How Palliative Care Can Smooth Your Cancer Journey

We’ve written a lot about palliative care in the past here on the Regency Blog. As an example, here is a detailed post about the difference between palliative care and hospice care.

As a quick recap, palliative care is an area of healthcare that focuses on relieving and preventing the suffering of patients. This is care given in conjunction with curative medical care, most commonly for cancer. The patient will see an oncologist or other doctor to treat and hopefully cure his cancer, and will also see a palliative care specialist to help manage pain and other unpleasant side effects from the disease and its treatment.

Hospice care, on the other hand, is a philosophy of care that focuses on relieving a terminally ill patient’s symptoms. On hospice care, the patient typically discontinues all curative care, and focuses on physical, emotional, and spiritual support during the last months and weeks of their life.

In short: Palliative care is an important part of the hospice program, but it is also a level of care on its own. Anybody suffering from any uncomfortable disease can benefit from palliative care.

How Does Palliative Care Help With Cancer?

A cancer diagnosis is overwhelming and frightening. Most of the time you need to act quickly against the cancer, and you’re plunged into a world of treatments, pain, and other uncomfortable symptoms.

Palliative care can help maximize your quality of life and peace of mind during the turbulent ride of cancer treatment. Your expert palliative care providers can offer effective pain relief, symptom management, improved communication, and emotional support while you navigate your cancer. The team also extends support to the patient’s loved ones who are also hurting.

The care team usually consists of a doctor or nurse practitioner, a social worker, and a spiritual care provider such as clergy.

Says Dr. Rebecca Burke, palliative care specialist at Rutgers Cancer Institute of New Jersey, “Palliative care is appropriate at any stage of a cancer diagnosis and can be provided along with curative treatment. The oncology team may refer patients to meet with the palliative care team due to worsening pain, uncontrolled symptoms, or for extra support when facing serious illness.”

Dr. Burke provides palliative care to outpatients at Rutgers Cancer Institute, as well as at Robert Wood Johnson University Hospital in New Brunswick. Her team helps cancer patients manage pain, control nausea, deal with anxiety, and many other issues.

“A growing body of research shows that early consultation with the palliative care team leads to improved pain and symptom management,” Dr. Burke says. “Some studies have even shown improved survival when palliative care is provided early in the course of cancer care.”

Introduction to Wound Care

Nicked your finger on the edge of a paper or got a nasty bruise after bumping into a doorknob? Your body has the incredible ability to heal itself. Clotting cells in your blood, called platelets, mobilize at the scene of an injury, and get to work repairing small wounds in a fascinating natural process.

But what happens when you have a very large wound? Say it’s a bedsore or advanced diabetic wound that just won’t heal on its own. In that case, you need wound care.

What is Wound Care?

Wound care is a set of various treatments for pressure sores, diabetic foot ulcers, burns, and other wounds. Some of the most common wounds that require specialized wound care are pressure sores, or decubitus ulcers. Pressure sores develop in bed-confined individuals when too much weight presses against a pressure point for too long. This is typically on the buttocks, elbows, heels, and ankles. Other common wounds are diabetic ulcers—wounds that develop in patients with diabetic neuropathy. We talked about neuropathy at length in a previous blog, but the gist of it is that some people with diabetes develop a condition where they lose sensation in their extremities. When that happens, they may not notice an injury to their foot until it develops into a serious wound.

Treatment of Pressure-related Ulcers

If the ulcer is pressure-related, the main goal is to reduce or eliminate pressure right away, before the wound deteriorates. This can involve:

  • Turning the bed-confined  patient at regular intervals
  • Introducing a special surface, like an egg-crate or gel mattress, that alternates pressure points and reduces friction
  • The use of specialized beds that relieve pressure by constantly moving air through the cushioning

Treatment of Advanced Wounds

If the wound is not treated, infection and necrosis can set in. Wounds are typically rated in four stages. The lower the stage, the more superficial the wound. Treatment for stage I and II ulcers involves keeping the wound clean and moist, and making sure the surrounding area is clean and dry. Wet skin is more prone to turning into an ulcer. Wound care nurses will use saline washes, povidone iodine, or sodium hypochlorite to keep the wounds clean and sterile.

More serious wounds, in stage III and IV, will benefit from more advanced treatment. This commonly includes:

  • Hyperbaric Oxygen Therapy: This treatment saturates the body with oxygen. The patient rests in a pressurized chamber of oxygen for up to two hours, absorbing 100% oxygen into their bloodstream. The extra oxygen increases healing capability at the wound site, and clears bacterial infection. This type of treatment is generally available at hospitals, such as Robert Wood Johnson in New Brunswick.
  • Topical or oral antiobiotics: If the wound is already infected or there is concern of infection, the patient’s doctor may recommend antibiotic treatment. This can be administered orally in pill form, or topically, via anti-bacterial lotions.
  • Debridement: This is a surgical procedure that removes dead tissue via scalpel or chemical agents. Removing the dead, or necrotic, tissue allows for the growth of new, healthy tissue. Since debridement involves blood loss, it’s often not an option for anemic patients or patients with other blood conditions.

