Getting the most out of your medical appointments: more tips from a Consultant Oncologist

 

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Meet Richard!

Following on from his last blog post about preparing to meet your oncologist, Consultant Oncologist Richard Simcock writes about the best way to start a consultation with your doctor – and ways you can follow up afterwards.

 

 

 

 


Signposting

If you go to a show you normally know what you’re going to see. Have you ever seen a film or play where you literally knew nothing at all about it before it started? You were likely to have been initially bewildered as you got your bearings. Arriving at a consultation knowing what to expect means less confusion: it allows you to get straight to the substance. It is good practice for a healthcare professional to explain the purpose of the meeting (‘Today I want to explain your radiotherapy treatment’ etc.), but that isn’t always the case.

A reasonable question to ask is ‘What are you hoping to discuss today?’ This also gives you an opportunity to highlight any areas that you know that you want to cover and leads to better time prioritisation. If a follow-up meeting is being arranged, then asking ‘what would you expect us to discuss at our next meeting?’ leads to even better preparation.

Ask for Copies

After almost every clinic consultation a letter will be written. These letters have multiple purposes: they inform the referring clinician, they may be a request (e.g. ‘please prescribe drug X’), and they also act as a record of the meeting (much better than a scrawled note in undecipherable handwriting!).

Eighteen years ago, the NHS plan recommended ‘patients should as of right receive copies of all correspondence between health professionals about their care.’ This was enshrined in the 2015 NHS Constitution. Copies of letters written about you will be sent automatically in most cases. If you’re unsure whether and how this happens, it’s reasonable to check just in case it isn’t yet routine for the doctor you are seeing: ‘Will you send me a copy of the letter you send to my doctor?’

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Try filing your own notes

Not every patient wants their letters, and if you wish not to receive a copy you should make that clear too, in case letters are sent automatically.

In my opinion, far better is a letter written to the patient first and foremost. This should avoid issues with jargon and misunderstanding, but it’s also a part of patient-centred decision-making. The Academy of Royal Colleges recently produced a report (‘Please Write to Me’)  with a  ‘How to..’ document for doctors around writing directly to patients, and I’m hopeful that this will become increasingly standard practice.

You are entitled to copies of results and reports too. This can be problematic as these are almost always written in the dense jargon of the specialty. Breast Cancer Care produces a guide to understanding a breast cancer pathology report and there are other online resources for other cancers. Asking for a summary of what the report means is very reasonable, but asking for a tutorial on the meaning of every word may not be the best use of precious consultation time. As we move to a time where patients will (hopefully) be able to access more of their own data via portals, medical specialists will need to produce more readable report summaries.

Key worker

You should be allocated a ‘key worker’ – this will most often be a clinical nurse specialist (CNS). Many CNS are highly expert in their field and will know answers to all the common questions, and most of the complicated ones too. They can be invaluable in helping you navigate what is happening before, during, and after a consultation. They will often help patients ‘debrief’, particularly if a clinic meeting has been complicated or upsetting. Key workers are there to act as your advocate and help you to get the best, most personalised care. If you know that you have a lot of questions to ask, then first flag this with your key worker before a meeting: your key worker will be able to answer many questions for you, as well as prepare the doctors in the clinic and potentially organise a longer slot.

Macmillan helps to support over 4300 CNS in the NHS and yet we know there are still inadequate numbers. This means not all patients will get the CNS/key worker access they need or deserve. It is always reasonable to ask ‘Do I have a key worker/CNS? And how can I get hold of them if I have questions?’

Occasionally, a doctor-patient relationship is not good.  Communication will be poor as a result. Every doctor can have a bad day when they perform less well, but if you think you are not able to have a good meeting with a doctor attached to your care then this is an issue that your key worker should be able to handle sensitively. Key workers can often help by arranging another member of the team to see you where possible.

Second (and third and fourth) opinions

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Your case is reviewed by multiple doctors

It is standard within the NHS that all newly diagnosed cancer cases are discussed by a multidisciplinary team of professionals. I attend two of these meetings a week. In the Head and Neck cancer meeting, I sit with two other oncologists, a consultant radiologist and pathologist, three specialist nurses, three dieticians, two speech and language therapists, a consultant dentist, a specialist radiographer, and six consultant surgeons and trainees. We discuss every case, and multiple different approaches to the patient’s problem. Later in clinic we will meet the patient and present a summary view. The ‘first opinion’ is often the combination of multiple expert opinions.

