Just Diagnosed

Q. As a patient, what can the Providence Regional Cancer Partnership offer me that I might not find elsewhere?

A. At the Cancer Partnership our sole focus is cancer. Our physicians treat more cancer patients in a year than most doctors treat in a lifetime. For our patients, this specialization and focus translates to world-class medical expertise and patient care that goes beyond the norm. We approach care as an integrated team of experts so you won't have one provider working on your behalf, you'll have an entire team.

The Cancer Partnership is home to state of the art technology delivering the most advanced methods for diagnosis and treatment including cutting edge new therapies. And everything you need to take care of your cancer including diagnosis, treatment and all the support services, are available in one convenient location. 

But aside from our team approach, state of the art facility and treatment options, what really makes the Cancer Partnership different is the people who work here. These people have dedicated their lives to helping treat people with cancer and they go above and beyond to do whatever it takes to help their patients. They get to know their patients, they care about them as if they were their friends and family. Because in a sense, that's what they become. Meet our team.

Q: What is cancer?

A: Cancer is what happens when a group of cells grows uncontrollably and in an abnormal and disorderly way. It's really a result of what happens when, for reasons that are only partly understood, the normal growth-control mechanisms fail. Cancer cells have two properties that make them dangerous: They can invade into neighboring tissues, and they can spread to distant areas of the body, forming secondary tumors or metastases.
 

Q: What causes cancer?

A: Two types of factors contribute to the cause of cancer. One is a tendency or predisposition to develop cancer; the other is exposure to the triggers that start it off (such as cigarettes, sun exposure, or liver damage, for example).
 

Q: What is cancer staging?

Q: Why do some people get cancer and not others?

A: In a few cancers (such as retinoblastoma) and in a small proportion of the more common cancers (such as a small proportion of breast and ovarian cancers), there seems to be an inherited factor that we can (partly) identify. In most cancers, we assume that a person’s cells have a low threshold for becoming malignant, and thus he or she will develop a cancer with relatively less prompting by a trigger (such as cigarettes or the sun) than another person whose cells have a higher threshold and who may be able to tolerate more exposure to a trigger without developing a cancer.
 

Q: Is there an epidemic of cancer?

A: Not really. An epidemic means a very rapid increase in the amount of the disease, and in most cancers there is no real change. In some cancers (such as stomach) there has been a decrease, and in some cancers (such as breast) there has been a small, steady increase, which may be partly accounted for by better diagnosis. There is an epidemic of discussion and awareness (thank goodness), so that at last people are talking about cancer, whereas until recently it had been a taboo subject.
 

Q: Do we get cancer from what we eat?

A: Yes and no! The high-fat, low-fiber diet common in developed countries may play a role in about a third of all cancers (though we don’t know this for certain yet). There are, however, no toxins or chemicals in modern foods that cause cancer; in fact, the opposite is true. For example, the fact that cancer of the stomach is becoming less common may be because of the way we preserve foods and prevent bacterial decomposition of what we eat.
 

Q: Are chemicals and pollutants causing cancer?

A: In a very small proportion of special cases only. In certain occupations, prolonged exposure to a few identified chemicals may cause certain (rare) kinds of cancers. Nowadays almost all of these substances have been identified and are regulated.
 

Q: Does cigarette smoke really cause cancer?

A: Yes. Cigarettes cause the vast majority of cancers of the lung and are a major factor in cancers of the bladder, pancreas, mouth, larynx, esophagus, and kidney.
 

Q: Can attitudes or stress cause cancer?

A: Not as far as we know. In fact, the idea that the cancer “personality” or a bad attitude contributes to the cause of cancer may be part of the ancient human habit of blaming the patient for the disease.
 

Q: Can a change in diet alter the course of cancer?

A: Again, not as far as we know. Many cancer centers are currently involved in finding out whether a certain diet can alter the course of cancer in some selected early cases. There is no evidence that diet supplements, vitamins, minerals, or special diets actually change the course of a cancer once it has developed.
 

