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Rushcliffe Cancer Forum Information booklet for patients, carers, family and friends. www.rushcliffeccg.nhs.uk What to have in your medicine cabinet Even a minor illness and ailment – such as colds, headaches and diarrhoea – can disrupt your life. Be prepared for most common ailments by keeping a well-stocked medicine cabinet at home. This list is not exhaustive, but it will help you deal with most minor ailments. Always follow the directions on medicine packets and information leaflets, and never exceed the stated dose. If you have further questions about any of these medicines or you want to buy them, ask your local pharmacist. The Rushcliffe Cancer Forum was formed in October Always keep medicines out of the sight and reach of children. A high and 2003 to developa cool, anddry place is improveideal. communication and lockable cupboard in understanding between and professionals Regularly check the expiry dates. If patients, a medicine iscarers past its use-by date, don’t use Commissioning (CCG). itwithin or throwRushcliffe it away. Take Clinical it to your pharmacy, where it canGroup be disposed of safely. The forum has developed this booklet to provide useful information covering a variety of topics on which you may focus your thoughts and feelings. Please do not hesitate to contact Sue Knowles on 0115 9699060 or [email protected] if you would like more information, or are interested in joining the Cancer Forum. Self-help directory Tell us your story...and help improve health services for everyone People who use the NHS shape it provides. We want more people The self-help directory is a can list of localthe andservices national NHS services, charities and to share their that stories experiences can use themhealth to develop better and organisations youand may find usefulso inwe relation to your and wellbeing more health services. Everyone who has had an experience with or thatpatient-centred of your family and friends. the NHS has a story to tell, and we want to hear them all. The Patient Experience Team is here to listen and ensure that your story makes a difference. Tell us your story today! E [email protected] T 0800 028 3693 (Option 2) Working with professionals When you are living with cancer you are likely to come into contact with a number of health and social care professionals. Working together with these people will help you to get the best information and care for your needs. You and your doctors There will be a variety of people who will be able to provide care and support for you and your family during your cancer journey. A selection of these is listed over the next few pages. As it is likely that doctors will be the first people that you talk to about your condition, we have described how these different doctors will interact with you during your illness. Your General Practitioner (GP) should co-ordinate the help you want during your diagnosis, treatment and beyond. They are responsible for all aspects of your medical care at home and can arrange further help from other professionals such as nurses. Your GP will refer you to a hospital doctor or specialist (a doctor who specialises in a particular area of medicine). Doctors are busy people and their time is often limited. You may feel rushed when you are with them. However, it is important that you ask for an explanation if you do not understand anything your doctor tells you. Even when the doctor is being clear and thorough, it is often difficult to take in what is being said, particularly if you are worried or anxious about the information you are being given. You may find it helpful to: •take someone to your appointments with you •make notes before, during and after your appointment. Remember: there are no ‘right’ or ‘wrong’ questions, and no wrong time to ask them. You can ask any question at any time. www.rushcliffeccg.nhs.uk 03 People who are there to help: Your health care team Primary health care team: this is the community-based team, which includes the general practitioner, practice nurses, receptionists, district nurses as well as other professionals. 1General Practitioner Your GP is responsible for all aspects of your medical care at home, and can arrange help for you from other professionals or services. 2Community Matron / District Nurse / Community Nurses The district nursing team provide ‘hands-on’ nursing care and practical advice at home. In Nottinghamshire, the district nursing service is available 24 hours a day. 3Clinical nurse specialist A clinical nurse specialist (CNS) has been specially trained to an expert level in a particular area of medicine or care. You may come into contact with various clinical nurse specialists, both in hospital and in the community. 4Macmillan nurse Macmillan nurses are clinical nurse specialists, specialising in cancer care. They have been specially trained to help people living with cancer. They are skilled in pain and symptom control, and can offer emotional support and practical advice to people with cancer and their families. In Nottingham, there are three teams of Macmillan nurses; one based at Queen’s Medical Centre Campus, one based at Nottingham City Hospital Campus and one covering the community. 5Marie Curie nurse / Hospice at Home nurse These nurses provide care for people with cancer in their own homes. They support the work of the primary health care team, and are available through the district nursing team. They provide care either during the day or at night, which allows family/carers to have a break or sleep. 