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Cancer Care Centre

Pharmacy  |  Clinical Psychology  |  Dietitian  |  Occupational Therapy  |  Social Work  | Speech Pathology  |  Physiotherapy

Pharmacy

The Oncology Day Unit has dedicated pharmacy staff with specialist knowledge in the use of medications used in the treatment of cancer. These include traditional chemotherapy cytotoxic agents and the newer novel agents known as targeted therapies such as monoclonal antibodies.

As treatments for cancer become more sophisticated, care is required to tailor therapies to suit the individual patient. The pharmacist reviews treatment protocols and recommends, designs or modifies the therapeutic plan of treatment in conjunction with the medical team according to the patient's needs.

In addition the pharmacist:

  • Is responsible for ordering and supplying cfhemotherapy treatment
  • Ensures treatment is provided under strict safety guidelines
  • Checks all treatment regimens and doses to make sure they are safe and appropriate
  • Monitors effects of treatment and advises on side effects and toxicity to health professionals and patients
  • Provides education to patients and staff and answers queries on their treatment, drug interactions, and alternative therapies

The pharmacist can be contacted on +61 7 422 66850.

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Clinical Psychology

The diagnosis and treatment of cancer can cause significant emotional distress for patients, their carers and loved ones. Stress, anxiety, feelings of panic, depression, anger and grief are all normal responses and are frequently reported by patients and carers. These responses can be quite overwhelming at times and can have a significant impact upon the person’s ability to cope with treatment; make decisions; manage personal relationships; provide support to others; and can cause problems in managing every day tasks at home and work.  People often need to seek support at such times.

Why see a psychologist?

Sometimes the usual avenues of support can be difficult to access. Patients can be reluctant to seek help from friends or family as they do not want to burden them with their concerns. Likewise, carers often feel guilty about asking for help as they believe they should be strong and able to cope, as they are not the ones who have cancer.

Clinical psychologists are trained in supporting people to cope with and adjust to the emotional stresses and strains that can occur when a person is physically unwell. 

Psychologists can support people to:

  • Learn relaxation and stress management techniques.
  • Support people to manage pain, fatigue and sleep difficulties.
  • Learn to cope with body image concerns.
  • Overcome anxiety and depression.
  • Discuss end of life issues and understand grief and loss.
  • Address relationship difficulties.
  • Prepare for recovery and life after cancer.

What happens when you see a psychologist?

Psychologists just talk and never need to conduct physical examinations.  The psfychologist will listen to your concerns and will try to help you think about ways of coping in the future. This might involve learning some new skills, developing new ways of thinking and exploring the link between your thoughts and feelings.

Sometimes just one appointment may be enough but often more appointments are required. The information the psychologist gathers remains confidential and is only shared with the person’s consent or if there are concerns for the person’s safety.

Who can be referred to see a psychologist?

Anyone who has been affected by cancer can be referred, including the patient, partner, spouse, family member, carer or friend. You can also be referred for support after your medical treatment has finished.  Family and carers can be referred after a loved one has passed away.

How can I be referred?

Talk to any member of the health team about a referral or you can refer yourself by calling +61 7 4226 7817

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Dietitian

Malnutrition is a common problem among people with cancer, affecting between 40% to 80% (more commonly in Head and Neck or pancreatic cancers). Malnutrition is associated with poor responses to therapy, increased susceptibility to treatment-related adverse events, as well as poor outcomes and quality of life.

Dietitians are university qualified consultants in nutrition and dietetics who have the skills and training to provide food and nutrition advice to meet individual health and lifestyle needs. Currently a Dietitian is available Monday – Friday from 0800-1630.

