Ladies First Provider Newsletter
June 2017  
Palpable Lump                      Cancer Support                            Cancer Distress                       Dental  
PalpablePalpable Breast Lump, No Imaging Abnormality and Negative Mammogram: What's next? 
Follow-up Suggested

The National Comprehensive Cancer Network (NCCN) breast screening and diagnosis   
guidelines suggest if a woman is less than 30 years old and has a palpable mass even though there is no imaging abnormality and a negative mammogram, the provider should conduct a clinical breast exam every 3-6 months plus ultrasound every 6-12 months for 1-2 years to assess stability. If the provider thinks the palpable mass is clinically suspicious at any time the provider can consider referring the member for a diagnostic mammogram. If the member is over age 30 providers can visit the NCCN guidelines here

PatientPatient Support in Vermont
Get help for your patients
The Cancer Patient Support Foundation (CPSF) is an independent, non-profit organization dedicated to enhancing and furthering the availability of comprehensive psycho-social services to cancer patients and their families throughout Vermont and Northern New York.  The Foundation's vision is that all who face cancer can do so with dignity, confidence and serenity.  
To watch stories from those the foundation has helped, click here.

To learn more about the Cancer Support Foundation website, click here.  

NewNew Supportive Care Resources Help Patients with Cancer Confront Distress

Patients with breast or cervical cancer experience some level of distress associated with their cancer diagnosis and the effects of the disease and its treatment-regardless of the stage of disease. Not only does distress affect a patient's mental and psychosocial well-being, but because distress is a risk factor for non-adherence, uncontrolled distress can have a significant impact on a patient's overall survival.
And yet - many patients don't feel comfortable talking about their anxiety, family problems, or other issues with their oncologist. 

Empowering patients through education
To empower patients confronting distress after a cancer
diagnosis, the National Comprehensive Cancer Network (NCCN) has published the  NCCN Guidelines for Patients and NCCN Quick Guide for Distress 
through funding from the NCCN Foundation and Good Days, a patient advocacy organization providing financial assistance to patients so that they do not have to choose between access to medicine they need and affording everyday living. These resources are available free of
charge at and on the NCCN Patient Guides for Cancer mobile app.
Self identifying stress levels
In 2015, the American College of Surgeons (ACS) began to require that cancer centers have a process in place for distress screening in all patients diagnosed with cancer. Many had already been relying on the widely-used NCCN Distress Thermometer, which was first created in 1997 as part of the NCCN Guidelines for Distress Management. Similar to the pain scale used in various areas of medicine, the distress thermometer allows patients to self-identify their stress level from zero to 10, with 10 being an extreme level of distress. Under the guidelines, patients reporting above a "4" should be referred to supportive care that will best serve their needs.  

As described in the NCCN Guidelines for Patients: Distress, the NCCN Distress Thermometer,  which meets the ACS Commission on Cancer's requirements, is presented with a "problem list" where patients can identify sources of distress from the following categories:
  • Practical Problems
  • Family Problems
  • Emotional Problems
  • Spiritual/Religious Concerns
  • Physical Problems

Today, the NCCN Distress Thermometer is accessible in the   NCCN Quick Guide sheet for Distress.  
DentalOral Health Important for Cancer Patients
Collaboration for optimal health
Oral health is an important part of overall health; this is especially true for Vermonters who have diabetes, coronary artery disease, cerebral vascular disease or who are pregnant. In fact, recent research identifies the promotion of oral health as an unexpected strategy for reducing health care costs and improving health outcomes. Good oral health is also an important aspect of cancer treatment; more than one-third of people treated for cancer develop complications that affect the mouth. These problems may interfere with cancer treatment and diminish the patient's quality of life.

Learn more here.
Timely information from Ladies First!