You might want to ask ‘Has my case been discussed at the MDT and were any other options discussed?’. This might be particularly important if there are different possible treatments.

Records of the MDT discussion are also available.

Despite these multiple opinions you may still feel that you would like another team to consider your case. A second opinion can be arranged by your treating team (hospital to hospital) but the mechanisms by which hospitals get paid mean that it is often preferred if the request for another opinion comes from your GP. Transferring clinical information and the masses of data contained within scans can now usually be achieved instantly and electronically. Be aware that another opinion will inevitably lengthen the time before treatment can be delivered.

Research and Trials

Research in cancer is vital to drive innovation and improve survival. Clinical centres that engage in research may produce better results (this has been shown in recent radiotherapy trials), perhaps through more detailed systems of quality assurance.

You may be offered the opportunity to take part in a clinical trial, but if you are not then a good question to ask is ‘Are there any clinical trials for my situation in this hospital?’

If there are no local trials then looking at the National Cancer Research Institute website and their Portfolio Maps for a specific cancer will show what important questions investigators have about treating that disease.

If trials are not available locally it is helpful to ask if there are other accessible centres that are running relevant research. This information will usually be available to your team although you will have to consider carefully if the promise of a trial justifies the burden of travel to a centre further away from home.

Conclusion

There is a whole science devoted to analysing different styles of doctor-patient communication and ultimately doctors want the meetings with their patients to be effective, efficient, and friendly.

‘Communication’ has a double meaning – it can also mean a connection between places, a route or a bridge. Good communication should be able to take you somewhere new: bring you to a new point of awareness or knowledge. I hope these tips help you make the best use of those vital minutes, so you have maximum opportunity to arrive at the best possible destination of understanding.

Richard tweets as @BreastDocUK. He is a Consultant Clinical Oncologist at the Sussex Cancer Centre. 

Getting the most out of your medical appointments: tips from a Consultant Oncologist

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Consultant Clinical Oncologist, Richard Simcock

We’ve all been there: you spend weeks stressing over an upcoming appointment with your medical team – but you walk out feeling like you forgot to ask three of the four Very Important Questions you had and you’re not sure you made the most of the precious minutes you were allocated. While at Shine we’re used to seeing things from the patient’s point of view, we thought it might be useful to hear from someone on the other side of the table – what do doctors think about making sure those stressful appointments go well?

We were very happy that Richard Simcock, who is a Consultant Clinical Oncologist at the Sussex Cancer Centre, took on our blog challenge.  In the first of two blogs, he shares some of  advice about getting the most out of your face-to-face meetings with your oncologist. Please do share – or let us know if you think he’s missed anything!

 


As a Consultant Oncologist, a large part of my week is spent in clinics where I talk and listen. I have a schedule that averages around 40 appointments a week. Visits are listed between 20-40 minutes but can range from 5-90 minutes and more.  There’s a lot to get through in this short amount of time. In this environment, it’s easy to forget that a patient may have been waiting days, weeks, or even months for this conversation. The conversation itself is not evenly balanced: on one side is a healthcare professional under time pressure but with (hopefully) the answers and on the other, a patient with much on their mind and the greatest possible personal interest in the outcome. If this weren’t difficult enough, there’s the extra complication of a whole new language. Here is a place where ‘stage’ has nothing to do with actors, ‘progression’ is a bad thing, ‘negative’ nodes are a positive and the drug names seem deliberately difficult.

It’s not surprising then that many patients find clinic meetings unhelpful and sometimes a source of frustration and even anxiety.

Lots of things can conspire to make it more difficult (such as time pressure, or bad news), but there are ways in which you can be surer that a consultation will be effective and useful for you.

In the next two blog posts, I’ll take you through a list of things which I think are helpful. First up: four ways to prepare for the consultation.

1. List your questions

Memory is a fickle thing – that essential question that popped into your head uninvited at 3am is likely to be difficult to recall by 9am, and absolutely missing without trace by the time your appointment comes around. The question that was on the tip of your tongue may be kicked to a distant corner of your brain if the doctor starts asking about your bowels. Don’t take the risk of forgetting an important question: write a list.

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Make a list!

A doctor will not be irritated by a list. A careful set of questions can be really helpful in a consultation and helps manage time and concerns effectively. A list avoids the inconvenience of ‘oh, I just remembered one last thing’ (some people can manage to have multiple and separate ‘one last things’). More inconvenient still is to have to contact the patient again days later because ‘they forgot to ask….’ This is really time-consuming for everybody.

I mention lists of questions first – because so should you.