Q: Why does the diagnosis seem to be so delayed in so many cases?

A: Cancer cells can multiply to produce literally billions of cells before a tumor becomes big enough to detect. That is why prevention and some methods of screening are so important.
 

Q: Can cancer be prevented?

A: We think a lot of it can. The established preventive methods (including refraining from smoking, avoiding sun damage, sensible sexual behavior, eating a high-fiber, low-fat diet, having regular Pap tests) would reduce the incidence of cancer dramatically. We could probably prevent more if we knew more, so research is very active in this field.
 

Q: Does treatment work?

A: Yes. Surgery, radiation therapy (after or instead of surgery) and chemotherapy are all forms of treatment that are used to treat cancer. These treatments can produce remissions in a proportion of cases when cure is not possible. Discussions you have with your doctor about your particular case are important, and why the doctors at the Cancer Partnership get to know all they can about your case. Then they create a treatment plan just for you.
 

Q: Why is the treatment so difficult?

A: Treatment is so difficult mostly because cancer cells are only slightly different from normal cells. In this respect, cancers are totally different from, say, bacterial infections such as pneumonia or tuberculosis. Because bacteria are completely different from our body’s cells, antibiotics can kill them and not affect us very much. But because cancer cells are very like our normal cells, in order to kill them we (usually) risk doing considerable damage to normal cells or tissues.
 

Q: I am going to start radiation next week. What should I expect, and what can I do to decrease the fatigue?

A: Fatigue related to radiation treatments usually starts about the second or third week of treatment, and may continue for up to three months or longer afterwards. It is important to take good care of yourself. This means eating a well-balanced diet, drinking lots of fluid, sleeping well at night, and doing exercise as tolerated, such as walking regularly. Once you start feeling fatigued, then you should match your activity level to how you feel. You should identify the activities or tasks that you have to do, and ask someone else to do the other.

First, if you are driving yourself to your radiation treatments, see if someone else can drive you when you start feeling tired.

Second, try keeping a diary of how you feel, what makes you feel more energetic, what makes you feel more tired, and avoid the more tiring activities. Rate the activities using a simple scale, such as on a scale of 0(full of energy) to 10 (absolutely exhausted, no energy).

Third, talk with your doctor or nurse about problems that arise, or if your fatigue is severe.

Finally, access the support services the Cancer Partnership offers. There are many resources available to help you manage this difficult process.

Brachytherapy is a type of radiation therapy used to treat:

• prostate cancer

• cervical cancer

• endometrial cancers

Unlike external beam therapy, in which high-energy x-ray beams generated by a machine are directed at the tumor from outside the body, brachytherapy involves placing a radioactive material directly inside the body. The seeds are carefully placed inside of the cancerous tissue and positioned in a manner that will attack the cancer most efficiently. 

Brachytherapy allows a physician to use a higher total dose of radiation to treat a smaller area and in a shorter time than is possible with external radiation treatment. 

Brachytherapy may be either temporary or permanent.

In temporary brachytherapy, the radioactive material is placed inside or near a tumor for a specific amount of time and then withdrawn. Temporary brachytherapy can be administered at a low-dose rate or high-dose rate. 

Permanent brachytherapy, also called seed implantation, involves placing radioactive seeds or pellets (about the size of a grain of rice) in or near the tumor and leaving them there permanently. After several weeks or months, the radioactivity level of the implants eventually diminishes to nothing. The seeds then remain in the body, with no lasting effect on the patient.

A linear accelerator (LINAC) is the device most commonly used for external beam radiation treatments for patients with cancer. It delivers a uniform dose of high-energy x-ray to the region of the patient's tumor. These x-rays can destroy the cancer cells while sparing the surrounding normal tissue.

The most advanced machine of its type in use today.

The Varian Trilogy is the most advanced, sophisticated radiation machine of its type in use today. It is so precise that it can deliver a beam within one-millimeter accuracy. It is the world's first image-guided radiation therapy system to deliver all forms of external-beam radiation therapy. There are only 54 of these machines in the world, and the Cancer Partnership has one of them.

