Oncology and Hematology

They are the study of cancers and blood disorders.

Not everyone needs chemotherapy and radiation.

There are many types of cancer treatments that are TAILORED to individual’s needs. Surgery, chemotherapy and radiation are types of cancer treatment.

A treatment plan tailored to your cancer will be developed with you and your provider.

Radiation services are contracted to outside facility through the VA.

Resource: Information and support - Macmillan Cancer
Video: Chemotherapy Basics 

At Robley Rex VA Medical Center, 3 South

Many cancers are watched with scans periodically during treatment, there are also blood tests that monitor some cancers.

What is a Cat Scan?

Please visit: https://www.radiologyinfo.org

What is a PET Scan?

Please visit: https://www.radiologyinfo.org

What is a Mammogram?

Mammogram X-Plain

How to do a breast self-examination

Can I eat before chemotherapy?

Yes.

Can I bring food with me?

Yes. Light snacks like peanut butter crackers, chicken salad, puddings and juice are available for veterans.

There is a cafeteria located on the second floor in which food can be purchased.

There is a refrigerator available on chemotherapy unit where food can be placed, ask at the desk so name can be placed on food from home.

Yes.

Chemotherapy is given at Robley Rex VA Hematology/Oncology Treatment Unit (HOTU) located on 3 South, 800 Zorn Ave, Louisville KY 40206.

Veterans receiving chemotherapy will be either in a hospital room or in a large treatment room with reclining chairs.

There are restrooms in the hospital rooms and across from the elevators for people in the treatment room.

No.

It is usually recommended for the first treatment, so that you and your family can get more comfortable with the process.

It is OK to bring a family member/friend with you to treatment.

No.

You may want one for your first chemo until you see how well you do.

Sometimes medicines are given prior to chemo and may make you tired/drowsy.

MOST PEOPLE DO NOT GET SICK ON THE DAY OF CHEMO

You could have some nausea with chemotherapy.

You will be given medications prior to most chemotherapies to prevent nausea/vomiting and be given medications for home.

NOT everyone gets nauseated/vomits with chemo.

Each chemo is different and some have a higher potential to cause nausea so more medications are given prior to chemo and even after chemotherapy to prevent this.

Comfortable clothes.

NOT all chemotherapies require ports (implanted devices under skin).

Some chemotherapies require a port placed under their skin for chemo to be given thru.

Some veterans need a port because their veins are not very good for chemo.

Resource: Your Implanted Port --  Memorial Sloan Kettering Cancer Center

You will meet with the oncology nutritionist on your first chemotherapy day who will help guide your food/drink requirements.

REMEMBER: You MUST keep eating even though foods may not taste the same and MUST keep drinking water to stay hydrated.

NOT A GOOD TIME FOR A DIET!!

Resources: Eating Hints: National Cancer Institute

Getting proper nutrition during cancer treatment can help you fight infections, give you needed energy to tolerate cancer therapy, help your body heal, and give you a better chance at recovering from your cancer. Keep in mind that your nutritional needs may change during your treatment.

Both chemotherapy and radiation treatments may affect your nutritional status. The most common side effect is loss of appetite. You may also experience altered taste, nausea, diarrhea, dehydration, sore mouth and throat. There are things you can do to reduce or eliminate these. Consult with your dietitian for assistance with your specific needs and concerns.

Please check with your oncology/hematology provider before taking ANY herbal supplements.

Some of these supplements may make chemotherapy less effective, so alert your provider of any herbal supplements so that they can be checked for any interactions.

Resource: Memorial Sloan Kettering Herbal webpage

Yes.

It will be important for you to stay away from people who are sick during treatment.

If you have an event to attend such as wedding/graduation-GO!

Just be careful and use strict handwashing!!

We can provide you with masks to wear for events if you need some.

Some side effects that a person CAN have with chemo are rash, infection, drop in blood counts, nausea/vomiting, diarrhea, hair loss, fatigue, loss of appetite, weight loss and/or change in taste of foods.

