IN THISISSUE: 2 Benefits of Tobacco

Cessation for Cancer Patients

4 Getting the Most From Your Doctors’ Visits

7 Nutrition After Cancer Treatment Ends

Finding colorectal cancer earlyColorectal cancer is often found after symptoms appear; in fact, most people with early colon or rectal cancer have no symptoms of the disease. Symptoms usually appear only with more advanced disease, which is why getting the recommended screening tests before any symptoms develop is so important.

Regular screening can often find colorectal cancer early, when it is most likely to be curable. In many cases, screening can also prevent colorectal cancer altogether because some polyps, or growths, can be found and removed before they have the chance to turn into cancer.

Signs and symptoms of colorectal cancer

Colorectal cancer may cause one or more of the symptoms below. If you have any of the following you should see your doctor:

• A change in bowel habits, such as diarrhea, constipation, or narrowing of the stool, that lasts for more than a few days

• A feeling that you need to have a bowel movement that is not relieved by doing so

• Rectal bleeding, dark stools, or blood in the stool (often, though, the stool will look normal)

• Cramping or abdominal pain

• Weakness and fatigue

• Unintended weight loss

Most of these symptoms are more often caused by conditions other than colorectal cancer, such as infection, hemorrhoids, irritable bowel syndrome, or inflammatory bowel disease. Still, if you have any of these problems, it’s important to see your doctor right away so the cause can be found and treated, if needed.

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A newsletter for those affected by cancer

SPRING 2014

HEALING

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Colorectal cancer awareness quizTrue or False?

1. Age does not affect colon cancer risk.

2. Diet can affect your risk for colon cancer.

3. Colon cancer is preventable.

at age 50. Talk to your doctor about earlier screenings if you have personal or family history of polyps or colon cancer, as these are factors that place you at higher risk of developing colon cancer.

Answers:1. FALSE. The risk of colon cancer

increases as you get older. More than 90% of diagnoses occur after the age of 50. That’s why you should schedule regular colon cancer screenings starting

Benefits of Tobacco Cessation for Cancer Patients

Surgery:If you require surgery, quitting tobacco now will…• Promote faster wound healing. Tobacco use causes

blood vessels to constrict, and wounds do not heal as well.

• Lessen danger of getting respiratory infections after surgery.

Radiation Therapy:If you undergo radiation treatments, quitting tobacco now will…• Reduce likelihood of complications such as tissue

breakdown around the radiation site as well as scarring.

• Decrease infections which can cause poor healing.

Chemotherapy:If you undergo chemotherapy, quitting tobacco now will…• Maximize the positive effects of chemotherapy drugs

as tobacco use can interfere with their effectiveness.• Decrease side effects such as nausea.

Pain Management:If you are working to manage pain symptoms, quitting tobacco now will…• Maximize the effectiveness of pain medications.

People who smoke or use chewing tobacco tend to have more pain as tobacco can interfere with the body’s ability to respond positively to medications including opioids. Tobacco use can decrease analgesic effects of pain medications.

General Improvement in Quality of Life for Cancer Patients:• Improved sense of smell and taste• Improved appetite and less weight loss• Less nausea• Decreased shortness of breath• Fewer respiratory problems• Fewer headaches• Less depression

Cancer Recurrence:• People who have both smoking-related and non—

smoking-related cancers face an increased risk of their cancer recurring at the same site or another site if they continue to smoke.

• Continuing to smoke after a cancer diagnosis increases the risk of recurrence for up to 20 years after the original diagnosis.1

1Smoking as a Risk for Second Malignancy (Cancer.gov)

It’s never too late to quit using tobacco. Whether or not you have a serious illness like cancer, quitting tobacco is beneficial to your overall health. If you are interested in quitting, please call the Catholic Health Initiatives cancer center nearest you to find out what resources are available in your area.

