Frequently Asked Questions About Medical Oncology

We understand that a cancer diagnosis can bring stress and uncertainty. That’s why your cancer care team at Beaufort Memorial includes a nurse navigator and social work navigator. Navigators provide one-on-one support throughout your journey so you can focus on getting well. Your navigators work with your entire team of cancer specialists to ensure you receive all the services you need to fight cancer.

Count on your navigators to:

• Provide education to help you understand your diagnosis and treatment options.
• Act as a patient advocate on your behalf.
• Coordinate support services, such as nutritional counseling.
• Provide access to clinical trials.
• Provide information on palliative care to help manage the symptoms of cancer and treatment.
• Help overcome any barriers to treatment.
• Help you coordinate your appointments and assist with physician referrals.
• Coordinate delivery of test results, lab work and X-rays.
• Introduce you to survivorship programs and create a plan for life after cancer.
• Help with transportation and financial concerns.
• Organize and explain paperwork.
• Provide counseling sessions and introduce you to support groups.

This list of questions to ask your physician can also be helpful when trying to better understand your diagnosis and treatment options.

The Beaufort Memorial Keyserling Cancer Center has been accredited as a community cancer program by the Commission on Cancer of the American College of Surgeons. This distinction recognizes our commitment to providing the best in cancer diagnosis, treatment, support and outcomes.

We provide a team of cancer care specialists—including medical and radiation oncologists, specially trained nurses, registered dietitians, physical therapists and others—who work together to create a personal treatment plan for you or your loved one and support you throughout your journey.

In addition, our affiliation with the Medical University of South Carolina (MUSC Health) means more treatment options, promising clinical trials and experienced subspecialists who are available without having to travel far from home.

Medical oncology, a subspecialty of internal medicine, is devoted to the diagnosis and treatment of malignant tumors. It primarily involves the use of chemotherapy (powerful medications that destroy cancer cells), as well as immunotherapy and targeted therapy. Medical therapies may be used in combination with cancer surgery and/or radiation therapy, depending on your unique needs.

A multidisciplinary team, like the one at Beaufort Memorial, consists of cancer specialists from diverse areas who work together to help you fight cancer with confidence. Your team may include:

• Surgical oncologists
• Medical oncologists
• Radiation oncologists
• Radiologists
• Pathologists
• Specially trained nurses
• Nurse navigators and social workers
• Physical therapists
• Registered dietitians
• Physicists
• Dosimetrists
• Pharmacists

The team comes together to develop a personal treatment plan that takes into account all aspects of care—everything from prescribing the most appropriate tests or therapies to addressing educational needs and emotional concerns. We’ll then discuss the plan with you so you can make informed choices about your preferred course of care.

Seeking a second opinion is a personal choice. There are several reasons you may want to consider doing so. Most patients are looking for reassurance that the first opinion is correct and that they are exploring all of their treatment options. It is important to us that you are aware of all that is available to you before deciding on a course of treatment. We may also recommend you seek a second opinion if an oncology subspecialist would be appropriate.

The only time a second opinion for any type of medical care is not appropriate is in an emergency.

Many health insurance companies pay for second opinions. Your best source of information about your specific coverage is the insurance company that issued your health insurance policy or your employer's benefits office (if you are covered under a group policy through work). We recommend that you call to find out what they cover and if you need a referral or preauthorization.

A consultation is a time for you to meet your oncologist and discuss your diagnosis and treatment options. You are welcome to bring a family member or friend with you to help absorb all of the information and possibly take notes. We encourage you to ask any and all questions; view this list of common patients questions that you may want answered.

An initial consultation with an oncologist usually takes about an hour.

Chemotherapy involves medications given by injections or pills for cancer. Treatment is circulated throughout the entire body and is generally prescribed by a medical oncologist. It can be used to:

• Make a tumor smaller before surgery or radiation therapy. This is called neoadjuvant chemotherapy.
• Destroy cancer cells that may remain after treatment with surgery or radiation therapy. This is called adjuvant chemotherapy.
• Help other treatments work better.
• Kill cancer cells that have returned or spread to other parts of your body.