EACH chemo has different side effects and EACH person has different side effects.

Some chemotherapies will cause HAIR LOSS until after treatment has completed, NOT ALL CAUSE HAIR LOSS.

Resources: Tips for Managing Chemotherapy Side Effects:

• Understanding Chemotherapy Fact Sheet
• Side Effects of Chemotherapy
• Understanding and Managing Chemotherapy Side Effects
• Side Effects of Chemotherapy
• Hand-Foot Syndrome and Hand-Foot Skin Reaction

Each veteran receiving chemo will be assigned an oncology/hematology nurse navigator to assist with any questions and will be given their contact numbers for questions.

The phone number to 3s is for more urgent questions/ message can be left for navigators.

PROCEED to the Emergency room for any emergent issues.

MyHealthevet can be used to send a secure message your provider or nurse navigator.

Every chemotherapy regimen is different.

Chemo regimens can be daily, weekly, every other week, every 3 weeks or monthly

Your provider will be able to give you this information.

• Robin Szczapinski (Director Hematology Oncology Treatment Unit/Lead NP Medicine Service/Oncology NP)
• Cheryl Booth (Hematology/Oncology Nurse Practitioner, Robley Rex VA Stem cell Transplant Coordinator)
• Christy Threlkel (Nurse Manager, Oncology Nurse Navigator)
• Kristen Sherrard (Assistant Nurse Manager, Oncology Nurse Navigator)
• Julie Brothers (Hematology Nurse Navigator)
• Susan Thornton (Hematology/Oncology Nurse Navigator)
• Bridgette Irvin (Hematology/Oncology Nurse Navigator)
• April Walker (Hematology/Oncology Nurse Navigator)
• Ashley Bell (Infusion Nurse)
• Bobbie Hughes (Infusion Nurse)
• Megan Shelton (Infusion Nurse)
• Etta “Charlye” Dotson (Infusion Nurse)

(YES) (NO) Have you been sick lately?
(YES) (NO) Have your children/child been out of school for sickness in past week?
(YES) (NO) Have you recently received any LIVE VACCINATIONS such as SHINGLES VACCINE?

If NO to all 3 questions, people are OK to come to your home while receiving chemo

When undergoing chemotherapy, people can have their immune system weakened and are more apt to get sick.

1. Strict Handwashing. If soap and water are not available, hand sanitizers can be used.
2. Wash fresh fruits and vegetables
3. Avoid crowds and crowded places
4. Monitor self for signs/symptoms of infection:
   - Elevated temperature
   - Burning with urination
   - Cough
   - Redness/warmth on area of skin.

• WALKMED 350VL Patient Quick Reference

• https://clinicaltrials.gov/

Watch this video series:

• What is oral chemotherapy?
• Oral Chemotherapy: Handling Safely at Home
• Oral Chemotherapy: Remembering to Take It

What is cancer survivorship? Living with, through and after cancer

Recommendations

• Keep up to date with all cancer screenings
• Live a healthy life, stay active
• No Smoking or illicit drug use
• Use moderation with alcohol

For More information about cancer survivorship and recommendations, see below link:

• Cancer Survivorship & Nutrition - pending
• Living Well During Treatment

Click on links below for information about where and how to stay active, community resources:

• Survivorship - National Cancer Institute
• CDC - Cancer Survivorship
• Livestrong at the YMCA
• Gilda’s Club Louisville

Smoking Cessation at Robley Rex VA:
Coordinator: Patricia Weiter
Phone:

• What is Palliative Care? - Palliative Medicine & Treatment
• Understanding Advance Directives, Living Wills, Power of Attorney

• List of Service Officers in Indiana to assist Veterans with filing VA claims
• Jefferson County Assistance Programs
• How to apply for Social Security Benefits

Oncology/Hematology Social Worker:
Susan Marcum
Phone:

Watch this video for information about Immunotherapy and its possible side effects:

https://www.youtube.com/watch?v=CfKYcd8G0Cs