Sandton Oncology

Medical Oncology

Methods of treatment vary according to the type of cancer, stage and general physical condition of the patient. Surgery, radiation, chemotherapy or combinations thereof may be used to treat the disease.

Our treatment is underpinned by a holistic approach to our patients and their condition and our ability to treat and care for them under one roof. Through an array of skilled medical professionals with extensive experience in cancer and its management, we offer the following services:

  • Confirmation of a diagnosis
  • Advice on available treatment options
  • Referral to a radiation oncologist on site should you require radiation treatment
  • A referral to a wide range of surgeons and other specialists for a multi-disciplinary approach to treatment
  • Chemotherapy, Hormonal and Targeted therapies (oral, subcutaneous, intramuscular and intravenous)
  • Supportive care in between your treatments and upon completion
  • Counselling for you and your family: We work closely with a psychologist who will help you and your family to cope with the new diagnosis, its treatment and the journey ahead.
  • We work very closely with a palliative care team to assist our patients with pain management and palliative-symptomatic care.
  • Clinical research with new drugs and approaches putting you at the forefront of global medical research and treatments.

What are clinical trials?

  • A research study on new or existing treatments, involving human volunteers.
  • Every clinical trial will be conducted according to a protocol, which must be approved by an Ethics Committee and Medicines Control Council.
  • Patients need to give written consent to participate in a clinical trial.

Why are clinical trials conducted?

  • To see if a new drug is safe and effective to use.
  • To compare existing treatments to see which is better.

Possible benefits of participation?

  • Access to new research treatments.
  • Contibuting to medical research.

Possible risks of participation?

  • Side effects of treatments
  • Treatment may not be effective
  • Participation in a clincial trial can be time consuming

Ten questions to ask before participating in a Clinical Trial:

  1. What is the purpose of the clinical trial?
  2. Does the study involve a new, existing or placebo treatment?
  3. What is expected of me as a participant?
  4. Will my identity be confidential for the duration of the trial?
  5. How often will the treament be given?
  6. How will the treatment be given?
  7. Do I or my medical aid have to pay for anything?
  8. Will I be reimbursed for travel costs?
  9. If I am responding well to the treament, can I keep using it after the study?
  10. At the study end, will there be follow up care?

Chemotherapy is the treatment of cancer using drugs that kill cancer cells by interfering with their multiplication. It is available mostly as an intravenous formulation (drip). Some drugs also have oral preparations which are equally effective and convenient.

The side effects of chemotherapy stem from the understanding that chemotherapy kills actively multipying cells, like cancer cells. However other rapidly multiplying cells like the cells of the hair and gut, can get affected as "bystanders". These however recover once the treatment is completed.

The common side effects of chemotherapy are therefore hair loss, nausea and vomiting, constipation, fatigue and mouth ulcers. It is important to note that none of these side effects are universal and your oncologist will discuss any side effects specific to your chemotherapy regimen with you.

Other treatment modalities in the fight against cancer are hormonal manipulation,where the hormonal mileau is manipulated to treat some cancers or decrease the risk of recurrence after surgery and/or chemotherapy.

In recent years new drugs termed "monoclonal antibodies" have also emerged as an important treatment tool. These drugs are not chemotherapy, but interfere with cellular communication, thereby slowing down the growth of the tumour.

Radiation Therapy is the science of treating diseases, mainly cancers, with radiation. Radiation also can be used less often to treat benign disease such as keloids. Radiation oncology makes use of high energy x-rays, which deposit energy into cancer cells causing them to die and thereby preventing further growth and spread of the disease. The delivered radiation cannot be felt or seen and treatment sessions are therefore completely painless. Modern radiation techniques are designed to spare normal tissue wherever possible, while delivering a high dose to the tumour (cancer) area. However, some irradiation of normal cells is unavoidable and this may produce side effects that are limited to the treatment site. Radiation-sensitive cancer cells are preferentially killed while normal cells are able to repair the damage caused, thereby producing a therapeutic benefit. The goals of treatment with radiotherapy can be either curative or palliative. Palliative treatment is designed to improve symptoms such as pain, bleeding or obstruction of vital organs. Because of its good side-effect profile and high efficacy, radiotherapy is an excellent treatment modality to palliate the distressing symptoms that can be caused by cancers. Radiation oncology is sometimes delivered in combination with chemotherapy that acts as a radiation sensitiser, thereby improving the cell-kill of the radiation.

