US Oncology Research is a national leader in community-based cancer research, bringing patients the latest treatment options close to home through deep clinical expertise and high-quality solutions that help practices efficiently address the complexities involved in executing clinical trials in the community.

Investigators affiliated with US Oncology Research span every cancer type and stage and are dedicated to advancing cancer care. Together, we have contributed to some of the most important developments in cancer treatment, including the approval of 100 FDA-approved cancer therapies. 

Since 1999, more than 80,000 patients have participated in approximately 1,600 clinical trials through practices associated with US Oncology Research.

What is a clinical trial? 

A clinical trial is a research study that uses volunteers as participants to test new therapies for a variety of medical conditions, illnesses and diseases. These studies are designed to find better treatment options for cancer and other serious conditions. 

Why are clinical trials for cancer treatments important? 

There is much to gain from cancer clinical trials. Researchers learn critical medical knowledge that contributes to making progress against cancer. This is used to improve the care of patients. 

The only way that new cancer treatments can be tested to determine their safety and effectiveness before the public can use them is through clinical trials. The cancer therapies that are used today are based on the results of previous clinical trials. 

What are the different kinds of cancer clinical trials? 

There are four primary types of cancer clinical trials:

1. Treatment trials test new medical procedures, treatment combinations or drugs. 
2. Prevention trials search for additional ways to prevent disease in one of two ways. Action studies focus on items such as lifestyle changes while agent studies involve taking a substance like drugs, minerals or vitamins. 
3. Screening trials look for new ways to find a health condition or disease early. Earlier detection can lead to better patient outcomes. 
4. Quality of life trials are designed to find ways that increase the comfort of patients and improve their quality of life. 

How are cancer clinical trials undertaken? 

Researchers and physicians design clinical research trials by developing an action plan or protocol. This protocol outlines what is involved in the study, how it will be undertaken and describes the necessity of each part. 

For each study, there are eligibility criteria that determine who is able to participate in it. Some factors can include medical history, age, gender, current health status and type of cancer. Every physician and researcher involved in the study uses the same protocol. 

What benefits can participants gain from a clinical research trial? 

As a participant in a cancer clinical research trial, you can experience many benefits including: 

• access to new therapies that could be less toxic, more effective and safer than those used today. These promising treatments are not yet available to the public or those patients who are not participating in the study. 
• close monitoring of your health throughout the entirety of the trial.
• playing a proactive role in your care by increasing your options for treating your cancer. 
• contributing to the overall body of knowledge available to cancer doctors and patients. 
• expert medical advice, care and treatment throughout the trial and your treatment. 

What risks could be involved while participating in a clinical trial? 

When deciding if participating in a cancer clinical trial is the right decision for you, keep these possible risks in mind: 

• There might be unknown risks or side effects with new treatments. 
• All of the patient care costs might not be covered by your health insurance or managed care providers. If this is the case, the patient is responsible for them. 
• Though the therapies are promising, they ultimately might not be better than the current treatments for cancer. 
• Studies that are randomized do not allow participants to choose the treatment they receive. 

How are a participant's rights protected? 

Strict ethical and scientific principles govern clinical research trials. All research studies are approved by expert groups at the local and national levels before they are allowed to proceed. 

The institutional review board (IRB) of the research agency involved in the trial is comprised of researchers, doctors, community leaders and other community members. The purpose of this group is to protect the participants' safety by ensuring that the protocol is fair and that the participants are informed of their rights throughout the process. 

Who pays for cancer clinical trials? 

A clinical trial typically generates two types of costs: research costs and patient care costs. Research costs are related to the patient's participation in the trial. While these costs are not usually covered by health insurance, they are often paid for by the sponsor of the trial. Some examples of research costs include study drugs, lab tests and imaging tests. 

Patient care costs are directly related to treating the patient's cancer. This is true whether the participant is receiving standard therapy or is receiving new therapy. Often, health insurance pays for these costs though coinsurance fees and copays apply. Hospital stays, lab tests, and doctor visits are some examples of patient care costs. 

Does the participant still see their primary healthcare provider? 

