Windsor Regional Internet Site

Planning Your Care





Your Cancer Centre Visits

About Your Treatment


Additional Information

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Your Care Team [top]

Medical Oncologists

Dr. Tarek Elfiki, M.B.Ch.B., M.R.C.P.I. Dr. Akmal Ghafoor, M.D., F.A.C.P.
Dr. Rasna Gupta, M.D., Adjunct Professor at the Schulich School of Medicine and Dentistry, University of Windsor    Dr. Caroline Hamm, M.D., F.R.C.P. (C), Assistant Professor at the Schulich School of Medicine and Dentistry, Western University, Adjunct Professor at the Schulich School of Medicine and Dentistry, University of Windsor
Dr. Mohammed Jarrar,
M.D., F.R.C.P.
   Dr. Sindu Kanjeekal,
M.D., F.R.C.P. (C), Adjunct Professor at the Schulich School of Medicine and Dentistry, Western University
Dr. Amin Kay,
M.D., F.R.C.P.
Dr. Swati Kulkarni, B.Sc., M.B.B.S., F.R.C.P.(C), ABIM, Adjunct Professor at the Schulich School of Medicine and Dentistry, Western University
Dr. John Mathews,
M.D., F.R.C.P (C), Adjunct Professor at the Schulich School of Medicine and Dentistry, Western University
Dr. Indryas Woldie, M.D., Assistant Professor, Department of Oncology, Division of Hematology Oncology at the Wayne State University School of Medicine


Radiation Oncologists

Dr. Khalid Hirmiz, M.B.CH.B, F.R.C.P. (C), Adjunct Professor at the Schulich School of Medicine and Dentistry, Western University Dr. Ming Pan,
M.D., F.R.C.P.(C)
Dr. Kenneth Schneider,
M.D., F.R.C.P. (C), Adjunct Professor at the Schulich School of Medicine and Dentistry, Western University
  Dr. Colvin Springer,
M.B.,BS., F.R.C.P. (C), BSc., MSc., Adjunct Professor Schulich School of Medicine and Dentistry, Western University
Dr. Junaid Yousuf, BSc., M.D., F.R.C.P. (C), Adjunct Professor at the Schulich School of Medicine and Dentistry, Western University    


Palliative Care

Dr. Lawrence Aoun, M.D.                      Dr. Nicole Freeman, M.D.


Nurse Practitioners 

Kimberly         
Simard Grubb,

RN (EC) ACNP-MN-Adult          

Kit McCann
RN(EC), MScN, NP-C

Nurse Practitioner, Complex Malignant Hematology and Transplant
Adjunct Professor at the Schulich School of
Medicine and Dentistry, University of Windsor



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What to Expect During Your First Visit [top]

First Visit Orientation

After checking in at the Main Lobby – Registration Desk, Your first visit to the Cancer Centre will include an orientation where you will meet with a Supportive Care staff member and a volunteer.

You will meet a volunteer who will show you the Cancer Centre and answer any questions you may have about the centre.

You will then have a nursing assessment and a consultation with an Oncologist and/or a Nurse Practitioner, and together you can discuss the most effective care and treatment for you. At this time we strongly recommend having a family member or friend with you. They can help complete the “Patient Summary Form” and can write down the answers to your questions.

Your first consultation visit will take approximately 3 hours. Delays may happen, so it is recommended that you do not schedule other activities or appointments that day.

Consultation

It is important to acknowledge that the first visit to the Cancer Centre can add to the significant emotional stress of a cancer diagnosis. Your Oncologist/Nurse team understands this, and are focused on guiding you through this visit while completing the crucial tasks within their areas of expertise. The Oncology Nurse gathers information and will take a detailed medical history. They may provide some general information as to what to expect during the plan of care, and outline additional supportive care services that may be helpful depending on your Oncologist’s treatment recommendations. The Oncology Nurse also plays an important role in assessing any new concerns or symptoms that may be related to your diagnosis or treatment. Your Oncologist will be made aware of any concerns requiring further assessment.

Your Oncologist reviews all of the required information from biopsies, surgical procedures, lab and imaging tests, and will carry out a physical examination. The primary role of your Oncologist is to evaluate this information and determine the best treatment approach for your diagnosis. This approach includes factors related to the cancer, its state, any other existing medical conditions and your physical ability to handle the treatment course. In an effort to balance treatment effectiveness without reaching unacceptable toxicities, treatment may even be altered depending on the severity of side effects.