The objective is to reduce the possibility of hair loss or the need to wear a covering aid on your head during chemotherapy. Please note that this is NOT an experimental procedure or a clinical trial.

Scalp cooling is a well-accepted approach in many places around the World and tens of thousands of oncology patients receive it annually. The history of scalp cooling dates back over 30 years, with 56 Trials conducted between 1973 and 2003, and many more since then. The average success rate of the studies carried out before 1995 was 56% with an increase to 73% in the studies carried out from 1995 onwards; with continual improvements to date.

Chemotherapy-induced alopecia (hair loss) (CIA) occurs with an estimated incidence of 65% (Trüeb, 2009). CIA is often categorised as anagen effluvium in which hair follicles in the growth phase (anagen) are attacked by chemotherapy agents resulting in almost total atrophy of the hair follicle. This results in the shedding of the affected hairs approximately 2 weeks after the commencement of chemotherapy. The damage that chemotherapy causes to the hair follicle can be alleviated using a scalp cooling device. The optimum temperature for scalp cooling is not yet known but studies show that 22oC is mostly effective:

  • In one study good hair retention was achieved when the scalp temperature was cooled to <22oC (Gregory, 1974)
  • Keratinocyte growth inhibition is greatly reduced when cells are incubated at 22oC during chemotherapy exposure compared to 37.5oC. (Paxman IV project,2011 & Janssen,2008)

There are two scientific scalp cooling rationale that are frequently quoted in literature:

  • Cooling causes vasoconstriction which reduces blood perfusion rate and consequently reduces the amount of cytostatic drugs reaching the hair follicles.
  • Cooling reduces the metabolic rates of biochemical processes which result in less damage being made to the hair follicles.

More recently, academics are studying the role that the p53 tumour suppressor plays in CIA and the prevention of CIA through scalp cooling

Here is a summary on the safety of scalp cooling:

Safety of Scalp Cooling in the Management of Chemotherapy-Induced Alopecia

As a result of the use since the 1970's of scalp cooling for the reduction of chemotherapy-induced hair loss, the side-effects associated with scalp cooling are well known.

Short- to Medium-Term Side Effects

Known short- to medium-term side effects recognised as being associated with scalp cooling include:

  • cold discomfort (during scalp cooling);
  • headache (during and after scalp cooling);
  • forehead pain (during scalp cooling) caused by pressure and tightness of the cooling cap;
  • dizziness or light-headedness (during scalp cooling);

All of the above occur during the scalp cooling process, are transient in duration and are generally recognised as presenting a low risk of harm (although in some cases, patients have discontinued scalp cooling because of these effects).

Of more clinical significance are the potential consequences of scalp cooling in patients who suffer from either:

  • Cold urticaria - an allergic reaction to cold temperature which results in welts on the skin. There is a risk that scalp cooling could elicit a severe anaphylactic reaction, which can be life-threatening; or,
  • Cold agglutinin disease - individuals with this condition have high concentrations of circulating antibodies to red blood cells. There is a risk that scalp cooling could cause the low-temperature binding of these antibodies to the patient's red blood cells, potentially resulting in haemolytic anaemia.

Scalp cooling is typically contraindicated in individuals known to be, or suspected of being, affected with either of the above conditions.

Long-Term Side Effects

The only known potential long-term side-effect of scalp cooling is also the most controversial one; this is that scalp cooling, when used on patients receiving chemotherapy for breast cancer, could lead to an increased incidence of scalp metastases (because the same mechanisms that restrict the effectiveness of the chemotherapeutic agent against hair follicle cells in the scalp will also restrict its effectiveness against cancerous tissue in the scalp).