Immunotherapy is given by IV infusion and is circulated throughout the entire body as an initial cancer treatment or after surgery to help keep cancer from coming back. Some types boost the body’s immune system in a general way and others help train the immune system to attack cancer cells specifically. Different types of immunotherapy can:

• Take the brakes off the immune system to help it recognize and attack cancer cells. This is called an immune checkpoint inhibitor.
• Start an immune response against a certain disease (a cancer vaccine).
• Attack a very specific part of a cancer cell with synthetic versions of immune system proteins or monoclonal antibodies.

Radiation therapy is produced by a linear accelerator or another radiation source, and is prescribed by a radiation oncologist. The radiotherapy beams are focused on a very specific area of the body.

Chemotherapy is designed to kill cancer cells. Depending on which drug is used, chemotherapy can be given in a variety of ways, including:

• Orally Swallowed as pills, capsules or liquids
• Intravenously (IV) Injected directly into a vein
• By injection Injected into a muscle in your arm, thigh or hip, or right under the skin in the fatty part of your arm, leg or belly
• Topically Rubbed as a cream into your skin

Chemotherapy works by destroying cancer cells, but unfortunately it cannot tell the difference between a cancer cell and a healthy cell. So chemotherapy eliminates not only the fast-growing cancer cells but also other fast-growing cells in your body, including hair and blood cells.

Some cancer cells grow slowly while others grow rapidly, so each chemotherapy drug is designed to target the growth patterns of a specific type of cancer cell. As a result, each drug works differently and is effective at specific times in a cancer cell’s life cycle. Your doctor determines the chemotherapy drug that is right for you.

Immunotherapy, also called biologic therapy, is a type of cancer treatment that boosts the body's natural defenses to help your immune system fight cancer. It uses substances made by the body or in a laboratory to improve or restore immune system function. Immunotherapy may work by:

• Stopping or slowing the growth of cancer cells
• Stopping cancer from spreading to other parts of the body
• Helping the immune system work better at destroying cancer cells

The immune system’s purpose is to attack any cell that it sees as unhealthy or abnormal. One reason that cancer cells thrive is that they are able to hide from your immune system. Certain immunotherapies can mark cancer cells so it is easier for the immune system to find and destroy them. Other immunotherapies boost your immune system to work better against cancer.

Clinical trials are medical research studies to test new treatments in people with cancer and find better ways to treat the disease.

Clinical trials can test new:

• Cancer drugs
• Types of surgery for cancer
• Treatment methods, such as gene therapy

There are three phases of clinical trials:

• Phase I trials are the first step in testing a new treatment in humans and where researchers are looking for a better way to help cancer patients.
• Phase II trials decide whether the new treatment has an anticancer effect.
• Phase III trials compare the new cancer treatment with the results of standard treatment.

Explore open clinical trials available at Beaufort Memorial.

Through our partnership with Medical University of South Carolina (MUSC Health), we offer access to leading-edge clinical trials. These studies test promising new therapies, medications and devices before they become widely available.

In many cases, standard treatment produces excellent outcomes. When you are evaluated by one of our board-certified specialists, he or she can discuss the potential of a clinical trial that is appropriate for your diagnosis and condition.

Explore open clinical trials available at Beaufort Memorial.

Each cancer research study has certain entry requirements for potential participants. You can speak with your doctor or nurse navigator about your situation and whether you meet a particular trial’s requirements.

Your cancer care team at Beaufort Memorial includes a nurse navigator and a social work navigator. Navigators provide one-on-one support and work with your entire team of specialists to ensure you have everything you need to fight cancer:

• Education for you and your family on your diagnosis and treatment options
• Help in overcoming any barriers to treatment
• Nutrition counseling from a registered dietitian
• Physical therapy
• Cancer rehabilitation programs and lymphedema specialists
• Access to clinical trials
• Help with transportation
• Financial resources to ease the monetary strain of medical care, prescriptions, utilities, housing and food
• Assistance with insurance coverage, disability paperwork and medical leave matters
• Counseling sessions and support groups
• Palliative care to help manage the symptoms of cancer and any side effects of treatment
• Survivorship programs and help creating a plan for life after cancer

Beaufort Memorial offers several options for you to connect and share with other patients and survivors. See upcoming support group meetings.

Many patients may have underlying medical problems that the cancer care team does not manage. You should maintain an ongoing relationship with your primary care physician who will continue to refill your regular medicines and care for any conditions other than cancer. Our team will also work closely with your primary doctor and provide updates on your cancer treatment plan.

