We currently have five wonderful infusion centers for your convenience, all centers are located in the Central Valley. We have our corporate location located in Stockton and our four other locations are located in Lodi, Manteca, Tracy, and Modesto. We know how important comfort should be while receiving chemotherapy treatment so we offer the following to help your appointment be more relaxing; infusion chairs that recline with side tables for snacks/drinks, open seating areas, curtains for privacy, coffee, snacks, music and visitor chairs (1 max per patient).

Choice of cancer treatment is influenced by several factors, including the specific characteristics of your cancer; your overall condition; and whether the goal of treatment is to cure your cancer, keep your cancer from spreading, or to relieve the symptoms caused by cancer. Depending on these factors, you may receive one or more of the following:

• Surgery
• Chemotherapy
• Radiation therapy
• Hormonal therapy
• Immunotherapy
• Targeted therapy
• Biological therapy

One or more treatment modalities may be used to provide you with the most effective treatment. Increasingly, it is common to use several treatment modalities together (concurrently) or in sequence with the goal of preventing recurrence. This is referred to as multi-modality treatment of the cancer.

Currently, in this section we will concentrate on chemotherapy and the management of its side effects.

Chemotherapy is any treatment involving the use of drugs to kill cancer cells. Cancer chemotherapy may consist of single drugs or combinations of drugs, and can be administered through a vein, injected into a body cavity, or delivered orally in the form of a pill. Chemotherapy is different from surgery or radiation therapy in that the cancer-fighting drugs circulate in the blood to parts of the body where the cancer may have spread and can kill or eliminate cancers cells at sites distant from the original cancer. As a result, chemotherapy is considered a systemic treatment.

More than half of all people diagnosed with cancer receive chemotherapy. For millions of people who have cancers that respond well to chemotherapy, this approach helps treat their cancer effectively, enabling them to enjoy full, productive lives. Furthermore, many side effects once associated with chemotherapy are now easily prevented or controlled, allowing many people to work, travel, and participate in many of their other normal activities while receiving chemotherapy.

The frequency of chemotherapy depends on the drug prescribed by your doctor, and your individual needs. Your doctor and the nurse will explain this carefully. Chemotherapy is usually given in the office, but rarely your doctor may decide to admit you to the hospital to treat certain aggressive cancers.

The length of treatment will vary according to the type of medication you are to receive, and how well the chemotherapy is working. You may spend anywhere from 1 hour to 6 hours in the office on the day of your treatment, depending on the type of chemotherapy drugs that are being administered. The frequency of each treatment will vary according to the regimen your doctor has prescribed. You doctor and nurse will discuss your chemotherapy treatment with you in detail.

Your doctor will examine you frequently, and ask how you are feeling and coping with the side effects. He will also perform blood tests, x-rays, or other tests such as a CT scan or an MRI to determine if your tumor has not grown and/or is getting smaller.

Cancer cells tend to grow fast, and chemo drugs kill fast-growing cells. But because these drugs travel throughout the body, they can affect normal, healthy cells that are fast-growing, too. Damage to healthy tissue causes side effects. Although side effects are not always as bad as you might expect, many people worry about this part of their cancer treatment.

The normal cells most likely to be damaged by chemo are blood-forming cells in the bone marrow; hair follicles; and cells in the mouth, digestive tract, and reproductive system.

You are not alone if you have questions about side effects. Before chemo starts, most people worry about whether they will have side effects and, if so, what they will be like. The most common side effects of chemo are listed here.

• Anemia (low red blood cell count)
• Fatigue
• Hair loss
• Increased chance of bruising, bleeding, and infection
• Nausea and vomiting

The American Cancer Society periodically publishes the management of frequent side effects and are explained below

Nausea and vomiting are 2 of the most common and most dreaded side effects of chemo. How often you feel these side effects and how bad they are depend on the drugs you are getting and how they affect you. Nausea and vomiting may start during treatment and last a few hours. Sometimes, but less often, severe nausea and vomiting can last for a few days. Your doctor can prescribe anti-nausea drugs such as Zofran (Ondansetron) or Compazine(Prochlorperazine) to alleviate nausea and prevent vomiting.

• Avoid greasy or spicy food
• Avoid strong food odors
• Eat small, frequent meals.

Diarrhea is most often defined as 2 or more loose stools in 4 hours. If you have diarrhea that lasts for more than 24 hours, or if you have pain and cramping along with it, call your doctor or nurse. In severe cases, the doctor may have you take an anti-diarrheal medicine such as Imodium.