Concerns over the risk of increased incidence scalp metastases following scalp cooling and the lack of long-term safety data from published scalp cooling studies to address this risk led the US FDA in 1990 to ban the commercial distribution of cryogel caps in the USA for the purpose of scalp cooling.

However, in the time since the FDA ban on cryogel caps, a number of oncologists have published studies specifically aimed at investigating the long-term incidence of scalp metastases following scalp cooling. In a review of scalp cooling by Grevelman and Breed [1] that included 56 studies and approximately 2,500 patients across 56 separate studies, scalp metastasis was reported in just nine patients (0.36%). In a total of 24 of the 56 studies reviewed, specific attention was paid to the risk of scalp skin metastases following the use of scalp cooling. It was reported that no scalp skin metastases were found in 16 of these studies. The follow-up time of the studies included in the review varied from 2 months to 63 months.

In 2006, Christodoulu et al [2] reported on a series of 227 breast cancer patients who underwent scalp cooling with a cold cap while receiving chemotherapy.. Two of the breast cancer patients (0.88%) developed scalp metastases. Both of these patients had advanced cancer with multiple metastatic sites. Although the follow-up period for this study was not specified, the authors concluded that "the incidence of scalp metastases in patients using scalp cooling methods during chemotherapy is low and it does not seem to influence the clinical outcome."

In a prospective multicentre study by Spaeth et al [3], 911 cancer patients were included from 2002 to 2006. . Eight hundred and seventy-six of these patients were women, most with localized or advanced breast cancer, whom were treated with adjuvant chemotherapy or palliative chemotherapy. There were 770 cancer patients who chose chemotherapy with scalp cooling and 141 who chose to have chemotherapy without scalp cooling. During the follow- up, a minimum time of at least 2 years, there were one cutaneous scalp metastasis and two subcutaneous scalp metastases occurring among the patients who had scalp cooling, and no scalp metastases among the patients who abstained from scalp cooling. The brief report does not give any indication of what kind of primaries the three patients with scalp metastases had, or if the chemotherapy was given as adjuvant treatment or as palliative treatment for advanced disease involving other sites of metastases.

In 2009, Lemieux et al [4] reported on a retrospective cohort study of women diagnosed with invasive breast cancer between June 1998 and June 2002 at a single institution in Quebec. Scalp cooling was routinely offered to women with breast cancer. Of a total of 640 patients included, 86.4% received scalp cooling during neoadjuvant or adjuvant chemotherapy. Six patients (1.1%) in the scalp cooling group developed scalp metastases (with or after the diagnosis of metastases to multiple other sites), along with one patient in the control group (1.2%). The rate of scalp metastases in the scalp cooling group and the control group was not statistically different. In this cohort, scalp metastases never presented as the sole metastatic site and these patients with scalp metastasis had widely metastatic disease. See table 1 below for details of the 7 patients with scalp metastasis.

scalp-cooling-table-1

Rugo and Melin [5] analysed all the literature to date in a correspondence . This included a 1972 study by Browstein and Helwig where metastatic sites were identified in a study of 167 women with breast cancer and cutaneous metastasis who did not receive chemotherapy. The incidence of scalp involvement in these women with cutaneous metastasis was only 3%. The authors also emphasized that the scalp metastasis in women with breast cancer usually occurred late in the disease. Furthermore Rugo and Melin, looked at three studies from 1976 to 2009, involving a total of 2,697 breast cancer patients who received chemotherapy without scalp cooling and who were followed up for around 5 years; the incidence of scalp metastases ranged from 1.2% to 2.5% (while the incidence of all skin metastases ranged from 24% to 30%). When breast cancer is metastatic and involves the skin or scalp, the breast cancer is usually widespread and it would be exceedingly rare to have breast cancer recur with the scalp as the only site of metastatic disease. It is also exceedingly rare for scalp metastases to be the first site of recurrence in breast cancer patients.