Yes, because most clinical trials do not offer comprehensive primary care. 

Is a patient required to participate in a clinical research trial? 

During a clinical trial, the patient's participation is always voluntary. Before considering participation in any clinical research trial, you must learn all you can about the study. This includes the benefits of the specific research trial as well as the risks and its overall purpose. 

This is part of your informed consent. Asking many questions and being certain that you understand the answers is an important part of the consideration process. 

What kind of information about a study will a patient receive? 

The research team at Blue Ridge Cancer Care provides you with crucial facts about the study. This information includes the study's purpose, the tests and procedures involved, possible benefits and any anticipated risks. 

Additionally, the doctor, nurse or another staff member will provide you with a written consent form that fully explains the study. If you decide to participate, you'll be asked to sign this form. It's important for you to understand that even if you sign the consent form, you can stop participating in the study at any point in time. 

How can a patient prepare when meeting with the research coordinator or physician? 

There is a great deal of information that is involved with a clinical trial. Try to come prepared with any clinical trial questions that you, or your family members, might have. Doing so allows you to obtain the information necessary to make an informed decision. 

It also might be helpful if you are able to record the discussion. You can do so by bringing your own recording device to the meeting. Another strategy you can also use is to bring a family member or friend with you to the meeting. Not only can they provide you with support, but they can also hear what the research team says to you about the study. 

Can a participant leave a trial once it has started? 

Yes, as a participant in a cancer research trial, your presence is always voluntary. You can stop participating at any time and for any reason. Before doing so, inform the research team about your decision and the reasons you are doing so. 

There are a number of reasons why clinical trial phases are used as part of a cancer clinical trial. The following are some of the most common ones:

• To test new treatments for cancer
• To test existing treatments on cancers of a different type
• To understand how treatments that are already approved can be used for better results in different combinations

What Does the Clinical Trial Phase Mean? 

After being initiated by the lead investigator – who is also the lead physician – a clinical trial is categorized as one of four distinct phases. In most cases, new cancer treatment will move through the three phases known as Phase I, Phase II and Phase III. 

In some cases, a Phase IV clinical trial might not be needed for a therapy. This is most often because this phase isn’t needed to prove that the cancer treatment is effective and safe. 

Phase I

During Phase 1 of a cancer clinical trial, the investigators are testing the study drug for the first time. This is primarily to evaluate if the therapy is safe.

Usually only a small group of participants – between 15 and 30 people – is used. They are monitored carefully throughout the process. A placebo is not part of Phase 1. 

This phase can also be used to gather information about the drug's side effects and the optimal dosage range. It might also explore the ideal delivery method, such as by vein, mouth or another route, for the drug. 

Phase II

Cancer clinical trials that are in Phase II place emphasis on evaluating the drug for its effectiveness at treating a particular type of cancer. While no patient is given a placebo, participants might be placed into specific groups.

If that is the case, each group receives the therapy on a different schedule or using a different dose. This approach is designed to tell the researchers which method works the best and with side effects that are tolerated. 

In most cases, there more participants are used during Phase II trials than Phase I trials. However, there are usually fewer than 100 people involved who have met the researchers' requirements. 

Phase III

During Phase III clinical trials for new cancer therapies, the treatment is carefully compared to those that are already available for the specific type of cancer. Participants during this phase might be grouped together randomly. 

Some participants will receive the new cancer treatment that is being tested while others will receive a therapy that is already being used. In many cases, neither the patient nor the investigators know which participant is receiving which type of treatment. This helps preserve the integrity of the results. 

Phase IV

Once a cancer therapy has already been approved for a particular use, it could move on to Phase IV testing. Typically, these tests involve hundreds – or even thousands – of participants who are followed and evaluated over the course of many years. 

The purpose of putting a cancer treatment through Phase IV of a clinical trial is to determine the effect the therapy has on the patient over the long term. During this phase, the researchers will collect information regarding the patient's quality of life as well as the length of their life. In addition, any long-term side effects that were not anticipated by the researchers will be noted. 

It is also during Phase IV that the investigators might combine already-approved therapies in new ways. After studying these new combinations, the investigators can determine if the patients had better outcomes. 

