What can I expect on my first visit to the Cancer Center?
What can I expect on my Education Day?
What is Chemotherapy?
What are the common chemotherapy side effects?
What can I expect on my first day of chemotherapy treatment?
What is a Port?
What is Radiation Therapy?
What are the common Radiation Therapy side effects?
What can I expect on my first day of Radiation treatment?
What are clinical trials?
How do you feel about family involvement?
How do I keep up with my appointments?
What do I do if I miss an appointment?
How do I contact my doctor after hours?
What should I do if I’m really sick?
When should I call the Nurse?
When do I get the results from tests, scans, or labs?
What do I do if I don’t have insurance or I don’t have enough insurance?
What is the Patient Assistance Fund and who is it for?
What resources, Support Groups and Complementary Therapies are available to cancer patients and their caregivers?
What can I expect on my first visit to the Cancer Center?
Your first visit to the Cancer Center will be a consultation with your doctor. Prior to your appointment you will be mailed a history form that should be completed before arriving. If you have misplaced your form you may print one out. Patient History Form
We also ask that you bring ANY medications you are taking with you to this appointment. This includes all vitamins, herbal supplements, soy products or special diet limitations. Please bring medications in their original bottles. Some of these products may conflict with your cancer drug regimen.
On your first doctor visit we encourage patients to bring a caregiver or family members with you. This is the time your doctor will decide a plan of action, set up your education appointment and make a treatment plan recommendation.
What can I expect on my Education Day?
Once you and your doctor decide on a treatment plan, you will come in for an education session. This will be a 2 hour education meeting with four key people during your treatment process; a nurse, dietitian, social worker and our insurance and billing coordinator. During this time they will talk to you about your treatment, what side effects to expect and how to treat them. They will share information about support programs and resources and address concerns regarding the cost of cancer care. They will also give you information about getting in contact with the clinic after hours and will be available to answer any questions you may have. We encourage patients to bring family members and/or their primary caregiver with them to this appointment. It is a time for their questions to be answered as well.
What is Chemotherapy?
Chemotherapy treatments use powerful drugs to kill and control the growth of cancer cells. Chemotherapy may involve one or many drugs depending on the type of cancer and its rate of progression. Chemotherapy can be used in combination with other treatments such as radiation and surgery to ensure that all cancer cells are eliminated. The experienced staff at the Marion L. Shepard Cancer Center provides extensive chemotherapy treatments. The Cancer Center features a 13-chair chemotherapy bay with individual televisions and headphones for each patient. The chemo bay offers a calming environment overlooking the Barbara Gray Howdy Meditation Garden.
What are the common chemotherapy side effects?
Chemo drugs are very strong. They kill any cell that is growing (dividing) fast, whether it's a cancer cell or not. So, some of the normal, healthy cells in the body that grow quickly can be damaged. This causes side effects. Some people experience no side effects from chemotherapy drugs. But sometimes chemo will make you feel sick.
Here are some normal cells that grow quickly. They are often affected by chemo, which causes side effects:
Cells in your bone marrow--this can make you feel tired, bruise and bleed easily, and put you at a higher risk of infection
Cells that grow hair--this can cause you to lose hair on your whole body Cells of the skin and mouth--this can cause dry skin and make your mouth feel dry and have sores
Cells in your stomach and intestines--this can cause you to feel sick to your stomach, vomit, or have diarrhea
Other organs of the body can be affected by some chemo drugs as well. Your doctor may do additional tests to find out if you can receive certain chemotherapy medications, if you need a lower dose of chemo drugs, or if you need longer breaks between doses. Most side effects are short-term and will go away after treatment stops.
What can I expect on my first day of chemotherapy treatment?
The first day of treatment can be very intimidating. Every patient’s experience is different depending on the cancer, stage and drug being used. Be assured that the staff and nurses will walk you through every step and are ready and willing to make you as comfortable as possible.
Our Chemotherapy room has 13 reclining chairs each with individual TVs and music. We have wireless Internet available if you wish to bring a laptop with you. You will be offered food or drinks and warm blankets if you are cold. You may also bring your own snacks if you choose. Some patients bring books to read or needlework projects to pass the time during chemotherapy.
Generally before any treatment is administered you will have bloodwork done to make sure you are healthy enough to receive a treatment. Once your lab results come back clear you will be brought back to the Chemo Bay and the nurses will start an IV or access your port. Your chemo drugs will be mixed immediately in the Cancer Center’s pharmacy and administered through your IV or port.
