Coping with Cancer - Surviving and Thriving

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Talk to our Survivorship Coordinator about Cancer Care activities and support call (317) 338-3551.

Being a cancer survivor starts at the time of your diagnosis. Every journey may include a time when you need more support with complex symptom management for life-limiting or potentially life-threatening conditions. This applies to adults and children battling cancer.

Palliative Medicine defined: This medical specialty is a comprehensive approach to supportive care for any patient with a serious illness such as cancer, congestive heart failure, COPD, renal failure, and progressive neurological disorders (including Alzheimer’s disease).

The St. Vincent Supportive Care Team can initiate services at the time of diagnosis and continue throughout the medical journey in order to better control distressing symptoms: dyspnea, nausea, psychosocial, emotional and spiritual distress. Depending on your treatment plan, Supportive Care may be provided alongside of a curative treatment or be the main focus of care.

  • Assist with difficult or complex medical or psychosocial issues to help patients better tolerate cancer pain and other symptoms associated with medical treatments.
  • Support patient and family education throughout the care plan.
  • Coordinate care with the medical team to improve quality of life for every patient and achieve patient goals.
  • Address Advanced Care (Directive) Planning to define goals of care, including referrals to hospice care when appropriate.

Supportive Care Team

At St Vincent, our Supportive Care team includes physicians, mid-level providers (PA/NP), nurses, social worker and a chaplain. The team coordinates care for symptom management, emotional and spiritual needs.  We are available to help manage care inpatient at St Vincent Hospital (86th Street, Indianapolis) and support various outpatient services.

  • Board-certified palliative medicine physicians caring for adult patients with complex medical conditions
    • One of our physicians and a nurse practitioner also specialize in the needs of children with childhood cancer and other serious illnesses that may benefit from palliative medicine.
     

To learn more about Cancer Survivorship programs and activities click here.

NEW AT St. Vincent Cancer Care

Family history, genes and cancer risk

Dawn McIlvried, MS, CGC (left) and Stephanie Cohen, MS, CGC

  • A St. Vincent Genetic Risk Assessment CALL-line is now available at toll-free
    1-855-931-6957 for questions and follow-up regarding high risk breast cancer notifications, and  other hereditary cancer risks in children, women and men.
  • St. Vincent Cancer Care is now doing a genetic screening assessment on all women having any type of mammography breast screening test at the St. Vincent Diagnostic Radiology Services at the Cancer Center and Breast Care Center (Nabb Rd.), St. Vincent Carmel Hospital, St. Vincent Anderson Regional Hospital and St. Vincent Kokomo Hospital. The purpose of a cancer genetic risk assessment tool is to improve the identification of women at high-risk for breast cancer and make sure you are getting the surveillance you need.

Our body's DNA is a roadmap to understanding cancer risk and how cancer cell may behave. Cancer is caused by abnormal gene changes called mutations and certain gene mutations can predict more aggressive cancer behavior. Family history is one risk factor for potentially developing cancer. That is why inheriting a gene mutation can increase the risk especially for family cancer syndromes. However, environmental factors (such as smoking, exposure to chemicals, and UV radiation from sun and other radiation exposure) can also influence gene mutations.

St. Vincent Genetic Counselors are leading efforts to better identify women and families at high risk for breast cancer and other hereditary cancers such as ovarian and colorectal cancer. For example, every time a woman gets a digital or 3-D mammogram at a St. Vincent Diagnostic Radiology Center, the mammogram technician will ask questions as part of a genetic assessment questionnaire. This information along with the mammogram results will be analyzed using several cancer risk assessment models and shared with your doctor.

"If a patient is flagged as high risk that information is shared with all concerned so we can make sure you get the surveillance and education you need to make informed decisions." -- Stephanie Cohen, Certified Genetic Counselor, St. Vincent Cancer Care

When to meet with a Genetic Counselor?

St. Vincent's Cancer Genetic Risk Assessment program led by board-certified and oncology trained genetic counselors is a service for:

  • Individuals who are concerned about getting cancer
  • Cancer patients who may have a gene mutation that influences the aggressiveness of the cancer cells
  • Any man or woman who is diagnosed with cancer who also has close relatives with cancer, especially the same type
  • Family members of a close relative who had cancer at a young age (under the age of 50) or who had multiple types of primary cancer
  • Family members of a close relative who is a known carrier of an inherited cancer type

The St. Vincent Genetic Counseling is available to patients with a referral from your physician. Reasons for referral include being diagnosed or having a personal or family history of these cancers or being a gene mutation carrier for a cancer type.