04 www.rushcliffeccg.nhs.uk Secondary health care team: This is the hospital health care team 6Hospital doctors There may be several types of hospital doctors involved in your care, depending on the type of cancer you have and the treatment this requires. These include: Cancer surgeons – carry out operations to remove cancerous growths. They specialise in removing cancer from a particular area in the body (such as bowels), but may also carry out surgery on people for reasons other than cancer. Oncologist – involved in treating cancer with drugs or with radiotherapy (high energy X-rays) and usually specialise in treating particular types of cancer. Drug treatment includes chemotherapy, biological therapies and hormone therapies. Haematologist – specialise in the treatment of cancers of the blood and lymphatic system, such as leukaemia, lymphoma and myeloma. Palliative Medicine Consultants – are specialists in the management of pain and other symptoms caused by cancer or the side effects of the treatment. They provide supportive emotional, social and spiritual care for patients and their families. 7Specialist palliative care team / Hospice team These teams focus on achieving the best quality of life for patients and their families, taking into account the person and the issues that are important to that individual. This team is often based in a specialist palliative care unit or hospice. The hospice team includes a variety of professionals who work together to provide care tailored to the individual and family. 8Other support Social workers – professionals who can help you to get practical help, emotional help and financial support. You may come into contact with a social worker whilst in hospital, or at home. Social workers (Rushcliffe) can be contacted on 0300 0830 100. Occupational therapists (OTs) – provide advice on carrying out activities that may have become more difficult due to illness, such as cooking, washing and dressing. There are OTs based in the hospital and others based in the community. OTs can be contacted on 0300 0830 100. www.rushcliffeccg.nhs.uk 05 Physiotherapists – can help to maximise a person’s mobility and maintain their independence. They offer practical advice and exercises in order to achieve this. Please speak with your GP should you feel that a physiotherapist assessment might be helpful to you. Dieticians – can offer support and practical advice on a range of problems connected with diet, such as loss of appetite, nutritional needs and appropriate food to try. Local information and key contacts You may find it helpful to keep a list of your key contacts. Contact GP Community matron District nurse Hospital consultant Oncologist Clinical nurse specialist Physiotherapist Occupational therapist Social worker Dietician Macmillan nurse Home care team Other 06 www.rushcliffeccg.nhs.uk Name Telephone number Help and support If you are concerned about your condition or symptoms that you are experiencing, if possible do not let it go beyond the middle of the week without contacting the relevant health professional (GP, district nurse or hospital team). If it is left too close to the weekend it may be more difficult to sort out. Please remember if you need help, whatever time of day or night, contact your health professionals. Make sure you know how to contact your local health professionals out-of- hours. Out-of-hours medical services are provided by Nottingham Emergency Medical Services (NEMS) based at a primary care centre at Platform One Practice, Station Street, Nottingham. You can contact the NEMS service by telephoning your usual GP surgery, or dial 111 for urgent advice when the surgery is closed. To contact the district nursing service outside of office hours, please use the telephone number found inside the district nursing notes. This service is available all day, every day. Useful tips for helping you to organise your care 1Keep all useful telephone numbers easily available, such as your district nurse and GP. There is a page in this booklet for you to record these. 2You may find it helpful to keep a notebook with details of your contact with any health and social care professional at home. 3Use a file to keep all leaflets, appointment cards and information together in one place. 4You may find it helpful to speak with your GP following hospital appointments. Your GP may also find it helpful to hear from you to find out how you are. www.rushcliffeccg.nhs.uk 07 Services and Support information Macmillan have a local drop-in centre at Nottingham City Hospital, advice includes finances, emotional support, cancer symptoms and treatments. Macmillan Information Centre at Nottingham City Hospital T 0115 8402650 Macmillan Cancer Support Line (National Call Centre) T 0808 808 00 00 Nottinghamshire County Council has a benefits team to give advice regarding financial help. Please call 0300 500 80 80. You may qualify for Personal Independence Payment (PIP) (under 65 yrs). Please call 08457123456 for a form. You may qualify for Attendance Allowance (over 65 yrs). Please call 0345 6056055 for a form. You may be entitled to a disabled badge for your car. To enquire, please call Nottinghamshire County Council on 0300 500 80 80. For Blue Badge enquiries, please call 0844 463 0213. Advance Care Planning (ACP) Advance care planning gives you the chance to tell us how you would wish to be cared for if you became seriously or terminally ill and couldn’t tell us. The aim is to develop a better understanding and have a record of your priorities, needs and preferences and those of your family/carers. Recording these decisions can help your doctors and nurses to act in accordance with your wishes if you weren’t able to tell us at the time. It assists forward planning for the best possible, joined up care plan personal to you. Please talk to your GP/Nurse who will be able to provide some documentation. Self Help support groups A self-help support group is a group of people who have experience of a particular health issue of life situation. This may be their own experience or as a parent, family member, friend or carer. 