Blue Ribbon Info

March is Colorectal Cancer Awareness Month, as well as National Social Worker Appreciation Month. Both subjects are cause for celebration, but for different reasons of course...

Colorectal cancer incidences have been decreasing over the last two decades, and is now listed as the third most common cancer in men and women, where it used to rank in the number two spot. Screening tests have increased in availability and accessibility, and have played a significant role in this change.

Specifically, colorectal cancer screening tests that allow for the detection and removal of polyps have been found to be highly effective in preventing cancer. These polyps - whether or not they are cancerous upon removal - have been shown in research to eventually progress into colon cancer. Removing them when they are first seen has become standard procedure and is saving lives.

Colorectal cancer is difficult to detect in early stages without the aid of a test such as the colonoscopy, since it doesn't typically show any distinct symptoms. Advanced disease can be indicated by rectal bleeding, blood in the stool, a change in bowel habits, cramping pain in the lower abdomen, decreased appetite, or weight loss. In some cases, loss of blood caused by the cancer can lead to anemia which causes its own symptoms such as weakness and fatigue. In recent years, there has been an increase in colorectal cancer diagnoses in individuals under fifty years of age, so any of these symptoms in someone in that age bracket should cause enough concern to warrant a visit to the doctor for screening.

Current recommendations for colon cancer screening say to begin at age 50 for anyone at average risk for developing the disease. Recommendations on type of test and time interval changed in 2008 based on the American Cancer Society's collaboration with several other organizations. For the breakdown of the new recommendations click here.

Social Workers are the life-blood of many non-profit organizations - especially those, like Hope Cancer Resources, that provide services to people in the community. Not only do our social workers provide navigation for cancer patients who request assistance from us, but they also network into the community to help a patient find assistance that is not within the scope of our organization's mission.

Our services are provided to patients who are going through one of the most difficult times of their lives - cancer treatment. Not only can the disease and the treatment drain an individual's body of strength and stamina, but the emotional toll it takes on someone who has trouble finding the light at the end of the tunnel can be just as devastating. Our social workers address patients' emotional needs instantly, the very first time they meet with patients, and for some patients that's one of the most important services they receive: the providing of hope. Perhaps these quotes from grateful patients say it best:

"We thank you so very much for being there for Fred when we didn't think we had any hope." -- MSW

"I do not have the words to express how much you have meant to me and my family. Not only have you helped us financially, but you have also met so many emotional needs. Thank you does not seem like enough, but it is all I know to say."  -- KT

"Your generous assistance is so appreciated. Your help will not only help me with expenses, but help alleviate some of the stress and tension caused by such worries. Thank goodness for organizations like yours, ... literally saving patients from some of the stresses that can hinder recovery. Thank you!"  -- RR

We are proud of the work our social workers do every day to support cancer patients in Northwest Arkansas, and we honor all the social workers doing their work throughout the country. Take a minute to thank a social worker you know this week... you might meet one at your child's school, at the hospital, at the nursing home, at the local food bank or shelter, or even at a church or public service organization office. They're all doing great work every day.

Treating the Whole Patient

If you have spent any time with a cancer patient as they underwent treatment, you probably know that the physical effects of the disease are only one part of the journey. A change in an individual's ability to function as they did pre-diagnosis causes a tremendous amount of stress. Fear of the unknown - and even the fear of the known - can also cause a patient to endure a level of stress that can be detrimental to their emotional health. These stresses can affect relationships with caregivers and other loved-ones, as well as their ability to function at work or perform routine tasks.

1 in 2 men and 1 in 3 women will be diagnosed with cancer in their lifetimes, according to American Cancer Society estimates. Nothing can prepare a person to receive a diagnosis that can be potentially fatal. And even when a patient has successfully made it through treatment and is declared "cancer free", there still may be a tremendous amount of residual worry.

The National Cancer Institute addresses stress and cancer on their website: 

Studies have indicated that stress can affect tumor growth and spread, but the precise biological mechanisms underlying these effects are not well understood. Scientists have suggested that the effects of stress on the immune system may in turn affect the growth of some tumors. However, recent research using animal models indicates that the body’s release of stress hormones can affect cancer cell functions directly.

A review of studies that evaluated psychological factors and outcome in cancer patients suggests an association between certain psychological factors, such as feeling helpless or suppressing negative emotions...

Every time a staff member at Hope Cancer Resources interacts with a cancer patient or their family members there is an opportunity to provide emotional support. Even the smallest thing - like providing a brochure - can reduce a patient's stress level. Our licensed oncology social workers help patients and caregivers cope with emotional distress through counseling, education and  information on support groups offered in our community. 