Introduce your questions early to help plan the time: ‘I know that you need to go through some things with me today, but I also have some questions I’ve written down. Is it OK if I tell you what these are at the beginning?’

Many doctors will prefer to know what the questions are at the outset as they may be able to answer them in the course of their usual conversation.

Try to order your list: are these questions about a clarification, current treatment, or what happens next? Grouping helps to deal with them efficiently. Also try to think what priority these questions have – particularly if you have lots. In a time-sensitive situation and with a list of 30 questions, it may be reasonable for a doctor to ask ‘which of these are the most important for us to deal with today?’

2. Bring someone

asking-beautiful-brainstorming-601170It isn’t always possible to have someone with you in clinic, but it can be really helpful. It’s too easy to end up in a consultation somewhere very different from where you expected to be (after bad news, for example). A friend or relative is likely to be calmer and can remind you of important details. They can also act as your secretary, as you will see.

3. Record

You wrote down the questions, so shouldn’t you record the answers? The answer is definitely ‘yes’ (and you shouldn’t need to write that down). You can’t remember everything that is said no matter how hard you try. The average brain can probably only keep around four things at once in it, for around 30 seconds, and 40–80% of medical information is forgotten immediately after a consultation.

You don’t need to come to your appointment with a stack of notebooks and leave with writer’s cramp – it can be unhelpful for patients to write their own notes. If you’re trying to capture every word, scribbling furiously like the last five minutes of your school English exam, you will miss details. Bring someone who can take notes while you focus on what’s being said.

Less stressful than writing is recording. An audio recording of the consultation is the perfect way to ensure that everything is captured, and nothing is forgotten.  In my department we have been recording consultations for patients since the 90s, using tapes and CDs. We have found it to be enormously helpful.

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You’ve probably got a voice recorder with you already

These days, almost everyone carries a portable recorder around in their phone. Both Android and iPhones/iPads have voice recorders as standard and they are easy to use. Make sure you know how it works before the clinic and test the settings – it’s a clinic, not a sound-check! Once recorded, these sound files can then be emailed anywhere, e.g. to a relative overseas.

There are also useful apps that allow you to add questions before the clinic and then record the answers for future reference. The OWise App is aimed at UK-based breast cancer patients, and the Cancer Net App is produced by the American Society of Clinical Oncology for all patients (although with a US bias in the information sections). These recordings are secure to your phone, which is a good way to protect privacy, but means they that cannot be shared as widely as simple sound files.

Finally, remember to ask your doctor before you record the meeting. Secretly recording a consultation is legally permissible but should be avoided – it suggests a significant breach of trust and a sense that doctor and patient are not on the same ‘team’.

Richard Simcock is a Consultant Clinical Oncologist at the Sussex Cancer Centre, with particular expertise in breast and head and neck cancer. He also works as a Consultant Medical Advisor for Macmillan Cancer Support.

He is a member of the National Cancer Research Network subgroup in psychosocial oncology and he is interested in research which improves the experience of people living with cancer. He was part of the James Lind Alliance Priority Setting Partnership that established the Top 10 priorities in research for people living with and beyond cancer.

He has been involved in communication skills training for healthcare professionals for many years, but still learns something new every week.

In his next blog post, Richard shares some more tips and tricks for the meeting itself, as well as some ideas for seeking further opinions and learning more about clinical trials. 

Richard tweets as @BreastDocUK.

Moving on – with the help of broken crockery

Here at Shine HQ, we frequently see questions about “returning to normal” in our online groups. Young cancer patients rightly want to know when they’ll be able to get back to there they were before but, in most cases, there isn’t an easy answer. For many people we work with, we know that life doesn’t ever really go back to normal. That’s not to say that it can’t be good (or even better) than before – it’s just that something as big as a cancer diagnosis can leave you feeling changed. In our latest blog, Karen shares her thoughts on “moving on” – and explains how it relates to the Japanese art of Kintsugi!


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Blog author, Karen Myers

The end of active cancer treatment is a weird time. It’s all you’ve wanted since diagnosis – an end to hospital appointments, tests, treatments, side effects, surgery, pain, discomfort, feeling a little bit shit. And then, if you’re lucky, it is over. You’re told that your treatment has done it’s job, got rid of the invaders, killed those nasty cancery cells so you’re NED (No Evidence of Disease) or in remission. You’re good to go. Back to normality.