Clinical Trial Phases Offered at Blue Ridge Cancer Care

Blue Ridge Cancer Care offers clinical trials that are Phase I, II, III and IV trials. However, all patients are informed of the phase of the trial as well as any considerations to keep in mind before agreeing to participate. Contact your cancer care team to learn about any clinical trials that might be right for you. 

Download VSee User Guides for help setting up:

• VSee Patient User Guide - Desktop
• VSee Patient User Guide - Mobile Devices

For technical assistance on VSee, please call  The USON Support desk at  855-345-3375, press 4

The FDA and CDC recently announced guidelines making COVID-19 vaccine booster shots available to eligible individuals, including certain cancer patients and those with immunodeficiencies (please see CDC guidelines below).  Retail pharmacies throughout Southwest Virginia can now administer booster doses without the need for a note from a physician.  If you meet the CDC criteria, you are strongly encouraged to consider a vaccine booster shot through a local pharmacy.

 

Currently, CDC is recommending that moderately to severely immunocompromised people receive an additional dose. This includes people who have:

•        Been receiving active cancer treatment for tumors or cancers of the blood

•        Received an organ transplant and are taking medicine to suppress the immune system

•        Received a stem cell transplant within the last 2 years or are taking medicine to suppress the immune system

•        Moderate or severe primary immunodeficiency (such as DiGeorge syndrome, Wiskott-Aldrich syndrome)

•        Advanced or untreated HIV infection

•        Active treatment with high-dose corticosteroids or other drugs that may suppress your immune response

 

 

• Per CDC guidelines staff, patients, and visitors should continue to wear masks as recommended in all healthcare facilities, therefore masks must be worn at all times in Blue Ridge Cancer Care offices regardless of vaccination status. 

 

• If you tested positive for COVID-19, have symptoms of COVID-19 or have been in close contact with someone who has been diagnosed with or exposed to COVID-19, please notify our office before keeping for your appointment.

 

• Cancer patients may have compromised immune systems.  To limit the risk of exposure, BRCC has a NO Visitor Policy.  Exceptions will be made for a new patient's first visit with their physician.

 

• The health and safety of the Blue Ridge Cancer Care community is our top priority. We continue to monitor COVID-19 closely, and you can find the latest information on the Centers of Disease Control and Prevention (CDC) website.

Roanoke Valley

 

ARCH

404 Elm Ave SW

Roanoke, VA 24016

(540) 344-8060

https://archservices.org/

 

Bethany Hall (ARCH)

1109 Franklin Rd., SW

 Roanoke, VA 24016

(540) 343-4261

https://archservices.org/

 

Blue Ridge Behavioral Healthcare Access Center

The Burrell Center

611 McDowell Avenue

Roanoke, VA 24016

(540) 343-3007

http://www.brbh.org/

 

Emergency Services

The Burrell Center

611 McDowell AvenueRoanoke, VA 24016

(540) 981-9351

http://www.brbh.org/

 

Crisis Stabilization Unit

Rita J. Gliniecki Recovery Center

3003 A Hollins Road NE Roanoke, VA 24012

(540) 344-6208

http://www.brbh.org/

 

Blue Ridge Independent Living Center

1502 B Williamson Rd NE Roanoke, VA 24012

(540) 342-1231

http://www.brilc.org/

 

Bradley Free Clinic

1240 3rdSt., SW  Roanoke, VA 24016

(540) 344-5156

http://bradleyfreeclinic.com/

 

Carilion Clinic

1906 Belleview Ave., SE Roanoke, VA 24014

(800) 422-8482

https://carilionclinic.org/

 

Carilion Clinic Dental Care

2017 S Jefferson St., Roanoke, VA 24014

(540) 981-7128

https://www.carilionclinic.org/specialties/dentistry

 

Carilion Financial Assistance

1906 Belleview Ave., SE Roanoke, VA 24014

(800) 422-8482

https://www.carilionclinic.org/billing/financial-assistance

 

Carilion Medication Assistance Program (CMAP)

