Patient Education

Our primary goal at Queens Medical Associates is the provision of the highest quality of care to each patient. The second and equally important goal is our commitment to making each patient and their family feel important.  It’s all about the patient’s needs. 

We offer the convenience of receiving your chemotherapy on an outpatient basis.  Our infusion therapy suite has 26 infusion chairs (comfortable recliners) each equipped with a television and 4 beds. Our specialized team assists each patient with all aspects of their care.  Every effort is made to provide a pleasant and comfortable atmosphere during treatment. 
 
The goal of our practice is to administer chemotherapy and non-chemotherapy infusions in a safe and comfortable environment.  The nursing staff will provide individualized education regarding your particular treatment which will include common side effects and methods to reduce, prevent, or manage these side effects.

Each patient reacts differently to their particular chemotherapy drug regimen. Some people who take chemotherapy drugs experience mild side effects, others may have more severe side effects which their Doctor/PA or Oncology Certified Registered Nurse will help them to manage.  Side effect management has come a long way over the last few decades. Today, many side effects once associated with chemotherapy can be controlled or even prevented and there are some things you can do on your own to make it easier to cope with some of these side effects.
 
Coping With the Side Effects of Chemotherapy

Chemotherapy drugs are used to kill cancer cells, but while killing cancer cells, it may also kill some healthy cells that grow rapidly. This is why most chemotherapy drugs have side effects. Some common side effects of chemotherapy are:

• Nausea and vomiting
• Diarrhea
• Dry skin
• Sores in the mouth
• Hair loss
• Sensitivity to cold
• Fatigue (tiredness)
• Anemia (not enough red blood cells)
• Leukopenia (not enough white blood cells)
• Neuropathy
• Thrombocytopenia (not enough platelets)

As with any drug, everyone reacts differently. Some people who take chemotherapy drugs experience mild side effects, whereas other people may have more severe side effects, which a doctor or nurse will have to help them manage. There are some things you can do on your own to make it easier to cope with some of these side effects.
Beginning chemotherapy treatment is often stressful. It is not unusual to feel anxious or frightened. The psychological and physical needs of each patient will be evaluated, and referrals will be made to appropriate resources, for management of those needs identified by patients, family members, or staff members.
Treatment times can range from 5 minutes to several hours, so it is therefore requested that those patients receiving lengthy treatments schedule appointments times earlier in the day.
On the day of the treatment, you are requested to arrive at least 10 minutes before your scheduled appointment and to first check in with the receptionist. You will then be instructed to have a seat, and the doctor will be notified of your arrival. After visiting with the doctor, you will be called to the treatment room as soon as a nurse is available to care for you. Patients are allowed to have visitors in the treatment room, but in consideration of other patients, each patient is asked to have no more than one visitor in the room.
Patients who will be in the treatment room for extended periods should bring a cold lunch from home (a refrigerator is available). It is recommended for you to wear warm comfortable clothing. The nursing staff is dedicated to making your treatments as easy and stress-free as possible. Our focus is to meet both the physical and emotional needs for all of our patients.


Other Signs and Symptoms To Report To Your Nurse or Doctor

• Fever
• Shaking or chills
• Cough or sore throat
• Flu-like symptoms
• Feeling of burning when urinating
• Redness or swelling, especially around a cut, sore, pimple, or boil

Side Effects


Nausea and Vomiting:

Right before each chemotherapy treatment, the nurse usually gives the patient a medication known as an antiemetic, to prevent nausea and vomiting. In between treatments, you may be able to prevent nausea and vomiting by remembering to do the following:

• Eat smaller, more frequent meals and snacks throughout the day
• Eat slowly and chew thoroughly
• Avoid greasy, high-fat foods, such as hamburgers, fried foods, and potato chips
• Right after eating, rest sitting up, and avoid lying down
• Be aware that your favorite foods may taste different to you during your treatment
• Avoid beverages that contain alcohol

Constipation:

Some people undergoing treatment for cancer can become constipated because of the chemotherapy drugs or prescription pain medication they are taking. Others may be constipated because they are suddenly less active or are experiencing a change in their diet or eating habits. If there are extreme changes in your normal bowel habits, it is necessary to communicate this to your health care team. Sometimes, a simple change in diet can help. However, it might be necessary to include the use of a laxative or stool softener, as instructed by the doctor or nurse.
Some Helpful Hints to Deal With Constipation

• Drink plenty of fluids (water, fruit juices, and prune juices) to help loosen the bowels
• Eat a diet high in fiber. High-fiber foods include bran, whole-wheat breads and cereals, raw or cooked vegetables, fresh and dried fruit, figs, dates, and prunes
• If possible, get some exercise. Even a short walk daily can be beneficial

Use of Laxatives in Treating Constipation
The use of Senokot® tablets is normally recommended in the treatment of constipation. Senokot® is a natural laxative, which stimulates the bowel. Unless otherwise instructed by your doctor or nurse, it is recommended to take 2 tablets at bedtime. If you do not have a bowel movement in the morning take 2 more Senokot® tablets after breakfast. If there is still no movement, take 3 Senokot® tablets at bedtime.
Sometimes it may be necessary to add a stool softener, such as Colace®/Docusate if the constipation continues. In some instances, other medications may need to be prescribed. Patients should ask a doctor or nurse before using suppositories or enemas, as these treatments can sometimes cause bleeding or infection.

