Survey
* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
Anne Katz, PhD, RN Monday April 11th 11:55am Helping families into and through survivorship While many patients and their families welcome the end of the active phase of treatment for breast cancer, transitioning out of the intense treatment phase and into recovery and survivorship can be challenging. Cancer survivors and their families are not always well prepared for what comes next and health care providers have an important role to play in educating them about post-treatment changes, physical and emotional, as well as anticipatory guidance related to surveillance for recurrence. The survivorship care plan should provide a road map for post-treatment care and issues however not everyone receives the document and many patients forget that they have this piece of paper and what it comprises. Some survivorship care plans do not adequately address the many psychosocial challenges facing women after breast cancer including back to work issues, alterations to body image and sexuality, as well as the changes posed by early or sudden ovarian failure. This session will highlight the key messages that we should be providing to women in the immediate post-treatment phase as well as health behaviors that women should integrate into their life after treatment is over. Başak E. Dogan, MD Tuesday April 12, 2016 Everything You Need to Know about Radioactive Seed Localization Get off the Wire Addiction – Time to get started in RSL! Radioactive I-125 seed localization (RSL) is a new breast lesion localization technique which was developed as an alternative to pre-operative wire localization of nonpalpable breast lesions. A standard I-125 titanium seed with activities ranging 0.1000.300 mCi is implanted within targeted breast lesion. A handheld gamma probe optimized to 27keV is then utilized by the surgeon to identify the lesion intraoperatively. Lesion removal is confirmed by documenting counts in the specimen, with no residual counts in breast and/or subsequent specimen radiography. Seeds can be placed up to 5 days prior to Surgery. This allows “uncoupling” of the radiology and surgical schedule, as well as flexibility while timing placement. I-125 and Tc 99m are of different Geiger counter peaks and can be individually distinguished with handheld Gamma detection probe if concomitant sentinel lymph node biopsy is being performed. Studies consistently show increased patient satisfaction, improved scheduling, shorter localization procedure and OR times. Randomized controlled trials (RCT) and cohort studies report at least equal success to imaging-guided needle localization (NL) for achieving negative surgical margins; some cohort studies suggest improved negative margin and re-excision rates. Procedure is user friendly for the radiologists and is a preferred method for non-palpable localization among surgeons. One of the greatest barriers in implementation of RSL is the off-label use of I-125 brachytherapy seeds for this procedure. While application for breast localization is vastly different, NRC rules and regulations governing the process is the same as for its radiation therapy use. Another issue is the long half-life of I125 seeds rendering storage problematic, while dispensing carries liability after their use. After seed insertions, patients carry minimal radioactivity, and while the full body dose from a single seed for the purposes of localization is minimal, in the event it is not removed, dose needs to be calculated, documented and reported to NRC. Lastly, there is a lack of trained individuals who are credentialed to perform RSL procedure both in Radiology and Surgery communities. Implementation of RSL procedure is a complex and multidisciplinary process that involves Radiology, Radiation Safety, Nuclear Medicine, Surgery and Pathology departments. One or more authorized users must be determined, which are responsible for proctoring other practitioners. Each practitioner is required to take an annual Radiation Safety test, and adhere to a pre-developed protocol during insertion and removal. To ensure the safe and appropriate use of the seeds, they must be tracked appropriately from ordering to retrieval and return to the seed vendor. Special care must be taken to ensure none of the seeds are lost, all deployed seeds are accounted for and transection of a seed during removal does not occur. In my presentation entitled: “Get Off the Wire Addiction – Time To Get Started in RSL!” I will review the legacy localization techniques and outcomes, explain in detail the documentation and framework required for successful program development. I will address and illustrate our solutions to seed selection, storage, dispensing and outline the key points of seed procedure planning and insertion by the Radiologist, communication and reporting to the surgeon. James A. Simon, MD, CCD, NCMP, IF, FACOG Saturday April 9th 2:10pm Navigation/Survivorship Break out Fertility Issues Facing Women with Breast Cancer Decreased ovarian function following a breast cancer diagnosis results in reduced fertility whether from a delay in childbearing during breast cancer treatment or the adverse effects of adjuvant chemotherapy or both. Approaches to assessing current fertility and ovarian follicular “reserve” prior to definitive breast cancer therapy may facilitate more realistic expectations of post-treatment fertility. Setting realistic goals can go a long way to reducing anxiety and frustration. Current approaches to preventing or minimizing the adverse effects of adjuvant chemotherapy on future ovarian function will be reviewed. The brave new world of oocyte and embryo cryopreservation, ovarian transplantation, as well as cutting edge treatments using the energy-producing mitochondria from egg precursor cells (immature egg cells found in the protective lining of the ovaries) or mitochondria from younger more fertile women to supplement the existing mitochondria to boost the older eggs’ energy levels for better embryo development will be reviewed along with the inherent risks, benefits, and costs of these procedures. Sally Swift Joyce Sunday April 10th 1:30pm in the Navigation Break Out Camp Hope: An Escape from Cancer At Northside Hospital-Atlanta, we call that Camp Hope. Is it possible to give someone dealing with cancer a place to go to where they can have a time of relaxation and fellowship with others and not feel like a “PATIENT”? Camp Hope is a place where people can relax, meet new friends, and learn ways to help take care of themselves both physically and mentally surrounded by country air, two lakes, walking paths, a farm, and much more. Campers relax and slow down, and find out that they can conquer more than they thought they could. With many different activities, campers find themselves opening up to many new things, from drumming, to fishing, to storytelling, to dancing and more. Camp Hope is a fee-free, three-day retreat for our patients giving them a rest from what they face every day and allowing them to just breathe. This session will explain how Camp Hope got started and how it has stayed successful for the past twelve years. It may also give you pointers on how your hospital can start a similar program.