The consultation appointment is, by necessity, a limited block of time. Within this visit, many details are discussed in addition to the diagnosis and prognosis including possible side effects of treatment, timeframe for their improvement, delayed toxicities that may or may not occur and how these may affect day-to-day function and quality of life. As well, there is a critically important aspect of dealing with the emotional stresses of cancer and its treatment. This includes the impact on family and work responsibilities. Clearly, all these issues cannot be effectively addressed at one visit. The role of your Oncologist and the Oncology Nurse is to acknowledge these issues and concerns and arrange any further visits or referrals to other providers to assist where possible.

What about the Prognosis?

One very significant concern on any patient’s mind is “what is my chance of cure and how effective will treatment be?” This can be a complex question to answer and is guided by medical data and statistical information that your Oncologist uses to provide general guidance. It is important to understand that a discussion on prognosis can be addressed in many different ways or at different points in time during the course of treatment or follow-up check-ups. Although accurate information must always be provided by the Oncologist, the details and timing of this discussion can vary based on the patient’s request or need for this information at a point in time.

The Era of the Internet

In this day and age, a wealth of information is available at the push of a few keys on a computer keyboard. However, it is important that information is from reliable sources, and your Oncologist is ideally suited and educated to help you interpret this information if required.

Click here to view a list of recommended online resources.

Coping with the Frustrations of Waiting

Despite our Ontario Cancer System being of the highest quality, there will be waiting time within our system. Some waits are reasonable. Our system is attentive to continuous improvement in this area. This may include access to required tests, pathology reports, treatment start times and the constant effort to respect the clinic waits to see the Oncologist. Considering the complexity of best patient care, we are constantly balancing a quality visit where patient’s needs are met while attempting to minimize wait to see the Oncologist.

Will I Receive the “Best Evidence-Based” Treatment for my Cancer?

One critically important aspect of cancer treatment is ensuring not only timely treatment, but a treatment plan based on best scientific evidence. Your Oncologist, by the very nature of their training and expertise, follows evidence-based treatments and guidelines for their recommendations. Cancer Care Ontario also outlines Evidence-Based Guidelines, which can be found
here.

Your Oncologist also has the opportunity to discuss treatment approaches at Multidisciplinary Cancer Conferences that are attended by cancer specialists with focuses in various areas including Oncology, Surgery, Pathology and Diagnostic Imaging. This provides, where required, input into complex cases. Multiple experts provide a consensus opinion that can ensure the best evidence is used in the decision-making for cancer treatment. 

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What to Bring to Your Cancer Centre Visits [top]

Preparing for your appointments is important. It helps get you ready to see your care team and makes the most of the time you have with them.

To help you prepare, here are some items to bring with you when you come to the Cancer Centre:

Items to Bring to Every Appointment and Treatment:

  1. Your health card. On the first visit you will also be required to provide a second piece of photo identification with your address.
  2. A family member or a friend who can wait with you, support you and take notes for you.
  3. A note pad and pen to take notes or write things down.
  4. A list of questions and concerns you may have or want to ask the Oncologist or Nurse.
  5. Something to help you pass the time such as a book, magazine or electronic device. Devices that have sound should have a headset or ear buds.
  6. Coins for parking ($3), if you are parking in the Cancer Centre lot.
  7. Your parking identification card (yellow card) that was mailed to you in your welcome letter.
  8. If you have oxygen or require medication during your appointment or treatment, please bring enough to cover the time you are here.
Items to Bring to Your Oncologist Appointments:

  1. Your health card.
  2. If you have additional insurance coverage, your insurance card.
  3. Medical records or test results from other places that the Cancer Centre may not have access to. This may include X-rays, CT scans, lab tests and surgery reports.
  4. All current medications you are taking in the original containers.
  5. All vitamins, minerals or herbal products you are taking, in their original packages.
  6. A list of known allergies or sensitivities.
  7. The Next Steps in Care appointment log (which will be provided to you during your first visit.)
Items to Bring to Your Systemic Treatments:

  1. Your health card.
  2. A family member or friend that can wait with you. Please limit visitors to one person at a time. Additional visitors may sit in the waiting room. Visitors under 16 years of age are NOT permitted to enter the treatment area for safety reasons.
  3. Questions, concerns or changes in how you are feeling from your last visit.
  4. A list of symptoms or side effects you are experiencing.
  5. For your personal comfort you may bring:
    • A personal water bottle
    • Your own blanket or pillow
    • A snack or boxed lunch

Please refrain from eating foods which may have a strong odour as they may contribute to nausea or other symptoms for patients. Visitors are NOT allowed to eat in the chemo suite for safety reasons. 