Except there’s not really a ‘normal’ after cancer. At least not the same normal as there was before. It’s a readjustment. Your energy levels, your self-confidence, your relationships, your work and social life, your body and your body image have all been knocked. With the safety net of treatment removed, you are confronted with the things cancer has left you with or taken from you. After my breast cancer surgery, which removed my entire right breast and used skin and tissue from my stomach to rebuild a new ‘foob’ (fake boob), something I’ve definitely been left with is scarring. Physical and emotional.

My physical scars are going to remind me every day, for the rest of my life, what cancer has done to my body. They’re pink and vivid, only three months after my surgery, and although I know they will fade in time, I also know they are a permanent marker of the path cancer traced across my skin and my life.

But scars don’t have to be thought of as ugly reminders of something terrible, of the price your body has paid for fighting cancer. In an attempt to see my own scars in a different light, I’ve become a bit obsessed with broken crockery and the Japanese art of ‘kintsugi’.

Kintsugi, translated as ‘golden joinery’, is focused on repairing broken items of pottery with a lacquer mixed with gold powder. By using the golden glue, those joins where the broken pieces have been put back together aren’t hidden or disguised but embraced and celebrated. Kintsugi says that the breaks, and the subsequent repair, should not be ignored, but valued as an indicator of the hard history of that item. By adding gold, that history, the cracks, the breaks and the struggle to bring about repair, make the broken item of crockery even more beautiful than before. Kintsugi recognizes the fragility of the broken piece, but also testifies to its strength by making the new bonds glow and shine, to celebrate that which is holding them together.Kintsugi

To me, this is one of the most beautiful concepts that cancer survivors can apply to themselves. Now, I’m not suggesting that everyone tattoo their surgical scars gold (although it is somewhat tempting). Instead, I’m trying to embrace the philosophy behind kintsugi as a way to accept my scars, both those visible on my skin and those hidden in my heart and mind, as evidence of both my fragility and my strength. Bodies do break and break down. The human form is fragile, even when we’re young. There’s no shame in being ill, so why should we be ashamed of the scars that mark us out as having endured? Alongside the suffering these scars, these breaks in the pottery, also show endurance, strength, resilience, determination, sheer bloody-mindedness, and, we hope, recovery. No-one asked for them but, just like a piece of kintsugi-rescued crockery, our scars are part of our cancer, and life history.

Of course, when active cancer treatment has finished, anxieties about the future still abound – we worry about the risk of recurrence, of developing secondary cancers, the impact of depleted energy resources, the possibility of resuming work and the damage done to our mental wellbeing. It’s too simplistic and insulting to assume that because we have finished treatment we can simply ‘move on’ or ‘return to normal’. But for those of us lucky enough to be officially cancer-free, the kintsugi philosophy asks us to see those emotional scars and continuing anxieties as markers of our resilience. We might not feel resilient or brave – I hated anyone telling me I was brave during treatment. I wasn’t brave. I cried and raged a lot. I got on with it because I didn’t have any choice – but the golden lacquer shows that what broke us initially was overcome. We face continuing physical and psychological challenges, but with a history of obstacles overthrown marked into our skin and our psyche. It is glued into our repaired bodies and recovering minds.

I’ve never been much of one for tattoos. But since losing my breast to cancer, I’ve been fascinated by the stunning skin-inked artwork that some women have chosen to cover their mastectomy and/or reconstruction scars. Rather than opt for nipple reconstruction or 3D nipple tattoos, these women have put their own bold, beautiful stamp on their bodies. To honour what has been lost and to shout to the world that there is beauty even in scarred and damaged tissue. For me, it seems strange that the scars I see every day will eventually be forgotten by most of the people I know, even close friends and family, because they are hidden. So I see that tattooed artwork as a contemporary body-art form of kintsugi, and it may be that is the way I reclaim my own body, my own sense of self and remind the world that I have been broken but repaired.

Moving on is always going to be hard when you bear scars. But maybe with a glint of gold in your post-cancer wounds, be it real tattoo ink or metaphorical mind-glue, you can start the process of healing and re-forming into a new, fragile but resilient, kintsugi-d you.

Karen Myers is a blogger, baker, knitter, traveller, theatre-goer and escape room addict. She was diagnosed with invasive breast cancer in July 2018 and has blogged about her experience at atozeeofbc.com.

Living with incurable cancer: talking to my children

In this guest blog post, Shine community member Beth writes about her story of living with incurable bowel cancer, and shares her experiences of talking about her illness with her young children.


