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Double Check to Confirm You're Receiving the Correct Chemotherapy




This week, our Pal, Paul, shares the procedures in place at the clinic where he receives his chemotherapy treatment:
Last week we offered suggestions to a patients who had received the incorrect dosage of chemotherapy, intended for another patient at the same clinic.

1.     When I arrive at the oncology clinic, I am given a list of the medications I am going to be given on that day. The certified Oncology nurse reviews them with me and discusses the optional drugs in the list.

2.     Before I am given any pretreatment drugs, the oncology nurse confirms my name and date of birth.

3.     Before I am given any chemotherapy drug, a second certified Oncology nurse comes in double checks the dosage and the drug. Both nurses must sign off on the medication. Frequently I see them double checking the dosage by multiplying my body mass times the recommended dosage and when there is a difference they call my oncologist to verify why I am on a reduced dosage or a different dosage than the company recommends.

4.     All of this is signed off in the clinic’s electronic medical system.





Articles posted in PMP Pals and on www.pmppals.org are written from the perspective of patients and family caregivers and are not intended to substitute for licensed, professional legal or medical advice. Each patient’s case is unique; therefore consult with a licensed professional regarding your specific needs.
Copyright © 2014 by PMP Pals’ Network. All rights reserved. Todos derechos reservados.
Visit us on the web at www.pmppals.org

We have HOPE for YOU






 
 
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Patient Received Wrong Chemotherapy; What Would You Do?




This week one of our Pal members advised us that her oncologist and his nurse informed her that she had inadvertently received a chemotherapy treatment intended for another patient (and vice versa.)

While our Pal has not experienced any toxic side effects from this error, she has been understandably apprehensive. She brought her concerns to the Pals’ desk for suggestions as to how to protect herself from a similar error in the future.

Patient advocate GG responded:

“I suggest that each patient be his/her own advocate; if that is not possible, then ask that a spouse, relative or friend to assume that role.

Ask your physician(s) to provide you with a print out of every electronic prescription they order for you, including chemotherapy(ies.)

Each time a medication, including chemotherapy is administered, ask the nurse to show you the label on the medication (in the case of chemotherapy, on the bag or vial.)

The label should match the printed prescription your physician provided you with a copy of.

Additionally, prior to administering any medication, including chemotherapy, the nurse should ask you for your full name and birthdate.

These additional step should help in the prevention of future errors, which although rare, are unsettling at the very least, and may be harmful in the worst case scenario.

Additionally, by taking these steps, you may gain more confidence and peace of mind. We are sending our best wishes for your successful chemotherapy and good health in the future!”






Articles posted in PMP Pals and on www.pmppals.org are written from the perspective of patients and family caregivers and are not intended to substitute for licensed, professional legal or medical advice. Each patient’s case is unique; therefore consult with a licensed professional regarding your specific needs.

Copyright © 2014 by PMP Pals’ Network. All rights reserved. Todos derechos reservados.
Visit us on the web at 
www.pmppals.org
We have HOPE for YOU



 
 
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Are Bloating, Reflux and Weight Loss Common After HIPEC?

 


Today the Pals’ Network shares a conversation from our HIPEC Pals’ Resource Group regarding post op digestive distress and weight loss. Pal Tony, presented the original question…

 Pal Tony asked:

While in the hospital at major cancer treatment center in the US, the surgical team was great in preparing me for what was to come during the post op (CRS + HIPEC) recovery time in the hospital.

However, not knowing what complications could arise when I returned home and how to deal with these issues has been a problem.

From the outset after leaving the hospital my biggest problem has been bloating after meals, and the inability to eat enough foods to keep my weight stable. In 3 months I have lost 45 lbs (from 220 lbs to 175).

In addition to the bloating, I am now experiencing acute acid reflux which I have from drinking water or eating any foods. As this is occurring 3 months after my surgery and I am not taking post op chemo, I question if I have a totally separate issue with my esophagus/stomach valve. I have asked the medical team at the hospital where my surgery was performed, to schedule some upper GI tests to determine what is going on.

Have any other “Pals” experienced similar issues?