You should see the Oncology Dietitian if  you:

  • Have lost weight recently without trying
  • Have been eating poorly because of a decreased appetite
  • Have lost your taste or have taste changes resulting in a reduced dietary intake
  • Have a sore mouth and/or throat resulting in a reducedf dietary intake
  • Are fatigued and having difficulty preparing meals
  • Suffer ongoing diarrhoea, constipation or nausea/vomiting

Outpatients:

  • Anyone with cancer; before, during or after treatment is eligible to see the Dietitian
  • anyone can refer or patients can self-refer
  • there is a prioritisation protocol and you may be placed on a wait list

Inpatients:

  • Cancer patients admitted to Cairns Hospital are seen on a referral basis
  • Referrals can be made through nursing, medical or allied health staff
  • As with outpatients, there is a prioritisation protocol and patients are seen based on clinical need.  If you are unable to be seen during your admission, you may be referred to be seen as an outpatient

Oncology Dietetic services can be accessed by contacting:

Ph: +61 7 4226 7813

Ph: + 61 7 4226 7863

Email: CBH_cancer_care_dietitian@health.qld.gov.au

Fax: + 61 7 4226 6204

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Occupational Therapy

Occupational Therapy is concerned with promoting health and well-being through occupation.  Occupation refers to everything that people do during the course of everyday life

Occupational Therapy Services in oncology include:

  • Assessment of function and   identifying problems (including physical, cognitive, psychological or environmental) that may be impacting on participation in meaningful daily living activities.  
  • Education for the patient and their family/ carer in relation to remedial or compensatory strategies to maximise performance and quality of life
  • Prescription and education regarding the appropriate use and maintenance of equipment
  • Home assessments to provide recommendations for home modifications, equipment and service needs
  • Lymphoedema assessment, treatment and risk reduction education
  • Education for the patient and family/carer. Regardign the impact of illness including side eccects of cancer treatment

Lymphoedema Service

Patients who undergo treatment for cancer may be at risk of a condition called "lymphoedema ".

The lymphatic system is a network of vessels and lymph nodes that work to fight infection and remove toxins and excess fluid

Lymphoedema occurs when the lymphatic system is interrupted or damaged. This can be caused by trauma, surgery, infection or radiation. This may result in the lymphatic system failing to function normally and fluid builds up in the tissues. Please remember, not all patients with cancer will develop lymphoedema.

Lymphoedema is not the same as swelling and areas of numbness or tingling that can immediately follow surgery and radiotherapy.

If the swelling persists or increases, you should have it checked by your doctor. It may be appropriate for a referral to see a lymphoedema therapist.

How lymphoedema can be treated

An individual treatment plan is developed to manage the condition. This may incorporate some or all of the following components:

  • Skin care
  • Education
  • Exercise
  • Lymphatic massage
  • Compression bandaging
  • Compression garments

Self management techniques are an important part of the overall management

Additionally, where considered beneficial, the following may be offered:

  • Low level laser therapy
  • Kinesiotaping

It is important to check any symptoms as soon as possible. If a diagnosis of lymphoedema is made, assessment and treatment should be sought early to prevent progression, and to achieve the best outcome.

It is very important to receive treatment by a trained lymphoedema health professional (they include physiotherapists, occupational therapists and registered nurses) who have undertaken additional training to be specialised in this area

Referrals

Inpatient referrals are to be make by Cairns Hospital staff via patient flow manager

We request a written referral for all outpatient services.

A written medical  referral is required for lymphoedema assessment and treatment. This can be completed by your GP/local doctor, surgeon or oncologist.

The Occupational Therapy Department can be contacted on +61 7 422 66330.

References

CAOT Position Statement on Everyday Occupations and Health, 2003

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Social Work

Cancer has a significant impact on the lives of many Australians. Each patient will experience a range of practical, psychological and emotional challenges as a result of their diagnosis and treatment. Further disruptions may occur as a result of role changes, family functioning and financial strain. Some patients may face progressive illness and preparing for death, while others may also struggle with the challenges of survival. Social workers can help to reduce patient and family distress when usual resources and coping strategies are not enough.