Items to Bring to Your Radiation Treatments: 

  1. Your health card.
  2. A family member or friend that can wait with you. Please limit visitors to one person at a time. Additional visitors may sit in the waiting room. Visitors under 16 years of age are NOT permitted to enter the treatment area for safety reasons.
  3. Questions, concerns or changes in how you are feeling from your last visit.
  4. A list of symptoms or side effects you are experiencing.

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Registration [top]

You will need to check in at the Main Lobby at the Registration Desk in the Cancer Centre before each appointment with a physician.

Please have your health card for every visit. A second piece of photo identification that has your address on it is also required for your first visit only. This will help us serve you faster.

Please let the Registration Clerk know if you have any changes in your next of kin, family physician, home address, home or cell phone number. 

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Call Centre and Appointments [top]

The Cancer Centre has a Call Centre. The Call Centre is there for you or your family members to help you.

You can ask:

  • Questions about your treatment
  • Questions about your appointments
  • For help with your symptoms
  • Questions about your medication
  • For directions or parking information

They can also help you with other questions or concerns you may have.

The Call Centre staff may be able to answer your question right away; however, if they are not able to, they will take your information and have someone call you back within 1-3 business days.

The Call Centre telephones are answered Monday through Friday from 8:30 am to 4:00 pm.

The Call Centre telephone number is 519-253-5253.

In order to give all of our patients the best care possible, we need to carefully organize the clinic schedules. As such, the Cancer Centre is unable to see you if you do not make an appointment. Thank you for understanding.

What to do if you have a Cancer Related Health Concern

If it is an emergency, go to the closest emergency room. Make sure you tell the emergency room staff that you are a patient at the Cancer Centre.

If you have a cancer related health concern (or if you have a health concern related to your cancer diagnosis), and it cannot wait until your next visit, please call the Cancer Centre at 519-253-5253. Telephones are answered Monday through Friday from 8:30 am – 4:00 pm by Call Centre Clerks. The Call Centre will give your message to your care team. Calls are answered in order of importance. You will be called back within 1-3 business days.

Due to the increasing number of patients needing care, our Oncology team has a dedicated focus on patients receiving active treatment, such as chemotherapy or radiation, within a 3 month window. Outside this timeframe, please contact your primary care provider for any questions, concerns or test results. 

Test Results

Please note that you will not receive a call from your care team with normal test results. The care team will only contact you directly if a test ordered by an Oncologist comes back abnormal. If you need a cancer related prescription renewal, please let your pharmacy know at least 3 business days before your prescription runs out. If required, the pharmacy will contact the ordering Oncologist.

To protect your confidentiality, we need your permission if we are to speak to a family member. If you wish to appoint one family member as your spokesperson, please tell us who that person will be. Please talk to a member of your health care team about your wishes regarding confidentiality.

For health concerns unrelated to your cancer diagnosis, please contact your primary care provider. If you do not have a primary care provider, please let your care team know so that they can help you locate one.

Rescheduling a Regular Visit

If you cannot attend your scheduled visit, please let us know as soon as possible and/or 48 hours prior to your scheduled visit. Clinics are scheduled well in advance, so you may need to wait 6-8 weeks for another visit. 

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Your Symptoms Matter and Your Voice Matters [top]

Your Symptoms Matter – General Symptoms (ESAS) and Daily Activities (PRFS)

Your Symptoms Matter is a web tool you use to express how you are feeling based on nine different symptoms.

Your Symptoms Matter is used to help you track your symptoms over time. It also helps you and your care team understand which symptoms you are experiencing, so together, you can plan how to make them better.

Every care team uses Your Symptoms Matter to help patients, including community Nurses visiting patients in their home and the care team at the Windsor Regional Cancer Centre.

We ask you to complete this simple, quick and easy-to-use tool before each visit with your Oncologist.

Your Symptoms Matter is done by using a touch screen at a computer station. The stations have “Your Symptoms Matter” signs on them and can be found on each floor of the Cancer Centre.

You do not need to have any computer knowledge. Volunteers are there to help you use the tool.

Your Symptoms Matter will ask you to describe pain, tiredness, drowsiness, nausea, lack of appetite, shortness of breath, depression, anxiety and well-being. There is one “other problem” line for you to use if you need to report anything additional, that is not listed. You will also be asked about your level of activity on the Patient Reported Functional Status Tool.