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2. TRUE. A diet high in fat, processed foods and red meats increases the risk of colon cancer, so limit your consumption of these foods. Eating a diet rich in fruits and vegetables, whole grain breads and cereals, and nuts and beans can decrease your risk. Maintaining an ideal body weight and exercising regularly also appears to reduce risk.

What is an electronic health record (EHR)?An electronic health record (EHR) is a digital version of a patient’s paper chart. EHRs are real-time, patient-centered records that make information available instantly and securely to authorized users. While an EHR does contain the medical and treatment histories of patients,

an EHR system is built to go beyond standard clinical data collected in a provider’s office and can be inclusive of a broader view of a patient’s care. EHRs can:

• Contain a patient’s medical history, diagnoses, medications, treatment plans, immunization dates, allergies, radiology images, and laboratory and test results

• Allow access to evidence-based tools that providers can use to make decisions about a patient’s care

• Automate and streamline provider workflow

One of the key features of an EHR is that health information can be created and managed by authorized providers in a digital format capable of being shared with other providers across more than one health care organization. EHRs are built to share information with other health care providers and organizations – such as laboratories, specialists, medical imaging facilities, pharmacies, emergency facilities, and school

and workplace clinics – so they

contain information from all clinicians involved in a patient’s care1.

CHI Nebraska Cancer Centers recently completed implementation of its electronic health record, Elekta MOSAIQ®. On January 17, the Oncology EHR team finished converting the radiation oncology departments at the three CHI Nebraska cancer centers—Saint Elizabeth Radiation Therapy Department, Lincoln; Good Samaritan Hospital Cancer Center, Kearney; and Saint Francis Cancer Treatment Center, Grand Island. In December, the medical oncology departments in Kearney, Grand Island and its Hastings clinic were converted from paper to MOSAIQ.

The completion of these waves caps a project that has spanned more than two years. MOSAIQ will ensure that CHI Nebraska Oncology becomes a more unified, well-coordinated network of cancer centers, capable of sharing best practices with each other and continue delivering safe, well-coordinated care to patients. v

1What is an electronic health record (EHR)? ( HealthIT.gov).

3. TRUE. If polyps are found and removed early enough through a colonoscopy, the cancer can be prevented before it gets started. If cancer is detected and found early, 90% of cases are curable.

Information courtesy of Cleveland Clinic http://www.clevelandclinic.org/health/interactive/coloncancer.asp

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Getting the Most from Your Doctors’ Visits >>>

Talking with your doctor isn’t always easy, and with the average face-to-face time only lasting around seven minutes, you don’t have a lot of time in which to do it. In order to make the most of your visit, it’s important that you get prepared ahead of time.

Before your appointment:

• If you’re seeing a new doctor, call ahead to make sure the visit will be covered by your insurance. Many insurance companies have that information available online, but you’ll also want to verify coverage with the business staff at the clinic.

• Get your ducks in a row before you get to the doctor’s office. Prepare a list of your questions and concerns, as well as a list of your current medications (prescription and non-prescription). Keeping a personal health journal is also helpful so you don’t forget any details.

• Bring a pen and pad to take notes, or bring a friend or relative with you to the appointment. It’s easy to forget what the doctor tells you, so it helps to write it down or have a second set of ears with you.

During your appointment:

• Dress appropriately for your visit. Your doctor will need to see and feel the parts of your body in question, so it’s best to not wear multiple layers of clothing if your doctor needs to listen to your heart or lungs.

• Be specific about your symptoms. Let your doctor know what the symptom is, when it started, how long it lasts, how often it happens, what makes it worse or better, and anything it prevents you from doing.

• Inform your doctor of all the medications you are taking, including vitamins and supplements. It’s important to let them know EVERYTHING you are taking, as some medications cause problems when taken together.

• Answer all of your doctor’s questions honestly. Don’t’ leave out details even if they are embarrassing – your doctor and nurse have heard it all

before, and leaving things out can prevent them from giving you an accurate diagnosis.