Pal Mari Jo responded: 

I also had my surgery at the same cancer treatment center, and did experience some bloating, extreme fullness feeling after eating.  I found that eating very small amounts, often, and then going to the recliner and stretching back would help.  It took months for my weight to stabilize.  I came home with a feeding tube so I had issues with my protein levels stabilizing but in time they did.  

Pal Mike responded:

Mari Jo has expressed what many of us experience. I had my last CRS over 2 1/2 years ago (at a different cancer treatment center) and I still have exactly the same bloating issue and fullness after meals she describes. I also "graze" a lot when it comes to eating.

I weighed 195lbs when diagnosed nearly 5 years ago and have been as low as 145lbs but managed to stabilize gradually at about 170-175lbs even with a very short small intestine - it takes time. 3 months post op is still early for many people and it can be really difficult to even have an appetite.  The acute acid reflux sounds more of a concern but Gabriella has addressed that in another comment.       

Pal Fred responded:

I had the same weight loss as others following surgery at a different cancer treatment center. I dropped from 150lbs pre surgery to 109 3-4 months later.  Moved up to about 116lbs during the next 6 months and stayed at that weight for about 2-3 years, then moved up to about 124-5lbs and have stabilized there.

 I’ve had stomach issues off and on, though not the after meal bloating described.  I eat 6 times/day – regular breakfast/lunch/dinner and snacks between and at night. Acid problems have occurred and I was prescribed Protonix a couple of years ago and again last week (from a gastroenterologist unrelated to the surgery, but familiar with it; he did an endoscopy a couple of years ago when checking my stomach issues).  The medicine (generic version) seems to help.  

Pal Gabriella responded: 

Tony, it sounds like you may be experiencing two different conditions; one is very common (post op weight loss) and the other is less common.

RE: bloating, reflux, digestive distress....you are describing symptoms of a partial bowel blockage. Your local gastroenterologist or the physicians at cancer treatment center can provide you with a variety of tests to determine any possible causes of a partial blockage (adhesions, tumor, etc.).

RE: post op weight loss....very, very common, and depending on which if any portions of your digestive system were removed during surgery, may or may not be resolved with:

a/diet

b/time during the coming year.

To address nutrition needs please the following:

Pseudomyxoma Peritonei Nutrition (malabsorption, lactose intolerance and short gut syndrome are the most common factors among post op weight loss)

Please scroll down farther along the same page and read "Why do I continue to lose weight" and "Why can't my father gain weight?"





Articles posted in PMP Pals and on www.pmppals.org are written from the perspective of patients and family caregivers and are not intended to substitute for licensed, professional legal or medical advice. Each patient’s case is unique; therefore consult with a licensed professional regarding your specific needs.


Copyright © 2014 by PMP Pals’ Network. All rights reserved. Todos derechos reservados.

Visit us on the web at www.pmppals.org


We have HOPE for YOU


 
 
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Is HIPEC Effective for Treating Pancreatic Cancer?

 





Today’s FAQ comes from Pal member, Judy, who asks:

“I was treated for appendiceal cancer with the HIPEC treatment and am now cancer free. A friend of mine has recently been diagnosed with metastasized pancreatic cancer. Is HIPEC effective for treating pancreatic cancer?

Surgical oncologist, and HIPEC treatment specialist, Dr. Andrew Lowy responds:

“There is clearly no role for the treatment of established metastatic disease. Dr. Paul Sugarbaker has done a small pilot trial using it as an adjuvant following pancreatic surgery. That is clearly not mainstream and is not being done routinely anywhere though his outcomes were surprisingly good.

The fundamental issue with pancreatic cancer is that it metastasizes via lymphatics and the bloodstream well before clinical detection in 90% of cases and HIPEC has nonimpact on these sites of disease.”

About Dr Lowy:

Dr. Andrew M. Lowy, MD, FACS is a Professor of Surgery and  Chief, in the Division of Surgical Oncology an at UCSD Moore’s Cancer Center specializing in treating  Gastrointestinal Cancers (including appendiceal/Pseudomyxoma Peritonei) and Pancreatic Cancer.



This article is copyrighted and may not be reproduced without written permission from the PMP Pals’ Network/Copyright © 2014/All rights reserved. Todos derechos reservados.