Oncology social workers can help with:

  • Counselling to individuals and families
  • How to tell children and how to support them
  • Adjustment to illness counselling
  • Dealing with changing roles and relationships
  • Assisting in decision making
  • Assisting with difficult to solve problems
  • Developing useful coping strategies
  • Providing information about the impact of cancer
  • Providing information about the health system
  • Providing information and referral about financial issues, including Centrelink and superannuation
  • Supporting care givers
  • Enduring Power of Attorney and Advanced Health Directives
  • End of life planning
  • Referral to other community services

Outpatients can contact the social worker directly by phoning +61 7 4226 6090 or +61 7 4226 9753.

Alternatively you can email CBH_cancer_care_social_work@health.qld.gov.au and a social worker will be in contact with you.

Inpatients can access the social worker on the ward by asking their nurse to contact the social worker.

Anyone affected by cancer can ask to see a social worker. You do not need a referral. However any health professional can also refer to the social worker on your behalf.

Appointments can be made to fit in with when you are already attending the clinic if that suits you.

A drop-in service is available Monday to Friday between 11 am and 12 noon in the Cancer Care Centre, E Block. Simply let reception know you would like to see the social worker – no appointment needed.

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Speech Pathology

Patients with cancers of the mouth, throat, head or neck may experience various side effects, following radiation, chemotherapy or surgery, which can impact on their swallowing and communication abilities.   A Speech Pathologist can assist by:

  • Providing suggestions to keep your mouth moist and ideas to help reduce any sticky / thick saliva in your mouth and throat
  • Providing ideas to make eating and drinking easier and more enjoyable
  • Working with the dietitian to help you gain weight safely
  • Recommending changes or modifications to what you eat and drink to assist with any swallowing difficulties
  • Recommending specific exercises and strategies that may also help you swallow better
  • Assessing and monitoring your speech, voice and swallowing function throughout your treatment
  • Assist with further therapy if required after you finish your treatment

Speech Pathology services can be accessed without a referral by contacting +61 7 4226 6363

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Physiotherapy

A physiotherapist has many roles in assisting people to manage cancer or the effects of cancer treatments like surgery, chemotherapy and radiation therapy.  

Physiotherapists aim to support people to manage the temporary or permanent physical changes associated with cancer or cancer treatments.

Physiotherapists are commonly known for their skills in the management of musculoskeletal impairments - like shoulder pain and dysfunction after breast cancer surgery for one example.   Physiotherapists can also help people to manage mobility issues, pain and respiratory/ breathing difficulties.

Cancer related fatigue is the most common and distressing symptom reported by patients having chemotherapy (Berger 2003, de Jong 2002) and evidence supports the role of physical activity whilst on cancer treatments in improving fatigue and managing other upsetting symptoms.  Physiotherapists can assist with managing this type of fatigue to promote your best possible physical condition to reduce complications associated with your treatment.

Occupational Therapists and Physiotherapists are both able to assist patients to manage lymphoedema, which is the long term swelling of part(s) of the body which could occur following some necessary cancer treatments.

Summary of Physiotherapy Services in Oncology:

  • Management of swelling or lymphoedema in the arm/leg/face/other areas (doctors referral required for lymphoedema treatments)
  • Musculoskeletal physiotherapy to improve joint restriction, muscle stiffness or weakness and promote best posture after cancer surgery or radiation
  • Management of cancer related fatigue/tiredness
  • Difficulty moving a limb associated with chemotherapy lines (PICCs)
  • Poor balance, unsteady gait, falls or worsening mobility
  • Exercise advice
  • Advice on walking aids to improve safety and prevent falls, reduce pain and promote independence
  • Respiratory care – managing shortness of breath, breathing exercises,  airway clearance techniques to clear secretions (perhaps you have a tracheostomy)
  • Assistance with pelvic floor impairment, continence, sexual dysfunction
  • Carer advice, education and safe manual handling/ transfer solutions

Referrals

  • Referrals for ward based physiotherapy assessment, treatment and discharge planning can be made by Cairns Base Hospital staff members.
  • A doctor’s referral is required for Lymphodema assessment and treatments.
  • For patients, please feel free to discuss any queries with your doctor, nurse or physiotherapist.

The Physiotherapist can be contacted on + 61 7 4226 6838 or +61 7 4226 77825

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Last updated: 1 August 2013