In consideration of scalp metastases as the first site of recurrence of cancer, Rugo and Melin looked at reference data from the National Surgical Adjuvant Breast and Bowel Project (NSABP), involving 7,800 women with breast cancer treated with surgery alone or combined with chemotherapy (Rugo 2010). Of these 7,800 women, only 2 (0.025%) experienced scalp metastasis as their first site of recurrence. Both of these patients had positive lymph nodes and one of them had received adjuvant chemotherapy. It is not mentioned in the correspondence how many of these women had skin metastases or scalp metastases. Rugo & Melin's expert opinion was "that scalp cooling can and should be offered to breast cancer patients who will be treated with adjuvant chemotherapy, and also those who are offered palliative chemotherapy associated with a significant risk of alopecia. The risks involved appear to be extremely small and the potential gain for the large number of women receiving adjuvant chemotherapy for breast cancer in the United States is substantial.

  1. Grevelman EG, Breed WP. Prevention of chemotherapy-induced hair loss by scalp cooling. Ann Oncol, 2005; 1
  2. Christodoulou C, Tsakalos G, Galani E, Skarlos DV. Scalp metastases and scalp cooling for chemotherapy-induced alopecia prevention. Ann Oncol, 2006; 17(2): 350
  3. Spaeth D, Luporsi E, Weber B, Guiu S, Braun D, Rios M, Evon P, Ruck S. Efficacy and safety of cooling helmets (CH) for the prevention of chemotherapy-induced alopecia (CIA): a prospective study of 911 patients. J Clin Oncol, 2008; 26 (20 Suppl): 9654.
  4. Lemieux J, Maunsell E, Provencher L. Chemotherapy-induced alopecia and effects on quality of life among woman with breast cancer: A literature review. Psychooncology, 2008; 17(4): 317-328. 5. Rugo HS, Melin SA.
  5. Expert statement on scalp cooling with adjuvant/neoadjuvant chemotherapy for breast cancer and the risk of scalp metastases, April 2010 [personal communication].

Radiation Therapy

Methods of treatment vary according to the type of cancer, stage and general physical condition of the patient. Surgery, radiation, chemotherapy or combinations thereof may be used to treat the disease.

Our treatment is underpinned by a holistic approach to our patients, and their condition and our ability to treat and care for them under one roof. Through an array of skilled medical professionals with extensive experience in cancer and its management, we offer the following services:

  • Confirmation of a diagnosis
  • Advice on available treatment options
  • Referral to a Medical Oncologist on site, should you require concurrent treatments such as chemotherapy
  • A referral to a wide range of surgeons and other specialists for a multi-disciplinary approach to treatment
  • Supportive care in between your treatments and upon completion
  • Counselling for you and your family: We have an Oncology Social Worker onsite who will help you and your family to cope with the new diagnosis, its treatment and the cancer journey ahead.
  • We work very closely with a palliative care team to assist our patients with pain management and palliative-symptomatic care.

What is brachytherapy?

Brachytherapy, also known as internal radiation, is a type of radiation treatment performed for the treatment of cancer. The treatment involves the delivery of high doses of radiation to specific areas of the body.

The procedure can be used to treat a number of types of cancer, including cancers of the brain, breast, head, neck, pancreas, prostate and skin, among others.

How does it work?

Before brachytherapy begins, your oncologist may perform scans and imaging tests to prepare for the treatment.

During the treatment session, radioactive material is placed inside the body in one of a number of ways, including:

  • Intracavity brachytherapy
    During this treatment, a device that contains radioactive material, such as a tube or cylinder, is placed inside a body cavity. The device is placed either by hand, or with a computerised machine.

  • Interstitial brachytherapy
    A device containing radioactive material is placed into the body tissue, such as the breast or prostate. The radioactive material may be contained in tiny seeds or wires, which are inserted into the tissue with the use of special applicators. In some cases, the material may be administered through catheters.

Brachytherapy can be delivered in either a high or low dose, depending on your specific needs. During high-dose brachytherapy, the radioactive material is placed in the body for a short period only. You will be positioned on the treatment table and the radiation device will be inserted into your body. The procedure will take around twenty minutes, after which you will be able to go home.