PMP Pals” articles are written from the perspective of patients and their immediate family caregivers and are not intended for substitution of advice or recommendations from licensed healthcare providers. The PMP Pals’ Network does not provide medical advice. Patients must seek the counsel of their own physicians and healthcare professionals.


 
 
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Today's Appendix Cancer FAQ comes from Marty who asks:

"My brother in law resides in the UK and has been diagnosed with appendix cancer. Where can he find a specialist?

GG responds: "Prof. Brendan Moran is the most experienced specialist in the treatment of Appendiceal Cancer in the United Kingdom.

Prof. Moran's professional profile, and contact information is posted on the HIPEC Cancer Treatment Centers page at www.pmppals.org

 
 
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Should My Children Be Tested For Pseudomyxoma Peritonei?

 

 


Sharon from the USA asks today’s FAQ:

My husband died from “PMP” in 2002. There was a history of cancer in his family; his mother died from colon cancer and his uncle died from pancreatic cancer.

Given my late husband’s family history, should our three adult children should begin colon screenings at age 45?

Should my children, nieces and nephews, and grandchildren be tested for “PMP” and colon cancer, as well?”

GG responds:

“At this time, there is no testing or gene marker for Pseudomyxoma Peritonei and there is no evidence that Pseudomyxoma Peritonei is a hereditary or familial condition.

Families affected by the Lynch Syndrome related to Colon Cancer, may have a familial or hereditary trait. Your late husband’s family does not appear to have been affected by the Lynch Syndrome, however, your children can be tested for it.”

We asked Dr. Brian Loggie, of Creighton University, to answer the question, “Is Pseudomyxoma Peritonei hereditary?

Click here to read his answer >




Articles posted in PMP Pals and on www.pmppals.org are written from the perspective of patients and their families, unless otherwise noted, and are not intended to substitute for specific medical care. Patients should seek the counsel of their individual specialists regarding their specific personal needs.

Copyright © 2014 by PMP Pals’ Network Publishing/All rights reserved.
Visit us on the web at www.pmppals.org



 
 
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Do Vitamin C Injections Cure Appendix Cancer?

Donna from the USA asks today’s appendiceal cancer FAQ:


“My uncle was diagnosed this month with appendix cancer. He has asked me to find out what information is available on Vitamin C injections to treat appendix cancer.

Can the PMP Pals’ Network provide me with information about Vitamin C injections for the treatment of appendix cancer?”

GG responds:

“We (the PMP Pals’ Network) are unaware of any responsible, verified studies recommending the use of Vitamin C injections for the treatment of appendiceal cancer or any other cancer.

Typically appendix cancer is treated through specialized, detailed surgery, in conjunction with HIPEC. Systemic chemotherapy is also utilized for adjuvant therapy.

Ø  Here is an article, written by Dr. Timothy J. Moynihan, of the Mayo Clinic, responding to another question about the use of Vitamin C for treating cancer, in general.


Note that Dr. Moynihan states “However, there is still no evidence that vitamin C has any effect on cancer.

Ø  Here is information about HIPEC which is commonly used for treating appendiceal cancer.


Ø  Here is information about systemic chemotherapy, and its use for appendix cancer patients with specific needs.”


 

 

 


Articles posted in PMP Pals and on www.pmppals.org are written from the perspective of patients and their family caregivers and are not intended to substitute for licensed, professional legal or medical advice. Individual should seek counsel from licensed professionals regarding their specific needs.

Copyright © 2014 by PMP Pals' Network/All rights reserved. Visit us on the web at www.pmppals.org



 
 
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Appendix cancer patient, KA, age 40, poses today’s question:

“I had CRS and HIPEC seven weeks ago. I am feeling better, but still get tired when I go for short walks around my neighborhood. When will I be able to return to work?”


GG responds:

“There are many variables regarding the amount of time needed for recuperation before returning to work. Among those variables are:

The extent of your surgery (a longer, more detailed surgery versus a shorter, less complicated surgery)

Your overall health and condition prior to surgery,

The type of work you do (i.e. a desk job vs. physical labor)

Your individual feeling of energy or fatigue level (do you need to take naps, is your appetite and calorie intake sufficient, are you able to walk a few blocks, etc.)

