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Support – Cancer What Now
What Now?

Your Colorectal Cancer Treatment & Recovery Online Resource in Alberta

Answers, insights & inspiration

Step 4: Support

Where to go for help?

There is a team of people caring for you during radiation and chemotherapy. Each member of the team has an important role. Working together we ensure the best possible care. Find out more what each member of your cancer team can do for you.

Oncology Team is made up of many members:

Radiation Therapists

Radiation therapist are care providers who deliver your radiation treatments. While your Radiation Treatment is prescribed by your Radiation Oncologist, it is the Radiation Therapists who perform your simulation CT scan, plan your radiation treatment, educate you about your treatment process, and deliver the therapeutic doses of radiation. Radiation Therapists have specialized knowledge about the technical and medical aspects of your treatment, and can answer many of your questions or connect you to members of the health care team who can answer your questions best. You will see a Radiation therapist daily while receiving radiation. They are your point of first contact if you have problems or questions about your radiation.

Radiation Oncology Nurse

Every patients is assigned a primary radiation oncology nurse. They will meet you on the first week of radiation so that they can get to know you and review any questions about the radiation or side effects. They will often review your medications and provide prescriptions to use during your radiation therapy. Radiation nurses provide care to you throughout your radiation treatments and will have a planned check up weekly. These nurses have specialized knowledge about radiation treatments and the side effects that may develop, and how to manage them. Your radiation nurse may answer many of your questions about your side effects, medications, supportive services, or can connect you with other specialists that you may require during or after your radiation treatment. Each radiation oncology nurse works with your Radiation Oncologist.

Chemotherapy Nurse

Every patient is assigned a primary chemotherapy nurse. They will meet you before your start treatment and when you receive your chemotherapy. They will often review your medications and provide prescriptions to use during your chemotherapy. Chemotherapy nurses provide care to you throughout your chemotherapy and will have a planned check up with each cycle of chemo. These nurses have specialized knowledge about chemotherapy treatments and the side effects that may develop, and how to manage them. Your chemotherapy nurse may answer many of your questions about your side effects, medications, supportive services, or can connect you with other specialists that you may require during or after your chemotherapy treatment. Each chemotherapy nurse works with your Medical Oncologist.

Radiation Oncologist

Radiation oncologists are specialized doctors who prescribe radiation treatments to patients under their care. Your Radiation Oncologist studies your medical history, diagnostic procedures, and pathologic information prior to meeting with you to discuss and decide what the best treatment option for you would be. There are many technical, physical and emotional aspects of deciding which treatment plan would be the best option for you, and is decided upon in your consultation appointment. The Radiation Oncologist may request further diagnostic procedures and orders your simulation CT scan where you are placed in your treatment position so that the CT scan can be used for the planning of your radiation treatment. Your radiation oncologist then carefully analyzes your planning CT scan to decide where the radiation should be targeted and identifies all of your critical structures and normal tissues. Once a treatment plan has been created by a Radiation Therapist, the Radiation Oncologists with evaluate the plan and approve it for treatment. Your Radiation Oncologist will see you on a weekly basis through your radiation treatment and assist you with your side effects and medication management.

Medical Oncologist

Medical oncologists are specialized doctors who prescribe chemotherapy to patients under their care. Your medical oncologist studies your medical history, diagnostic procedures, and pathologic information prior to meeting with you to discuss and decide what the best treatment option for you would be. There are many technical, physical and emotional aspects of deciding which treatment plan would be the best option for you, and is decided upon in your consultation appointment. The medical oncologist may request further diagnostic procedures. Your medical oncologist works with your surgeon and radiation specialist to develop a combined plan of therapy. Your medical oncologist will see you on with each cycle through your chemotherapy treatment and assist you with your side effects and medication management.

RT Dayroom

The Tom Baker Cancer Centre contains a centralized area for nursing and supportive care and is known at the “RT Dayroom”. Patient are often brought to the RT Dayroom to be assessed by a radiation oncology nurse. In the RT Dayroom you may receive information, education, guidance and symptom management for concerns related to radiation therapy. Radiation oncology nurses can provide information, education and guidance how to manage many common treatment problems. RT dayroom helps patients who need daily medical attention (IVs, Tube feeds, Skin care/dressings, moderate diarrhea, moderate pain) and are well enough to remain at home.

 The Tom Baker Cancer Center RT Dayroom contact phone number: (403)521-3993

Psychosocial Oncology and Rehabilitation

Uncertain??  Lack of control??  Depressed??  Helpless??  Anxious??  Stressed??? Angry??  Alone?? Pressured to be “positive”??  Cancer causes significant emotional distress to patients & family members through all stages: diagnosis/ treatment/survivorship/ terminal illness/death/ bereavement.  Taking care of the physical and emotional well-being of you and your family is a vital part of your treatment.  

Psychosocial Oncology, as part of cancer care, offers a broad range of evidence-based therapeutic interventions to address the unique emotional/practical/social/spiritual /informational needs of GI cancer patients/family members:

  • Individual, family, and couple counseling/therapy
  • GI Men’s Support Group,
  • GI Supportive Expressive Women’s Group
  • Cognitive Behavioral Stress Management & Relaxation Program
  • I Can Sleep Program
  • Mindfulness Based Cancer Recovery Program
  • Caregiver Support Group
  • Resource Counselling:  How to get help for your finances & other basic needs
  • Psychiatric services

These services/programs can assist you and your family to handle periods of calm and turmoil, minimize emotional suffering, enhance coping/adjustment, improve quality of life, and experience extraordinary opportunities for healing.