Here's a story of one of our patients who received emotional support from Hope Cancer Resources:

"Jason" is a cancer patient, married with three grown children. When we met him, he was suffering from chronic pain stemming from a previous accident as well as increasingly acute pain related to his cancer diagnosis.  Jason refused all but the mildest forms of pain medication. His pain was so extreme that he considered ending his life.

 Jason had never been to a counselor. He had always been strong and able to "handle anything on my own." Not wishing to burden his family, he kept his suffering to himself, but doing so had taken its toll on this once vibrant person who had already overcome many obstacles in life. Were it not for the insistence of his physician, Jason might never have sought help. By the end of his first therapy session, however, he shared what a relief it was to have a safe place to talk about both his physical and emotional pain.   

Over the next several weeks, he and one of our licensed counselors met on a regular basis and explored his beliefs about asking for help as well as his fear that taking strong pain medications would cause him to develop an addiction.  Subsequently, Jason felt comfortable discussing and pursuing additional options for pain relief with his physician.    

By his fourth session, there was nothing less than a remarkable change in Jason.  Physically, he appeared "lighter," peaceful and well rested, but it was the change in his outlook on life that really made an impression. His focus had shifted completely.  Whereas Jason had previously been plagued by persistent thoughts of death, he now talked in great detail of his renewed relationship with his wife, their summer travel plans, and resuming hobbies he enjoyed.  With a big grin on his face, he came in one day to simply say, "I've got a lot to live for."

If you know someone who is undergoing treatment for cancer and could benefit from the emotional support services we offer, contact one of our social workers at 479-361-5847.  

Information Overload

Meet Kay: She consulted with a physician at Highlands Oncology Group in Fayetteville when she was initially diagnosed with cancer. She did meet with one of our social workers, but was so overwhelmed by all the information she was receiving and the speed of her diagnosis, she didn't really enter into a discussion. Because the type of cancer Kay had was extremely rare, she was referred to a surgeon out-of-state where she was treated and will continue to receive follow up treatment for an undetermined amount of time.

Kay didn't need our services during her treatment, and was able to recover from surgery and get back to her life without much interruption, but she kept our social worker's card in her wallet. As she passed our building every day on the way to and from work, she began to feel compelled to contact us. She made an appointment to talk to a counselor to discuss her cancer journey so far, to vent, and talk about the road ahead. She just needed, as she put it, "an ear and a shoulder."

For most of the 20th century, information about cancer was not easy to get your hands on unless you were a physician. Patients relied on their family doctor or specialists, if they had access to them, to provide a diagnosis and discuss different procedures and methods of treatment. The doctor's word was usually the last word in cancer treatment for people in our grandparents time, and even in many of our parents' time.

Fast-forward to 2011: In today's "connected" society, we are likely to do some research (or a lot of research) ourselves via the internet. We will take the information we find online to our doctors' appointments. We will discuss the local oncologists and treatment options with support groups and friends who have fought cancer. We will be completely involved in the final decisions made about our treatment.

More information can be a great thing. In fact, information - "awareness", in particular - is a vital component to cancer prevention programs like those managed by Hope Cancer Resources. We promote making healthy choices regarding sun exposure, tobacco use, and the frequency of tests and screenings that are designed to catch cancer or pre-cancerous conditions early. But we also understand that the amount of information available to patients online and in the printed materials in our resource libraries, and even coming straight from the physicians, can be, as Kay said, overwhelming.

Our social workers are here to help. We are available to help you with emergency needs that might come up during treatment, and we're here to help point you to reliable sources of information if you are looking for places to do your own research. But we are also here to listen. Our confidential counseling sessions are available to patients before, during, or after treatment, and to caregivers in some circumstances as well. We are here to help you make sense of your diagnosis and the changes that occur in a body and a lifestyle that has been affected by cancer. We're here to let you cry, or laugh, or just be reminded that you're not alone. No matter when you think you need us - we're here.

Fatigue and Cancer Treatment

We've probably all experienced the effect that a poor diet can have on our bodies and minds. We have stayed up late preparing for the big test drinking sodas and eating pizza. We have skipped breakfast when we're running late and lunch while on a deadline at work. We may have met the deadline and passed the test, but we probably didn't feel well for a couple of days afterward. Sacrifices like this are common among healthy people who don't think twice about sacrificing some level of health in order to get things done. But for someone going through cancer treatment, maintaining proper nutrition and getting enough rest becomes more than something they can put off on a whim.