Regency Nursing’s Excellent Wound Care Programs

While we’ve only touched on the basics of wound care, you can learn more about wound care by talking to our expert staff in any of our Regency facilities. Regency Nursing’s wound care specialists work hand-in-hand with patients and their doctors to maximize wound healing. To learn more, feel free to contact us here.



Area Hospitals Earn Superior Grades

We at Regency Nursing are thrilled to report that our local hospitals have by and large earned A’s on their safety report card in April 2018. The report was released by Leapfrog Hospital Safety Grades, an initiative to improve health care in hospitals nation-wide.

Our area hospitals are important partners in our residents’ health care, and it’s great to know we have these quality facilities close by. We salute the top-graded hospitals, and their commitment to safety, and we wish them continued success in excellent patient care.

About the Leapfrog Hospital Safety Grades

The Leapfrog Group, a national nonprofit organization dedicated to improving health care, began assigning grades to hospitals in 2012. They issue a report twice a year—in April and October—grading each hospital on an A–F scale. The Spring 2018 grades came out this morning, and 22 hospitals in New Jersey earned an A.

An A means the hospital is above average in most areas of patient care and outcomes. The grade does not measure doctors’ care; rather, it tells you how safe the hospital’s staff will keep you or your loved one. Leapfrog’s criteria include doctor and nurse staffing ratios, the number of post-surgical infections, and the rate of blood clots.

Some hospital officials maintain that Leapfrog’s methodology is too simplistic and doesn’t take the most up-to-date information into account. However, the report has become a valuable tool in educating the public and raising awareness about hospital safety.

While the survey downgraded New Jersey’s overall ranking to 17th from 11th place, we are still home to many top-ranked hospitals in patient safety.

Which hospitals earned an A

Bayshore Medical Center in Holdmel, just two miles from Regency Park, made the grade, as did Riverview Medical Center slightly farther away.

Regency Gardens in Wayne has five A-rated hospitals within a 20 mile radius: Hackensack University Medical Center, Clara Maass Medical Center, Holy Name Medical Center, Saint Barnabas Medical Center, and The Valley Hospital. Of note, Saint Barnabas—also around 20 miles from Regency Grande in Dover—earned an A on every single report card since Leapfrog started issuing them in 2012. They are the only hospital in New Jersey with this distinction.

Morristown Memorial Hospital, just 12 miles from Regency Grande, also made it to the top 22. Robert Wood Johnson University Hospital in New Brunswick, while not earning an A in the Leapfrog survey, landed near the top with a B grade. That means it’s average in some areas, and above average in others.

Here are New Jersey’s top 22 hospitals, listed in alphabetical order:


Proton Therapy Gains Popularity in NJ

Doctors first used proton therapy to treat cancer in the 1950s, but it only started gaining popularity in the 1990s, when the first hospital-based proton therapy center opened.  What is this revolutionary cancer treatment, how is it different from traditional radiation, and is it appropriate for your loved one suffering from cancer?

How Radiation Therapy Works

According to, the website of the American Cancer Society, radiation treatment “uses high-energy particles or waves to destroy or damage cancer cells.” It works by breaking the DNA in cells, which makes it harder for them to multiply. Rapidly dividing cancer cells are particularly susceptible to this kind of damage, so tumors often shrink or disappear.

Radiation therapy is a localized treatment, unlike chemotherapy, which affects the whole body. The therapy aims radioactive waves at the specific area where the cancer is located. The goal is to limit the damage to the healthy cells in the body, but with traditional radiation therapy, the entire target area is at risk.

How Proton Therapy is Superior

The difference between traditional radiation and proton therapy is in how the radiation is delivered. Traditional therapy sends a  dose of radiation that affects all the tissue in the wave’s path. Proton therapy uses beams of protons—charged subatomic particles that can be controlled with magnets. It uses a small amount of radiation, and most of it goes directly into the tumor. None of it passes through the other side.

An example of how this works is that proton radiation aimed at a spinal tumor wouldn’t reach the heart or lungs, as it would with traditional radiation. Or if the tumor is one part of the brain, the other half would remain unaffected from the treatment.

In addition, because the radiation is more focused, and more of it reaches the tumor, you can use a smaller overall dose. This further limits the radiation damage to healthy cells. Another benefit of proton therapy is that patients must hold still for only seconds at a time, compared with minutes for traditional radiation. An entire treatment takes just a couple of minutes. As with other types of radiation, patients go for treatment once a day, five days a week, for five to eight weeks.

Who Benefits from Proton Therapy

Children with cancer benefit most from proton therapy. This is because more of their normal cells are developing rapidly, making them more prone to damage that could stunt the growth of healthy organs. People with tumors in the head, neck, and spine, and those who have cancers near other very sensitive organs, also benefit greatly. The precision of proton therapy protects their organs from radiation damage caused by traditional radiation.

