EXPERT VOICES

Timely insight on cancer topics from the experts of the American Cancer Society

American Cancer Society Expert Voices

The American Cancer Society

General (20 posts)  RSS

Tips for your first oncologist's appointment

October 13, 2014

By Francisca Alvarado, BSN, RN, OCN


The cancer journey brings about many overwhelming feelings. Many thoughts may go through your mind when you hear, "You have cancer and you need to be seen by an oncologist." You may wonder how this will impact you, your family, and your friends. The possible anxiety caused by wondering what the oncologist will tell you at the appointment and which decisions you will have to make may take over your thinking. You may have trouble listening, understanding, or remembering what anyone is telling you during this time due to the very normal distress, uncertainty, fear, and anger you may be feeling.

Having a better understanding of what to expect, what to take with you, and which questions to ask at your first oncologist's appointment may help you better prepare and lessen the anxiety. 

Get the logistics clear


Before your first appointment, make sure you know the answers to these questions. Although they seem obvious, it can be easy to overlook these details when you're worried about your diagnosis:

  • What is the full name of the oncologist I will be seeing?
  • Does the oncologist take my insurance? What will I be expected to pay on the first visit?
  • How will the oncologist get my medical records? Will the referring physician send them, or do I need a copy to take to the first appointment? If I need a copy, how can I get it?
  • How do I get to the oncology office?
  • Where do I park, and how much will I have to pay for parking?
  • How long will the first appointment take?

More...

Filed Under:

General | Survivorship

Adults Need Vaccines, Too

September 22, 2014

By William Schaffner, MD


As I like to tell my patients, the best approach to everyday health is a proactive one, and that means staying up-to-date on recommended vaccinations in addition to annual checkups.

Many adults don't visit a doctor unless they feel ill, nor do they think about vaccination as part of their routine, preventive healthcare. This leaves them needlessly vulnerable to diseases that can cause severe health complications or even death. 

Vaccines are a safe, effective way to help prevent a number of diseases at any age-from 6 months to 60 years, and beyond. In fact, there are several vaccines recommended specifically for adults because of their risk for certain infections.

It's important for all adults to check with a healthcare professional about which vaccines are recommended for them, as we all need some vaccinations as we age. For example, the chance of having complications from the flu, or getting shingles or pneumococcal disease (see below for more information) increases with age. In other cases, a weakened immune system or the presence of underlying illnesses like cancer, heart disease, or diabetes can make us more susceptible to diseases.

Many adult vaccines are readily available at primary care medical offices and in pharmacies, and the cost of vaccination is usually covered by Medicare and most private insurers. So, there are no excuses for not staying up-to-date!

Vaccines and the immune system


If you have a weakened immune system due to cancer or related treatment, there are vaccines you should receive - and some that you should not receive.

Vaccines come in two forms: inactivated or live. Inactivated vaccines only contain killed viruses or bacteria and can be used for those with compromised immune systems. Live vaccines, such as the flu nasal spray (but not the shot, which has inactivated virus) or shingles, contain weakened but live components. While this does not pose a risk for people with a healthy immune system, live vaccines are not recommended for people whose immune system is weakened by certain cancers, cancer treatment, or other factors. 

Cancers like leukemia, lymphoma, and Hodgkin disease interfere directly with the immune system. In most cases, however, it's not the cancer itself, but the cancer treatment, that changes the immune system. Some cancer treatments, such as radiation, certain chemotherapies, and transplantations, prevent your immune system from responding the way it should to infections. If you aren't sure whether your immune system is being affected, talk to your doctor or other healthcare professional before you or anyone you spend a lot of time with gets any vaccines. More...

Filed Under:

General | Survivorship

How electronic health records can help on your cancer journey

August 20, 2014

By Simone Myrie

Ed. note: This guest post by Simone Myrie of the Office of Consumer eHealth, Office of the National Coordinator (ONC) for Health Information technology, US Department of Health and Human Services. In it, she explains how electronic health records and Blue Button can help cancer patients, survivors, and caregivers as they navigate their cancer journey.


No two experiences with cancer are alike, but there are certain things that almost all cancer patients and their loved ones share in common. From getting a diagnosis, to coordinating care among doctors and at home, and on to long-term survivorship plans, the cancer experience is one centered around information. Some of the information we seek is mostly objective: What can I expect this disease to do? What are my treatment options? How can I improve my odds of beating cancer?

But some of the most important information you can gather, keep track of and share is information unique to you: Your own health records. The visit summaries, clinical notes, test results, medication lists, treatment histories, and other documents represent a critical picture of your individual cancer experience. This information has implications for your individual choices, your professional care, and the care you receive from loved ones. More...