Cancer treatment can affect different people in very different ways, but one of the most common side-effects is fatigue. Some patients will deal with it intermittently as they go through treatment - many chemotheraphy patients take to their beds for several days after every bi-weekly treatment. Others may feel it build and get harder to manage the longer their treatment lasts. This is a common concern among radiation patients. Their 5-7 week regimen may not seem like much at first, with the actual treatment taking less time than it took the patient to drive to the clinic, but radiation is very taxing on a body. The buildup of that exposure can lead to a variety of side-effects.

So, how do patients and their caregivers prepare for and manage the fatigue that accompanies cancer treatment? CureToday.com recently published a great article on the subject and offered the following tips:

• Conserve energy. Organize your day so you have enough energy to do what’s most important. Spread chores throughout the week and make rest part of your daily routine. This seems to be the hardest thing for many people who equate napping with being lazy. Just make sure they're short, too much sleep can actually backfire and contribute to more fatigue and the additional challenge of insomnia.

Don't forget to ask for help. If mowing the lawn, doing laundry or running errands are too tiring, enlist friends and family to help. (Most of them really want to, but don't know what to offer!) If a trip to the grocery store is necessary, most stores offer motorized carts for customers.

• Get moving. This may not make sense, but it's true that regular physical activity can help relieve symptoms of fatigue. Experts claim that patients can increase their energy by exercising at a slow and steady pace several times a week. Be sure to increase activity levels slowly (even after treatment has ended) and include your daily to-do list as part of your activity plan.

• Rearrange your environment. Simply picking up or putting away the things you use most can add up to sap your energy. So place things you use often within easy reach, whether it’s your favorite cooking pot or the shampoo in the shower.

• Improve sleep quality. Go to bed and get up at about the same time every day, including weekends. Don’t exercise in the evening and avoid caffeinated drinks and foods. You may also consider creating a relaxing bedtime ritual that starts one hour before bedtime—and that means turning off the television. Listen to calming music or take a bath instead. If you're a caregiver, offer to give your patient a foot massage and help manage the room temperature to induce sleep. Do not drink alcohol or eat immediately before going to bed.

• Screen for and treat the possible underlying cause. Sometimes fatigue serves as a clue to another medical problem. If cancer treatment depletes a patient’s red blood cell count, for instance, the body’s tissues don’t get enough oxygen and fatigue sets in. Treat the anemia, and you’ll start to get your energy back. If blood is being drawn at each visit to the oncologist, keep tabs on what the blood counts are and ask what you can do to help build your blood iron level. Many foods offer a good serving of iron, and supplements are available as well (although food sources are usually easier on the digestive tract). Other side effects of treatment that can lead to fatigue include pain, depression, anxiety and nausea.

For local patients in Northwest Arkansas, our trained oncology social workers are available to help you manage the challenges you encounter during treatment and will be happy to talk to you about any depression or anxiety you may be experiencing. They can also provide materials from our resource library that may help you find foods that can boost your energy or helpful hints for managing your stresses. Contact us for more information or to set up a confidential visit with a social worker between 8am and 5pm, Monday - Friday at 479-361-5847.

"In Sickness and In Health"

In the days leading up to Valentine's Day we are bombarded with images of hearts and flowers, aisles crammed with candy and cards and love-themed gifts intended to prove the devotion of the giver. It's a time to intensify already growing feelings, or to reinforce those feelings that have already been there for a time... It's a time to sell a lot of candy and cards!

But sometimes the feelings that send people scrambling to the local Hallmark store the week before February 14th can be at risk of faltering in the face of illness. The mental and physical fatigue that can result from stress and tasks added to the "to-do" list of a caregiver is potentially devastating to even the strongest relationships. At the very least, it can put the caregiver at risk for needing their own mental health support, and they shouldn't be afraid to ask for it.

We're all capable of imagining the emotions a cancer patient might experience as they embark on their journey of treatment and recovery, but a study published in the Journal of Clinical Oncology and reported on Newsmax.com explored the stress levels of caregivers and found them at risk for their own emotional challenges. Thirteen percent (13%) of the people in the study acknowledged feelings that signaled problems such as anxiety disorder, depression, and post-traumatic stress disorder. It's easy for the outside world to focus on helping the patient as they fight the disease and not realize that a very intense battle is going on in the head and heart of the caregiver as well. Caregivers deal with a multitude of feelings, including:

• fear - of losing their loved one;
  
• anger - about their loved-one's diagnosis and/or for the added burden they they are being required to bear;
• inadequacy - at not being able to do enough to help, or not doing it all well enough;
• grief - for the loss of the "normal" life they were living before the diagnosis; 
• guilt - that they are healthy, or they they are feeling some of the feelings listed above.