Knowing your risk helps our patients make informed choices about surveillance, cancer screening and other preventive measures.

Family history, genes and cancer risk

Some cancers affect more than one generation of a family. "Recording a family medical history is one the the most important genetics test you can do." – US Surgeon General, Family History Initiative.

As the patient you (and your family) will meet with the genetic counselors as part of information gathering phase and complete a questionnaire. You will have ample time to ask questions and explore concerns.  Our genetic counselors work closely with your physician to help communication findings that may be important to cancer surveillance, a cancer treatment plan and long-term follow-up and survivorship. The Cancer Genetic Services are based at the St. Vincent Cancer Care Center at 8301 Harcourt Rd, Suite 100. For more information or to schedule a genetic counseling appointment call 317-338-RISK (7475)

Blood Tests and Genetic Assessment

Once a St. Vincent Cancer Care patient is diagnosed, your physician may order various blood tests that are gene profile tests including:

BRAC 1 / 2 sequencing; multi-site 3 BRAC analysis, single site BRAC, MHL1, MSH2, MSH6, PMS2 analysis and single site testing, MSI and/or IHC on tumor tissue, APC and MYH sequencing, and single site APC.

The genetic counselor coordinates this testing and is specially trained to analyze the test results along with the patient's medical history and genetic assessment questionnaire. Communication is very important and these genetic counselors are available to the patient and your physicians to interpret the information in support of your overall treatment plan.

Our genetic counselors routinely participate in the different multidisciplinary cancer conferences as complex and challenging cases are presented for review. They are also involved in cancer clinical trials to further our understanding of the genes and cancer. Their services are also available through St. Vincent Anderson Regional Hospital and St. Vincent Kokomo Regional Hospital. A genetic consultation is considered an outpatient visit and is usually covered by insurance.

Family Cancer  Syndromes – Cancers Passed Down Through the Family Gene Pool

Approximately 5-10% of cancer patients will have an inherited gene mutation which can increase the likelihood of developing certain types of cancers. The word, "Family Cancer Syndrome" refers to the relationship between certain gene mutations and certain cancer types.

For example, St. Vincent Genetic Assessment Counselors use the OncoType DX test to help breast specialists look at the activity of certain genes in the tumor tissue. The certified Genetic Counselors help patients and families better understand the risk for developing breast  and ovarian cancer based on BRAC 1 & 2 gene mutations.

As of June 1, 2015, St. Vincent Genetic Counselors are currently recruiting BRAC carriers over the age of 18 who have had breast or ovarian cancer to participate in a monthly survey and do a self-breast exam as part of a BRAC Positive Patient National Questionnaire. For more information call 317-338-RISK (7475). Several factors are linked to family cancer syndrome:

  • Having several close relatives with rare types of cancer (such as kidney cancer)
  • Having a relative with colon cancer as a young adult under the age of 30
  • Having a sister, aunt, mother or maternal grandmother with both breast and ovarian cancer
  • Having close relatives with cancer in both breasts, both eyes, both kidneys
  • Having multiple brothers and sisters with a childhood cancer such as sarcoma
  • Relative with male breast cancer

The type of cancer matters when assessing a cancer-related genetic risk and family cancer syndrome. This list is an example of more common family cancer syndromes.

Hereditary breast and ovarian cancer syndrome (HBOC) is related to BRAC 1 and BRAC2 gene mutations. HBOC is also linked to fallopian tube cancer, primary peritoneal cancer, male breast cancer, pancreatic cancer and prostate cancer.
 
Hereditary non-polyposis colorectal syndrome (HNPCC), also known as Lynch syndrome, is related to the MLH1, MSH2, MLH3, MSH6, PMS1, PMS, andTGFBR2 genes. In women, the risk increases for endometrial cancer, and in men getting colon cancer at an early age (before the age of 50). Other cancers linked to HNPCC include: ovarian, stomach, small intestine, pancreatic, kidney, brain, and bile duct cancers.