Once you have completed Your Symptoms Matter, a copy will print so you can give it to your Nurse who will review it with you. We also have paper forms if you cannot use a computer or the computer is not working. Be sure to ask a volunteer if you have questions or need help to complete Your Symptoms Matter.

Your Voice Matters

Your Voice Matters is a set of questions in a survey that will follow your Symptoms Screening tool at the computers or kiosks within the Cancer Centre. This survey takes on average 3 minutes to complete. It gives you the chance to share your thoughts about each visit to your Cancer Centre. The survey can be completed with the assistance of your caregiver. Trained volunteers will also be available for assistance with the tool.

If you choose to complete the survey, you will not be asked to complete it again for 30 days.

You do not need to answer all of the questions. If the question is not relevant to you, please select “not applicable.” If you are not sure of the answer, select “do not know.” This is your chance to share your thoughts in order to help make things better for patients with cancer and their families across Ontario.

The information you share in Your Voice Matters is confidential and will not be shared with your health care team. This survey is only available electronically at the computer or kiosk within the Cancer Centre. 

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Goals of Care [top] 

Goals of Care clarifies a patient’s values, wishes, and goals regarding their treatment. The process aims to clarify a person’s illness understanding and more specifically, their wishes. Advanced care planning should begin early in a patient’s course of care. The Goals of Care Designation Order follows the Patient in order to guide all health care providers.

Goals of Care Designations involve many options and should be discussed and considered carefully. Whether care involves resuscitative care, medical care, or comfort care, there are many considerations. Although at times, these decisions may be difficult to think about, it is important that Goals of Care are clear and documented. This most often puts minds at ease and positions the Patient and their wishes at the centre of care. It can also reduce stress on family and loved ones when the Patient’s wishes are clearly communicated and in place.

For additional information, including frequently asked questions, please click here to visit the main Windsor Regional Hospital website.  

Every patient has the right to make their Goals of Care choices known. Please discuss your or your loved one’s Goals of Care with your health care provider.

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Your Next Steps in Care [top] 

We encourage you and your family to ask questions about your next steps in care. We are always happy to answer your questions or will link you to another team member who can.

                                                           

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Systemic Therapy [top]

Systemic therapy is a type of cancer treatment that travels through the blood to reach cells all over the body.

Systemic therapy includes:

  • Chemotherapy drugs (also called chemo) that kill, stop or slow the growth of cancer cells
  • Hormones that change hormone levels to stop or slow cancer growth
  • Biological therapies that stop or slow cancer growth
How Does Systemic Therapy Work?

Systemic therapy may be your only cancer treatment, or you may receive it along with surgery and/or radiation therapy.

Systemic therapy can:

  • Slow or stop cancer growth
  • Reduce the risk of cancer coming back
  • Kill cancer cells that stay after treatment, have come back or spread to other parts of your body
  • Shrink a tumour before other treatments are given
  • Ease symptoms, such as pain
  • Help other treatments work
 
Your care team will decide and explain which systemic therapy will work best for you and your type of cancer.

How will I get Systemic Therapy?

There are several ways systemic therapy is given:

  • By mouth - in a pill, capsule, or liquid form
  • By needle - liquid drugs that will go right into your skin or muscle
  • By needle - into a vein. This is called an intravenous (IV) infusion
Systemic therapy may be given in cycles. A cycle means you will receive treatment for a period of time, such as a few weeks, and then take a break from treatment. Then you will begin again, followed by a break, and so on. Your care team will tell you how many cycles you need.

Not all of the systemic therapy will be used up in your body. Some of it will still be in your body fluids. To protect your family, you will need to follow your care team’s advice for a short period of time. Your Nurse may give you more details about this, depending on your type of treatment.

Chemotherapy

Once you and your Oncologist have decided on chemotherapy, your treatment will be booked. The Cancer Pharmacist and Nurse will talk to you about the drugs and their side effects and explain how to deal with them.

Each chemotherapy visit will begin with a blood test to see if your blood counts are at the correct levels to receive treatment. Blood should be drawn and processed by the hospital. This ensures faster results and the availability of results directly through the hospital computer system. 

The time a chemotherapy treatment takes depends on the drugs being used, and can be from one hour to six hours.

Your treatment visits will be booked ahead of time. Each time you are at the Cancer Centre, the Clerk will give you a time for your next visit.
 

It is important to us that we answer your questions and make you as comfortable as possible. We can also arrange for visiting Nurses or other help at home during or after your treatment. 