On the other hand, people with certain cancers will not be candidates for proton therapy. Lymphoma, for example, often requires treatment in a wider area around the lymph nodes because of the way the cancer grows and spreads.  Many common cancers fall into a gray area. Patients and their doctors need to weigh the risks, costs and benefits of different types of treatments.

Because of the lack of extensive research, as well as the price, proton therapy is still considered an uncommon treatment for most cancers. There are only 28 therapy centers in operation in the entire country. However, patients who decide, with their doctor’s guidance, to embark on proton therapy are fortunate to have choices right here in New Jersey. Robert Wood Johnson Medical Center provides proton therapy at the Laurie Proton Therapy Center in their New Brunswick campus. In addition, ProCure Proton Therapy Center, located right near Regency Jewish Heritage in Somerset, opened in 2012 as an affiliate of the CentraState Healthcare System.

If you think you or your loved one can benefit from proton therapy, speak with your doctor today. The cure for your cancer could be just around the corner.


Help your Loved One Quit Smoking

cigarette with smoke rising from itDid you resolve to stop smoking in 2018? Do you have a loved one who wants to stop smoking? We’re a quarter of the way into the year, and if you haven’t yet stopped smoking, now’s the time to do it.

Smoking is a significant contributor to many serious diseases, like heart disease, stroke, and cancer. Secondhand smoke also causes health problems for the people around us. Even thirdhand smoke—the chemical residue left on indoor surfaces after someone smoked there—can trigger asthma attacks and other potentially serious reactions.

Our risk for developing diseases and health conditions rises as we age. Smokers are at even greater risk of disease. According to a fact sheet compiled by Robert Wood Johnson University Hospital, the leading hospital for cancer care in NJ, most lung cancers are linked to smoking, and are preventable.

If you have a loved one who smokes and is having difficulty quitting, here’s how you can help them:

Acknowledge that it’s hard.

Quitting smoking is not just ending a bad habit. It’s breaking a serious, entrenched addiction. The best thing you can do for your spouse, child, or other loved one who is struggling with quitting is to acknowledge how hard it is. Most people can’t do it on their own; your relative needs your support.

Create a smoke-free environment

Work with your loved one to remove anything smoking-related from his or her surroundings. Get rid of ashtrays, matches, lighters, and spare cigarettes. Put out air fresheners to cover the smoke smell that may trigger the desire to smoke. Don’t allow visitors or other household members to smoke anywhere near the house. In addition, encourage your loved one to avoid places where he or she might be more likely to smoke.

Prepare for Withdrawal

Nicotine withdrawal, the body’s reaction to stopping smoking, is uncomfortable and may make your loved one grumpy or irritable. Depression, anxiety, and headaches are also common with nicotine withdrawal. It usually takes two weeks for the symptoms to subside fully. Help your loved one get through withdrawal by preparing beforehand. Find activities he or she enjoys to serve as a diversion during that time.

You may also suggest using FDA-approved nicotine replacement therapies, such as skin patches or gum, which offers relief from withdrawal symptoms. Most importantly, don’t take your loved one’s irritable behavior personally. It’s not you—it’s the withdrawal.

Don’t overreact if they smoke once or twice

Most people can’t stop smoking cold turkey. While working hard to quit smoking, it’s fairly common for to give in to an overwhelming urge now and then. A temporary lapse does not mean they’ve quit on quitting. If you find your loved one stealing a puff, empathize with him or her, and then let it go.

Consider joining a Quit Smoking program

Programs such as Robert Wood Johnson’s Tobacco Quitcenter can provide treatment, therapies, and support for aspiring non-smokers. These programs help people understand why they smoke, teach coping skills, and treat withdrawal symptoms. If your loved one is struggling alone, you may want to suggest they find a smoking cessation program near them.

Helping your loved one kick their smoking addiction is hard work that can take months or years of dedication. Remember to keep a positive attitude and empathetic outlook to support your loved one achieve a happier and healthier life.



2018: The Year of the Flu?

This winter is shaping up to be pretty tough on all of us. The weather has been more extreme, and, unfortunately, so has the flu virus. The CDC says flu activity is widespread in all U.S. states except Hawaii, and the projections put the season continuing until May.

Hospitals in NJ are seeing huge increases in flu cases as compared to last year. Bayshore Medical Center in Holmdel reported a 187% increase in flu patients this year. Robert Wood Johnson University Hospital in New Brunswick also confirmed an upsurge in flu admissions in January.

Part of the problem is that the flu strains active this year are particularly aggressive, and the vaccines are less effective than normal. Still, the CDC advises that if you haven’t gotten the vaccine yet, it’s not too late to get it now. This flu season is one of the worst in recent history, and getting the vaccine will offer you an extra level of protection.

Feeling under the weather and not sure if it’s the flu? Here’s a neat little chart from the CDC comparing the symptoms for the common cold and the flu:

chart showing the difference between cold and flu symptoms
Credit: Centers for Disease Control & Prevention