You must obtain the approval of your surgeon and primary care physician before returning to work. Schedule a consultation to meet with your licensed healthcare provider to evaluate your timetable for returning to work.

Ask your employer if you have the option of returning to work part time for a trial period before returning to your job full time. Is working from home, an option for you?

On average, patients return to work approximately twelve weeks post op.

Be "patient" with yourself during the recuperation time. Recuperation may seem challenging for those of us who are used to be being active and busy; we get frustrated by when we feel idle. We become bored and want to feel "normal" again. However, the healing process is very important, especially following CRS and HIPEC. Allow your body adequate time to heal!






Articles posted in PMP Pals and on www.pmppals.org are written from the perspective patients and their families and are not intended to substitute for licensed professional legal or medical advice. Patients should seek the counsel of their licensed healthcare professionals regarding their specific medical needs.
Copyright © 2013 by PMP Pals’ Network Publishing/All rights reserved.



 
 
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Obstructions: Causes and Treatments

Today’s Pseudomyxoma Peritonei FAQ comes to the PMP Pals’ desk from Valory, who asks:


“My mom is a 5 year PMP cancer patient. She has had three surgeries. She is in the hospital right now being treated for her 7th bowel obstruction. Her doctors are talking about putting in a G tube or J tube in her stomach. She is on tubal feedings and has an NG tube in her nose. Can someone help me? I am at a loss for words.” 

Gabriella responds:

“Valory, there are a wide variety of reasons Appendiceal cancer and “PMP” patients experience obstructions.

Among the causes are:

Tumors

Scar tissue/adhesions (generally from previous surgeries)

Diet (e.g. indigestible fiber, usually from quantities of fresh/raw fruits and vegetables, rice or cooked meats)

Lack of peristalsis (sometimes caused by the use of opioids)

Dehydration

Lack of exercise, etc.

If the cause appears to be temporary, e.g. caused by diet/indigestible food matter, the obstruction may be treated with the insertion of an NG tube, supplemented with IV fluids, as your mother is receiving.

If the cause appears to be permanent, but possible resolvable, the obstruction may be treated with surgery to remove/reduce the tumor and/or scar tissue.

If the cause appears to be inoperable, then the patient may be treated with palliative care which may include the G tube or J tube supplemented with TPN IV feeding.

Your mother’s physicians will help her to determine the most appropriate treatment for her specific needs.”

Please click here for additional information about Obstructions: Symptoms, Causes and Treatment.

 

 


Articles posted in PMP Pals and on www.pmppals.org are written from the perspective of patients and family caregivers and are not intended to substitute for licensed, professional legal or medical advice. Each patient’s case is unique; therefore consult with a licensed professional regarding your specific needs.

Copyright © 2013 by PMP Pals’ Network. All rights reserved. Todos derechos reservados.
Visit us on the web at www.pmppals.org

We have HOPE for YOU!


 
 
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Should I Have a Shingles Vaccine?



Today’s frequently asked question comes from Pal member BR in the USA:





“I was treated for Pseudomyxoma Peritonei last year and successfully recuperated from CRS with HIPEC. I have been disease free for one year!

I had chicken pox when I was a child. Should I get a Shingles vaccine?”

GG responds:

“This is a good question as many of us “Pals” had chicken pox when we were children and are now asking ourselves the same question!

The answer depends on the individual patient, and specific needs, among them the state of your immune system, whether or not you are receiving chemotherapy or are otherwise immune system compromised.

Please make the decision as to whether or not to be vaccinated against Shingles after consulting with your personal PCP regarding the most appropriate choice for you specific needs.



The PMP Pals' Network welcomes your comments>







Articles posted in PMP Pals and on www.pmppals.org are written from the perspective of patients and their family caregivers and are not intended to substitute for licensed, professional legal or medical advice. Each case is unique; therefore, patients should seek counsel for their specific cases from licensed healthcare professionals. Copyright © 2013 by PMP Pals’ Network Publishing.

Visit us on the web at www.pmppals.org

We have HOPE for YOU!