1906 Belleview Ave., SE (Ground Floor)

Roanoke, VA 24014

(540) 981-7647

 

CHIP of Roanoke Valley

1201 3rdSt., SW Roanoke, VA 24016

(540)857-6993

https://chiprv.org/

 

Children’s Trust Roanoke Valley

541 Luck Ave., SW #308

Roanoke, VA 24016

(540) 344-3579

http://www.roact.org/

 

Christian Free Clinic

7330 Roanoke Rd.Fincastle, VA 24090

(540) 353-0509

http://www.christianfreeclinic.com/index.html

 

Christian Soldier’s Food Pantry

728 A Church Ave., SE

Roanoke, VA 24013

(540) 206-3466

 

Roanoke Community Garden Association

1731 Grandin Ave., SW  

Roanoke, VA 24015

Tina Badger-Co-Director, Resource Development

(540) 929-1390

http://roanokecommunitygarden.org/

 

Community Housing Resource Center

339 Salem Ave., SW

Roanoke, VA 24016

(540) 266-7551

https://www.roanokeva.gov/

 

Community-Housing-Resource-Center The Council of Community Service

502 Campbell Ave., SW

 Roanoke, VA 24016

(540) 985-0131

http://www.councilofcommunityservices.org/

 

Dental Health Initiative

302 2nd St., SW

Roanoke, VA 24011

(540) 777-4673

https://www.tapintohope.org/DHI.aspx

 

Roanoke Human Services Department

1510 Williamson Rd., NE 3rd Floor

Roanoke, VA 24012

(540) 853-2591

https://www.roanokeva.gov/372/social-services

 

MedExpress Urgent Care

5610 Williamson Rd. Roanoke, VA 24012

(540) 265-8924

 

Carilion Roanoke Memorial Hospital ER

1906 Belleview Ave., SE Roanoke, VA 24014

(540) 981-7337

https://carilionclinic.org/

 

Goodwill Industries of the Valleys

2502 Melrose Ave., NW

Roanoke, VA24017

(540) 581-0620

https://www.goodwillvalleys.com/

 

FAMIS, Cover Virginia

1-855-242-8282 (Toll free)

http://www.coverva.org/programs_famis.cfm

 

Family Services of Roanoke Valley

360 Campbell Ave., SW

Roanoke, VA 24016

(540) 563-5316

https://www.fsrv.org/

 

Feeding America SW Virginia

1025 Electric RD

Salem, VA 24153

(540) 342-3011

 https://www.faswva.org/

 

New Horizons Healthcare (FQHC)

3716 Melrose Ave., NW

Roanoke, VA 24017

(540) 362-0360

 https://newhorizonshealthcare.org/

 

 

Rosalind Hills Baptist Church

2712 Brandon Ave.

Roanoke, VA 24015

(540) 344-7888

http://www.rosalindhills.org/

 

 

G. Wayne Fralin Free Clinic (Rescue Mission)

402 4th St., SE

Roanoke, VA 24013

(540) 343-7227

 https://rescuemission.net/what-we-do/fralin-free-clinic-for-the-homeless/

 

 

Good Samaritan Hospice

2408 Electric Rd.

Cave Spring, VA 24018

(540) 776-0198

http://www.goodsamhospice.org/

 

*Governor’s Access Plan*

1-855-869-8190

www.coverva.org/gap.cfm.

 

 

Happy Healthy Cooks

1914 Belleville Rd., SW

Roanoke, VA 24015

(540) 314-2375

 Heather Quintana, Executive Director.

 http://happyhealthycooks.org/

 

 

Local Office on Aging

706 Campbell Ave., SW

Roanoke, VA 24016

(540) 345-0451

http://www.loaa.org/

 

 

Total Action For Progress (TAP/Head Start)

302 2nd St., SW

Roanoke, VA 24011

(540) 777-4673

https://www.tapintohope.org/Default.aspx

 

 

Health Department

57 Williamson Rd., NE, 2nd floor

Roanoke, VA 24012

(540) 283-5050

http://www.vdh.virginia.gov/roanoke/

 

 