• Try to avoid self-diagnosing or demanding specific medications or treatments. You may have consulted “Dr. Google” and think you have the answers, but let your doctor determine what’s wrong and what treatment is best.

Before you leave:

• Make sure you understand your diagnosis – what it means, what’s the best way to learn more about it, and if there are things you can do to ease the symptoms.

• Find out your next steps, such as completing further testing, scheduling a follow-up appointment, or simply calling back if you’re not feeling better. Don’t be afraid to ask for clarification, or for a printed copy of your doctor’s instructions, and don’t leave until you are certain about your diagnosis or treatment plan.

• Ask about signs or symptoms you should watch for, and at what point you need to call in if you experience something abnormal. Find out the best way to reach the doctor or nurse, whether it’s for general questions or for an emergency.

Being prepared and knowing the right questions to ask can help you make the most of your doctor’s visit and give you an active role in managing your health. v

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American Cancer Society recommendations for colorectal cancer early detection:

People at average risk

The American Cancer Society believes that preventing colorectal cancer (and not just finding it early) should be a major reason for getting tested. Finding and removing polyps keeps some people from getting colorectal cancer. Tests that have the best chance of finding both polyps and cancer are preferred if these tests are available to you and you are willing to have them.

Beginning at age 50, both men and women at average risk for developing colorectal cancer should have a colonoscopy.

People at increased or high risk

If you are at an increased or high risk of colorectal cancer,

you should begin colorectal cancer screening before age 50 and/or be screened more often. The following conditions make your risk higher than average:

• A personal history of colorectal cancer or adenomatous polyps

• A personal history of inflammatory bowel disease (ulcerative colitis or Crohn’s disease)

• A strong family history of colorectal cancer or polyps (see “Risk factors for colorectal cancer”)

• A known family history of a hereditary colorectal cancer syndrome such as familial adenomatous polyposis (FAP) or hereditary non-polyposis colon cancer (HNPCC)

If you fall into any of these categories, talk to your doctor about how often and when you should be screened. v

Finding Colorectal Cancer Early(continued from cover)

The Rollin’ Colon, an inflatable colon, is coming to Grand Island.

Central District Health Department (CDHD) is bringing an incredible, inflatable, interactive replica of a human colon – big enough to walk through – to the Conestoga Mall to educate people about the risks, symptoms, prevention, early detection, and treatment options for colorectal cancer.

The 20-foot long, 8-foot high Inflatable Colon will be on display at the Conestoga Mall March 14-16, 2014, during regular mall hours. Visitors can walk through, at no charge, to get a close-up look at healthy colon tissue, tissue with non-malignant colorectal diseases, and tissue with various stages of colorectal cancer. Representatives from the CDHD and Saint Francis Cancer Treatment Center will be on hand to educate visitors and give tours through the inflatable colon.

“Colon cancer is the third most common cancer diagnosed in both men and

women in the United States,” said Dr. Copur, Director of Medical Oncology at Saint Francis Cancer Treatment Center. “Overall, a person’s lifetime risk of developing colorectal cancer is about 1 in 20 (5%). Fortunately, because of increased screening efforts, the death rate for colon cancer in both men and women has been dropping for more than 20 years.”

The Inflatable Colon exhibit is sponsored by Central District Health Department and the Great Plains Colon Cancer Task Force. The Task Force was formed in 1999 in the interest of increasing public awareness of colon cancer and the importance of early detection and prevention.

Health organizations, businesses, colon cancer survivors and volunteers throughout the community collaborated to develop a comprehensive effort to get the community talking about colon cancer, provide free colon cancer screening through FOBT kit distribution and save lives.

Bringing this diverse group together has strengthened our efforts in reaching more people with the message of education, detection and prevention. The Task Force is taking the taboo out of colon cancer and helping people realize that it is highly preventable and can be discussed openly.