Learn more

Other Services

  • Tom Baker downloadable patient guide
  • Colorectal Cancer Association of Canada – section on Support Resources

When should I ask for more help?

There is never a wrong time to ask for more help.

If this is an emergency (after business working hours) please call 403-944-1110

  • Let the operator know if you are a radiation or chemo patient
  • Ask for the Oncologist on Call – there will be a doctor available from 5pm – 8am

During business hours contact your Nurse.

Always get help and seek medical advice if:

  • You have a temperature or fever > 38.3 deg and receiving chemotherapy
  • You have lots of liquid diarrhea > 1.5 L (5 cups) in day.
  • Severe pain
  • You have new and unusual symptoms during treatment

If you have questions for the doctor that are not urgent write down your questions and save them for your weekly meeting.

How do I deal with Diarrhea?

Diarrhea has 3 elements that are important.

  1. Number: How many times per day did you go
  2. Volume: How much did you go?
  3. Consistency: Was the stool watery or more solid (like toothpaste)

More than 5 large volume BM or > 5 Cups / day in an ostomy is concerning. You could become dehydrated which can cause a vicious cycle of worsening diarrhea. It is important to treat this aggressively early (within 24 hours) and speak to your medical team.

Some patients have many many small urgent bowel movements passing gas, mucous and small amounts of stool . This Is NOT Diarrhea – this is likely irritation of the area by the tumor or treatment

What can I do to prevent Diarrhea?

  • Begin using Metamucil 1-2 scoops in a glass of water daily usually on the first week of Radiation
  • Metamucil acts to protect your bowel from radiation injury
  • It help with BOTH diarrhea and constipation making your stools more formed soft and less irritating
    • If you do not like the flavor Metamucil comes in many different flavors including sugar free
    • If you do not like the consistency Metamucil comes in Tablet, or Cookies

Dietary advice to prevent diarrhea

  • Maintaining your health and nutrition are difficult during treatment
  • We typically recommend a low residue diet during radiation
  • Avoiding foods that cause you gas bloating or diarrhea
  • Common foods to avoid are:
    • Milk products (Lactose)
    • Beans
    • Whole wheat and high fibre foods
    • Broccoli
    • Cheese and Greasy foods

What do I do to treat Diarrhea?

Imodium

  • We suggest monitoring your Bowel movements carefully during radiation
  • Make sure that you drink > 8 cups of fluids / day so that you do not become dehydrated
    • As soon as you start having more liquid or volume of stools begin using Imodium immediately
    • Inform your Radiation Therapist, Nurse and Doctor the next day
    • You can use up to 8 tablets of Imodium per day
    • We suggest using 2 tablets 2-3 time per day if you start having diarrhea
    • If after 24 hours you continue to have diarrhea increase to 2 Tablets 4 times / day
      • If this doesn’t reduce your diarrhea – You should seek medical attention

Call 403 944 1110 – and ask for the Oncologist on Call and seek urgent advice 

Learn More about diarrhea click here

How do I deal with other side effects?

Fatigue

Fatigue builds slowly through treatment. It is your body’s way of telling you that its fighting the cancer and trying to heal. Listen to your body. The best way to fight fatigue is to:

  • Be active – you need to remain active to fight fatigue. If you spend all day sitting around your fatigue will get worse. Try to be active do the things that you enjoy, as much as possible
  • Eat Well – make sure that you are eating nutritious healthy meals and drinking enough fluids. Your body needs energy to fight the cancer and to heal.
  • Sleep well – If you have been active you may still feel the need to stop and take a nap, listen to your body. When it tells you to stop you should stop and take a break or a nap. Use sleep hygiene to ensure good quality sleep

Learn More

Urinary Burning

Some patients develop burning when they urinate. You can drink more water to ensure that your urine is not too concentrated. Sometimes drinking cranberry juice, concentrate or eating cranberry concentrate tablets can reduce urinary irritation. If this symptom persists please talk to your nurse as this could be a sign of an infection.

Skin redness or irritation

Glaxal Skin cream

Begin using the cream within the first 2-3 weeks of radiation in all the area of the Groin and skin folds of the buttocks. Do not place the cream right before radiation – but you may put it on anytime afterwards. Be generous and apply liberally as many times per day as needed.

Avoid Rubbing

Avoid rubbing the skin with rough materials, soaps or scented products

Sitz Bath

Ask your nurse for a sitz bath, you can do this several times per day to ensure that your skin is soothed and clean. Sometimes people place epsom salts – some people find this soothing. Use very little salt so that the water tastes no saltier than a tear drop. After your sitz bath pat the skin dry and let it air.

Air your skin

Let your irritated skin breath several times per day using a fan, or loose clothing

Proctomyxin cream or Suppositories

Use externally for itching or burning

Nausea

You will receive prescriptions for anti nauseant medication

The most common mediation is called:

 

Pronunciation

Maxeran

Max-RAN

Metoclopramide

Met-o-KLO-pra-MIDE

Stemetil

Ste-Metal

Prochlorperazine

Pro-CLOW-per-A-zine

  • These are ALL the same / similar Drug
  • Use this every 4 hours as needed to treat nausea
  • You can take this medication even BEFORE you have nausea to prevent it