How To Receive Complete Cancer Care:
Empowering Body, Mind and Spirit
Robert Rutledge, MD, FRCPCRadiation Oncologist and Associate Professor
Dalhousie University, Halifax
HealingandCancer.org
Overview
• Empower yourself with the best strategy to face a cancer diagnosis
• Maximize your chance of being cured or living as long and as well as possible
• Increase your sense of well being• Find purpose on your journey
HealingandCancer.org
Use What Works For You
• There is no one best way
• We are all unique
• Different strategies work best for various
personalities
• Use your rational mind and listen to your
own inner wisdom
• Your strategy will change with time
• Different needs at diagnosis, on treatment and in
follow up
HealingandCancer.org
What is Complete Cancer Care?
• Understanding what’s happening to you
• Getting the best from the medical system
• Empowering yourself with healthy lifestyle
• Exercise, diet, sleep, relaxation techniques
• Adopting a positive attitude
• Drawing on a spiritual life
HealingandCancer.org
Information is Power
Learn about
• Cancer in general
• Treatment options and side effects
• The medical system
• What else you can do
• Lifestyle habits
• Where to find support
• Role of complementary and alternative medicine
HealingandCancer.org
Purpose of Information
• Learn to speak the language of the medical system
• Increase your sense of control and well-being
• Help you make the best medical decisions
• Empower yourself with non-medical ways to improve your health and outcome
HealingandCancer.org
Too Much Information?
• If information gathering is making you tired
• If you find conflicting information
• See your doctor to clarify
• Trust what you are doing is the best for you
HealingandCancer.org
Best Sources of Information
• Your physician/oncologist - individualizes the
information and gives you the best medical advice
• Prepare for these conversations by researching and
understanding cancer in advance
HealingandCancer.org
Sources of General Information about Cancer and its Treatment
• Librarian at a cancer centre or hospital
• National Cancer Society
• Eg. Canadian Cancer Society - www.cancer.ca
• Respected Community Based Organization
• Eg. Leukemia and Lymphoma society of Canada
HealingandCancer.org
How to Get the Most from the Health Care System
Learn to advocate for yourself by:
• Preparing for each doctor’s visit
• Contacting your doctor/nurse if you have questions or
concerns
• Drawing on extra services if needed
• Asking for a second opinion if needed
HealingandCancer.org
Getting the Most from your Doctor’s Visit
Before the visit:
• Create a concise summary of symptoms
• Bring a list of current medications and allergies
• Write down your questions before the visit
• Someone should accompany you
• Decide who will make record of the visit
• You may create a file with all your test results
• You can get a copy by visiting medical records
HealingandCancer.org
• Be honest and open• Speak up if you’re feeling overwhelmed: “I’m not sure I
understand”• Wait until the summary then ask all your questions• Take notes or record the interview• Find out what to expect• Know what to do for each side effect
• When do I need to act?
• Who you should call in case of problems?
Getting the Most From Your Doctor’s Visit
HealingandCancer.org
After Your Doctor’s Visit
• Keep a journal and list of results• If need be ask for a family conference• You are the most important person• You or a ‘family member’ may be able to do the talking• Call to clarify information or ask for appointment• You are entitled to a second opinion
HealingandCancer.org
Getting More Physical Care
• Multiple services are available in medical system• Nutrition
• Psychology
• Home care nursing
• Rehabilitation
• Spiritual care
• Palliative Care Team
• Social worker can help coordinate if needed
• Ask your nurse or doctor
• Talk to an expert
HealingandCancer.org
The Importance of Nutrition
• Effective way to improve your overall health
• Individualize to what works for you• Different diet during different phases of treatment
• Ask your doctor and/or professional nutritionist if persistent problems with:• Ongoing unintentional weight loss or loss of muscle
• Nausea and vomiting
• Diarrhea / constipation
• Treatment affecting the GI tract
HealingandCancer.org
General Nutrition Advice
• Follow Canada’s Food Guide recommendations www.hc-sc.gc.ca/fn-an/food-guide-alimentindex_e.html
• Choose a variety of food from all food groups daily
• 5-10 servings of fruits and vegetables/day
• Choose lower fat food groups• Fat to make up < 20% of caloric intake
• Choose high fiber foods• Whole grain breads and cereals
• Drink plenty of healthful fluids
• Maintain healthy weight
HealingandCancer.org
Taking Your Vitamins
• Ask your doctor
• Off therapy minimum:• Vitamin D 1000 IU / day
• Calcium 1,500 mg / day
• Healthy diet should provide the rest
HealingandCancer.org
The Benefits of Exercise
• Effective way to improve energy, sleep,
mood and overall health
• You need to listen to your body to guide
yourself
• Individualize to phase of journey
• Slowly increase activity each week
• After recovery, aim for at least 30 minutes
5+ days/week
HealingandCancer.org
The Importance of Sleep
• Melatonin experiments (hormone)
which suppresses cancer cells
• Need an average of 7-8 hours of
sleep per night
• Take care of yourself
HealingandCancer.org
Practice Relaxation
• Learn to relax
• Practice relaxation
techniques (i.e., yoga,
meditation, Tai Chi) to
calm the mind
• Proven to improve overall health
• Decreases heart disease, mental illness, hypertension,
and diabetes
HealingandCancer.org
Understanding the Emotional Aspects of Cancer
• Normal to feel any and every emotion including:
• Shock
• Worried, scared or anxious
• Guilty
• Lonely
• Sad or hopeless
• Angry
• These emotions can be exaggerated or come out
unexpectedly
HealingandCancer.org
Dealing with Difficult Emotions
• There’s no one right way
• Find a wise person to talk to
• Realize emotions change with time
• Be kind to yourself
HealingandCancer.org
When to Get Help with Emotional Problems
• Emotional distress is expected but if you:
• Feel overly depressed e.g., crying constantly
• Are withdrawing from all social contact
• Unable to enjoy life / feel hopeless
• Are so distressed can’t decide on treatment
• Can’t sleep because of anxiety
• Can’t talk about cancer because it brings up terrible
memories
• Talk to a psychologist
HealingandCancer.org
How to Get Help with Emotional Distress
• Tell your oncologist or nurse during the next
appointment
• Schedule a visit to your family doctor
• Call the psychologist / counsellor at the cancer centre
• Find another expert
• Support groups