Filed Under:

General | Survivorship

The Same, Only Scarier -- The LGBT Cancer Experience

June 05, 2014

By Liz Margolies, LCSW


Getting a diagnosis of cancer is frightening for everyone. But for many lesbian, gay, bisexual, and transgender (LGBT) patients, the immediate concerns about treatment options and survival are compounded by an additional set of worries: 

  • "Should I come out to my healthcare providers?"
  • "Will I be safe if I do?"
  • "Will my chosen family be welcome?"
  • "Will I be able to find the information I need to take care of my relationship, my sexuality, my fertility and my family?"

LGBT cancer patients and survivors are underserved and that is partly as a result of being underreported. No cancer registries collect information about gender identity or sexual orientation, leaving LGBT cancer survivors buried in the data and often invisible to healthcare providers. Treatment facilities and social service organizations may also be unaware of the true number of LGBT people they serve because their intake forms do not invite disclosure (coming out as lesbian, gay, bisexual, transgender), and fear of discrimination keeps many patients in the closet. As a result, the healthcare system often fails to recognize LGBT patients and isn't trained to meet their needs.  

The American Cancer Society estimated in January 2014 that there were approximately 14.5 million Americans living with a history of cancer. Approximately 4% of Americans identify as LGBT, and LGBT people are known to have increased cancer risks and decreased screening rates. Considering all these factors, the National LGBT Cancer Network, estimates that there are more than 1 million LGBT cancer survivors in the country today. You might even know one or more of them. More...

Filed Under:

Disparities | General

What to keep in mind when you see STUDIES SAY

March 31, 2014

By Alvaro Carrascal, MD, MPH

You may have seen some of these headlines recently in national newspapers and online:

More coffee linked to higher mortality rate: study

Four cups of coffee a day may raise early death risk in younger adults

4 Cups of Coffee a Day Can Be Deadly

New Study: Coffee Can Kill You

Under 55? Think twice before you reach for that extra cup of coffee, researchers say

After seeing these reports on the web and morning news, I had a thought as I reached for my morning cup of joe: Should I consider tea instead?

As a person who grew up drinking 2-3 cups of coffee a day, should I change my habits based on these news reports? What would happen if I don't? Should these reports stop my life-long friendship with Juan Valdez? More...

Filed Under:

General

International Women's Day, a Chance for Change

March 06, 2014

By Ambassador Sally G. Cowal


We celebrate International Women's Day March 8. Originally, it was an event to promote equal political rights, including the right to vote, for women. As a Chicagoan I'm proud to say that one of the earliest Women's Day observances was held in that city in 1908!

Today, although women have the right to vote almost everywhere, health inequalities and disparities between women in the developed and developing worlds -- and between men and women in many countries and regions of the world -- continue to exist.

Women's health is important, not only for women, but for men and for families. Women are the caregivers in most places in the world, and when a woman is ill or dies prematurely, her family -particularly her children - carry the burden.  That is one of the reasons why it is so important to prevent premature illness and death in women from cancer. Although we think of cancer as a disease that affects people in high income countries, the reality is that 57% of cancer cases and 65% of cancer deaths are in low and middle income countries - that is 5.3 million deaths a year.  And the trends point to a continuing shift of the burden to lower income countries.

In addition, the cancer experience in lower income countries is very different from the experience of cancer patients in the US. For example, in the US, 60% of breast cancer cases are diagnosed in the earliest stages of disease, whereas in Brazil only 20%, and in Mexico, only 10% are diagnosed at an early stage. When cancer is caught later, treatment is less likely to be successful.  As a result, advances in cancer survival that we have experienced over the last few decades in the US are not reflected in the experiences of people with cancer in lower income countries. More...

Does it matter if a cancer center is accredited?

February 25, 2014

By Katherine Sharpe, MTS

 

Recently, in a meeting, a representative from another patient advocacy organization made a comment that caught my attention. He said, "People vet their plumbing company more than they do their hospital." I reflected on this comment and for many people that is probably true. The Better Business Bureau has long offered "grades" on businesses, based on certain criteria. But with about 5,000 hospitals nationwide, how do you know which are the most trustworthy and are best to give treatment?

What is accreditation?


One way is through accreditation. Accreditation, simply put, is a formal process to show that a hospital meets certain standards. The standards are designed to improve the safety and quality of care provided to patients and encourage continuous improvement efforts within a hospital.

The standards focus on how patients receive care, what kinds of rights patients have, and hospital functions that are essential to providing safe, high-quality care. These might include things like clinical ethics (the making of "right" decisions in the delivery of health care), infection control and prevention, how the building is managed and maintained, and how patient information is managed. Accreditation standards are usually seen as cutting-edge yet achievable for hospitals.

