Together We Can -- Newsletter of the Joan Karnell Cancer Center

Summer 2004

Supportive Care Services
Understanding Lymphedema
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Supportive Care Services

The Joan Karnell Cancer Center at Pennsylvania Hospital offers a variety of supportive care services to help patients and their families cope with the physical and emotional challenges of cancer diagnosis and treatment.

Music Therapy
Music therapy uses music experiences, and the relationships that develop between a music therapist and a patient, to meet a wide variety of needs for patients undergoing cancer treatment. Music therapy is oriented toward supporting the experiences of the person as a whole, and helping each person to find solutions to their own problems, creatively. In general, the music therapist works with patients to address on or more of the following areas:

  • Exploring and working through emotions experienced as a result of diagnosis and treatment
  • Finding meaning in the cancer experience
  • Reviewing one's life
  • Developing individualized stress management techniques
  • Developing music cds that can be used at home to promote calm

“Music and Imagery” is one method that music therapists have found helpful in supporting the needs of patients with cancer. The following is an example of how one patient benefited from the music therapy process.

Jenny was referred to music therapy because she was having trouble with stress and fatigue related to chemotherapy. She often felt anxious during treatment and tired in the days afterwards. Jenny sought music therapy to help change her experience of treatment, and to help manage some of the side effects.

Together with the music therapist, she planned a series of seven weekly sessions that coincided with her chemotherapy and the rest weeks in between. The purpose of the sessions was to help Jenny learn a variety of relaxation techniques that she could use throughout her day to help manage her anxiety and fatigue and to instill a sense of calm and composure that she felt was essential to her well-being.

In each session, which typically lasted 50 minutes, Jenny was guided through a 20-minute meditation that focused on her body and breathing, followed by a music listening period. Sessions were designed around what she felt she needed that day. Some weeks, she listened to the music in a very deep and relaxed way, and this instilled in her a sense of calm and peace. Other weeks, she used music and imagery techniques (somewhat like a dream) to reduce her anxiety and moderate her own experiences of bodily soreness and fatigue.

In one such experience, Jenny imagined herself walking on a beach, feeling the ocean waters, sand and air. She found a place to rest on the beach, and allowed these natural elements to soothe her.Afterwards, Jenny felt a palpable sense of beauty and peace. She was reminded that in all the difficulties of treatment, there was still beauty inside her to which she could connect.

Over time, Jenny and the music therapist developed several CD music listening programs that she used at various times of the day and night. One she found specifically helpful before bedtime, another worked best when she felt anxious. As a result of the skills she developed, Jenny was better able to manage her treatment, and felt more creative, less anxious and more in control of herself.

For more information, call 1-800-789-PENN (7366). You can also request an appointment online.

Psychological Services
Therapy is conducted primarily by clinical psychology interns and postdoctoral Fellows from Pennsylvania hospital's Department of Psychology. To help patients cope with the psychological impact of cancer, the Joan Karnell Cancer Center at Pennsylvania Hospital offers psychological support services as an addition to standard medical care.

Clinical psychology interns and post-doctoral Fellows from Pennsylvania Hospital’s department of psychology primarily conduct the work. The therapists have an impressive range of training and experience in working with varied populations – adults and children, individuals and families, patients with chronic physical illness, patients with severe mental illness, and patients from differing cultural and ethnic backgrounds. They are capable of providing a range of skills and knowledge to help individuals adjust to a diagnosis of cancer.

Services include:

  • Individual therapy
  • Family sessions
  • Therapy with young children
  • Relaxation training
  • Hypnosis
  • Assessment of key problem areas
  • Couples therapy
  • Group psychotherapy for breast cancer patients
  • Hospital visits

Within these services, our therapists have developed relaxation techniques to reduce patients’ nausea and vomiting, used hypnosis in post-surgery recovery, helped patients explore and better understand how their past impacts the present and how their hopes for the future shape today.

Our therapists are aware that one’s sense of identity, self-understanding and unique personality can get lost in the context of suddenly becoming a “patient with cancer.” We work to hear beyond the medical diagnosis — to find the person amidst the fears, doubts, and confusion of dealing with cancer.