 

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Meet Beth

My name is Beth, and I was diagnosed with bowel cancer in 2016 at the age of 37. I was working as a Paralegal, and about to start the final year of my law degree. This diagnosis could not have come at a worse time, just when I was finally pursuing the career of my dreams and becoming a solicitor. However, it was not my career that came to mind, but my family: my husband and my babies.

In 2017 things went from bad to worse. I was told that the cancer had spread to my lungs and was now incurable. I was given six months to three years to live. My son Joseph was nine at the time, and my daughter Abigail was just seven. How was I going to tell them? What was I going to tell them? How much should I tell them? How much would they understand? How could I make sure I was always a part of their lives? What could I put in place for them emotionally for when I was gone?

I had a lot of questions – mostly about my kids, not medical questions for the doctors. Who to ask? I found charity leaflets about talking to children about cancer, but they were very generic; I felt that there was a lack of support for parents and children in this situation. I wanted to speak to child psychologists, parents who had been through this, adults who had lost a parent as a child – anyone who could give me insight into the best things to do for my children. in the end I found help, ideas and support from my followers on my Facebook page. I asked if anyone had lost a parent at a young age and if so, what had helped them. Then the ideas came flooding in.

When I was first told I had cancer, we told the kids that I had some bad cells and the doctors were going to take them out, meaning that I would be in hospital for a bit. After my initial operation, we explained that I would need to have some medicine to kill off any tiny bad cells that the doctors could not see and help prevent any more bad cells growing. We explained that the medicine might make me feel ill. The progression of my cancer meant that I needed to break the news that the bad cells were back, the doctors could not cure me and – the bit I still needed to get my head around – I was going to die (but we had no idea when).

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Beth and her family

I talked to Richard, my husband. We planned to sit the children down and talk as a family, but not about time frames. Unfortunately, we never did get to sit down and do this. Life has a funny way of taking these things out of your hands.

I did tell Joseph and Abigail, but it was one afternoon when I was snuggled up on the sofa watching TV with them. An advert about cancer came on and Joseph turned to me and said ‘you had cancer didn’t you, Mummy? But you don’t have it anymore.’ My heart sank. We had never used the ‘cancer’ word, but he knew. Yet that was not what got me. Yes, I was going to have to shatter their world, and it would have to be now because I could not lie to them. The conversation went something like this:

 

Me: Well, you know that medicine to try and stop it coming back?

J&A in unison: Yes, Mummy.

Me: It looks like the medicine didn’t work as well as we thought, and I do still have cancer.

A: But Mummy, cancer can kill people.

J: But the doctors will make Mummy better, Abi.

Me: Unfortunately, the doctors can’t cure me, but they are going to do whatever they can to keep me here with you for as long as possible.

A: Are you going to die, Mummy?

Me: We all die one day, but I will probably die sooner than we would like. You know that if there is anything you want to ask me, you can. We can talk about anything.

There were lots of tears and cuddles, but oddly no questions – well, not then. A few weeks later my daughter, who is very matter-of-fact, asked ‘Mummy, will you last until Christmas?’. I am still not sure if she was more concerned about her presents – the man in a red suit does not get all the credit in our house…!

Both children made us promise that we would tell them whenever we got any new information. Joseph wanted to know about scan results and treatments. They seemed reassured by being included in what was going on. Just over a year on, we still have no idea how long I have left, but we take each day as it comes, and do everything we can to make as many memories together as possible.

We talked about making memory boxes, something they would have to keep their memories of me and our lives together as fresh as possible. The children put things into their boxes that remind them of something we have done together. It could be a photo of us together, anything that means something to them. I hope these boxes will help them to connect to me through physical things they can hold, touch, see, and smell.

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Dreaming about holidays

I am also doing things that the children do not know about: for example, I have written their birthday cards all the way up to the age of 21. This was tough and I cried a lot, but it was important to me. I set up an email address for each of them and I send them emails. I include a summary of something we have done together, what I enjoyed most, and a picture or two. I bought some books that ask questions about my life, and about their lives. I am in the process of completing these books and trying to answer all the questions.

I plan on recording videos and writing letters for special occasions. My husband can give them if he feels appropriate. The most important thing, though, is to be there for them right now and make the most of the time we do have together.

I am currently on a holiday booking spree…

 

You can learn more about Beth and get in touch with her via her blog, Facebook page, or Instagram/Twitter: @bowelwarrior. 

If you would like more support about talking to children about cancer, you can…

 

Ten tips for handling chemotherapy

Receiving a cancer diagnosis can feel as if you are stepping into the unknown. We often receive questions about how to prepare for different types of cancer treatment – and chemotherapy is usually top of the list. We turned to our Shine Cancer Support community members and asked them to share their tips on making it through chemo and we’ve compiled them below. Knowledge is power so read on for our top ten tips…!