What is a Port and why might I need one?
A port is a small device that is surgically placed under the skin, usually in the upper chest area between your collarbone and breast. It eliminates the need find an arm vein every time you get your chemotherapy. This prevents the risk of “blowing” your vein. Some types of chemotherapy can only be given through a port because they are dangerous to give through a vein. The port is placed by a general surgeon as an outpatient surgery. You will be given moderate sedation; this means you will not be put completely to sleep but will not experience any pain. You will need to have your port accessed and flushed by a nurse every 8 weeks to make sure it continues to work properly. Appointments will be made for port flushes once your chemotherapy is finished.
What is Radiation Therapy?
Radiation therapy uses high-energy rays to damage or kill cancer cells by preventing them from growing and dividing. (I moved this to beginning of paragraph) Radiation treatment may be externally or internally delivered and may be used to cure or control cancer or to reduce cancer related symptoms. It generally involves treatment every day for a period of a 1-7 weeks, depending on the cancer type. By offering radiation treatment here in Washington we help lessen the burden of traveling long distances for this treatment.
The Marion L. Shepard Cancer Center offers radiation therapy through a partnership with the ECU Brody School of Medicine. Located in the Cancer Center is an IMRT-capable linear accelerator that provides radiation treatment. We have a Radiation Oncologist in the Center on a daily basis.
What are the common Radiation Therapy side effects?
The most common side effects of radiation treatments are fatigue and skin changes. The skin changes can include itching, redness, peeling and rarely, blistering. Sometimes patients may develop a metallic taste in their mouths. If radiation is given to the abdomen, you may experience nausea or diarrhea. If you receive radiation for lung cancer, neck cancer or esophagus cancer, you may have a sore throat or difficulty swallowing. Except for the fatigue and metal taste in mouth, there are medications given to alleviate the other side effects while a patient is under treatment.
What should I expect on my first day of Radiation treatment?
Depending on the area being treated, you may need to change into a gown in order for the therapists to see the set up marks drawn on their skin. You will then be positioned on the treatment table in the treatment room (the vault). The table will be adjusted and the treatment areas will be verified.
During the actual radiation delivery, the therapists leave the room and close the door but they will monitor you with visual and auditory equipment while operating the treatment console. The therapists may go back into the room between each treatment to make adjustments. There is a CD player in the room to help with the anxiety as well as a “squeaky toy” alert system you can use to signal the therapist. You should never try to get off the treatment table by yourself as the table is usually 3- 4 feet up in the air. The radiation treatment may be stopped at any moment deemed necessary and the therapist will enter the room to assist as needed.
You should not feel anything during the actual treatments. If you do have side effects, they usually appear 2-3 weeks into the treatments and will be monitored and treated by the doctors and nurses. Treatments are given the same time each day, Monday for the duration of the appointments.
What are clinical trials?
Clinical trials are research studies that involve cutting-edge therapies to improve upon diagnosis and treatment of diseases. Both Dr. Crews and Dr. Inzerillo are actively involved in clinical trials. Our Center is affiliated with clinical trial programs with the National Cancer Institute, the University of North Carolina and the Duke Oncology Network. We also participate in investigator initiated trials and pharmaceutical sponsored trials. Providing access to clinical trials allows our patients to participate in treatments that otherwise might not be available to them. It also advances our knowledge base to help treat future patients. We are currently participating in over 20 ongoing clinical trials in breast, lung, colon, and prostate cancers.
How do you feel about family involvement?
We understand the importance of family and caregiver involvement and support so we encourage them to attend ALL your doctor’s visits. Patients will generally see their doctor every 2-4 weeks during treatmetnt. This is the time reserved for patients and family to review current scans, test, and treatment outcomes. This provides the opportunity for everyone to address questions and concerns. We encourage patients to write down questions they may have for the doctor during the weeks prior to their visit. After treatments are complete, you will continue to see your oncologist for regular check ups.
During chemotherapy treatments, family and caregivers are not allowed to sit and wait in the Chemo bay with patients. This is due to the limited amount of space. We do however, encourage family and caregivers to occasionally come back to check on their loved one.
How do I keep up with my appointments?
Keeping up with appointments can be difficult especially if you come frequently for treatments. We provide you with an appointment card for each visit and call you the day before your scheduled office appointment. We encourage you to keep a calendar or appointment book for an easy reference of your upcoming visits.