If hospitalizations are required for other medical conditions not related to your cancer treatment, let your primary care provider and cancer care team know. They may wish to obtain the notes on care provided while you are in the hospital.

Cancer patients often receive a combination of treatment types, including chemotherapy, immunotherapy, hormone therapy, radiation therapy and/or surgery. To ensure the best possible outcome, we have a multispecialty approach that brings all of your doctors and other care specialists together as a team. Team members consult closely with one other and you before treatment starts to determine the best course of action.

All of your chemotherapy, infusion and radiation therapy treatments are conveniently provided in the same building.

The Keyserling Cancer Center, located at 989 Ribaut Road, is home to Beaufort Memorial Oncology Specialists, Chemotherapy and Infusion Services, Surgical Specialists, Radiation Oncology, the Breast Health Center, an imaging center and a lab.

The first floor of the Okatie Medical Pavilion is home to the New River Center. Located at 122 Okatie Center Blvd. North, the Center offers Beaufort Memorial Oncology Specialists, Chemotherapy and Infusion Services, Surgical Specialists, Radiation Oncology, the Breast Health Center, an imaging center and a lab.

For chemotherapy, infusion and radiation therapy at the Keyserling Cancer Center, convenient parking is available at the rear of the building (989 Ribaut Road, Beaufort, South Carolina 29902). For appointments at Beaufort Memorial Oncology Specialists, the Breast Health Center, imaging or the lab, the front entrance of the building provides the easiest access as well as elevators. Patient parking can be found to the front, south and rear of the building.

All services at the New River Cancer Center are accessed through the front entrance (122 Okatie Center Blvd. North, Okatie, South Carolina 29909) with ample parking.

During your initial consultation, you will meet your medical oncologist to review all of your medical records and any recent tests, scans (CT scan or MRI) or X-rays and to discuss your treatment options. You should bring:

• Any reports from imaging, lab or pathology studies not that weren’t conducted at Beaufort Memorial
• A current list of all medications, supplements and herbal remedies you take, with their dosage and how often you take them
• Your health insurance card(s)
• Any co-payment required by your insurance
• A list of any questions you have for your doctor and a pen and paper to write down the answers. You may also wish to have a family member or friend come with you to listen along with you to what the doctor says and to take notes for you.

Chemotherapy can prolong your life and potentially eliminate your cancer. Side effects are unpredictable and depend on the type of drug therapy being used. Fatigue, infection or illness, easy bruising or bleeding and hair loss are some of the most common side effects.

Other common side effects include:

• Nausea and vomiting
• Anemia (low red-blood-cell counts)
• Appetite changes
• Constipation
• Diarrhea
• Weight changes
• Trouble concentrating
• Changes in mood, libido and sexual function
• Trouble breathing

Chemotherapy cannot tell normal cells from cancer cells and kills both, which is why side effects occur.

Doctors give chemotherapy at levels that both treat cancer and keep side effects to a minimum. They also try to avoid using multiple drugs that have similar side effects.

The normal cells most likely to be damaged by chemo are:

• Blood-forming cells in the bone marrow
• Hair follicles
• Cells in the mouth, digestive tract and reproductive system

Some chemotherapy drugs can damage cells in the heart, kidneys, bladder, lungs and nervous system. Sometimes, you can take medicines with the chemotherapy to help protect your body’s normal cells. There are also treatments to help relieve side effects.

Discuss you concerns about potential side effects and any changes you are experiencing with your physician and cancer care team.

You can help ease nausea and vomiting by changing your eating patterns:

• Eat five or six small meals daily rather than three large ones.
• Avoid strong-smelling foods.
• Slow down your pace of eating and drinking.
• Drink an hour before or after meals rather than during meals. Apple juice, tea and flat ginger ale may help.
• Avoid sweets and fried or fatty foods.

Your doctor may also prescribe anti-nausea medication. You may need to try different medications until you find one that helps you.

If you find yourself feeling more tired than usual:

• Rest or take short naps during the day.
• Get a little fresh air and exercise. A short walk may boost your energy.
• Ask family or friends for help when you need it.
• Focus your energy on important things.