1. Ask what to expect from your treatment

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Ask what to expect – it may not be as bad as you were thinking!

Cancer isn’t one disease – and chemotherapy isn’t ‘one size fits all’ either. Before you start treatment, ask your doctor or nurse for specific details about the drugs that you’ll receive. Will you need to take tablets, or will your treatment will be given intravenously? If you need to go to hospital for treatment, how long can you expect to be there? Once you’ve had the treatment, what side effects can you expect? What should you do if you feel unwell? Will your treatment affect your fertility? It can be helpful to sit down with friends or family and brainstorm a list of questions that you would like to ask your medical team. It might sound like a cliché, but there really is no such thing as a bad question. There may well be things you’ve never heard of before (hello mucositis!) but forewarned is forearmed and it’s better to know what might happen so you can be prepared to manage it.

2. Plan your time on the ward

It can be daunting to walk into a treatment centre for the first time. Before your first treatment, you might find it helpful to know a bit more about the place where you will be treated. Does the ward have wifi, for example, or a TV? What is the visiting policy? Do you need to bring snacks or will food be provided? You can usually get answers to these questions from your specialist nurse, or by calling the ward secretary. If you have time, you could also pop your head around the door of the ward before your treatment and see what it’s like.

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Waiting around can be BORING. Don’t just lie there – watch Netflix!

Shine member Neil advises looking at your data plan if your hospital doesn’t have good wifi – you might want to purchase extra in advance, or get a mobile wifi device. You don’t want to find yourself out of 4G halfway through your Netflix series!

3. Plan your journey (there and back!)

Running late can add even more stress to a situation that’s difficult enough! Take a moment to work out how to get to hospital for your treatment. Can someone drive you there, or will you need to take public transport? If you’re driving, do you need to pay for parking? Shine member Tracey recommends checking with your medical team: some hospitals offer free or discounted parking to patients who are in regular treatment. If you’re in London, consider if and when you’re going to take public transport to and from your appointments. Cancer on Board will send you a free badge to wear while TfL also provides free “Please offer me a seat” badges – don’t be embarrassed! You deserve a seat!

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Tablet and phone recommended!

4. Treat it like a long-haul flight

When asked members of our Shine community what advice they would give to others who are about to start chemotherapy, this was the overwhelming consensus: pack a bag with all the things that you’d take on a long plane journey. Books, puzzle books, a laptop or tablet, fluffy socks, and a nice jumper or cardigan were all on our list! Shine member Christine highly recommends headphones: ‘even if you don’t want to listen to music/watch something on your tablet, you might need them if you get stuck next to an annoying person…!’

5. Track your side effects

Your medical team will want to know how you are doing between treatments. Keep a notebook with details of any side effects that you experience, so that you can give accurate information to your doctor. If notebooks aren’t really your thing, you could also use try note-taking apps. And don’t be shy about mentioning side effects – a lot of things can be managed with medication or the right support. Don’t suffer in silence!

6. Get some fresh air

Shine member Samantha found getting outside to be really helpful when she was having chemotherapy treatment: ‘even on the days when you are as weak as water, a toddle in the garden or wander up and down the street will give you fresh air, confidence in moving about and sense of accomplishment.’ Exercise has been shown to benefit people with living cancer (let’s face it – exercise benefits everyone!), but it can be difficult to know where to begin. If in doubt, ask your medical team for advice. If you exercised regularly before your cancer diagnosis, you might also want to look at cancerfit.me, a new community created by doctors and athletes with an interest in sport and fitness for cancer patients. And you can also read our blogs about how running, cycling and yoga have helped Shine members through treatment.

7. Get help!

It can be difficult to cope with a cancer diagnosis by yourself. Mobilise your team! You might find it helpful to ask a close friend or family member to co-ordinate those who come forward with offers of help. Specific offers of help are often easiest to take up, but many people struggle to know what to do when they hear that someone they love has been diagnosed with cancer. If you can, make a list of things that might be helpful and share this with a friend/friends. Do you need someone to make you meals, for example? Or someone to walk your dog? Would a visit from a friend make your week? Let them know! You can direct them to our blog about ways to help a friend with cancer – and you can direct them to our post on what to say to people with cancer while you’re at it!