The best thing friends and family can do is offer to relieve the caregiver on occasion to allow them some time away from the stress of their duties. For some, it will hard to even admit that they need this help, but it's vital that the caregiver be allowed to need support as well as the patient. It may help to attend a support group for caregivers or to speak to a counselor one-on-one to share fears and frustrations. A good counselor will help them recognize that their needs are important, and that caring for their loved-one is a demanding task - one that requires someone who is also taking care of themselves.

If you are a caregiver and would like information on support groups in your area, check with your oncology clinic staff. Seek out the services of a licensed social worker or counselor to discuss your options for self-care. If you are in Northwest Arkansas you can contact us for assistance. Our licensed social workers are here to help you through this very difficult time - you might meet with them once and feel better equipped for your journey, or you may need someone to offer support on a long-term basis. Either way, we're here to help.

Remember that your love will help your loved-one see light at the end of the tunnel on some very difficult days, but it's okay if it's not enough to keep you from becoming exhausted. Taking care of you will help you take care of them.

Optimism is Optional

It seems that everywhere we look lately, someone is linking positive attitude to good health or quicker recovery from physical ailments. It's on daytime t.v., it's in women's magazines, it's in blogs we read... people we don't even know are telling us to "cheer up!" to keep ourselves healthy.

When a person is diagnosed with cancer, there are always a handful of people who don't know what else to do except to encourage that person to remain hopeful and to be positive about a good outcome. But the fact is that there are some very real fears and difficulties associated with their disease, and it really is okay for those people who are dealing with it to be angry and scared and even have days when they would rather stay in bed than do almost anything else.

It goes without saying that if you have to sit in a doctor's office and hear the words "It's cancer." there isn't a lot of cheer to be found. Or, at the very least - what's available doesn't seem like it's enough to do the job that will be required as you go through your treatment and recovery plan. In fact, some recent studies state that there is no tangible connection between positive thinking and better recovery and longer life when cancer is added to their daily routines. So, what do we do with that information?

First, let us suggest that the mere act of going to the doctor to investigate the symptoms that have led to the cancer diagnosis as an outward sign that there is, somewhere inside us, a tiny nugget of hope and optimism. Otherwise - why get diagnosed at all? And while a simple "positive attitude" may not cure the disease (did we really believe it would??), remaining realistic but determined and hopeful can certainly cause a cancer patient to take steps that will provide a better opportunity for recovery than feeling defeated and hopeless. Altering diet, getting more exercise as appropriate and with a doctor's approval, and having access to much-needed emotional support can all affect the ability of a cancer patient to get through treatment successfully and start making plans for the remainder of their life.

The social workers at Hope Cancer Resources are trained specifically to work with oncology patients and the special burden of emotions and needs they experience during diagnosis, treatment and recovery. They work with patients individually if requested, or with their caregivers or partners, and we even host a support group for families with young children a couple of times a year.
 
We have a great list of support groups available in Northwest Arkansas on our website. We don't recommend the groups just because they're available, but because we truly believe that having a strong support system behind you as you go through treatment (and afterward) is beneficial for your mental health. Odds are, you will find a lot of people talking about being positive and keeping their chin up in these groups, but you will also find some folks who share your fears and frustrations. At the very least, you will meet some people to talk to when you feel you've said all you can say to your friends and family and they've said all they can say to you. Talking to our social workers or participating in a support group won't heal your body, but they might help you deal with some of your less positive feelings - which will go a long way to ease the rough spots along the cancer journey.

Oncology Social Workers - healing and giving HOPE

Most of us would assume that the words "You have Cancer." delivered by a medical professional would make us afraid for our health. Physical limitations might follow, which would be fairly easy to predict. Fear of death is a given, and we would probably think of our family, and the burden that we might become on them while we are ill.

But even though you expect the physical and emotional results of the diagnosis, you may not know the stress that dealing with a diagnosis and the resulting treatment brings, can have a very real impact on the ability a patient has to heal, recover, and survive. In fact, patients who receive phycho-social support in the form of counseling and support group activities have a higher rate of survival than those who do not. For that reason, cancer centers all over the U.S. are starting to add a social work component to their treatment plans.

HOPE, Inc. employs three licensed social workers in order to provide assistance to cancer patients in northwest Arkansas. Starting with the initial visit a patient makes to Highland's Oncology Clinic in Fayetteville, a social worker is assigned to assess their needs for financial and emotional assistance, and to keep in touch with that patient to continue access to our services as they make the frightening and sometimes confusing journey through cancer treatment.