Treatment Day Instructions

Thank you for being an active participant in your care and respecting the needs of yourself and other patients.

  • Please have your lab work completed 24 - 72 hours before your next treatment. No lab work = No chemotherapy
  • Please bring all of your current medication(s) with you on the day of your treatment (including pain medication, insulin etc.) that you may require during your appointment.
    • Please reorder medications 3 days prior to treatment.
    • Please notify your care team if there have been any changes to your medication or medical history.
  • Please limit visitors to one person at a time. Additional visitors may sit in the waiting room.
    • Visitors under 16 years of age are NOT permitted to enter the treatment area for safety reasons.
  • Please set your cell phone to silent or vibrate.
    • To maintain a calm and quiet environment, please refrain from accepting/making calls unless they are urgent.
    • You may text message. Complimentary Wi-Fi is available.
  • For your personal comfort you may:
    • Bring a personal water bottle
    • Bring your own blanket or pillow
    • Bring a snack or boxed lunch
    • Please refrain from eating foods which may have a strong odour as they may contribute to nausea or other symptoms for patients.
    • Visitors are NOT allowed to eat in the chemo suite for safety reasons.
  • Windsor Regional Hospital is proud to promote a scent and fragrance free environment.
    • Please refrain from wearing perfume/cologne on the day of your treatment. This applies to visitors as well.

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Radiation Therapy [top]

Radiation therapy uses high energy x-rays to destroy cancer cells.

Radiation treatments are often scheduled daily for 1-7 weeks. The type of cancer and the goal of the treatment will determine how many treatments are prescribed by the Radiation Oncologist.

Although cancer cells and normal cells react differently to radiation, it’s very hard to destroy cancer cells without damaging some normal cells too. The goal of radiation is to give enough radiation to destroy cancer cells in your body, but only enough radiation so that normal cells can recover. Side effects are related only to the area you are having treated.

Your radiation treatment team will give you instructions about any preparation you need for your daily treatments. The team consists of your Radiation Oncologist (doctor), Radiation Nurse, Clerks and Radiation Therapists. We also have Dietitians, Social Workers and Medical Physicists who are involved in your care.

Your radiation treatment team will ask you questions about how you are feeling, and can help you to cope with your side effects. Booklets to help manage side effects are available from any member of your treatment team.

Planning for Your Radiation Treatments

We use a specialized CT Scanner to plan your radiation treatments. It is called a CT Simulator. The CT Simulator looks very much the same as one you may have seen in the Diagnostic Imaging (X-Ray) department. During your planning session, the radiation therapists will determine the position you will be in for your daily treatments. We may use a specific dye (through an IV injection) or a barium drink to see certain areas more clearly on the scan. On the day of your planning session it is very important that you follow the preparation instructions that you have been given. The radiation therapy team will create a treatment plan that is specific to you.

Treatment Day Information

Go to the Radiation Reception Desk on the ground floor of the Cancer Centre. This is where the clerk will check you into the computer. This tells the treatment team that you have arrived. Remember to bring your appointment card.

You may need to change out of your clothes for your treatment—this information is on your radiation treatment appointment card. The clerk will show you where to change, where to store your clothes and which waiting room to use.

We have warm blankets and warm robes available for all of our patients. Ask any member of the treatment team and we can show you where to get one. 


A radiation therapist will come to get you from the waiting room and will explain what will happen during your radiation treatment appointment.
 

Your radiation treatment visit is usually between 15-30 minutes. Most of this time is spent getting you positioned on the treatment table. The radiation beam is only “on” for a few minutes. The therapists will ask you to hold still and breathe normally. You do not feel anything during the radiation treatment. We may take x-rays and/or a CT scan before your treatment. These x-rays help to ensure you are in the exact position needed for your treatment. The x-rays do not give us information about how the treatment is working.

The radiation therapists will leave the room to give you your treatment—they can see you and hear you at all times.

You do not become radioactive from the radiation treatments.

If you have any questions about your treatment or how you are feeling, you can speak to any member of your treatment team. 

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Palliative Care [top]

Palliative care aims to improve the quality of life of patients who are diagnosed with life-limiting illnesses. This medical approach looks at each individual as a whole – physically, emotionally, psychologically, and spiritually.

The goal of palliative medicine is to provide education and help you and your family make proactive and informed decisions about managing your illness and symptoms. These symptoms may include pain, shortness of breath, nausea/vomiting, fatigue, loss of appetite, physical stress, or mental stress. These symptoms may come from the disease itself, or from the treatments used to treat the disease. Medication, radiation therapy, and other complementary therapies may be used to manage symptoms.