8. Prepare yourself for bad days

Some people sail through cancer treatment with very few side effects, while others can find themselves cowering under a duvet for days after treatment. Shine member Stewart says: ‘plan for the side effects… BUT don’t get drowned in the gloom of EXPECTING them all. Everyone’s experience is different, so know about things like the possible options for creams, gloves, hair shaving, food to ease/slow bowels, support networks etc.’ Your doctor or nurse will be able to provide you with specific information about how to treat side effects from your drugs. And, as hard as it is, remember that they won’t last forever.

9. Don’t forget the good days

More wise words from Stewart! He recommends that you also ‘plan for the time in-between.’ You may have to manage expectations around what you can do, but that shouldn’t stop you from having fun! Shine member Caroline keeps a list of things that she’d like to do on good days: ‘I have a list of new cafes or restaurants that I’d like to try, and places that I’d like to visit on day trips. They’re all options, rather than firm plans, but on good days I love to scan the list and pick out something fun to do.’

10. Listen to your body

Receiving a cancer diagnosis can make you much more in tune with your own body. Are you suddenly noticing lots of niggling aches and pains that you swear weren’t there before? Join the club! If you have any concerns about your health, contact your medical team – that’s why they’re there! If you’re feeling tired, perhaps think twice about going on that big night out and invite a friend over to spend the evening with you instead. By the same token: if you wake up in the morning and feel well, embrace it! Life doesn’t have to stop when you have cancer.

 

Cancer can make you feel lonely. If you’d like to chat to other young people with cancer and share more tips and tricks about how to cope, join our private Facebook group Shine Young Adult Cancer Support (20s, 30s & 40s). You can find out more about all the support we offer via our website.

Special thanks to Joe Hague for letting us use his photo (above!). If you’d like to learn more about his photography, please check out his Facebook page or his Go Fund Me page.

Dancing through cancer: how a new project is helping women with cancer

In a special guest post Emily Jenkins, founder of Move Dance Feel, introduces her project and writes about the work she does to support women living with cancer.


I love to dance. Be it in my kitchen, on the train platform, or (more appropriately) at a festival, I like to move. Why? Because it brings release, it’s revitalising, and it eases tensions in my mind and body. Dancing helps me to breathe better, sleep better, and feel more alive.

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Emily Jenkins

We are all capable of dancing, despite the self-conscious mind telling us otherwise. Far too often people concern themselves with the aesthetics of dance: how it looks, rather than how it feels.

I work with different  groups in community and arts contexts, and in recent years have specialised in an area known as Dance and Health. Using dance in health contexts is not a new phenomenon, though due to greater recognition of its benefits and connection to wellbeing it is rapidly growing in popularity.

My job is to break down preconceived ideas of what dance is, and inspire people to move in a way that feels good for them. I use creative techniques that encourage a greater understanding of and appreciation for the body, focusing on self-expression. Through shared, positive experiences, dance can promote social cohesion and help to build meaningful relationships based on trust and understanding.

Dance is a multifaceted art form which very much accommodates the multidimensional needs of people. In contrast to Western medicine, which often compartmentalises illness, dancing addresses the whole body, which in turn acknowledges the whole being – physically, mentally, and emotionally. This can have transformative effects on participants, as they get to know a part of themselves perhaps previously overlooked.

In 2016 I launched a project in East London, Move Dance Feel, providing free weekly dance and movement sessions for women affected by cancer. I established the project to explore what dance could offer in the context of cancer recovery, and to address a recognised need for post-treatment support.

My first personal encounter with cancer was in my teens, as I witnessed my grandfather wrestle with the devastating effects of melanoma. I recall visiting him shortly before he died and being very affected by how much the disease had taken him over. The image of his emaciated frame had a profound impact on me. Over time, as I supported friends living with cancer, I particularly noticed the overwhelming effects on the body, and also the mind.

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Move Dance Feel session

A motivation for setting up Move Dance Feel was learning that 70% of people affected by cancer report negative physical, emotional, and mental side effects between 1 and 10 years after treatment – a statistic that I found very hard to digest. At the same time, I read that physical activity proved effective in reducing the negative side effects of cancer treatment, as well as reducing the risk of reoccurrence, so I was puzzled as to why dance wasn’t being offered.

Originating at a community centre in Bromley-By-Bow with a Macmillan Social Prescribing Service, Move Dance Feel is now running in three cancer support organisations across London, providing sessions at Maggie’s Barts and Paul’s Cancer Support Centre as well. The project is for adult women (18+) with any type of cancer, including those who are supporting someone with cancer. We welcome people at different stages in their journey (pre, during and post treatment) and no prior dance experience is necessary. Participants are also welcome to bring along a female friend.