Even if a cancer patient is not being treated at the Fayetteville Highland's, they can still receive emotional and financial support from HOPE if they live in Washington, Benton, Carroll or Madison counties. For more information on our services please contact us at 479-571-4673 or visit our website at http://www.hopenwa.org/.

C.L.I.M.B. Group Starting Soon!

CLIMB® (Children’s Lives Include Moments of Bravery) is a family support group that helps children cope with and share their feelings about a parent or loved one with cancer. While the kids hang out with a social worker who helps them work through their questions and emotional issues through crafts and activities, the parents meet with another social worker to ask their own questions about talking to their kids about their diagnosis.

CLIMB is a six-week program that meets on Tuesday nights from 5:30-7:00 beginning April 7th. Registration is required. Please call (479)571-4673 to register. Limited space available, so call early!

Be a Spirit Jumper!

It's hard to believe that it's already February! The holidays have passed and the new year is well under way. Every day our social workers are meeting with new patients at Highlands Oncology Group. Last year they met with 3 of every 4 patients who received treatment at Highland's. We're so pleased to have made those important connections and our goal is to beat that number this year.

When Jessica, Christy and Miki meet with those new patients they usually find that they have many questions or concerns stemming from their cancer diagnosis. Many of them have a great support system standing by to help them cope with their emotional and financial needs as they make the journey down the road to recovery, but very often they do not. Even if they are fairly comfortable with the treatments they are receiving or their financial situation, though, it's likely they struggle with internal fears and bouts of depression that are natural for anyone in their situation.

We recently found a great non-clinical grassroots program that addresses these feelings of depression and you can get involved to help! When Meaghan was diagnosed in 2007 with end-stage cancer she was given a 20% chance of survival. But not only has she survived, but she also just completed law school!! Meaghan and her friend Stacy (who is currently battling melanoma) have created a wonderful blog, and associated service, called Spirit Jump. The mission of these two wonderful ladies is to connect caring people to people who need some emotional support. They accept submissions of names of people dealing with a cancer diagnosis and add them to their list, then they match them with folks who have contacted them to say "who can I help?".

Meaghan's personal story (you can read it here on her blog) describes how the little notes and gifts she received almost every day during her lengthy hospital stays kept her spirits up, and were a constant - and crucial - reminder that she was being prayed for and was loved... and it made a huge difference in her attitude. She wants to give that same inspiration and encouragement to others who are going through the same process. It's not always easy to remain optimistic when a patient is dealing with dozens of pills, tests, scans, nausea, anxiety... and the smallest gesture can have a huge impact.

Check out their site, and consider joining this wonderful effort. It only takes a few moments to send a card, and the emotional benefit for a cancer patient would be tremendous.

Social Workers in Cancer Care

Did you know HOPE, Inc. is home to the only social workers dedicated specifically to oncology in our region? Pretty cool, right? But what exactly IS an "oncology social worker"? What do they do? How can they help a patient undergoing cancer treatment?

Oncology social workers help persons with cancer and their loved ones in many ways:

They help individuals ~
* Access information to help understand diagnoses and treatments
* Cope with diagnoses and the emotions experienced
* Plan for the logistics of cancer care
* Apply for programs that offer assistance
* Find temporary housing during treatment

We can offer ~
* Counseling for patients and their loved ones
* Assessments of distress and suggestions for coping
* Information about available support groups and educational programs
* Referrals to community resources
* Information about national resources
* Planning and facilitation of support groups

We can teach about ~
* Communicating with treatment team
* Reducing stress and relaxation skills
* Coping with emotions such as sadness, fear, anger and worry
* Talking with children, family, friends or co-workers
* The basics of hospice care
* Living with cancer
* Life as a cancer survivor

At HOPE we do all of this and more for local oncology patients. We are champions for interventions that enhance the quality of life and survivorship of those we work with. We are extremely fortunate that we also have our own patient services programs to directly assist patients with practical and emotional needs.

Our social workers are licensed in the state of Arkansas, which means they have degrees in social work from a program accredited by the Council on Social Work Education, have successfully completed Board approved examinations, and have undergone a criminal background check. They are also members of the professional organization Association of Oncology Social Workers (AOSW). AOSW's 1100+ members embrace the mission "to advance excellence in the psychosocial care of persons with cancer, their families, and caregivers through networking, education, advocacy, research and resource development."

HOPE is a community leader in the psychosocial care of persons with cancer - and our social workers make it happen.