During low-dose brachytherapy, a low dose of radiation is released into the body over a longer period of time. Radioactive material is inserted into the body, sometimes by means of a surgical procedure. After a few days, the radioactive material is removed from the body.

What is a CT scanner?

CT scanners refer to the highly specialised equipment used by your oncology team to properly visualise your cancer and the surrounding structures in the treatment area.

How do they work?

During the treatment planning session, you will meet with your radiation therapist, who will guide you through the process and answer any questions you may have.

Your treatment planning scan will be done on a machine that simulates the treatment experience, in the CT scan room, where you will lie on a special scanner couch. You will be placed in the same position in which you will receive treatment. Your radiation therapist will take various measurements of your body, which will help to determine the best position for the radiotherapy treatment beams.

Your radiation therapist will then leave the room to operate a specialised CT scanner, which will be used to plan the correct dose of the radiation treatment, depending on the size, shape, and position of your tumour. The CT scanner has a large hole in the centre, and as the scanner rotates around your body, the examination table slides back and forth through the hole. The scan itself is painless, and you will not feel any discomfort during this treatment planning session.

Specialised CT scanners can produce 3D scans and computer images of the tumour and surrounding areas, which are very helpful in the treatment planning process. Being able to see a tumour in so much detail allows us to direct the radiation very precisely with minimal damage to surrounding tissue and organs.

When the radiation treatment planning is complete, special marks or temporary tattoo's will be made on your skin to ensure that you are correctly positioned for each treatment session. You will be given a treatment start date as soon as the treatment planning and authorisation has been completed and approved. This process takes approximately 5 working days, however, treatment can start immediately if your oncologist feels that this is necessary.

What is external beam radiation therapy? External beam radiation therapy refers to a type of cancer treatment, which makes use of high-energy rays to target tumours inside the body. Because the rays are so accurate, healthy tissues surrounding the tumour are not damaged during treatment. External beam radiation therapy is typically administered in several sessions over a period of a few weeks.

What types of external beam radiation therapy are available? There are a number of types of external beam radiation therapy. These include:

  • Three-dimensional conformal radiation therapy (3D-CRT)
  • During this treatment, radiation beams are delivered from various directions to accurately match the shape and size of the tumour being targeted.
  • Image guided radiation therapy (IGRT)
  • Before this radiation treatment begins, imaging scans are performed, allowing your oncologist to focus the radiation as accurately as possible.
  • Intensity modulated radiation therapy (IMRT)
  • During this treatment, the strength of the radiation beams is adjusted according to the area that is being targeted. Certain parts of a tumour may receive higher doses of radiation than others.
  • Helical-tomotherapy
  • Radiation is delivered to the tumour at different angles around the body, allowing for extremely precise treatment.
  • Proton beam radiation therapy
  • Proton beams are used to kill cancerous cells with minimal damage to healthy tissues.
  • Stereotactic radiosurgery
  • A large dose of radiation is delivered to a small area of a tumour, usually to treat brain cancer.

How does the treatment plan work? External radiation beam therapy is planned and administered by a team of experienced healthcare specialists. Your oncologist will explain the dose of radiation you require, as well as the treatment schedule best suited to your particular circumstances.

Before the therapy begins, your oncologist will perform a thorough physical examination. Some imaging tests will be performed in order to define the exact area of treatment, so that the radiation can be delivered very precisely.

What is intensity-modulated radiation therapy (IMRT)?

Intensity-modulated radiation therapy (IMRT) is a type of radiotherapy that makes use of linear accelerators, which are controlled by computers. The linear accelerators are devices that are designed to deliver very accurate and precise doses of radiation for the treatment of tumours. During IMRT treatment, the radiation conforms to the size and shape of the tumour, and the dose of radiation is delivered in varying intensity, depending on the area that is being targeted. This means that the radiation is focused on the tumour with extreme precision, with minimal damage to surrounding healthy tissues.

How does it work?