The Great Plains Colon Cancer Task Force is dedicated to increasing the number of lives saved from colon cancer by promoting education, early detection and prevention. v

The Rollin’ Colon:A fun and educational journey for colon cancer awareness

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In the CommunityA look at the upcoming events in your area

SPECIAL EVENTS

Good Samaritan:

• The Annual Colorectal Screening Program will take place March 10-21; interested parties should call 1-800-865-7884 to request a free test kit.

• The Annual Cancer Survivors Day Celebration will be held on Thursday, April 24, at St. James Catholic Church.

• Breast health information will be provided at the Taste of Home Cooking Expo on Tuesday, March 11, at the Buffalo County Fairgrounds Exhibit Building.

Saint Elizabeth:

• The “Celebrate More Victories” event honoring colorectal cancer survivors will take place Monday, March 3, at Saint Elizabeth. The program begins at 6pm on the lower level of the hospital, and will include a social hour, music, a light dinner and guest speakers. Please RSVP to 402-219-7000.

Saint Francis:

• The Rollin’ Colon will be set up at the Conestoga Mall in Grand Island March 14-16. The display educates visitors about the importance of early screening, explains risk factors and symptoms, and outlines prevention tips.

• The Loup Basin Public Health Department is holding a rural health fair in Burwell on March 18. Saint Francis willl be present to provide education on cancer prevention and screenings, as well as tobacco cessation.

• “Kick Butts” day will take place at Doniphan-Trumbull schools on March 19. Students will receive education about the health risks of smoking, e-cigarette use, and chewing tobacco.

• The Minority Health Fair will be held at the Grand Island YWCA on April 26. Multiple health screenings, including clinical breast exams and FOBT kits, will be offered. The event is free and open to the public. v

ONGOING MONTHLY PROGRAMS

Good Samaritan:

• Breast Cancer Support Group meets the second Tuesday of the month at the Good Samaritan Cancer Center.

Saint Elizabeth:

• Breast Cancer Support Group meets the first Wednesday of the month in the waiting room of the Radiation Therapy Center from 7-8:30pm.

• Expressions of Art and Hope Classes with the Lux Center for the Arts for Cancer Survivors meet the second Monday of the month at Saint Elizabeth. Upcoming topics: March 10—6-8pm: Cut-paper collage, April 14—6-8pm: Embroidery, May 12—6-8pm: Personal Still Life Painting.

• A Time to Heal, Cancer Survivor Rehabilitation Program—All Cancers Spring Session will be held Thursday evenings, 6-830pm beginning March 6 through May 22—will meet in Radiation Therapy Center at Saint Elizabeth.

Saint Francis:

• Breast Cancer Support Group meets on the second Tuesday of the month at 7pm in Conference Room 4, Saint Francis Medical Center.

• Cansurmount support group meets the first Wednesday of the month at 1:30pm in the Telehealth conference room at Saint Francis Memorial Health Center.

• From Surviving to Thriving support group meets the second Wednesday of the month at 3pm in the Telehealth conference room at Saint Francis Memorial Health Center.

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Most eating-related side effects of cancer treatments go away after treatment ends.

Sometimes side effects like poor appetite, dry mouth, change in taste or smell, trouble swallowing, or weight changes may last for some time. If this happens to you, talk to your health care team and work out a plan to deal with the problem.

As you begin to feel better, you may have questions about eating a healthy diet. Just as you wanted to go into treatment with the best nutrient stores that your diet could give you, you’ll want to do the best for yourself at this important time, too. Eating well will help you regain your strength, rebuild tissue, and feel better overall.

TIPS FOR HEALTHY EATING AFTER CANCER

Check with your doctor for any food or diet restrictions.

• Ask your dietitian to help you create a nutritious, balanced eating plan.

• Choose a variety of foods from all the food groups. Try to eat at least 2½ cups a day of fruits and vegetables, including citrus fruits and dark-green and deep-yellow vegetables.

• Eat plenty of high-fiber foods, like whole-grain breads and cereals.