The WRCC Palliative Care Team is made up of specialized physicians and nurses who work very closely with your larger care team, including oncologists, social workers, dietitians, and Community Care Access Centre (CCAC) or other community service providers. Our palliative care team works to understand your concerns, needs, and wishes, and creates an environment in which you feel comfortable asking questions and actively participating in your own care. Once symptoms have been well managed, many people experience an improved quality of life and reduced anxiety.

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Clinical Trials [top]

A clinical trial is a type of research study that helps to find new ways to diagnose, treat, manage or prevent a disease. Clinical trials test new drugs, new ways to do radiation or surgery, or any combination of these.

Clinical trials help us learn about how to make cancer treatment and cancer care better.  Most of the treatments prescribed by physicians went through the clinical trial process at some point; this is how it was determined that they would benefit patients.

During your appointment, members of your care team will talk about the types of treatments that are used to treat your type of cancer. One of your options may be a clinical trial. You will never have to take part in a trial without your permission.

Clinical trials give patients access to new forms of treatment. They also help our staff keep up with advances in cancer care.

If you would like to take part in a clinical trial, ask your Oncologist if there is a trial that is right for you.

You can also learn more about clinical trials by visiting http://itstartswithme.ca/

View our Clinical Trials Information Sheet

       

Current Clinical Trials 

Study Short Name

Protocol Title

Principal Investigator

TREATER+IGHT

Treatment of Canadian Postmenopausal Women with ER+ Advanced Breast Cancer in the Real-World Setting with Hormone Therapy ± Targeted Therapy



Dr. Swati Kulkarni


JASMINE 20130109

A randomized, Double-blind Study Evaluating the efficacy, safety and immunogenicity of ABP 798 compared with Rituximab in subjects with CD20 Positive B-Cell Non-Hodgkin Lymphoma (NHL)



Dr. Caroline Hamm


 DRE Study


Dandelion Root Extract in Patients with Refractory Hematologic Malignancies


Dr. Caroline Hamm

S4H Bladder Study
Identifying a Genetic Signature that Predicts Progression of Non-invasive Urothelial Carcinoma to Invasive Cancer
Dr. Sindu Kanjeekal



PCS VI

Phase III Study of Hypofractionated, Dose Escalation Radiotherapy vs. Conventional Pelvic Radiation Therapy followed by High Dose Rate Brachytherapy Boost for High Risk Adenocarcinoma of the Prostate



Dr. Junaid Yousuf


LUSTRE

Medically-inoperative Stage I non small cell lung cancer comparing stereotactic body radiotherapy vs conventional radiotherapy


Dr. Khalid Hirmiz



BR.34

A Randomized Trial of Durvalumab (MEDI4736) and Tremelimumab + Platinum-Based Chemotherapy in Patients with Metastatic (Stage IV) Squamous or Non-Squamous Non-Small Cell Lung Cancer (NSCLC)



Dr. Swati Kulkarni



EARLEE 1 - Not Yet Open

A phase III, multicenter, randomized, double-blind, placebo-controlled study to evaluate efficacy and safety of ribociclib with endocrine therapy as an adjuvant treatment in patients with hormone receptor-positive, HER2-negative, high risk early breast cancer


Dr. Swati Kulkarni


EARLEE 2 - Not Yet Open
A phase III, multicenter, randomized, double-blind, placebo-controlled study to evaluate efficacy and safety of ribociclib with endocrine therapy as an adjuvant treatment in patients with hormone receptor-positive, HER2-negative, intermediate risk early breast cancer


Dr. Swati Kulkarni

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Educational Classes and Programs [top]

Chemotherapy Education Classes

Chemotherapy Education classes will help you understand more about when, why, and how chemotherapy is used, possible side effects, and ways to handle side effects.

Classes are taught by a Registered Nurse. They offer a chance for you to have your questions answered by an expert. The program can also help you make a list of important questions to ask your care team.

We hope that you and your family will attend a chemotherapy class at the beginning of your treatment.

Please check with your Nurse for dates, times and locations.

Radiation Therapy Education Classes

Radiation Therapy Education classes will help you and your caregivers get ready for radiation treatment. The classes give you common information, and talk about possible side effects, and how best to handle side effects. Classes are led by a Radiation Therapist who will also answer questions about radiation treatment.

If you are getting radiation, we hope that you and your family will go to a class at the beginning of your treatment.