IMRT is most commonly used for the treatment of prostate, head and neck cancer and can be useful at any site where the tumour is of an irregular shape or lies close to normal tissues. Before the treatment begins, it is carefully planned with the use of 3D CT and MRI scans. These images allow your oncologist to determine the optimal radiation dose for the exact size and shape of the tumour.

The treatment works by preventing cancerous cells from dividing and growing, in turn slowing down or inhibiting the growth of tumours. In some cases, the therapy is successful in completely destroying cancer cells and eliminating whole tumours.

Your oncologist will position you comfortably on the treatment table. Imaging tests may be used to help ensure that your position is correct before treatment begins. The linear accelerator (also known as LINAC) is used to deliver radiation beams to the area of the tumour from various different angles. Depending on your treatment plan, the intensity of the beams will be adjusted according to the area that is targeted.

Are there any side-effects?

The treatment is painless, and you should not feel any discomfort during the session. Some patients experience radiation side-effects after the treatment, including hair loss, digestive problems, headaches, nausea, vomiting, swelling in the treatment area, and urinary and bladder changes.

What is a multidisciplinary forum?

A multidisciplinary forum for breast, head, neck and gynaecological cancer refers to a team of specialised healthcare professionals who work together, each with a different role, to assist in the treatment of cancer patients. The multidisciplinary team is made up of different specialists in the field, and each professional provides some level of support, be it surgical, practical, or emotional. Each case is discussed at these meetings and a treatment plan is recommended that will be personalised for your condition.

Who makes up the team?

In most cases, a multidisciplinary forum will include the following healthcare professionals:

  • Oncologist
    Your oncologist will specialise in the treatment of cancer, and will play a key role in planning treatments such as radiotherapy, chemotherapy and hormone therapy.

  • Surgeon
    Your surgeon will specialise in the specific cancer for which you are being treated, and will perform any surgical procedures necessary for the diagnosis and treatment of your illness. For head and neck cancers, dentists and maxillofacial surgeons are also involved.

  • Physician
    Your physician will specialise in the area of the body in which your cancer is located, and will work closely with your surgeon in the diagnosis and treatment of your illness.

  • Clinical nurse
    Your clinical nurse specialist will play an important role in your treatment process, and will have particular expertise. In some cases, your nurse will visit your home, and may specialise in specific types of cancer such as breast, head and neck cancer.

  • Oncology social worker and counsellor
    Your oncology social worker and counsellor are available to answer questions honestly and lend an ear when it is needed. In this way, you will receive the aid you need to deal with the realities of your illness and put coping mechanisms in place.

Physiotherapist, speech and swallowing therapists

Sometimes, head and neck cancers cause changes to speech and swallowing, in which case speech and swallowing therapists are available to assist with rehabilitation.
Patients with breast cancer may require the help of a physiotherapist, particularly after radiation treatment. Your physiotherapist is able to put together an exercise program to help restore flexibility to the arm and shoulder.

What is stereotactic radiosurgery?

Stereotactic radiosurgery refers to a type of non-surgical radiation treatment. During this type of cancer treatment, radiation is delivered in large doses to a small area of the body. It is commonly used for the treatment of brain tumours. Other cancers with early metastatic progression can benefit from this form of treatment as well.

How does it work?

During the treatment, your head will be placed in a special frame designed to keep it still. With the use of brain scans, your oncologist will be able to identify the area in which the radiation is required. The radiation can then be delivered very accurately to the area of the tumour, damaging as little surrounding healthy tissue as possible.

There are a number of ways in which stereotactic radiosurgery may be administered. These include:

Gamma Knife

This specially designed tool delivers small beams of radiation to the tumour from different angles. A large dose of radiation is delivered in a very short period, and in most cases, only one treatment session is necessary.

The treatment involves several stages, including the placement of your head in a frame; imaging tests to determine the exact location of the tumour; computerised dose planning, in which the correct dosage is determined; and the delivery of radiation.

The treatment is painless, and you should not feel any discomfort during the session.