Types of benign (noncancerous) tumors, for example multiple endocrine neoplasia type II (MEN II) syndrome increases ones risk for certain types of thyroid cancer.  

Li-Fraumeni syndrome is related to a gene mutation for P53 and CHEK2. This rare syndrome affects children and young adults and can lead to types of bone cancers, soft tissue sarcomas, leukemia, breast and brain cancers. Our genetic counselors work closely with the pediatric oncologists at the Peyton Manning Children's Hospital Center for Childhood Cancers and Blood Diseases to further understand potential hereditary risk factors and how that might apply to other members of the family.

Oncology Rehabilitation at St.Vincent includes Physical Therapists, Occupational Therapy/Lymphedema specialists, Speech Pathologists and Audiologists. These therapies are available at all points in the cancer journey. Oncology Rehabilitation is proven to help keep our patient mobile and active and help manage cancer treatment side effects, including pain. Working with a therapist can give patients and their families an easier path to the "new normal."

If you are experiencing symptoms from a cancer treatment, contact your physician. He or she may suggest an assessment by St.Vincent Oncology Rehabilitation specialist.

Typical symptoms after surgery, chemotherapy, or radiation therapy

(Note: this list may vary based on the type of cancer treatment you are receiving.)

  • Fatigue
  • Excessive swelling in the arms, hands, legs and feet
  • Weakness in the limbs (difficulty walking or rising from a chair)
  • Dizziness and balance problems
  • Shortness of breath
  • Vocal problems
  • Hearing difficulties
  • Difficulty doing daily self-care in the home
  • Non-cancer related pain

If you feel you are experiencing a medical emergency – CALL 911 IMMEDIATELY

Each St.Vincent Oncology Rehabilitation therapeutic plan is personalized for your needs and is flexible to adjust to your cancer survivorship goals. Therapies focus on:

  • Reducing functional decline during the cancer treatment stage
  • Restoring mobility and physical functions after cancer treatment
  • Giving patients therapeutic tools to help cope and manage pain
  • Educating and instilling self-confidence

Today in Indiana and nationally there more cancer survivors than at any other point in history, that's great news! St.Vincent Cancer Care is prepared to support cancer survivors as they age with a holistic approach to healing the body, mind and spirit.

As part of our comprehensive Cancer Care services, St.Vincent Oncology Rehabilitation Services now has an expanding presence at the St.Vincent Women's Health Center in Carmel, IN, with dedicated services for improving bone health, pelvic health and lymphedema education and exercise.

Looking for a Certified Occupational Therapists specializing in lymphedema?

  • St.Vincent Physical, Occupational. Speech and Voice Therapy at the Indianapolis Breast Care Service professional building at 8550 Nabb Rd., Suite 100, Indianapolis, IN 317-338-3364
  • St.Vincent Physical Therapy and Pediatric Therapies including women's health and lymphedema, 6085 Heartland Dr., Suite 101, Zionsville, IN 317-334-1080
  • D. Erskine Rehabilitation Center at St Vincent Anderson Regional Hospital 765-646-8663 

Frequently Asked Questions about Oncology Rehabilitation

What is Lymphedema?
Chronic swelling, typically in the arms or legs, can occur when the lymph fluid in the blood vessels that removes waste products from the body is deficient.  If, as part of surgery, the lymph nodes are removed or the lymphatic pathways are damaged due to trauma, surgery or radiation, lymphedema can result. Visible signs of lymphedema include swelling of the extremities, indentations on the tissue that last several seconds, and a slightly blanched color of tissues where fluid has built up. There are many treatment options available to control lymphedema such as gentle massage to reroute and remove the lymph fluid buildup, exercise programs, lifestyle changes and compression wear and bandaging available at the Women's Health Boutique at St.Vincent Carmel Hospital and Women's Health Center.

Why would I see an audiologist?
Some types of chemotherapy can cause hearing loss. Audiologist will monitor ears during and after cancer treatments and recommend interventions as needed.

Will my speech be impaired?
Each patient experience is different. When the cancerous tumor affects the throat and the vocal chords (larynx) in particular, speech pathologists are available to help.

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