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G. Lita Smith, RN, ACNP
GLitaSmithRN (Nurse (Verified) )| Communities: Breast Cancer | Answers: 8 |
| Member Since: Feb. 2013 |
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Professional Statement
I am a nurse practioner for breast cancer oncology at the University of Michigan Comprehensive Cancer Center. Beyond my current clinical responsibilities with breast cancer patients and families, I have taken on the role of the nurse practitioner supervisor for the now nearly 50 nurse practitioners within the cancer center. I oversee the care of breast cancer patients from diagnosis throughout the entire continuum of the disease.
Professional Info
Nursing school: The University of Michigan
Hospital or other affiliation: University of Michigan Health System
City: Ann Arbor
State: Michigan
GLitaSmithRN Activities
Chemotherapy in general can cause dry skin, so I always recommend moisturizing lotion for my patients on chemotherapy. Certain chemotherapy agents can cause skin rashes. The most common chemotherapy agents that can cause a skin rash include taxol/taxotere. If you develop a rash of any kind, discuss this with your oncologist or oncology nurse practitioner as treatment will be individualized based upon the severity of the rash.
New answer by GLitaSmithRN (Nurse (Verified))
1
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2 months ago
Lymphedema is caused by disruption in the lymphatic system of the arm most commonly from an axillary lymph node dissection and/or radiation therapy to the axilla. Thankfully, lymphedema is less common as it is often safe and appropriate for surgeons to perform a sentinel lymph node dissection, which only removes a few nodes as opposed to many nodes removed in an axillary lymph node dissection. More and more research has shown that keeping weight at an ideal level and exercise can help prevent lymphedema. For patients with existing lymphedema a referral to physical therapy/occupational therapy is very important. Lymphedema treatment is important to prevent worsening of the edema, and patients and family members will be taught how to do exercises to help control the lymphedema. Patients are often given compressions sleeves and gloves to wear to prevent and control lymphedema. There is no specific recommendation for skin care beyond keeping the skin well moisturized and prevent scratches/cuts to the arm that has had surgery. Sometimes even small cuts/scratches can lead to an infection.
New answer by GLitaSmithRN (Nurse (Verified))
1
Answer |
2 months ago
"Aromatase inhibitors" such as aromasin, anastrozole and letrozole are anti-estrogen medications and commonly used in post-menopausal breast cancer patients whose cancers are estrogen or progesterone receptor positive. The most common side-effect of these medications are joint and muscle pain which can range from mild to severe. At times, switching from one medication to another can help, as they are different compounds and can sometimes have different side-effects. Medications to help with joint pain include NSAIDS such a ibuprofen or naprosyn. Newer medications with pain relieving properties include drugs like cymbalta, ( although insurance coverage can be an issue at times). If all else fails, one may have to switch to a different type of anti-estrogen medications such as tamoxifen if deemed appropriate by the oncologist or oncology nurse practitioner.
New answer by GLitaSmithRN (Nurse (Verified))
1
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2 months ago
A DIEP flap procedure is a type of reconstruction using abdominal tissue to reconstruct the breast mound. There can be some on-going pain in the breast given scar tissue formation and the "knot" can be from the surgery as well. It is important to make sure the "knot" is not related to a breast cancer recurrence and an MRI of the area is appropriate to rule this out. For on-going pain, we send our patients to our physical therapy/occupational group, who do an excellent job of working to release scar tissue and alleviating pain through massage, ultrasound, scar tape placement, etc.
New answer by GLitaSmithRN (Nurse (Verified))
1
Answer |
2 months ago
Fatigue is probably the most common side-effect of chemotherapy and can be related to multiple factors. Chemotherapy itself can cause fatigue. The lowering of blood counts, especially anemia can cause fatigue. Sleep patterns are often disrupted and this causes fatigue. I usually tell my patients to "listen to their body". Patients often have high energy days and I encourage them to go about their normal activities during those days. They often have other lower energy days, and so I encourage them to take breaks, take a nap if needed and take it easier on those days. The mistake I sometimes see with patients is that they think "if I am tried, I will just stay in bed and maybe I will feel better. Unfortunately, that is often not the case. I encourage my patients to get up, showered and moving every day if at all possible. Often some activity often increases energy levels as opposed to making fatigue worse.
New answer by GLitaSmithRN (Nurse (Verified))
1
Answer |
2 months ago
I often tell patients and their family members that my "bag of magic tricks is quite large". What I mean by that is that I would expect patients to call me with any side-effects from chemotherapy given that there are many ways of treating side-effects these days. For example most patients are afraid of nausea/vomiting with chemotherapy, but with breast cancer chemotherapy, that is rarely a problems given the excellent anti-nausea medications we have available today. If a patient is struggling with mouth sores, diarrhea, constipation which are other common side-effects, I can help by prescribing special mouth rinses, bowel medications and educate patients about diet to help with bowel function, mouth soreness etc.
New answer by GLitaSmithRN (Nurse (Verified))
1
Answer |
2 months ago
If surgery is deemed to be the first line of treatment, you may meet a surgical nurse practitioner prior to surgery and after surgery. If you need to be seen by a medical oncologist, your first visit, would be most likely the time you would meet a nurse practitioner.
New answer by GLitaSmithRN (Nurse (Verified))
1
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2 months ago
In the institution where I practice, the University of Michigan, the nurse pracitioner has a very collaborative role with their physician partners. We provide care for patients from the time of their diagnosis, through chemotherapy treatments if needed, throughout anti-estrogen or other therapies if needed and then in long term follow up. We are involved in the diagnosis, treatment, symptom management, patient and family education, support etc.
New answer by GLitaSmithRN (Nurse (Verified))
1
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2 months ago
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