1. How To Receive Complete Cancer Care: Empowering Body, Mind and Spirit Robert Rutledge, MD, FRCPC Radiation Oncologist and Associate Professor Dalhousie University, Halifax

2. HealingandCancer.org Overview Empower yourself with the best strategy to face a cancer diagnosis Maximize your chance of being cured or living as long and as well as possible Increase your sense of well being Find purpose on your journey

3. HealingandCancer.org Use What Works For You There is no one best way We are all unique Different strategies work best for various personalities Use your rational mind and listen to your own inner wisdom Your strategy will change with time Different needs at diagnosis, on treatment and in follow up

4. HealingandCancer.org What is Complete Cancer Care? Understanding what’s happening to you Getting the best from the medical system Empowering yourself with healthy lifestyle Exercise, diet, sleep, relaxation techniques Adopting a positive attitude Drawing on a spiritual life

5. HealingandCancer.org Information is Power Learn about Cancer in general Treatment options and side effects The medical system What else you can do Lifestyle habits Where to find support Role of complementary and alternative medicine

6. HealingandCancer.org Purpose of Information Learn to speak the language of the medical system Increase your sense of control and well-being Help you make the best medical decisions Empower yourself with non- medical ways to improve your health and outcome

7. HealingandCancer.org Too Much Information? If information gathering is making you tired If you find conflicting information See your doctor to clarify Trust what you are doing is the best for you

8. HealingandCancer.org Understanding Cancer and the Medical System

9. HealingandCancer.org Best Sources of Information Your physician/oncologist - individualizes the information and gives you the best medical advice Prepare for these conversations by researching and understanding cancer in advance

10. HealingandCancer.org Sources of General Information about Cancer and its Treatment Librarian at a cancer centre or hospital National Cancer Society Eg. Canadian Cancer Society - www.cancer.ca Respected Community Based Organization Eg. Leukemia and Lymphoma society of Canada

11. HealingandCancer.org How to Get the Most from the Health Care System Learn to advocate for yourself by: Preparing for each doctor’s visit Contacting your doctor/nurse if you have questions or concerns Drawing on extra services if needed Asking for a second opinion if needed

12. HealingandCancer.org Getting the Most from your Doctor’s Visit Before the visit: Create a concise summary of symptoms Bring a list of current medications and allergies Write down your questions before the visit Someone should accompany you Decide who will make record of the visit You may create a file with all your test results You can get a copy by visiting medical records

13. HealingandCancer.org Be honest and open Speak up if you’re feeling overwhelmed: “I’m not sure I understand” Wait until the summary then ask all your questions Take notes or record the interview Find out what to expect Know what to do for each side effect When do I need to act? Who you should call in case of problems? Getting the Most From Your Doctor’s Visit

14. HealingandCancer.org After Your Doctor’s Visit Keep a journal and list of results If need be ask for a family conference You are the most important person You or a ‘family member’ may be able to do the talking Call to clarify information or ask for appointment You are entitled to a second opinion

15. HealingandCancer.org Getting More Physical Care Multiple services are available in medical system Nutrition Psychology Home care nursing Rehabilitation Spiritual care Palliative Care Team Social worker can help coordinate if needed Ask your nurse or doctor Talk to an expert

16. HealingandCancer.org The Importance of Nutrition Effective way to improve your overall health Individualize to what works for you Different diet during different phases of treatment Ask your doctor and/or professional nutritionist if persistent problems with: Ongoing unintentional weight loss or loss of muscle Nausea and vomiting Diarrhea / constipation Treatment affecting the GI tract

17. HealingandCancer.org General Nutrition Advice Follow Canada’s Food Guide recommendations www.hc-sc.gc.ca/fn-an/food-guide-alimentindex_e.html Choose a variety of food from all food groups daily 5-10 servings of fruits and vegetables/day Choose lower fat food groups Fat to make up < 20% of caloric intake Choose high fiber foods Whole grain breads and cereals Drink plenty of healthful fluids Maintain healthy weight

18. HealingandCancer.org Taking Your Vitamins Ask your doctor Off therapy minimum: Vitamin D 1000 IU / day Calcium 1,500 mg / day Healthy diet should provide the rest

19. HealingandCancer.org The Benefits of Exercise Effective way to improve energy, sleep, mood and overall health You need to listen to your body to guide yourself Individualize to phase of journey Slowly increase activity each week After recovery, aim for at least 30 minutes 5+ days/week

20. HealingandCancer.org Adopting Healthy Habits Balanced diet Exercise Maintain a reasonable weight Sleep Practice a relaxation technique

21. HealingandCancer.org The Importance of Sleep Melatonin experiments (hormone) which suppresses cancer cells Need an average of 7-8 hours of sleep per night Take care of yourself

22. HealingandCancer.org Practice Relaxation Learn to relax Practice relaxation techniques (i.e., yoga, meditation, Tai Chi) to calm the mind Proven to improve overall health Decreases heart disease, mental illness, hypertension, and diabetes

23. HealingandCancer.org Understanding the Emotional Aspects of Cancer Normal to feel any and every emotion including: Shock Worried, scared or anxious Guilty Lonely Sad or hopeless Angry These emotions can be exaggerated or come out unexpectedly

24. HealingandCancer.org Dealing with Difficult Emotions There’s no one right way Find a wise person to talk to Realize emotions change with time Be kind to yourself

25. HealingandCancer.org When to Get Help with Emotional Problems Emotional distress is expected but if you: Feel overly depressed e.g., crying constantly Are withdrawing from all social contact Unable to enjoy life / feel hopeless Are so distressed can’t decide on treatment Can’t sleep because of anxiety Can’t talk about cancer because it brings up terrible memories Talk to a psychologist

26. HealingandCancer.org How to Get Help with Emotional Distress Tell your oncologist or nurse during the next appointment Schedule a visit to your family doctor Call the psychologist / counsellor at the cancer centre Find another expert Support groups

27. HealingandCancer.org Empowering Yourself Complete care integral to recovery You can definitely improve your quality of life, longevity, and overall health Love yourself, love others