Benefits

The Trilogy provides physicians with advanced imaging capabilities.  Because the machine is so precise, it allows physicians to deliver very high doses of radiation with precise accuracy, and spare patients' healthy tissue. It is also 60 percent faster than conventional machines, which reduces the effect of tumor motion, shortens treatment times and improves patient comfort. The system can deliver radiation treatment so many different ways that the choice of treatment technique can be customized for each patient.

Positron emission tomography, also called PET, and computed tomography (CT) are diagnostic imaging methods used to find and assess tumors inside the body, and evaluate how a patient is responding to treatment. The GE Discovery PET/CT scanner blends both into one—a single, full-body scan generates two sets of images, which are fused to show a patient's anatomy and any hot spots of suspected cancer.  It also can be used with radiation therapy equipment for treatments.

Benefits

The GE Discovery PET/CT scanner is a new breakthrough in technology and helps physicians see and treat cancer faster than ever before with increased accuracy. It also provides patients with a more accurate diagnose, reduces exam times—results can be obtained within an hour—and can potential reduce invasive procedures such as biopsies and unnecessary surgeries for detection.

TomoTherapy is a new way to deliver radiation treatment for cancer. It delivers a very sophisticated form of intensity-modulated radiotherapy (IMRT), and combines treatment planning, CT image-guided patient positioning, and treatment delivery into one integrated system. 

The radiation treatment is delivered similar to the way a CT obtains an image, by continually rotating around a patient. However, it's not only capturing an image, but delivering a highly focused, intense beam of radiation to the cancer target area from multiple angles. TomoTherapy assists physicians in developing highly precise treatment plans with minimized side effects for patients.  

The Cancer Partnership's new TomoTherapy machine is one of only 120 in the world.

Benefits

This new technology is adaptive, and allows physicians to adjust and customize the size, shape, and intensity of the radiation beam to target the radiation to the size, shape, and location of the patient's tumor. This benefits the patient by minimizing radiation exposure to healthy tissue. New images are also created every time the patient is treated to help guide treatment based on patient anatomy for that day, rather than for last week or last month.

Patients who need surgery for treatment of lung cancer and other pulmonary diseases now have a minimally invasive alternative to traditional open thoracic surgery called Video Assisted Thoracoscopic Surgery (VATS) at Providence Regional.

VATS is performed by thoracic surgeons for biopsies and other small procedures, as well as for removing cancer in the lung (lobectomies). Using a tiny camera and surgical instruments inserted through a few small incisions, VATS gives the surgeon a clear view inside the patient's chest.

Because only small incisions are needed, VATS patients typically recover more quickly and with significantly less discomfort and scarring compared to traditional open thoracic surgery. And, since the recovery is less painful and shorter after VATS than traditional surgery, most patients who need chemotherapy can start it sooner.

All of the physicians at the Cancer Partnership follow The National Comprehensive Cancer Network (NCCN) Guidelines, further supporting their ability to coordinate patient care with one another. Regardless of which physician a particular patient sees, the patient is assured the same "gold standard" of care set by the NCCN.

In addition to the support services we provide, we also serve as your guide to an entire community of excellent resources all around you. They provide accurate information, caring support, other local referrals, and you can connect with them online.

For our complete list of Community Resources, click here.

• Coping with a new diagnosis, treatment or recurrence
• Creating a care team at home
• Family communication
• Support in making difficult treatment decisions
• Self-care for patients and caregivers
• Stress management
• Identifying resources
• Anxiety and depression
• Grief and loss
• Survivorship concerns
• End of life concerns

Support for Children & Teens

Youth Programs Offered by Providence Hospice & Home Care

Classes at the Cancer Partnership are open to all patients, family members, friends and caregivers. They’re a great way to build your support network and engage in the healing process with others who understand.

For a complete list of the classes available at the Cancer Partnership, click here.

Note: Classes are also open to the general public and to cancer patients who are not patients of the Cancer Partnership.