Advanced practice providers play key role in cancer care

Brandon Sterling’s first week as an advanced practice registered nurse (APRN) was a crash course in collaboration. As a newly credentialed advanced practice provider (APP) on a busy unit, he was tasked with transferring a post-operative urology patient who had a stroke to a nearby hospital. “I was working with the family, case manager, social worker, nursing team, attending physician, insurance company and receiving hospital. I was doing what I needed to do to ensure the whole patient received the care needed as quickly as possible,” Sterling says. This connector role appealed to Sterling, now an acute care nurse practitioner in MD Anderson’s intensive care unit. It enabled him to wear many hats, make sure others had the information they needed and take action to ensure the best possible outcomes for patients. Advanced practice providers play key role in patient care MD Anderson has more than 850 advanced practice providers, which include approximately 312 physician assistants, 448 advanced practice registered nurses and 95 certified registered nurse anesthetists. They manage about 325,000 autonomous patient encounters each year and share another estimated 250,000 encounters with physicians. “Nurses and physicians recognized a need in care coordination around the same time,” explains Todd Pickard, director of our Physician Assistant Program. As the volume of practice expanded for both professions in the 1960s, there was room for a third group that could take on aspects of both roles, reducing stress on the system and meeting patient needs with the right level of care.  “MD Anderson’s advanced practice providers run survivorship, fast track and procedure clinics across the institution and are critical partners in our...

10 chemotherapy tips from cancer patients who’ve been there

If you’re preparing for chemotherapy for the first time, you may be wondering what to expect. We asked our Facebook community to share their best advice for preparing for chemotherapy – and the side effects that come with it. Here’s what they had to say. 1. Get some rest Fatigue is the most common side effect experienced by cancer patients, especially those undergoing chemotherapy. So, get plenty of rest and avoid pushing yourself too hard, even if you feel good. Be patient with yourself and others since it may take some time to get back to your regular energy levels. And, remember that it’s OK to ask for help so that you can take it easy. 2. Stay hydrated  Diarrhea, vomiting and other chemotherapy side effects can cause you to become dehydrated. Not only can this cause you to have low energy, but it can also cause other health issues. So, be sure to drink plenty of water during your treatment. Decaffeinated tea, juices and milk can also help. If you’re having trouble consuming enough liquids or staying hydrated, talk to your care team. 3. Eat when you can Chemotherapy can cause nausea and appetite loss, so it’s important to eat when you can to avoid becoming malnourished. Keep in mind that many foods may taste different as you go through treatment. For some patients, food may have a metallic aftertaste during and after chemotherapy. 4. Create a sense of normalcy in your routine Stick to your normal routine as much as possible. That could be something as small as getting dressed up every day, or having a meal with...

10 chemotherapy tips from cancer patients who’ve been there

If you’re preparing for chemotherapy for the first time, you may be wondering what to expect. We asked our Facebook community to share their best advice for preparing for chemotherapy – and the side effects that come with it. Here’s what they had to say. 1. Get some rest Fatigue is the most common side effect experienced by cancer patients, especially those undergoing chemotherapy. So, get plenty of rest and avoid pushing yourself too hard, even if you feel good. Be patient with yourself and others since it may take some time to get back to your regular energy levels. And, remember that it’s OK to ask for help so that you can take it easy. 2. Stay hydrated  Diarrhea, vomiting and other chemotherapy side effects can cause you to become dehydrated. Not only can this cause you to have low energy, but it can also cause other health issues. So, be sure to drink plenty of water during your treatment. Decaffeinated tea, juices and milk can also help. If you’re having trouble consuming enough liquids or staying hydrated, talk to your care team. 3. Eat when you can Chemotherapy can cause nausea and appetite loss, so it’s important to eat when you can to avoid becoming malnourished. Keep in mind that many foods may taste different as you go through treatment. For some patients, food may have a metallic aftertaste during and after chemotherapy. 4. Create a sense of normalcy in your routine Stick to your normal routine as much as possible. That could be something as small as getting dressed up every day, or having a meal with...

Retired physician: I wish I’d gotten a colonoscopy sooner

I was hired as an infectious disease specialist by MD Anderson in 1983. And until I retired in January 2019, I routinely helped patients with one of the most common side effects of cancer treatment: infections. But despite working at MD Anderson for more than 35 years and watching several of my colleagues struggle with cancer diagnoses, I put off getting a colonoscopy until I was 66. That’s 16 years later than recommended. The results showed I had stage I colorectal cancer. My colorectal cancer diagnosis It was my wife who saved my life. Most people get a bit heavier over the holidays, but I’d been losing weight steadily for about four months by early 2017. And I was not trying to. I was also experiencing fatigue. One night, my wife finally looked across the dinner table at me and said, “You are literally melting away before my eyes. What’s it going to take to get you to go to the doctor?” That was the wake-up call I needed. I reached out to a colleague, who ordered a CT scan. It showed a 1.5-inch tumor in my sigmoid colon. A few days later, I had a colonoscopy. A biopsy of tissue taken during the colonoscopy revealed the tumor was adenocarcinoma. I had surgery to remove the tumor and part of my colon a few weeks later. Don’t put off screenings and preventive tests Fortunately, the cancer hadn’t spread to any nearby lymph nodes, so I didn’t need chemotherapy or radiation therapy. My recovery was relatively quick and pretty unremarkable. And my scans have been clear ever since the surgery....

8 breast biopsy questions, answered

Getting a breast biopsy? You might be wondering what it is and how it works. A breast biopsy is a diagnostic procedure in which a doctor removes a small amount of breast tissue to examine under a microscope. If the tissue sample shows cancer, the physician can have it analyzed further to provide the most accurate diagnosis — a critical first step in getting patients the best treatment possible for their particular type of breast cancer. A biopsy may be ordered when a mammogram or other breast imaging (such as an ultrasound) reveals an abnormality or you feel a lump in your breast, or when a physician notices something suspicious (such as dimpling or a change in skin texture) during a clinical exam. We spoke with Marion Scoggins, M.D., to learn more. Here’s what she had to say. What are the types of breast biopsies, and how are they different? There are two basic types of breast biopsy: surgical and needle. A breast biopsy done surgically through an incision in the skin is called a surgical breast biopsy. A breast biopsy done by inserting a needle through the skin is called a breast needle biopsy. There are two main types of breast needle biopsy:  fine needle aspiration, which uses a thin, hollow needle attached to a syringe, and core needle biopsy, which uses a larger needle that removes a small, tube-shaped piece of tissue with a spring-loaded device or a vacuum-assisted device. Because it’s important to pinpoint areas of concern and pull tissue from those exact spots, doctors typically use an ultrasound — or a mammogram or MRI, in some...