If you have been newly diagnosed with cancer, you may be overwhelmed initially by strong emotions, questions about your care, and concerns about your family and the future. It is normal to feel nervous, scared, sad, and even angry about receiving a cancer diagnosis.

Your reactions may vary day-by-day, and even moment-to-moment. Although your experience is completely unique, it may be comforting to know that other people have successfully made this journey with the help of Alta Bates Summit's collaborative and interdisciplinary team of oncology experts.

• Emotional & Spiritual Care
• How to Accept the Support of Others
• Your Physical Care
• How We Diagnose Cancer
• Understanding Your Pathology Report
• Your Next Steps: Taking Action

Emotional & Spiritual Care

Alta Bates Summit physicians and staff recognize that it’s as important for our patients to care for their emotional health as well as their physical health. In fact, recent research suggests that patients who attend support groups and discuss their experiences with others may have better clinical outcomes than those who did not participate in support groups during the course of their treatment. With this in mind, we offer a variety of cancer education and support programs to complement our clinical care services.

Visit the Complementary Therapy & Support Groups section of our website to find a class or group that fits with your schedule.

The Medical Center also provides Spiritual Care Services through our Chaplaincy Services Department. Hospital chaplains seek to embody compassionate, confidential support for people of all faiths and backgrounds who come to Alta Bates Summit Medical Center. Chaplains (of a variety of denominations and beliefs) are available to all our patients, guests, and employees to provide spiritual/religious services and to support a person's spiritual and religious needs during times of distress or hardship. Use the link above to learn more about the services they provide and how to contact a hospital chaplain.

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How to Accept the Support of Others

During the course of your cancer treatment, friends, family and loved ones may want to lend a hand and offer their support. This may come in the form of a phone call, a card, a visit, a home-cooked meal, or help with household chores. Although you may feel the need to "be strong" for others by rejecting these offers, it is very important that you accept these well-wishes and gestures of support. Here’s why…

A supportive environment will allow you to conserve your mental and physical energy for the activities that are most important to you. Relieving a few of life’s normal daily pressures allows you to focus on your physical health and supports your ability to cope. Friends and family can help to solve simple and not-so-simple daily tasks, such as what to have for dinner, so that you don't have to. Accepting support also brings you closer to loved ones, friends and your community.

Ultimately, accepting the support of others, whether these are gestures of good-will, prayers, or gifts, can help you remember the goodness in life which will promote positive feelings and a positive outlook. Feeling supported helps you cope with treatment, partner with your oncology care team and achieve the health outcomes you desire. So when your neighbors ask if there’s anything they can do to help, remind them that a little chicken soup or some simple TLC (tender loving care) goes a long way towards supporting your health during this stressful time.

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Your Physical Care

The term "cancer" describes a group of normal cells, either in a solid mass or in the blood, that for various reasons, may begin to multiply at an usually fast rate. These fast-growing or overly productive cells disrupt the normal functions of your body and affect the way you feel.

Caring for the needs of your body normally includes the basics: a healthy diet and regular exercise routine. When cancer is present, specialized cancer treatments may become necessary, but a healthy diet and regular exercise will be even more important to your physical health and the way you cope with stress. Always work with your doctor to identify the foods and exercise activities that will best support your unique health considerations.

For eating tips from the National Cancer Institute, visit Eating Hints for Cancer Patients: Before, During, and After Treatment

For exercise tips from the National Cancer Institute, visit Physical Activity & Cancer Fact Sheet

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How We Diagnose Cancer

If you experience symptoms that you believe are the result of cancer, or if a screening test (such as a mammogram) suggests cancer, your doctor will want to diagnose the cause or reason for your symptoms or test results. To do this, your doctor may ask you about your personal and family medical history, ask you to have a physical exam, and they may order lab tests, x-rays, or other procedures to diagnose or rule-out cancer. Below are three main methods used by your doctor to diagnose or rule-out a diagnosis of cancer.

Lab Tests
Tests of the blood, urine, or other fluids from the body can help doctors make a diagnosis. These tests can show how well an organ (such as the kidney) is doing its job. High amounts of some substances may be a sign of cancer. These substances are often called "tumor markers." However, abnormal lab results are not a sure sign of cancer. Doctors cannot rely on lab tests alone to diagnose cancer.

The National Cancer Institute (NCI) offers several fact sheets about lab tests. Go to the NCI Website and click on the "Publications" section to get fact sheets.

Imaging Procedures
Imaging procedures create pictures of areas inside your body that help the doctor see whether a tumor is present. These pictures can be made in several ways:

X-rays: X-rays are the most common way to view organs and bones inside the body.

CT Scan: An x-ray machine linked to a computer takes a series of detailed pictures of your organs. You may receive a contrast material (such as dye) to make these pictures easier to read.

Radionuclide Scan: A small amount of radioactive material is injected through your bloodstream and collects in certain bones or organs. A machine called a scanner detects and measures the radioactivity. The scanner creates pictures of bones or organs on a computer screen or on film. Your body gets rid of the radioactive substance quickly.

Ultrasound: An ultrasound device sends out sound waves that people cannot hear. The waves bounce off tissues inside your body like an echo. A computer uses these echoes to create a picture called a sonogram.

