of the floor where you will recuperate. Ask the charge nurse to give you a tour of the ward. You and your family caregiver will want to see an example of the room where you will recuperate, as well as any amenities the floor or hospital may have to offer, e.g. a lounge for patients and caregivers, cafeteria, access to Wi-Fi, etc.
Prior to meeting with the charge nurse, prepare your list of questions for him/her, just as you prepare your questions for the surgeon. Among the questions to consider asking are the following:
What is the "nurse to patient" ratio on this floor? (How many patients are assigned to each nurse?)
Will the majority of your hands on nursing care be provided by RNs, LVNs, or licensed aides?
How many HIPEC patients are cared for on this floor each week? (How experienced is the nursing staff in taking care of HIPEC patients?)
These are just a few of the important questions patients must consider when selecting a surgeon/specialist. It's important to pay attention to these details regarding the hospital itself because after you are released from the ICU, you will spend the remainder of your hospitalized recuperation on the floor (unit or ward) supervised by the charge nurse.
As a proactive cancer patient and consumer, interview all potential healthcare providers whenever possible. Your health and your future are deserving of your time and attention to investigating your healthcare treatment plan thoroughly, prior to scheduling your surgery.
These are just a few of the important considerations that one must examine prior to selecting a surgeon/specialist. A more detailed and comprehensive list of questions is included in the PMP Pals’ Network Handbook: Preparing for Surgery.This handbook is provided to all new members of the PMP Pals’ Network.
Articles posted in PMP Pals and on www.pmppals.org are written from the perspectives of patients and their families and are not intended to substitute for licensed, professional legal or medical advice. Each patient is unique and should seek specific counsel from their own licensed healthcare professional. Copyright © 2012 by the PMP Pals’ Network. All rights reserved.
Diagnostic CT Scans for Appendix Cancer
Several diagnostic tools, including scans and laboratory tests, are utilized to detect and monitor cancer. Among the tools most commonly used are those that utilize imaging techniques. Physicians use X rays, CT Scans, MRIs, Nuclear Scanning, PET Scans and Ultrasonography as tools for diagnosing cancer and metastasis.
In general, CT scans are most commonly ordered for Appendix Cancer and Pseudomyxoma Peritonei patients, however, MRI scans are now being considered for pre and post treatment monitoring. Consult with your physician about which type of scan is most appropriate for your particular medical care.
Prior to the scheduled day of the scan, ask your physician or radiologist the following questions:
Why is this scan being ordered?
Are any risks associated with this test?
Will the test be taken on an outpatient basis?
What “preparations” if any, are required prior or following this test? Fasting? Bowel cleansing?
Can I drive myself home following the test?
How much will the test cost?
Is the cost covered by my healthcare insurance?
Will the test be performed locally?
Who will administer the test?
When will the results be available to me?
What will I feel during the test?
Is the test uncomfortable in any way?
Will I feel claustrophobic in taking this test?
Can I take this test if I have a pacemaker, implants or hearing aids?
How long does the test take?
Does the test have any side effects?
How often should a patient be scanned?
General guidelines differ for American patients, who are generally monitored (including scans) quarterly during their first year, post treatment, as compared with patients in Australia, Canada and Europe. These differences in schedules may possibly be based on individual healthcare (insurance) plans.
Due to recent concerns about radiation exposure from CT scans, some patients have opted to reduce the number of scans during their first and subsequent years post treatment. These concerns are best discussed with your radiologist and/or surgical oncologist.
Regardless of your testing schedule, be cognizant of any changes in physical symptoms, i.e., bloating, unexplained pain, indigestion, elimination, etc.
Generally, if you remain disease free, your monitoring schedule will be reduced to annual tests, years five through ten, post treatment. After the tenth year, annual monitoring is often discontinued.
Once again, each patient’s case differs; therefore, it is necessary to address questions about your needs for scans to your surgical oncologist specialist.
Articles posted in PMP Pals and on www.pmppals.org are written from the perspectives of patients and their families and are not intended to substitute for licensed, professional legal or medical advice. Each patient is unique and should seek specific counsel from their own licensed healthcare professional. Copyright © 2012 by Gabriella Graham/PMP Pals’ Network. All rights reserved.