Please check with your Radiation Nurse for dates, times and locations.

Prostate Brachytherapy Education Videos

For detailed information regarding your Brachytherapy treatment please watch the following videos.

To Prepare for Your Seeds Procedure
  • Preparing for Brachytherapy
  • The Procedure - Seeds
  • Brachytherapy FAQ's

    To Prepare for Your HDR Procedure 

  • Preparing for Brachytherapy
  • The Procedure - HDR
  • Brachytherapy FAQ's

    Lymphedema Education and Awareness Classes

    The classes educate participants about the signs and symptoms of lymphedema, what can be done to lower the risk and how to manage the effects of it.

    Please check with your Nurse for dates, times and locations.

    Sexuality and Cancer Information Sessions

    The information sessions provide an overview of sexual health challenges, changes in sexual function and ways to improve intimacy and sexual relationships with a partner. The sessions also offer related community resources and support.

    Please check with your Nurse for dates, times and locations. 

    Smoking Cessation Program

    Quitting smoking and staying smoke free is one of the best things you can do. It helps in all cancer treatments, including surgery, radiation, and chemotherapy. Even reducing the number of cigarettes you smoke will help.

    At the Cancer Centre, we are committed to providing you with the best possible comprehensive care. During your time here, if you are identified as a smoker, please expect to receive a call from a member of your care team. This team member will offer you a variety of smoking cessation support and information about community resources to help you become smoke free. This may include putting you in touch with “Smoker’s Helpline” or a Social Worker at the Cancer Centre.

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    Follow Up Visits [top]

    After your treatment is completed your follow-up care will be arranged. The follow-up visit is to find out how you are feeling and talk about any concerns you have about your cancer or treatment.

    Should you have any questions or concerns before your appointment, please feel free to contact the Centre or to discuss them at the time of your visit. We encourage patients to write down questions before the appointment to ensure they remember them.

    The Windsor Regional Cancer Centre sends a copy of your file to your family doctor and to the doctor who referred you to the Cancer Centre. You can change these directions at any time.

    We suggest you keep close and regular contact with your family doctor during your cancer treatment and after it is finished. Please tell the Cancer Centre if you change your family doctor.

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    Additional Information About Cancer [top]

    • Cancer Care Ontario (CCO)
      Cancer Care Ontario (CCO) advises and guides the Ontario government about cancer issues. This website has information in both English and French. It includes information about:
      -
      preventing and screening for cancer
      - recent articles
      - professional training and education
      - treatment and support
      https://www.cancercareontario.ca/en     
          
    • Mayo Clinic
      This website provides up-to-date medical information and news about health topics.
      www.mayoclinic.com

    • National Cancer Institute
      This website provides recent and accurate information about cancer. It includes information about:
      - types of cancer, causes, and risk factors
      - preventing cancer
      - treatments and how to cope
      - research (clinical trials, testing, and genetics)
      www.cancer.gov

    • Oncolink
      This website provides information about specific types of cancer, updates on cancer treatments, news about research advances, and more.

      www.oncolink.com

    • Ontario Cancer Trials
      The Canadian Cancer Society and the Ontario Institute for Cancer Research worked together to set up this website. It allows you to search for cancer trials (research that patients take part in) taking place in Ontario treatment centres. You can also sign up for automatic trial updates.
      www.ontario.canadiancancertrials.ca/


    • Ontario Wait Times
      To help improve your access to care, this site provides the best available data on wait times for hospitals all across Ontario.
      www.health.gov.on.ca/en/public/programs/waittimes/

    • Patient Symptom Management Guides
      If you have cancer you may get side effects from treatment or symptoms from the cancer. Cancer Care Ontario has created patient guides to help you and your loved ones manage your symptoms. The guides are filled with easy to understand, practical tips for what you should do and when to get help from your healthcare team.
      https://www.cancercareontario.ca/en/symptom-management 

    • MedLine Plus
      This website provides free medical information and is produced by the National Library of Medicine. It provides reliable, up-to-date health information about diseases, conditions, and wellness.
      www.nlm.nih.gov/medlineplus/

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    Working During Treatment
     [top]

    Working during cancer treatment is a personal decision. When your care team looks at whether working during treatment is the best thing for you, they consider some of the following:

    • The type of treatment you are getting
    • The stage of your cancer
    • Your overall health
    • The kind of work you do
    What you are able to do will depend on how you feel during treatment. Some people with cancer can still go to work and do their usual everyday tasks while they get treatment. Others find that they need more rest or just feel too sick to do much. Your Oncologist may also want you to limit some of your activities.