• Buy a new fruit, vegetable, low-fat food, or whole-grain product each time you shop for groceries.

• Decrease the amount of fat in your meals by baking or broiling foods.

• Limit your intake of red meat to no more than 3 to 4 servings a week.

• Avoid salt-cured, smoked, and pickled foods (including bacon, sausage, and deli meats).

• Choose low-fat milk and dairy products.

• If you choose to drink alcohol, limit the amount.

If you are overweight, consider losing weight by cutting calories and increasing your activity. Choose activities that you enjoy. Check with your doctor before starting any exercise program.

Use the American Cancer Society’s Nutrition and Physical Activity During and After Cancer Treatment: Answers to Common Questions to help choose foods for a well-balanced meal plan. It is available at www.cancer.org. v

Information courtesy of the American Cancer Society

Nutrition After Cancer Treatment Ends

Should I exercise during cancer treatment and recovery?

Research strongly suggests that exercise is not only safe during cancer treatment, but it can also improve physical functioning and many aspects of quality of life. Moderate exercise has been shown to improve fatigue (extreme tiredness), anxiety, and self-esteem. It also helps heart and blood vessel fitness, muscle strength, and body composition (how much of your body is made up of fat, bone, or muscle).

People getting chemotherapy and radiation who already exercise may need to do so at a lower intensity and build up more slowly than people who are not getting cancer treatment. The main goal should be to stay as

active as possible and slowly increase your level of activity over time after treatment.

Are there special precautions survivors should consider?

Certain issues for cancer survivors may prevent or affect their ability to exercise. Some effects of treatment may increase the risk for exercise-related problems. For instance:• People with severe anemia (low

red blood cell counts) should delay activity until the anemia is better.

• Those with weak immune systems should avoid public gyms and other public places until their white blood cell counts return to safe levels.

• People getting radiation should

avoid swimming pools because chlorine may irritate the skin at the treatment area.

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Physical Activity and Cancer Treatment

Physical Activity and Cancer Treatment (continued from page 7)

Saint Francis Medical CenterSaintFrancisGI.org

2620 West Faidley Avenue • Grand Island, NE 68803(308) 384-4600

A newsletter for those affected by cancer

SPRING 2014

Saint Elizabeth Regional Medical CenterSaintElizabethOnline.com

555 South 70th Street • Lincoln, NE 68510(402) 219-8000

Good Samaritan HospitalGSHS.org

10 East 31st Street • Kearney, NE 68847(308) 865-7100

If you have questions or comments about this

newsletter, or would like to unsubscribe, please

contact Erin Martinez at emartinez@sfmc-gi.org

or (308) 398-6787.

HEALING

If you were not active before diagnosis, you should start with low-intensity activities and then slowly increase your activity level. Certain people should use extra caution to reduce their risk of falls and injuries:

• Older people

• Those with bone disease (cancer in the bones or thinning bones, such as osteoporosis)

• People with arthritis

• Anyone with nerve damage (peripheral neuropathy)

Can regular exercise reduce the risk of cancer coming back?

This has not been looked at for all types of cancer, but there have been studies of survivors of breast, colorectal, prostate, and ovarian cancers. In these studies, people with higher levels of physical activity after diagnosis lived longer and had less chance of the cancer coming back.

Still, more studies are needed to see if exercise has a direct effect on cancer growth. In the meantime, since physical activity is known to prevent heart and blood vessel disease, diabetes, and osteoporosis, cancer survivors should try to have a physically active lifestyle.

Is yoga helpful to cancer survivors?

Most of the studies of yoga in cancer have been in breast cancer patients. They have found that yoga can be helpful in terms of anxiety, depression, distress, and stress. It didn’t seem to be as helpful for more physical outcomes, such as body composition, fitness, and muscle strength. More research is needed, but to get the most benefit, it may be best to combine yoga with aerobic exercise and resistance (weight) training. v

Information courtesy of the American Cancer Society