Linear Accelerator

This is the most common means by which stereotactic radiosurgery is conducted. A linear accelerator (also known as LINAC) is a device that is controlled by a computer. It works by conforming to the tumour's exact shape and destroying the diseased cells without damaging surrounding tissue. Similar to the Gamma Knife, the treatment involves the placement of your head in a frame; imaging tests to determine the exact location of the tumour; computerised dose planning; and the delivery of radiation. During the treatment, the LINAC device rotates around the body, delivering radiation from various angles.

In most cases, this type of radiation treatment is limited to one session, but your oncologist will advise you should you require a repeat session.

Psychosocial Care

What is a survivor run support group?

DMO facilitates a survivor centre that is run by our patients, for our patients. Cancer impacts patients and their families profoundly. Here, patients get to soundboard, share with and encourage each other. The group is designed to help patients cope with the emotional issues associated with dealing with cancer, and is a safe space in which people are able to discuss their feelings, experiences and challenges with those who have been in similar situations.

Why join a support group?

Dealing with cancer often stirs up a range of emotional responses, and even those with supportive family members and caregivers may need to seek additional support from survivors with whom they can relate.

While support groups can provide the opportunity to share experiences, they can also be useful spaces in which to discuss practical information, including what to expect from certain treatments, how to deal with radiation side-effects, and what kinds of questions to raise with one's healthcare team.

You may choose to join a support group at any stage in your experience, including:

  • Diagnosis
    At the diagnosis stage, you may have a lot of questions about your illness, and may need support as you make decisions regarding your treatment options.

  • Treatment
    Going through treatment can be very stressful, and some patients find it helpful to share the experience with others. Practical advice about managing pain and side-effects can also be discussed at support groups.

  • After treatment
    It is common to feel different after your treatment is complete, both emotionally and physically. In some cases, certain health issues may arise after treatment. These include changes in sleep patterns, fatigue, pain and nerve damage. It can be helpful to share these experiences.

If you are interested in finding a survivor run support group, speak to your healthcare team. Your oncology social worker will be able to give you more information about the best group for your needs, and answer any questions you may have about the benefits of seeking support.

What is an oncology social worker?

Our oncology social workers and counsellors are available to walk the cancer journey with our patients and their families, answer their questions honestly and lend an ear when it is needed. In this way, our patients receive the aid they need to deal with their realities and put coping mechanisms in place.

They are qualified to assist with a wide range of issues associated with the illness, including those of a social and physiological nature. Our oncology social workers are also involved in research surrounding cancer, and can help to recommend useful resources for patients, families and caregivers.

At Sandton Oncology, we strive to provide a professional, compassionate and supportive environments of care; and to do so in a sustainable and conscientious manner. In keeping with this vision, our oncology social workers work hard to provide a treatment environment that upholds the dignity of our patients and that is supportive of their needs, from both physical and psychosocial viewpoints. Our patients are at the centre of what we do, and providing psychosocial care is an integral part of the recovery process.

Why see an oncology social worker?

The experience of dealing with cancer can be very stressful, and it can be helpful to consult with a professional who is able to address any questions and concerns you have along the way.

Oncology social workers are available to provide counselling, either on an individual basis, or within a support group. They can also help with practical considerations, like finding services to help with transport and home care. Having someone to assist with these types of issues can go a long way in alleviating some of the stress and fatigue that comes with dealing with your illness.

They are also experienced to assist you with some of the day to day issues that you may be dealing with for the first time, for example: medical boarding and temporary disability processes.

Value added

At Sandton Oncology, we continuously strive to expand on our Patient-focused services. When receiving prescriptions from your Oncologist, whether it be through your treatment plan or through your follow up journey, Dischem+ is conveniently located at the centre where you are welcome to take your prescription for the dispensing of the required medications, right after seeing your Doctor.

This eliminates the need to travel to a further location to fulfill your medication needs, and the Dischem+ at our location stocks additional oncology related medications that you may not always find at your local pharmacies. This is yet another way that we minimize our patients stress in an already difficult journey.