    Be sure to speak with your care team about working during treatment and if this is something you would like to do. 

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    Financial Information [top]

    Canada Pension Plan

    The Canada Pension Plan (CPP) pays money every month to people who:

    • Are between the ages of 18 and 65
    • Have paid into the CPP for a certain number of years
    • Are disabled according to CPP rules (a disability can be physical or mental)
    For more information go to Employment and Social Development Canada or call 1-800-277-9914.

    Drug and Nutrition Information

    Many patients who are getting treatment have trouble understanding which drugs are paid for by the government, drug programs, or private insurance.

    Staff in the Pharmacy at the Cancer Centre work to ensure that help with drug costs is considered for each patient. You should tell your Oncologist or Nurse if you have concerns about drug costs. You can also ask a Pharmacist and they too will make sure you get the help you need.

    Some patients may be able to get nutrition products paid for by these programs. A Registered Dietitian can help with this. If you are working, check with your employer about benefits and drug cost information.

    Canada Drug Assistance Program (CDAP)

    When you apply for this program, you are paired up with a CDAP case worker who will help you learn about all the help you can get with costs in all kinds of programs. You and your case worker will keep in touch until all the possibilities are explored.

    Speak with your care team for more information.

    Ontario Disability Support Program/Ontario Works

    Either the Ontario Works or the Ontario Disability Support Program can help you with costs.

    The Ontario Disability Support Program (ODSP) offers:

    • Money to help you and your family with living costs
    • Benefits for you and your family, including prescription drugs, vision care and nutrition products for some patients
    • Help finding and keeping a job, and moving up in your career
    A Social Worker at the Cancer Centre can tell you more about the help you can get with these programs or you can contact the local Ontario Disability Support Program office.

    To learn more:

    Ontario Trillium Drug Program

    The Trillium Drug Program is for people who live in Ontario and have a valid Ontario Health card and have high drug costs compared to how much money they make.

    To learn more:

    Non-Insured Health Benefits (NIHB) Program for Aboriginal People in Canada

    The Non-Insured Health Benefits (NIHB) Program pays for drugs and nutrition products that are not paid for by other private or provincial/territorial health insurance plans for eligible First Nation and Inuit people.

    To learn more:

    • Talk with a Social Worker at the Cancer Centre
    • Or, call the Ontario Regional Office at 1-866-225-0709
    Social Services Benefits

    Social Services Financial Assistance may help with costs when all other possibilities have been explored. Government programs include Ontario Works (formerly General Welfare Assistance) and Ontario Disability Support Program (formerly Family Benefits Allowance).

    To learn more, contact The Windsor & Essex County Social Services Financial Assistance:

    Patient Assistance Fund

    The Patient Assistance Fund is also available to help you. You can ask any member of your care team to help you. They will refer you to one of our Social Workers, or ask to speak with a Social Worker by calling 519-253-5253.

    The Patient Assistance Fund can help with emergency needs such as food, shelter, transportation and more.

    This is a program that is generously provided by the Windsor Cancer Centre Foundation.

    Credit Counselling Service

    Many credit counselling services can help patients and families plan for handling debt. Their services can give you private counselling, teach and coach you about money, and help you with your debt.

    To learn more, look in the yellow pages of the telephone book or do a search on the web for credit counselling services.

    Travel and Accommodation Expenses for Income Tax

    Cancer patients and their families can get tax deductions for some of the treatment costs. These include things like the cost of parking, travel, finding a place to stay, meals and drugs. The costs can be for the patient and those who go to appointments with them. The amount of help you can get will change over time.

    Contact Canada Revenue Agency or visit their website at www.cra-arc.gc.ca.
    Search for “medical expenses” to find more information

    Insurance Forms

    While you are being treated for cancer, there may be forms such as insurance, disability or sick forms that need to be filled out and signed by a doctor if you would like to apply for health benefits.

    If you need your doctor to fill out your form for you, you will need to bring the form to the Health Records unit at the Cancer Centre. 

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    Interpretation Services [top]

    It is important that you understand your care and treatment. If you need a translator or are hard of hearing, please speak with your care team.

    We also have Language Line services for direct translation. You or a family member may speak to your health care team for more information.

    If you are hard of hearing and would like Interpreter services, speak with your care team so that this can be arranged for you.

    If you are receiving active treatment, we strongly encourage you to have an interpreter with you during your visit. 

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