If there continues to be a problem and constipation lasts for several days, it is important to call your doctor.


Diarrhea:

Foods To Eat

Bananas      Rice    Applesauce    Toast
When you can tolerate the B.R.A.T. foods well, you can start to add the following bland, low-fiber foods.

• Chicken – white meat, without the skin
• Canned or cooked vegetables, without the skin
• White fish – cod, haddock, or sale
• Crackers, white bread
• Scrambled eggs
• Pasta (without sauce)
• Oatmeal or Cream of Wheat
• Cooked or mashed vegetables

Foods To Avoid

These foods can make diarrhea and cramping worse, so do not eat them.

• Fatty, greasy, fried, or spicy foods
• High-fiber foods (bran, raw fruits, and vegetables)
• Dried fruits, beans, popcorn, nuts, peas, and corn
• AVOID milk and dairy products
• Very hot or cold beverages, including alcohol
• Coffee, tea, and drinks containing caffeine
• Very sweet desserts and candies

Medicines To Avoid

• Laxatives, such as Milk of Magnesia®, Dulcolax®, Metamucil®, Colace®, and Senokot®
• Medicines that contain magnesium Maalox®, Mylanta®, and Bufferin®

It is important during diarrhea to try to increase your fluid intake, to avoid dehydration. To prevent this, it is important to drink clear, mild fluids (water, clear soups, or both). These will replace fluids and necessary nutrients and minerals lost through diarrhea.
Diarrhea can be controlled by the use of Imodium A-D, taken as directed on the package or by special instructions given to you by your doctor or nurse.
If diarrhea persists after all the above steps have been taken, it is necessary to call your doctor or nurse.

Care of Mouth, Gums, and Throat

Some chemotherapy drugs can cause sores in the mouth and throat. They can also make these tissues dry and irritated, and in some cases, cause them to bleed. In addition to being painful, mouth sores can become infected by the many germs that live in the mouth. Because infections can be hard to fight during your treatments, it is important to try and prevent them.
Here are some suggestions for keeping your mouth, gums, and throat healthy.

• If possible, see your dentist prior to treatment, to have your teeth cleaned and to take care of any problems such as cavities, gum disease, or poorly fitted dentures
• Brush your teeth after every meal with a soft-bristled toothbrush and rinse the toothbrush well after each use
• Avoid commercial mouthwashes, which contain alcohol and salt, as they can be drying to tissues and gums
• Rinse your mouth with cool water frequently, and especially after each meal and before going to bed

If you develop sores in the mouth, be sure to contact your doctor or nurse because you may need medical treatment for the sores. If the sores are painful or keep you from eating, you can also try these ideas.

• Ask the doctor if you may apply Maalox® or Milk of Magnesia® to the sores or gums, with a cotton swab. The doctor may also want to prescribe a medicine that can be used to further ease the pain.

• Eat foods at room temperature. Hot foods can irritate a tender mouth and throat
• Choose soft, soothing foods: ice cream, milkshakes, soft fruits, custards, puddings, Jello®. You can also puree cooked foods in the blender to make them easier to eat
• Try to drink plenty of fluids

Avoid irritating acidic foods, such as tomatoes, citrus juice, spicy or salty foods, and rough, coarse, or dry foods, such as raw vegetables, granola, and toast.
It is important to contact the office at the onset of sores in the mouth and throat,
to avoid a more serious infection.

How To Reduce the Risk of Infection

Chemotherapy can attack not only cancer cells, but also some healthy, normal cells. Some of the healthy cells can be the white blood cells, which are the cells that protect the body from infection. Prior to each treatment, and sometimes in between treatments, your doctor will order a blood test, which will indicate the white cell count. If the white blood cell (WBO) count is lower than normal, your doctor may want to past postpone treatment or reduce the dose of your drugs. The WBC count will gradually return to normal when either of these measures is taken.
When WBC is lower than normal, it is important to try to prevent infection by taking these steps.