Questions addressed in therapy include:

  • What are the strengths you can call upon to confront cancer on both a physical and emotional level?
  • How can you best understand the reactions of family and friends?
  • How do you communicate your needs to family and friends?
  • How do you handle losses associated with cancer?
  • How do you adjust to life after cancer?

For more information, call 1-800-789-PENN (7366). You can also request an appointment online.

Social Work
The diagnosis and treatment of cancer presents challenges not only to the patient, but also their caregivers and loved ones. Obstacles and tasks characterize each stage of the disease process. Trying to overcome these obstacles and accomplish these tasks can become overwhelming. Meeting with a social worker can help to normalize the situation and help both patients and their loved ones come to terms with this disease.

Services include:

  • Helping patients gain access to transportation.
  • Providing information about pharmaceutical benefits programs in the event patients cannot afford their medication.
  • Helping patients to access the medical assistance system if they have lost or have no insurance.
  • Providing resources to help with legal issues.
  • Providing groups to support those who need the comfort of others to help them.

Some of the support groups are cancer-specific such as Facing Forward for patients with breast cancer and Navigating the Course for patients with esophageal cancer. Other groups such as Through the Looking Glass, which focuses on maintaining optimal health and physical appearance, are for patients with any type of cancer.A listing of the current support groups, their meeting dates and times, can be found on the back page.

Social workers also meet with patients and families on an “as needed” basis to help them through crisis periods. For more information, call 1-800-789-PENN (7366). You can also request an appointment online.

Shiatsu Bodywork
The Joan Karnell Cancer Center has been offering shiatsu as a supportive care service for more than two years. It is a popular complementary therapy for patients undergoing chemotherapy and radiation therapy, for patients regaining strength and functioning after completing cancer treatment, and for patients experiencing extended illness. Shiatsu is also popular with caregivers and family members.

Shiatsu is a therapy based in Traditional Chinese Medicine (TCM). The three major branches of TCM are Asian bodywork therapies (ABT), acupuncture and Chinese herbs. Similar to acupuncture, shiatsu focuses on treating the patient’s bio-energetic system by applying finger and hand pressure to the body’s energy channels (meridians) and the acupoints.

The goal of treatment is to shift the imbalances within that bio-energetic system back into a state of balance, which enhances the ability of the body,mind and spirit to care for itself. Aside from being a pleasant experience, the benefits of Shiatsu include:

  • Stimulation of the body’s natural healing capacity.
  • Strengthening the immune system.
  • Decreasing stress, anxiety, fear, frustration, depression and anger.
  • Easing symptoms such as nausea/vomiting, aches/pain, and fatigue.
  • Reestablishing a positive and healthy relationship with one’s body.

A session begins with questions about a patient’s health history, illness and symptoms. A Chinese medicine assessment reveals the condition of the patient’s energy system and guides the shiatsu treatment.Most treatments are given in a massage chair, unless a patient’s limitations or comfort level requires otherwise. Patients always remains clothed during a shiatsu treatment. For more information, call 1-800-789-PENN (7366). You can also request an appointment online.

Eating well and utilizing nutrition, as a form of your personal attack against cancer, is important throughout treatment. Nutrition services offered at the Joan Karnell Cancer Center can help you develop your individualized nutrition plan.

Through the course of treatment, the areas of discussion may include:

  • Managing the side effects of treatment that might affect your ability to eat.
  • Finding ways to obtain adequate hydration.
  • Food suggestions to help maintain weight.
  • Food preparation ideas to conserve energy if fatigue is overpowering.
  • Drug nutrient interaction analysis between chemotherapeutic agents and herbs or nutrition supplements.
  • Use of alternative forms of nutrition such as tube feedings if eating is not feasible.

Consultations are available for a broad range of areas including:

  • Evaluating current nutrition supplementation that may be promoted to an individual with cancer.
  • Examining the safety and efficacy of nutrition and herbal supplements.
  • Exploring the role of nutrition in the recovery process.

Individual appointments are available with a registered dietitian to help assess your nutritional status and develop a strategy for improvement. For more information, call 1-800-789-PENN (7366). You can also request an appointment online.


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Need an appointment? Request one online 24 hours/day, 7 days/week or call 800-789-PENN (7366) to speak to a referral counselor.

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