Local Patient Authorizations

Once a patient is seen by our Doctors, and a decision regarding treatment is made, the treating Doctor prepares a prescription and that is uploaded into an Oncology focused form which includes the patient's details, relevant pathology, stage of disease and the therapy prescribed. This information is submitted to the patients' medical scheme, to an Oncology focused contact that will process the treatment request within the medical scheme's oncology department. It is at this stage, that the patient is loaded onto the Oncology programme to receive treatment funding.

Authorisation can take 2 -3 working days whilst been processed at the Medical Aid. It generally takes one day after authorisation for the treatment to be delivered to our Centre. Only then can the treatment commence. If and when there are any rejections, the proposed treatment plan will be submitted to a third party who will review the motivation and provide an opinion. A mechanism of appeal is available in those circumstances.

Medical Aids on the whole do not require the patient to follow up on this process. Our Authorisations department will keep in contact with the patient, as to the status of their authorisation process.

Again, please remember that your Oncologist will start your treatment should there be a clinical urgency. Potential authorisation delays will be navigated in discussion with you. You are at the centre of our focus through all parts of our journey with you.

Foreign Patient Authorizations

Private patients or non-medical scheme patients, both local and foreign, who wish to receive treatment at our centre are most welcome to come and see us. We request that you forward the following documents: A doctor's referral letter, along with relevant diagnostic reports such as: Histology results, radiology reports, blood test reports. Upon receipt, we will review the submitted documents and proceed to set up an appointment with you.

Further tests may be requested, such as blood tests, CT scans, etc, at or before your visit to the Centre. If any treatment is recommended by your attending Doctor, a quotation with detailed costs will be provided. Consultation fees are paid for on the day of your visit to the Centre.

Special arrangements and discounts can be discussed with the Doctors and the Accounts Department.

In addition to the sub-acute wards, the wards feature a unique rehabilitation suite that includes a state of the art gym and washroom that has been specially designed for patients with restricted mobility.

Our oncology trained specialists from Rehab Matters, assist patients with numerous services such as occupational therapy, physiotherapy, speech and swallow therapy, to name but a few.

These value-added services ensure that we aid our patients with optimal, specialized recovery to get them home to their loved ones as soon as possible.

Again, your treating Oncologist will assist you with the referral for such services as and when needed through your cancer care journey.

Our Medical Oncologist, Dr Keo Tabane, in collaboration with Rehab Matters will be starting an oncology focused rehabilitation class that will focus on the unique needs of our Oncology patients when it comes to fitness, health and wellness through and after the cancer journey.

Follow our newsfeed to look out for more information on this topic in the coming months.

What shuttle services are offered?

Patients who are on daily radiation treatment programmes and who have both transport and financial constraints are supported through a transport solution. The need for this service is assessed during the initial consultation process.

Our shuttle service initiative is offered in line with our mission to provide a compassionate and supportive treatment environment that upholds the dignity of our patients and that is supportive of their needs, from both physical and psychosocial viewpoints. We understand that the treatment process can be stressful, and it is our aim to minimise this stress wherever possible.

Our Medical Oncology department offers such services to patients on clinical trials as well.

How does it work?

We offer transport from your house to the centre and return on a daily basis while on treatment. The times for collection and return are determined by the demand for this service and location. It may mean that you have to spend some time in the centre waiting for other patients to complete their treatment.

At the 200 Rivonia Medical Centre, Sandton Oncology is enabled to extend value added services through its partners, such as Intercare, at the location. These services include sub-acute day wards run by experienced nursing employees that provide the extra amount of care, that our oncology patients may require from time to time, when admitted for various care needs whilst undergoing treatment.

The sub-acute wards feature executive one-bedroom suites and well as spacious four bed suites with modern features tailored to every need. The bathrooms are well designed to accommodate wheelchair and mobility challenged patients. Adjusted mirrors and hand basins and sensor triggered lighting are just a few of the unique features that will make your stay all that more comfortable.

Your treating Oncologist will assist you with the admission process through your cancer care journey as and when needed.

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