At the heart of Move Dance Feel is artistic practice, where women come together to dance instead of talk about their cancer. They meet each week to be active, creative and, most importantly, to laugh and have fun.

My favourite aspect of the project is meeting other women. As a communicative art form, dance provides insight into people’s characters and enables intimate moments of exchange. More often than not, these moments are energised and playful, but they can also be nurturing and grounding in times of instability. The nature of this exchange helps to experience a sense of belonging and can lead to feelings of self-discovery, learning from others how to help ourselves.

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Dancing at Move Dance Feel

My aim is to integrate dance as a permanent offer within cancer care programmes, and further evidence of its need within the public health sector. I am also in the process of setting up a performance element of Move Dance Feel to bring a sense of visibility to women who are living well during and after cancer – in the hope of inspiring others to dance (even if it’s alone in your kitchen!).


Emily will be running a taster session at our Shine Connect 2019 conference (11th May 2019). To register your interest in the conference and be notified when registration opens, click here!

If you’d like to know more about Move Dance Feel, or let others know it’s available for them, please follow Emily on Facebook or Twitter.

You can also find Emily at www.emily-jenkins.com.

Photos taken by Camilla Greenwell, www.camillagreenwellphotography.com. 

Can you support our #Give4Shine campaign on Giving Tuesday?

At Shine Cancer Support, we run 13 networks across the UK to support young adults with cancer. These Networks are the core of our support and always have been; they provide a unique way for young adults with cancer to meet others who have had similar experiences. This year, on Giving Tuesday, we’re asking for your help to raise £3,000 to keep these Networks going.

There are many ways that you can support our #Give4Shine campaign. Read on to get involved and help us to reach more young adults with cancer than ever before! ______________________________________________________________

If Shine is about one thing, it’s about community.  

We started Shine 10 years ago because we felt isolated and alone as young adults with cancer, and we wanted to change that. We began as a small group meeting together for coffee in Dorset. In 2012, we started our Shine London Network, bringing together capital-based young adults for meet ups and drinks, and we quickly spread to the Midlands, Newcastle, Cardiff and beyond!

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Ceinwen & Emma, Shine’s founders

While we’ve grown a lot, and developed new ways of supporting young adults with cancer (do check out our website for details of upcoming events!), the one thing that has stayed the same is our belief in the power of being surrounded by people who just get it – other young adults who know what it’s like to be the youngest person in the waiting room, who wonder how they’ll ever find the energy to get back to work, and who live with the uncertainty that a life-threatening illness brings to every part of life.

More than anything, we’re proud that we’ve been able to bring people from across the UK together to share their experiences, chat, and – very importantly – laugh.  Run by our volunteers (all of whom have had cancer themselves), we know that our Shine Networks make a huge difference: 97% of people who have attended a Shine event in 2018 say it’s made them feel more supported and less isolated as a young adult with cancer.

The best thing about Shine_ Knowing that I_m not alone, and that there are people my age who understand the way I feel. – JB, Shine member

This Giving Tuesday, we’re trying to raise £3,000 enough money to support our Shine Network meet-ups for a year. It’s the biggest one-day goal that we’ve ever set and there are a bunch of different ways you can help us!

  • Donate: Every little bit really does help and you don’t need to donate hundreds to make a difference!  If you’re able to support us with a donation, £10 would be very, very appreciated – simply text “TUES10 £10” to 70070.
  • Blog: Can you write a blog post to highlight how your peers with cancer – your cancer crew, if you will – help you? If you’ve been to a Shine meet-up, you could write about how our local Shine Network events help, what you’ve enjoyed about them and why you’d recommend them to others. Or anything else that shows the value of being with people who understand! We’re asking each blogger to inspire 10 readers to donate £10 – a total of £100, enough to support the activities of five of our local Shine Networks for one month. Get in touch at hi@shinecancersupport.org or via our website and we can send you further details.
  • Share: We’re asking as many people as possible to share on social media how Shine Networks support young adults with cancer. You can aim simply to raise awareness (which we need!) or your posts can also be aimed at inspiring your friends and family to donate £10 towards our goal.

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    Shine members on a 2018 Great Escape weekend

Download our images below (just right click and “save as”) and you can share them with your own comment about how Shine has helped you or why you’re supporting us.

And whatever you do, don’t forget to use the hashtag #GIVE4Shine!

Thank you!!

 

Save & share these images (or your own!):

If you’d rather make a direct donation, you can do so here