Healthy Families Virginia

541 Luck Ave. Suite 308

Roanoke, VA 24016

(540) 344-3579

http://www.roact.org/programs/healthy-families/

Homeless Assistance Team

339 Salem Ave., SW

Roanoke, VA 24016

(540) 853-1715

 https://www.roanokeva.gov/348/

 

 

Homeless-Assistance-Team HOPE Initiative

1240 3rd St, SW

Roanoke, VA 24016

(540) 339-9010

http://bradleyfreeclinic.com/services/roanoke-hope-initiative/

 

 

Lead Safe Roanoke

215 Church Ave., SW Room 208 N

Roanoke, VA 24011

(540) 853-5682

https://www.roanokeva.gov/684/Lead-Safe-Roanoke

 

LEAP Local Food Market

1327 Grandin RD #201

Roanoke, VA 24015

(540) 632-1360

http://leapforlocalfood.org/local-food/

 

Lewis Gale Medical Center

1900 Electric Rd

Salem, VA 24153

(540) 776-4000

https://lewisgale.com/location/lewisgale-medical-center

 

 

Roanoke Public Library

706 S Jefferson St.

Roanoke, VA 24016

(540) 853-2473

https://www.roanokeva.gov/892/Libraries

 

 

South Roanoke Nursing Home

3823 Franklin Rd., SW

Roanoke, VA 24014

(540) 344-4325

http://www.southroanokenursinghome.com/

 

 

Roanoke Human Services (Medicaid)

1510 Williamson Rd., NE, 3rd floor

Roanoke, VA 24012

(540) 853-2894

 https://www.roanokeva.gov/372/

 

 

Social-Services

175 Roanoke Social Security Office (Medicare)

612 S Jefferson St., Suite 100

Roanoke, VA 24011

1-800-772-1213

https://www.ssofficelocation.com/roanoke-social-security-office-so1436

 

 

Virginia Premier Medical Home

5060 Valley View Blvd, NW

Roanoke, VA 24012

(540) 278-1051

 https://www.virginiapremier.com/medical-home/

 

 

Mental Health America of Roanoke Valley

10 Church Ave., SE, #300

Roanoke, VA 24011

(540) 344-0931

http://mharv.org/

 

National Alliance on Mental Illness (NAMI)NAMI Roanoke Valley

 PO Box 20864

Roanoke, VA 24018-0087

(540) 977-3470

http://www.namiroanokevalley.us/

 

On Our Own Roanoke Valley

429 Elm Ave., SW

Roanoke, VA 24016

(540) 362-0061

https://vocalvirginia.org/events/roanoke-valley-offering-peer-recovery-specialist-46-hour-training/

 

Pantry at Calvary Chapel

3839 Shenandoah Ave., NW

Roanoke, VA 24017

(540) 774-8400

https://ccr.life/

 

Roanoke Parks and Recreation

215 Church Ave., SW, Room 303

Roanoke, VA 24011

(540) 853-2236

 https://www.playroanoke.com/

 

Presbyterian Community Center

1228 Jamison Ave., SE

Roanoke, VA 24013

(540) 982-2911

http://pccse.org/

 

Roanoke City Police Department

348 Campbell Ave., SW

 Roanoke, VA 24016

(540) 853-2212

https://www.roanokeva.gov/150/Police

 

REACH, Inc.

344 Church Ave., SW

Roanoke, VA 24016

(540) 529-9200

https://www.reachinroanokeva.org/

 

 

Roanoke Area Ministries

824 Campbell Ave., SW

Roanoke, VA 24016

(540) 345-8850

http://raminc.org/

 

 

Roanoke’s Prevention Alliance (RPA)

(540) 982-1427 x119

http://www.roanokepreventionalliance.org/

 

 

Salem Food Pantry

620 Chapman Ave

Salem, VA 24153

(540) 389-6938

http://salemfoodpantry.org/

 

 

Salvation Army724 Dale Ave., SE

Roanoke, VA 24016

(540) 343-5335

http://virginiasalvationarmy.org/roanokeva/

 

 