08 www.rushcliffeccg.nhs.uk There are a range of self-help support groups in Rushcliffe and Nottinghamshire devoted to people with cancer. For information on all self-help support groups in Nottinghamshire, please contact Self Help Connect UK on 0115 9111662 or [email protected], or visit www.selfhelp.org.uk Macmillan Cancer Support Cancer charity Macmillan provides a range of support services: Macmillan Cancer Support Line (National Call Centre) Please call 0808 808 00 00. Monday to Friday, 9am - 8pm. Other support Maggie’s Centre in Nottingham. City Hospital Campus, Gate 3, Hucknall Road, Nottingham NG5 1PH. Please call 0115 8718693. Marie Curie Support Line for confidential support and practical information on all aspects of terminal care. Please call 0800 090 2309, Monday to Friday, 9am - 5pm. Alternatively, please visit www.mariecurie.org.uk/help Marie Curie Helper in Nottingham. Please call 0845 304 8730 or email [email protected] Carers Trust UK East Midlands Please call 0115 9628920 or email [email protected] Alternatively, please visit www.carerstrustem.org Rushcliffe Cruse Bereavement Care Please call 0115 825348 or email [email protected] Rushcliffe Community and Voluntary Service (RCVS) Please call 0115 9699060 or email [email protected] Alternatively, please visit www.rushcliffecvs.org.uk CHAT – Cancer Help Action Team They usually meet on the first Wednesday in the month, for coffee at The Bistro, Main Street, Keyworth. Everyone is welcome, outings may also be organised. For more information, please contact Daphne Butler on 0115 9373734. Dove Cottage Day Hospice provides a range of services for patients over the age of 18 with advanced progressive disease, where the treatment is palliative. Referrals can be made by health professionals, individuals or their families. To make a referral, call 01949 860303 and ask to speak to one of the nurses. www.rushcliffeccg.nhs.uk 09 Medical terms explained Abdominal Referring to the body area including the stomach, intestines and other digestive organs. Carcinoma A cancer that arises from the lining of an organ or system. They are the commonest cancers. Adjuvant therapy Treatment, usually chemotherapy or radio-therapy, given following surgery. It is sometimes given even if there are no symptoms of cancer at the time of treatment. Chemotherapy The treatment of disease with chemicals, such as cytotoxic (cancer destroying) drugs. Alopecia Hair loss. Aromatherapy Gentle massage using oils from flowers, roots and leaves, often with relaxing perfumes. Benign Non-cancerous, used to refer to tumours which grow slowly in one place and which, once removed by surgery, tend not to recur. Biopsy Examination of a sample of tissue that has been removed from an area of the body where cancer is suspected. Bronchoscopy A test used to examine the inside of the lung. Cancer The name given to a group of diseases that can occur in any organ of the body, and which all involve abnormal or uncontrolled growth of cells. 10 www.rushcliffeccg.nhs.uk Computerised Tomography (CT scan) Produces a cross-section image of the head and body, which is then analysed by computer. Deoxyrivo Nucleic Acid (DNA) The genetic material present in our cells which is responsible for passing on vital information on cell growth, division and function. Endoscopy Looking inside the body through a small fibre-optic tube passed into the digestive system. Fine needle aspiration The use of a fine needle under local anaesthetic to take a sample of cells from a suspicious lump to determine whether it is benign or malignant. Haematologist A doctor who specialises in treatment of blood disorders. Hickman line A special tube inserted under anaesthetic through the chest into a large vein, so that chemotherapy drugs can be fed directly into the bloodstream. It can stay in place for months and means needles do not have to be used during treatment. Histology The study of tissues, used in diagnosis. Hormones Chemical substances produced by glands, which circulate in the blood and help control growth, reproduction and other functions. Hormone therapy Treatment with hormones to control growth, usually for cancer of the breast, prostate, thyroid and uterus (womb). Immune system The body’s main defence system against infections or foreign substances. Inoperable Refers to a cancer that cannot be removed by surgery, either because the cancer has spread to nearby organs or because removal might cause too much damage to normal tissue. In situ The earliest stage of cancer, when it is localised to its area of origin. Intramuscular Given by injection into a muscle. Intravenous Given into a vein by injection or infusion. Isotope scan A scan involving the injection of a very weak radioactive substance, which collects in the organ being investigated so that it can be viewed more easily with a special camera. Lumpectomy The surgical removal of a lump. Lymphatic system The system of lymph nodes and the vessels or small tubes which connect them. Lymph nodes are located throughout the body, filtering out dangerous substances and producing infection-fighting cells called lymphocytes. Lymphoedema Swelling, usually in the arms or legs, which occurs because the lymph vessels are damaged or blocked. This can occur following some treatments for cancer or due to the cancer itself. Magnetic Resonance Imaging (MRI) Uses magnets rather than X-rays to produce pictures, which are then analysed by computer. Malignant Cancerous. Malignant tumours can invade and destroy surrounding tissue and have the capacity to spread. www.rushcliffeccg.nhs.uk 11 Mammogram A specialised X-ray which shows up the breast tissue and can detect breast cancer at a very early stage. Pathology The branch of medicine concerned with the