1. Wellness and Cancer Oncology Liaison Nurses Bon Secours Hospital Kate Murphy & Roisin O’Sullivan

2. Don’t take statistics at face value. Everyone's cancer is different (www.cancersupportcommunity.org)

3. Cancer is not one single disease, but describes a process that begins with a series of cell changes In Ireland – Men - prostate, colorectal and lung Women - breast, colorectal and lung

4. New cases for cancer by sex, Ireland, 2010 New cases (counts)New cases (rate) TotalFemaleMaleFemaleMale All Cancers 33,73417,61616,118730.2765.5 All Invasive Cancers 27,81412,81914,995537.5712.5 Prostate 3,230n/a3,230n/a155.9 Breast 2,7602,73723123.31.1 Colon and rectal 2,4261,0291,39741.866.2 Lung 2,2539461,30739.062.0 Melanoma skin 89952637322.517.5

5. Deaths for cancer by sex, Ireland, 2010 Deaths (counts)Deaths (rates) TotalFemaleMaleTotalFemaleMale All Cancers 8,3163,9474,369175.2152.9206.7 All Invasive Cancers 8,1353,8654,270171.7150.2202.2 Lung 1,69371697736.528.646.4 Colon and rectal 94240753519.715.225.3 Breast 6596491014.326.50.5 Prostate 533n/a533n/a 25.3 Pancreas 47222824410.08.611.6

6. Things to consider before treatment……… Dentist Flu & Pneumococcal vaccines Giving up smoking –Seek advice about quitting smoking –HSE Quit team, free phone 1800201203 –Irish Cancer Society information nurses, in Daffodil Centres, can give advice on quitting smoking. –www.quit.iewww.quit.ie Review current medications Consider applying for medical card.

7. Things to consider to stay well during treatment…………

8. Medication Ask what side-effects you may expect Take medication, as prescribed

10. Rest Do not fight the tiredness Get plenty of rest, but don’t over do it Aim to keep your normal wake up time and go to bed time Take naps earlier in day If working, consider reducing working hours

11. Exercise Exercise shapes feelings of psychological wellness; exercise stimulates feelings of physical wellness; and exercise influences social wellness Make time daily for some regular physical activity ie walking Take it easy at first, increasing the amount as you feel stronger

12. Effect of Low-Intensity Physical Activity and Moderate-High Intensity Physical Exercise During Adjuvant Chemotherapy on Physical Fitness, Fatigue and Chemotherapy Completion Rates Hanna van Waart et al (2015) JCO June 10, 2015 vol 33 no. 17 1918-1927

13. 230 breast cancer patients having adjuvant treatment were assessed before, after treatment and at 6 month follow-up Randomised to aerobic exercise program versus usual care.

14. Results Exercise program resulted in Less decline in cardio respiratory fitness Better physical functioning Less nausea and vomiting Less pain Improved muscle strength Improved physical fatigue

15. Conclusion A supervised, moderate to high intensity, combined resistance and aerobic exercise program is effective for patients with breast cancer undergoing adjuvant therapy. A home based, low intensity physical activity program represents a viable alternative for women who are unable or unwilling to follow the higher intensity program

16. Sleep Have a bedtime routine If having problems with sleeping –Reduce caffeine –Relaxing before bedtime –Maintaining a regular sleep schedule Consider taking sleeping tablets

17. Eating Eat small, well-balanced meals Ask for help with meal preparation Aim to drink, at least 2 litres of fluid per day Don’t diet whilst on treatment Wash your hands frequently

18. Protect Your Skin Keep your skin covered up. Wear a high factor, ≥ 30 SPF Don’t sunbathe for long periods Wear a hat Consider wearing clothes with SPF protection

19. Talking If feeling worried or anxious, talk to your close friends or family about concerns Talk with your GP Community support groups – Arc house

20. Ask For Help Cut down on unnecessary tasks Get others to help you around the house, with shopping, cooking, childcare or travelling to hospital Family and friends can offer a listening ear and give advice, if needed. Some, may gather up-to- date information on cancer to know what to expect and what patient going through.

21. Complementary Therapies Some can boost your morale, like relaxation, reflexology Can be given alongside conventional treatment Help with symptoms ie acupuncture can help nausea, hot flushes Alternative therapies ie St John’s Wort can interact with chemotherapy https://www.mskcc.org/cancer- care/treatments/symptom- management/integrative-medicine/herbs/

22. Alert Card