MRI: A strong magnet linked to a computer is used to make detailed pictures of areas in your body. Your doctor can view these pictures on a monitor and can print them on film.

PET Scan: A small amount of radioactive material is injected into your bloodstream. A machine makes pictures that show chemical activities in the body. Cancer cells sometimes show up as areas of high activity.

Endoscopy: A thin, lighted tube is used to examine organs inside the body.

Biopsy
In most cases, doctors need to do a biopsy to make a diagnosis of cancer. For a biopsy, the doctor removes a sample of tissue and sends it to a lab where a pathologist looks at the tissue under a microscope. The tissue sample may be collected in several ways:

With a needle: The doctor uses a needle to withdraw tissue or fluid.

With an endoscope: The doctor uses a thin, lighted tube (an endoscope) to look at areas inside the body. The doctor can remove tissue or cells through the tube.

With surgery: Surgery may be excisional or incisional.
- In an excisional biopsy, the surgeon removes the entire tumor. Often some of the normal tissue around the tumor also is removed.
-In an incisional biopsy, the surgeon removes just part of the tumor.

It is usually a combination of these main methods of testing that your physician will use to either diagnose or rule-out a diagnosis of cancer.

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Understanding Your Pathology Report

When a sample of tissue is removed during a needle biopsy or during surgery, a pathologist will examine it thoroughly. A pathologist is a doctor that examines tissue and cells under a microscope and writes a report to let your doctor know if the cells are cancerous, and provides a detailed description of the sample. This report is intended to be read by your doctor, so it is quite comprehensive and written in medical language.

If the surgeon wants to have the tissue examined while you are in the operating room, it is called a "frozen section." Some initial observations can be reported at this time, but to get a more extensive review, the specimen must be "permanently fixed" which can take 24 hours. The written report usually takes three days to reach your doctor. This is an estimate. Often the pathologist will wish to use special stains or a new section of the tissue which can take additional days. The time needed for an accurate diagnosis does not affect your treatment.

The pathology report describes the sample in great detail and includes:

Gross Description - A description of what the sample looks like to the naked eye.

Microscopic Description - A description of what the sample looks like under a microscope
and a biological evaluation. If the sample does happen to be cancerous, it will contain information about the size of the cancer, the extent of the disease, and the exact type of the tumor.

Size - The classification of the specimen in terms of size.

Invasive vs. Non-Invasive - Once a cancer cell has broken through the membrane of its origin, it is considered to be invasive. Non-invasive cancer is considered in situ because it has stayed within the membrane. Non-invasive cancer cannot spread to your lymph nodes.

Histopathologic Grade - This indicates the type of cancer, the arrangement of the cells and how aggressive the cancer is.

Surgical Margins - The pathologist marks the edges of the sample with ink before cutting it so that when it is examined under the microscope, the closeness of the cancer to the edges of the sample can be measured. This tells the surgeon how close the cancerous cells are to the inked border. Sometimes if the margin is too close to a cancer, more surgery may be needed.

Lymph Node Status - Tumor cells can travel to other parts of the body through lymph nodes and vessels. During surgery, the doctor may remove some of the lymph nodes and vessels to see if the cancer has spread. This part of the report indicates how many lymph nodes were removed and whether cancer cells were found.

Hormone Receptor Status - Some cancer cells can have a high number of estrogen, progesterone, testosterone, or other hormone receptors. The tumor will grow in response to the presence of the hormone. For instance, if a breast tumor responds to the presence of estrogen and/or progresterone, it is considered positive. If the breast tumor receptors are low in number, the cancer is less likely to be stimulated by estrogen/progesterone and considered ER or PR negative. This is an indication to your doctor which therapies will be more effective.

HER2NEU Status - This can be measured in two ways and indicates how sensitive the cancer cells are to a particular growth factor, possibly speeding up their growth. This is reported as a positive or negative attribute and can help identify which therapy will best affect the biology of your cancer cell type.

Lymphovascular Invasion - Cancerous cells can penetrate the blood vessels and/or lymph channels. The rate at which this is occurring can indicate the proliferation of the cancer cells.

Summary and Diagnosis - Just like it sounds, this is the condensed version of the preceding evaluation, which will be reviewed by your doctor.

Medical terminology can be overwhelming, so ask your doctor to review your Pathology Report with you. Different institutions use different formats for the report, and sometimes the information can be confusing. Remember that each cancer is different. The pathology report is a personalized description from which future treatments will be based on - including any other clinical information about your general health.

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Your Next Steps: Taking Action

Those who are newly diagnosed with cancer frequently need to talk to a clinical expert about what to do next. While your physician is always the best person to talk to about your specific treatment plans and options, our cancer programs are equally sensitive to the needs of a newly diagnosed cancer patient and are available to answer your questions and help you get in touch with additional resouces.

Call an Alta Bates Summit Cancer Program
To speak with a program representative about accessing local resources or to get help researching your particular type of cancer, call any of the following cancer programs.

Carol Ann Read Breast Health Center - (510) 869-8735 * Webpages

Comprehensive Cancer Center - (510) 204-1591 * Webpages

Markstein Cancer Education & Prevention Services - (510) 869-8833 * Webpages

You may also consider visiting our "Cancer Articles & Information" webpage to empower yourself by gathering information about your specific condition.

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