examination of diseased tissues. Mastectomy The removal by surgery of all or part of the breast. Position Emission Tomography (PET scan) A Pet Scan can show how body tissues are working as well as what they look like. It can help diagnose and stage a cancer. It can help decide on treatment options. Metastases The spread of cancer from one part of the body to another, by way of the lymphatic system or bloodstream. Nausea The feeling of sickness. Neoplasm A medical term for tumour (any new abnormal growth). Neoplasm may be malignant or benign. Oncologist A doctor who specialises in treating cancer. A clinical oncologist, or radiotherapist, specialises in treating cancer with radiation, and a medical oncologist specialises in treating cancer with drugs. Orchidectomy Surgical removal of a testicle. Palliative care Palliative care concentrates on your quality of life and that of your family. It focuses on controlling pain and other symptoms, and meeting a person’s social, physical, emotional and spiritual needs. 12 www.rushcliffeccg.nhs.uk Primary cancer The first malignant tumour to develop in a particular part of the body. Prognosis An assessment of the expected future course and outcome of a person’s disease. Radiographer The member of the health care team who takes X-rays and scans (diagnostic radiographer) or gives you radiotherapy (therapeutic radiographer). Radiologist A doctor who understands and interprets a scan or an X-ray. Radiotherapy The treatment of cancer by X-rays or gamma rays to destroy cancer cells. Reflexology A relaxing massage technique which uses pressure to the feet and improves the blood supply to various parts of the body. Secondary cancer (secondaries) New tumours, or metastases, which are formed because cancer cells from the original tumour have broken off and been carried to other parts of the body in the bloodstream. Staging Determining the extent of cancer in an individual, using strict measures. It helps doctors decide on the best treatment. Stoma An artificial opening between an organ and the skin surface formed by surgery. There are different types including a tracheostomy (formed from the windpipe), ileostomy (formed from the small bowel), colostomy (formed from the large bowel) and urostomy (formed from the bladder). Subcutaneous Given by injection beneath the skin. Travel Syringe driver A means of administering pain-killing or chemotherapy drugs under the skin which relieves patients of the need for frequent injections. Terminal illness Active and progressive disease which cannot be cured. Curative treatment is not appropriate but palliative care is. Thoracic Referring to the chest area. Tumour A lump or mass of cells which can be either benign or malignant. Also known as a neoplasm. Tumour markers Substances produced by some cancers that can be traced in the blood. Ultrasound scan Use of sound waves to build up an image of the internal organs. People who have cancer and wish to travel may wish to secure travel insurance. for a letter from your GP stating that you are well enough to travel. Travel insurance can sometimes take several weeks to arrange and it is important to check the policy carefully for exclusions. It is advisable to obtain several quotes as costs can vary. Companies will look at an individual’s situation and their intended destination. They cannot guarantee to offer you insurance and some companies may not offer cover for cancellations. Most companies will ask Macmillan produces a useful document ‘Getting Travel Insurance’ and it is always helpful to consult friends or support groups with experience of travel in similar circumstances. www.rushcliffeccg.nhs.uk 13 Travel insurance A valid European Health Insurance Card (EHIC) will entitle you to reduced cost (sometimes free) emergency treatment in many European countries. However, the EHIC is NOT an alternative to travel insurance. It may not cover all treatment costs and never covers the cost of repatriation. Further information is available at www.nhs.uk/healthcareabroad. This website also contains information on some non-EU countries where agreements with the UK are in place to provide some healthcare services. When travelling with family and friends it is important to ensure that their travel insurance policy covers them in the event that: •you cancel the holiday due to ill heath •you need to return home earlier than expected •you need to extend your holiday due to ill health and require the assistance of one of your party. Note: The standard insurance cover provided with a package holiday is unlikely to cover anyone who has/had cancer, but there are a number of specialist companies available. Which (www.which.co.uk) provides a comparison table of specialist companies. 14 www.rushcliffeccg.nhs.uk Maggie’s Centre in Nottingham can provide a list. Please call 0115 8718693. BIBA (British Insurance Brokers Association) can also direct you to an appropriate insurance company or broker. BIBA are particularly helpful if you and/or any family member to be included on the policy, have a variety of ongoing medical conditions. Please call 0870 950 1790 or visit www.biba.org.uk Additional documentation It is advisable to carry a full medical summary with you on holiday, including the dates of key events. It can be helpful if it is translated into the appropriate language. Information sheets regarding surgery can also be useful, particularly if they contain pictures of the procedures, and details of current medications (e.g. copy of the latest prescription) may come in handy. Notes www.rushcliffeccg.nhs.uk 15 This booklet has been produced by Rushcliffe Cancer Forum. November 2015 Rushcliffe Clinical Commissioning Group Easthorpe House 165 Loughborough Road Ruddington Nottingham NG11 6LQ. T 0115 8837880 E [email protected] www.rushcliffeccg.nhs.uk