These quality measures have been developed for several disease types. In cancer, for example, a facility might be required to have wide-ranging diagnostic and treatment services on-site and participate in cancer-related clinical research.  

Also, there can be varying categories of accreditation, so that the best fit can be established for a particular type of center. Standards for pediatric cancer facility might be different from those for an adult cancer center, for instance. More...

Filed Under:

General

How I talk to patients about clinical trials

December 02, 2013

By Fadlo R. Khuri, MD, FACP

 

As a physician focused on the treatment of patients with cancer, many of whom face a potentially incurable disease, I make 3 promises to my patients:

1) We will always tell them the truth.

2) We will always do our very best for them, placing their interests and those of their families above all others.

3) We will never abandon them. 

These are important words to relay to a patient, particularly those who are considering participating in clinical trials.  The question, then, is, "Why should cancer patients participate in clinical trials?"

Cancer clinical trials are one of the most important methods we have to move the field forward. After all, it was through clinical trials that we have developed cures for childhood acute leukemia, Hodgkin disease, and testicular cancer, how we developed long-term highly effective therapies for chronic myeloid leukemia and breast cancer, and how we created personalized genetic therapies for lung cancer, melanoma, and other diseases. Cancer clinical trials also let us know how patients are feeling about their care, and can improve approaches for the treatment, prevention, and cancer screening tests for cancer patients. 

One of the first things I do as the treating physician is to complete a history and physical exam of the patient. The information I gather helps me form an opinion, and it helps me gain the trust of the patient and his or her family. 

After obtaining the history and physical information that I need, I discuss standards of care and explain why this care, like radiation or chemotherapy, might work (or not work). It is important to acknowledge our limits while reassuring patients of our considerable experience in treating others with a similar disease. I have occasionally seen physicians who rush to discuss the clinical trial before going through the full range of standard treatment options available. Identifying the standards of care and presenting them as a viable option for patients is far more likely to reassure patients that all options have been carefully considered. More...

Filed Under:

General

What is Blue Button?

September 16, 2013

[Ed. note: This guest post by Lygeia Ricciardi of the Office of Consumer eHealth, Office of the National Coordinator for Health Information Technology, US Department of Health and Human Services, explains how the Blue Button can help you access and use your healthcare records.]

 

Wouldn't you like to have key information about your health or the health of a loved one safely and easily accessible via mobile phone or computer?

Think of Blue Button as an easy way for you to get your health records securely and electronically. It won't magically fix everything, but it's paving the way for a more personalized, convenient, and higher quality healthcare experience for patients and their families by putting vital information at their fingertips.

The Blue Button symbol is now appearing on health-related websites nationwide. Click it to get key information from your personal health records securely and electronically from your doctor, insurance company, pharmacy, or lab. You can check your information, share it, and use it to manage your health... and make your life easier. More...

Filed Under:

General

Does drinking alcohol increase the risk of cancer?

June 26, 2013

By Susan M. Gapstur, PhD, MPH


Do you enjoy an occasional, or even a daily, glass of wine, beer, or other drink that contains alcohol? Many adults do. Indeed, 37% of adults in the U.S. report drinking low to moderate amounts, which is, on average, up to 1 drink per day if you are a woman, and 2 drinks per day if you are a man. Another 28% of adults drink more each day, which is considered heavy drinking. A drink of alcohol is generally defined as 12 ounces of beer, 5 ounces of wine, or 1.5 ounces of 80-proof distilled spirits.

Modest Benefit but Many Risks Associated with Alcohol Drinking


While low to moderate alcohol consumption is linked to a reduced risk of heart disease, drinking too much alcohol can increase risk of high blood pressure, heart failure, sudden death and stroke. Overall, alcohol consumption is one of the top 10 contributors to sickness and death from injuries, motor vehicle crashes, homicides and suicides, sexual assaults, sexually transmitted infections from unsafe sex, falls, birth defects, depression, disorders of the gastrointestinal tract, and sleep disorders.

Additionally, there is a lot of evidence that drinking alcohol increases the risk of several cancers. In 2007, a working group of experts convened by the World Health Organization's International Agency for Research on Cancer (IARC) reviewed the scientific evidence on alcohol and cancer risk for 27 different anatomic sites. They found sufficient evidence that alcohol drinking is a cause of cancers of the mouth, pharynx, larynx, esophagus, liver, colon, rectum, and female breast. And for cancers of the mouth, larynx, and esophagus, when people drink and use tobacco, the risks are combined to be greater than either tobacco use or alcohol use alone! More...

Filed Under:

Diet/Exercise | General

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