If nothing seems to help, speak with your doctor. Sometimes chemotherapy can lead to anemia or low red blood cell counts.

If you feel a bit foggy after treatment, you can try these tips for “chemo brain”:

• Use a daily planner or apps on your phone to keep track of appointments, names, addresses, phone numbers and to-do lists.
• Try to focus on one thing at a time.
• Ensure you are getting enough nutritious food and high-quality exercise and sleep.
• Keep your brain active with puzzles, reading, on-line classes and community lectures.

If your chemotherapy treatment causes hair loss, try:

• Cutting your hair short to help make it look thicker and fuller
• Using soft-bristle brushes and avoiding hair products with harsh chemicals
• Wearing a hat or scarf in cold weather and using sunscreen to protect your scalp from the sun
• Washing your scalp with mild moisturizing shampoos and conditioners if it feels tender and dry. Gentle lotions may also help.

If you think you will want a wig, shop for it before you lose your hair, when matching your hair color will be easier. Beaufort Memorial also offers custom wig-fittings from Alala, a unique boutique that visits the hospital monthly.

Telling your doctor about side effects is essential to getting good care and living as fully as possible. Untreated side effects can drain you physically and emotionally and detract from your healing. Your response to therapy is unique, and your doctors rely on you to report your experience and needs.

For a tumor that causes pain, surgery to remove the tumor and/or chemotherapy or radiation therapy to destroy all or part of it can help.

There are also many medications used to treat pain. You and your doctor can discuss the options and adjust medications as needed to minimize your pain.

Exercise has been shown to be safe for people going through cancer treatment, and in fact can be one of the best ways to relieve some of the symptoms associated with your cancer or treatment.

Your medical oncologist will help find the right balance of maximizing therapy effectiveness while minimizing side effects, so you can integrate exercise into your life and stay as active as possible while in treatment. You’ll also work with a physical therapist who can create an exercise program that is safe for you throughout your cancer journey.

Many of our patients remain at work and maintain a productive lifestyle during treatment. Whether or not you can work may depend on what kind of job you have. If your job allows, you may want to see if you can work part-time or from home on days you do not feel well.

Our physicians are dedicated to finding a drug therapy balance that will most effectively fight your cancer while minimally affecting your daily routine and lifestyle.

Knowing the stage and grade of the cancer helps your doctors know what treatment to use and determine outcome.

Staging reveals how far cancer has spread and grading helps predict how fast the cancer will grow and spread. Cancer is typically staged as:

• Stage 0: Cancer hasn’t spread.
• Stages I, II and III: Cancer has grown or has spread into nearby tissues and perhaps lymph nodes. The higher the stage, the farther the cancer has spread.
• Stage IV: Cancer has spread beyond the lymph nodes into other parts of the body (metastasized).

Grading, which is different from staging, refers to how abnormal tumor cells and tissue look under a microscope, an indication of how quickly a cancer is likely to grow and spread.

Grading systems vary by cancer type, but in general the following system is used:

• G1: Well differentiated (low grade)
• G2: Moderately differentiated (intermediate grade)
• G3: Poorly differentiated (high grade)
• G4: Undifferentiated (high grade)

The brain produces chemicals that affect how well our body fights disease. Through the mind-body connection, positive emotions and laughter send signals to the brain, which then produces chemicals that:

• Increase blood circulation
• Boost the immune system and help fight off infection
• Relax muscles, restore energy and lower stress
• Improve mood and better manage pain and stress

Your nurse navigator will assist the team with coordinating your various appointments so everything is scheduled appropriately. If you have questions about the timing of your treatments, speak with your oncologist or nurse navigator.

As the only not-for-profit 501(c)3 hospital in Beaufort and Jasper Counties, and the largest not-for-profit hospital between Savannah and Charleston, we rely on donations to continue to provide top-quality health care programs and services to our community. You can contribute to the Beaufort Memorial Hospital Foundation in a number of ways. We greatly appreciate any contribution you can provide.

Donate online now.

For gift planning assistance or information, please speak with a member of our development team. Call 843-522-5774 or email bmhfoundation@bmhsc.org.

Mailing address:

BMH Foundation

P.O. Box 2233

Beaufort, SC 29901

Physical address:

BMH Foundation

990 Ribaut Road, Third Floor

Beaufort, SC 29902