The Oncology Service & What to ExpectEach patient has an individualised treatment plan devised by your consultant based on international guidelines. Therefore you will see other patients who will be on different types of treatment plans to your own. Generally, you will have a scan every three to four months depending on your treatment and type of cancer. This determines how the treatment is working for you. You will see an oncology doctor in the outpatients department with your consultant present in the week or two after your scan and they will give you a plan regarding your treatment. It is a good idea to bring a family member to this meeting so that you and they can also ask any questions you might have. What to Expect on the Oncology Day Ward An oncology nurse will assess you each time you attend the oncology day ward to review if you are feeling well enough to have treatment that day. This includes having blood tests, having your vital signs taken and discussing how you are feeling. The nurse will also assess any symptoms you may have had since your last treatment. A doctor is always available in the Oncology Dayward should you need further assessment. Occasionally, if you are not well enough, or if your blood tests are not within a safe limit, your treatment might be delayed for a few days. This will always be discussed with your consultant. Before each appointment, it is necessary to have blood tests to make sure that it is safe to continue with the treatment that day. These blood tests are performed in the phlebotomy department in the Hospital or with the Community Intervention Team (CIT) the day before your treatment if applicable. Sometimes the blood tests are taken in the oncology dayward on the day of your treatment. We will go through all of this with you before your treatment starts. Each patient will be seated in the main treatment area of the oncology dayward. To reduce the risk of infection and to ensure privacy, no visitors are allowed in the main treatment area unless it is discussed and agreed with the nurse manager. Once your blood tests have been processed and checked by the nurse, your individual treatment will be ordered from the pharmacy. It will take some time to be prepared in the pharmacy and delivered to the oncology dayward. Therefore you will generally be in the oncology dayward for several hours each visit, depending on the length of your treatment and whether the blood tests have been done in advance. If your blood tests show that you need an extra infusion to have blood products or nutrients replaced before or after your treatment, this will also add time to your visit. If you are taking your treatment in tablet form, you will also need to attend regularly for blood tests and an assessment by an oncology nurse to make sure that you are feeling well enough to continue the dose you are on. What to bring to the oncology dayward Every time you attend the Hospital for an appointment you should bring a list of all your current medications. You can download the My Medicines leaflet here: (https://www.hse.ie/eng/about/who/nqpsd/patient-safety-programme/medication-safety/my-medicines-list-jan-2020.pdf) Please use this to keep an up to date record of your medicines. Remember to include any herbal medicines or supplements and any over-the counter medicines. It is very important that you bring this list to your oncology appointments so that your doctors, nurses and pharmacists know what medicines you are taking. This is because some medications and supplements can interact with cancer treatments. Bring something to read or your phone or tablet so that you can pass the time online but you must always bring headphones if you wish to listen to a podcast, radio or film while in the oncology day ward. A phone charger may also be useful. Insurance information/ medical card information is also helpful. You will be provided with refreshments including lunch while you are on the oncology dayward but you can bring your own snacks if you prefer. Patient Support Resources ARC https://www.arccancersupport.ie/ ARC is an Irish charity dedicated to supporting people diagnosed with cancer, their family members, friends and carers. The support is holistic and includes counselling, psychological support and complementary treatments. ARC is for any person diagnosed with cancer, no matter where they live or where they are being treated. It is also for: - Family members and friends of those diagnosed with cancer
- Parents whose children have cancer
- Members of the caring professions who work with people with cancer
- Children whose parent (or other significant adult in their lives) has cancer
See the ARC House website below for more information. Daffodil Centres Daffodil Centres are part of the Irish Cancer Society’s cancer support service. They provide information, advice and support to anyone affected by or worried about cancer and help them cope with the impact it is having on their lives. Find out more information about the Daffodil Centre in TUH or visit the Irish Cancer Society website here: https://www.cancer.ie/ Citizens Advice Information https://www.citizensinformation.ie/en/ General Dietary advice Diet and Cancer Cancer and its treatments can alter how the body uses nutrition and in some cases, how much nutrition your body requires. Often your energy needs increase, and your food intake decreases due to a poor appetite or other symptoms. This results in weight loss. Even if you are eating a normal amount of food, your body might not properly use the nutrients or burn energy faster than usual. Oncology dietitians play an important role in helping you if you are struggling to eat and are losing weight during your treatment. They also help in providing advice on managing the side effects of your treatment and your cancer so that we can improve your nutritional wellbeing. Nutrition & Dietetics service for Oncology Inpatient service: There is a dietetics service for oncology patients who are admitted to TUH. A dietitian can help those who are unwell to eat well and meet their nutritional needs during illness. This may involve helping people by advising nourishing foods and drinks, oral nutritional supplements and in some cases this may involve tube feeding or intravenous nutrition. Oncology Dayward Patients attending the oncology day ward are screened by nurses who may refer you on to the dietitian should it be required. A dietitian may then give tailored and practical advice to help you manage any dietary concerns relating to your cancer, cancer treatment or longer term treatment side effects. This might include: - Concerns about your weight
- Manging gastrointestinal symptoms e.g. diarrhoea, constipation, wind, bloating and pancreatic enzyme replacement therapy
- Eating well when you are living with cancer and beyond
General tips for eating whilst on treatment - Eat nutritious snacks and meals regularly during the day rather than three main meals – eat every three hours / four to six times a day. Focus on a little and often approach to eating.
- Make the most of your appetite to eat nutritious, high-energy foods and drinks.
- Fortify/ add extra goodness to each meal
- Add fats and calories by using full-fat dairy products, oils and frying or roasting some foods.
- Ask your doctor or dietitian about build-up drinks.
- Try to plan ahead so you have the right foods at home.
Useful evidence-based resources Irish cancer society website https://www.cancer.ie/cancer-information-and-support/cancer-support/coping-with-cancer/information-for-patients/diet-advice-for-cancer-patients Breakthrough Cancer Research https://breakthroughcancerresearch.ie/cancer-diet/ Irish Nutrition & Dietetic Institute (INDI) https://www.indi.ie/all-food-facts-and-fact-sheets.html#Medical%20Conditions Exercise and Cancer Physical activity is part of your cancer treatment. You will get more advice on what type of exercise to do when you attend the oncology service. You don’t need to become a marathon runner or join the gym to be more active – you don’t even have to leave your home! Anything that gets you a bit warmer, slightly out of breath, and your heart beating faster counts. The benefits of physical activity include: - Keeping a healthy weight
- Reducing the risk of cancer and being able to tolerate your cancer treatment better
- Reducing fatigue and some other side effects of cancer and your treatment
- Improving mood and reducing stress
- Reducing the risk of heart disease
- Reducing the risk of osteoarthritis
- Reducing the risk of dementia and depression
- Reducing the risk of falls in older adults
- Socialising
- Learning new skills
https://www.cancer.ie/cancer-information-and-support/cancer-prevention/physical-activity-and-cancer#:~:text=Physical%20activity%20reduces%20your%20cancer%20risk,-There%20is%20clear&text=It%20may%20also%20help%20prevent,can%20do%20for%20your%20health.
Home exercises for cancer patients and survivors
https://www.macmillan.org.uk/cancer-information-and-support/treatment/coping-with-treatment/changes-in-weight 
| 