What do I do if I miss an appointment?
If you miss your appointment we will contact you by the next business day to reschedule. If you know you wont be able to make your scheduled time please call us as soon as possible to let us know. We prefer a 24 hour notice to cancel appointments.
How do I contact my doctor after hours?
Our office hours are 8am-5pm Monday through Friday. If you are having a problem during office hours, please call the clinic and ask to speak to the triage nurse. You may reach the triage voicemail. If so, leave a message on the nurse voicemail with as much information as possible to describe the problem you are having. A nurse will call you back promptly to discuss your problem and if necessary, give you an appointment time to come in for evaluation. Please do not walk-in to the clinic without an appointment to discuss problems. Instead, let us schedule you a time to come in that day if possible. This will reduce your wait time and insure that scheduled patients are seen on time.
Whenever our office is closed (after hours, weekends or holidays) there is an answering service available. Just call our main clinic number (252) 975-4308 and give the answering service your name, number and a brief description of your problem. A nurse will then call you back.
What should I do if I’m really sick?
Call us! When you are not feeling well we need to know so we can get you an appointment as soon as possible if necessary. Your comfort is our number one concern. We ask that you do not walk-in to the clinic without an appointment to discuss a problem. Please let us schedule you a time to come in. This will reduce your wait time and insure that all patients are seen on schedule.
If you are having problems that are not directly related to receiving chemotherapy or as a result of your cancer diagnosis, then you may seek medical attention from your primary care physician or an urgent care. If your doctor feels we need to see you, then arrangements can be made.
When should I call the Nurse?
Below is a list of more commonly experienced side effects. It is very important to call the clinic (even if after hours) with these complaints. A nurse WILL CALL YOU BACK to discuss this further in detail.
1. Temperature of 100.4 degrees F or more (make sure you have a thermometer at home.)
2. Any new signs of infection such as:
a. New cough, shortness of breath, runny nose, sore throat or chills
b. Any problems urinating such as pain, burning, frequency or urgency.
3. Diarrhea. This means watery stools or more than 4 loose stools in one day. See Diarrhea information sheet before you call.
4. Constipation. This means no bowel movement for 2-3 days. See Constipation information sheet before you call.
5. Nausea or vomiting that is uncontrolled with nausea medicine (usually compazine). See Nausea and Vomiting information sheet before you call. If you have not been able to drink fluids because of nausea and vomiting, please call immediately.
6. Mouth Sores or sore throat that is not relieved with Magic Mouthwash and/or any white patches in the mouth or on the tounge. See Mouth Sores information sheet.
7. Nose bleed that lasts for more then 10 minutes while holding pressure.
8. Uncontrolled pain
When do I get the results from tests, scans, or labs?
Appointments are scheduled for you to return to the center to discuss test results with your doctor. If your results require immediate action, we will call you before your scheduled appointment. If you are having lab work only, we will notify you by the end of the business day if any labs are abnormal and what actions you will need to take. There is no need to wait for your lab results. If you choose to wait for your lab results, please tell the front desk when you check-in that you are waiting, so we will know that you are expecting results.
What do I do if I don’t have insurance or I don’t have enough insurance?
Each patient’s case is discussed on an individual basis. Our oncology social worker and insurance and billing coordinator will work with you to identify if there are resources available that may assist with drug costs, copays, scans or other diagnostic testing.
What is the Patient Assistance Fund and who is it for?
Cancer treatment and associated expenses can be a financial strain and many times patients are in need of emergency aid for medication, rides to their appointments and other expenses. This fund can help absorb costs associated with fighting cancer.
What resources, Support Groups and Complementary Therapies are available to cancer patients and their caregivers?
We are always evaluating our list of support groups and therapies to better serve our patients. We are currently offering these sessions listed below, committed to improving your cancer experience by involvement with others.
Caregiver Support Group
Conversations
Breast Cancer Support Group
Look Good...Feel Better
Massage Therapy
Restorative Yoga and Meditation
Knowledge is Power
Home Health and Hospice Referrals
Our staff is committed to partner with the family and caregiver for advice and help with changing patient needs. Caring for a loved one can sometimes become too difficult for one caregiver or family alone. We offer help and advice about Home Health referrals, acquiring medical equipment, and Insurance and emotional consultations. Please address any concerns about the level of care you feel our patient needs.