• Wash your hands often. Be sure to wash them before eating and before and after using the bathroom
• Try to avoid crowds and people who have colds, flu, or viruses
• Get lots of rest and try to eat well
• Be careful not to cut yourself when using scissors or knives. If you do experience a cut, clean it right away with water, soap, and antiseptic
• Practice good hygiene by bathing or washing daily and brushing your teeth with a soft-bristled toothbrush
• Wear protective gloves when gardening or cleaning after animals

When You Begin Your Treatment


Beginning chemotherapy is often stressful. It is not unusual to feel anxious or frightened. As you move beyond the initial shock of learning that you have cancer to beginning the journey to survival, you have many good reasons to be optimistic. Science and medicine have made and continue to make tremendous progress in treating cancer and in making treatments more manageable, both physically and emotionally.  Chemotherapy is one of the most significant advances in medicine.  For millions of people, chemotherapy helps treat their cancer effectively and allows them to enjoy full, productive lives.  However, chemotherapy is not without side effects and risks.
No one would call having cancer or undergoing chemotherapy a routine experience. But by proactively managing your treatment, including potential side effects, you can help ensure that your life stays as close to normal as possible.  Don’t forget, you are not alone.  Fighting cancer is a team effort that involves family, friends, and your health care team.

Links and Other Resources

A list of outside resources for different types of services available such as support groups for specific cancers, links to resources available to cancer patients and societies of specific cancers which offer many services.


These sites are a great place to start. They are easy to use, offer comprehensive information on most aspects of cancer, and can direct you to other appropriate resources.

• Cancer Guide
  Help in finding answers to your questions about cancer, and especially in finding the questions you need to ask
  www.cancerguide.org
  
• National Cancer Institute Cancer Information Service
  Free resources and educational materials on all cancer types
  800-4-CANCER
  www.cancer.gov
  
  
• American Cancer Society
  Source of news, information, and support
  800-ACS-2345
  www.cancer.org
  
• Oncology Nursing Society
  Information on cancer prevention, detection, diagnosis, and treatment; specific types of cancer; and other cancer-related topics
  www.ons.org

General Cancer Information

• American Institute for Cancer Research
  Focuses on the relationship between cancer and nutrition
  Nutrition Hotline: 800-843-8114
  www.aicr.org
  
  
• American Society of Clinical Oncology
  Information for patients, doctors, and scientists
  703-299-0150
  www.asco.org
  
  
• Cancer Consultants
  Dedicated to providing up-to-date information on the treatment and prevention of cancer for patients and professionals
  www.cancerconsultants.com
  
  
• Cancer Links
  Provides a comprehensive list of links for different kinds of cancer www.cancerlinks.org
• Cancer News on the Net
  Cancer news reports
  www.cancernews.com
  
  
• Cancer Research and Prevention Foundation
  Dedicated to cancer prevention through research and education
  800-227-2732
  www.preventcancer.org
  
  
• Heart of Gold Wigs
  Provides women experiencing medical hair loss with information and a variety of headwear options
  www.heartofgoldwigs.com
  
  
• International Cancer Alliance for Research and Education
  Provides focused, user-friendly cancer information
  www.icare.org
  
  
• National Cancer Institute Cancer Information Service
  Free resources and educational materials on all cancer types
  800-4-CANCER
  www.cancer.gov
  
  
• National Comprehensive Cancer Network
  Dedicated to providing state-of-the-art care to patients, advancing research on prevention, and enhancing the effectiveness of cancer care delivery
  888-909-6226
  www.nccn.com
  
  
• OncoLink
  University of Pennsylvania Cancer Center
  www.oncolink.com
  
  
• Support for People With Oral and Head and Neck Cancer
  "Survivor to survivor" network providing information, support, and encouragement
  800-377-0928
  www.spohnc.org

Support Groups

QMA offers a general support group for cancer patients. If you are interested, please contact Margaret Cawley, RN at 718-460-3445.  We also sponsor a program with the American Cancer Society called “Look Good, Feel Good”, where a trained cosmetologist helps the patient with their make-up and wigs.  The patient is given a makeover to help them look good, which also makes them feel good. The psychological and physical needs of each patient will be evaluated and referrals will be made to appropriate resources. 

What You Need to Know When Beginning Treatment

Treatment times can range from 5 minutes to several hours. Therefore, it is important for patients receiving lengthy treatments to schedule appointments earlier in the day, bring a cold lunch from home (a refrigerator is available)and wear warm, comfortable clothing.  If you have an infusaport (mediport), please wear a button down shirt, if possible, to make access easier.
On the day of treatment, you are requested to arrive at least 10 minutes before your scheduled appointment.

• First you will check in with the receptionist at the front desk. 
• Then you will be instructed to have a seat and the doctor/PA will be notified of your arrival.
• After visiting the Doctor/PA, you will be escorted to the treatment room where you will receive treatment and make your next appointment. (There are also televisions for most treatment chairs.  We also have beds available for those who need them).
• Patients are allowed to have one visitor with them in the treatment room. 

The Nursing staff is skillfully trained and dedicated to making your treatments as safe, easy and stress-free as possible.  The atmosphere in our treatment room is pleasant and uplifting.  Our focus is to meet both the physical and emotional needs of our patients and their caregivers. On-site services available are:

• Physician Nutritionist
• Pain Management Center
• Genetic Counselor
• General Support Group
• “Look Good”, “Feel Good” Program.