• Drink plenty of fluids to replace those you have lost through diarrhea. Mild, clear liquids, such as apple juice, water, weak tea, clear broth, or ginger ale are best. Make sure they are at room temperature and drink them slowly. Let carbonated drinks lose their fizz before you drink them.
• Avoid too much coffee, cola drinks, alcohol
• Avoid dairy products if they make the diarrhea worse

Some people become constipated from chemo. Others may become constipated because they are taking certain pain medicines. Your doctor may prescribe a bowel care regimen which would include laxatives such as Sennakot or Milk of Magnesia. Tell your doctor if you have not had a bowel movement for 2 or more days. Increasing your fluid intake also helps with constipation.

• Good mouth care is important during cancer treatment. Chemotherapy can cause sores in the mouth and throat.
• Rinse mouth frequently with salt water and baking soda gargles.
• Avoid mouthwashes that contain alcohol.
• Brush teeth with a very soft toothbrush

Eat foods cold or at room temperature. Hot and warm foods can irritate a tender mouth and throat. Choose soft, soothing foods, such as ice cream, milk shakes, baby food, soft fruits (like bananas and applesauce), mashed potatoes, cooked cereals, soft-boiled or scrambled eggs, cottage cheese, macaroni and cheese, custards, puddings, and gelatin. You also can puree cooked foods in the blender to make them smoother and easier to eat

Hair loss can be frightening for patients on chemotherapy. But not all chemo drugs will make you lose your hair. Some people have mild thinning that only they notice. It usually doesn’t happen right away. More often, hair loss begins after a few treatments. Your doctor will be able to tell you if your medicines are likely to make you lose your hair. If you do lose your hair, it will almost always grow back after the treatments are over.

However, hair loss is temporary, and your hair will grow back soon after you discontinue chemotherapy . In the meantime, you may want to wear a wig, hairpiece, or hat. Your nurse can give you information about wigs and hats.

The bone marrow produces 3 important parts of your blood:

• Red blood cells, which carry oxygen to cells throughout the body
• White blood cells, which fight infection
• Platelets, which help blood to clot and stop bleeding

Your doctor and nurse may request a blood test when you receive chemotherapy, called a Complete Blood Count, or CBC. This test is performed to check the function of the bone marrow. This will be done often during your treatment.

Having a low white blood cell count decreases your body’s ability to fight infections. One type of white blood cell, the neutrophil, is especially important in fighting infections. A shortage of neutrophils is called neutropenia. If your white blood cell count drops too much, your doctor may hold treatment, give you a lower dose of chemo, or give you a growth factor shot that makes your bone marrow put out more white blood cells.

• Report to your doctor/nurse if you feel you are developing an infection. Fever of 100.5°F or greater when your temperature is taken by mouth
• Chills
• Cough with sputum production that is new

If your red blood cells or platelets are low your doctor/nurse may decide to hold your chemotherapy or arrange for transfusions. You may also be given an injection to boost your RBC called procrit/aranesp.

We understand that this is a very stressful period in your life, and the information you have received may sound complicated and alarming; however, all the staff at SHOMG are available to help you in any way that we can. A nurse is on site daily during our office hours, and she ishappy to address any concerns about your treatment etc.

Immunotherapy is treatment that uses certain parts of a person’s immune system to fight diseases such as cancer. This can be done in a couple of ways:

• Stimulating your own immune system to work harder or smarter to attack cancer cells
• Giving you immune system components, such as man-made immune system proteins

Some types of immunotherapy are also sometimes called biologic therapy or biotherapy.

In the last few decades immunotherapy has become an important part of treating some types of cancer. Newer types of immune treatments are now being studied, and they’ll impact how we treat cancer in the future.

Immunotherapy includes treatments that work in different ways. Some boost the body’s immune system in a very general way. Others help train the immune system to attack cancer cells specifically.

Immunotherapy works better for some types of cancer than for others. It’s used by itself for some of these cancers, but for others it seems to work better when used with other types of treatment.

Our physicians, providers and highly-skilled nursing staff are on hand at all times to care for your needs. Our nurses constantly ensure that you are comfortable and that everything is going smoothly during your infusion. They offer the best care, moral support, hugs, and genuine interest in you and your family.

Even though the infusion centers treat many patients each day, we try our best to keep patients waiting to a minimum. We do everything within our power to welcome you, get you seated, and start your treatment as soon as possible. Because of our desire to serve your needs quickly and efficiently, it is important that you arrive at least 10 minutes early or on time for your chemotherapy appointments.

When cancer treatment includes chemotherapy, patients have many questions.
The packet note below helps address many of these questions.

IN ALIGNMENT WITH CDC GUIDELINES, FACE COVERINGS WILL BE REQUIRED AT ALL STOCKTON HEMATOLOGY ONCOLOGY MEDICAL GROUP LOCATIONS. EVEN FOR PEOPLE WHO ARE FULLY VACCINATED

Helpful information about COVID-19 (Coronavirus) (https://www.cancer.org/latest-news/common-questions-about-the-new-coronavirus-outbreak.html)

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