Carilion Clinic Family Medicine SE

2145 Mt. Pleasant Blvd., SE

Roanoke, VA 24014

(540) 427-9200

 https://www.carilionclinic.org/locations/carilion-clinic-family-medicine-southeast?utm_source=GMB&utm_campaign=local-listing

 

 

Virginia NavigatorCenter

706 Campbell Ave., SW

Roanoke, VA 24016

(540) 345-0451

http://virginianavigator.org/

 

 

Supplemental Nutrition Assistance Program (SNAP)

1510 Williamson Rd., NE

Roanoke, VA 24012

(540) 853-2591

https://www.benefits.gov/benefits/benefit-details/1593

 

 

Temporary Assistance for Needy Families (TANF)

1510 Williamson Rd., NE

Roanoke, VA 24012

(540) 853-2591

http://www.dss.virginia.gov/benefit/tanf/

 

 

Carilion Clinic Adolescent Medicine

902 S Jefferson St

Roanoke, VA 24016

(540) 985-9075

https://www.carilionclinic.org/locations/carilion-clinic-adolescent-medicine

 

 

Carilion Clinic Transgender Services

1906 Belleview Ave., SE

Roanoke, VA 24014

(540) 981-7000

 https://www.carilionclinic.org/locations/carilion-roanoke-memorial-hospital

 

 

United Way of Roanoke Valley

325 Campbell Ave., SW

Roanoke, VA 24016

(540) 777-4200

https://www.uwrv.org/

 

 

AFC Urgent Care

602 Brandon Ave., SW #222

Roanoke, VA 24015

(540) 774-0000

https://www.afcurgentcareroanoke.com/

 

 

Salem Veterans Affairs Medical Center

1970 Roanoke Blvd.

Salem, VA 24153

(540) 982-2463

https://www.salem.va.gov/

 

 

Virginia Cooperative Extension

3738 Brambleton Ave., SW

Roanoke, VA 24018-3639

(540) 772-7524

https://roanoke.ext.vt.edu/

 

 

Virginia Western Dental Hygiene

3094 Colonial Ave

Roanoke, VA 24015

(540) 857-8922

https://www.virginiawestern.edu/academics/health/dental/dental_clinic.php

 

 

WIC Roanoke

1502 Williamson Rd., NE 2nd floor

Roanoke, VA 24012

(540) 283-5050

http://www.vdh.virginia.gov/roanoke/women-infants-and-children/

 

 

 

New River Valley

 

Alcoholics Anonymous(540) 343-6857 (24 hours hotline)

 

American Cancer Society

2840 Electric Rd., STE 106A

Roanoke, VA 24018(540) 774-2716

https://www.cancer.org/about-us/local/virginia.html

 

 

Blacksburg Interfaith Food Pantry

706 Harding Avenue

Blacksburg, VA 24060

(540) 951-8134

http://newrivercommunityaction.org/

 

IFP/Brock Hughes Free Clinic

450 West Monroe Street

Wytheville, VA 24382

(276) 223-0558

http://brockhughesfreeclinic.org/

 

 

Carilion New River Valley Medical Center

2900 Lamb Circle

Christiansburg, VA 24073

(540) 731-2000

https://www.carilionclinic.org

 

 

CHIP of New River Valley

114 North Franklin Street

Christiansburg, VA 24073

(540) 394-3255

http://newrivercommunityaction.org/

 

Community Health Center of New River Valley

215 Roanoke Street

Christiansburg, VA 24073

(540) 381-0820

http://www.chcnrv.org/

 

Community Housing Partners

448 Depot Street, NE

Christiansburg, VA 24073

https://www.communityhousingpartners.org/

 

Dental Aid NRV

P.O. Box 6096

Christiansburg, VA 24068

https://www.nrvsmiles.org/

 

Free Clinic of Pulaski County

25 4th St NW

Pulaski, VA 24301

(540) 980-0922

http://pulaskifreeclinic.org/

 

HEAD START Program

135 Church St., NE

Christiansburg, VA 24073

(540) 552-0490

http://newrivercommunityaction.org/head-start-2/

 

 

Hokie Wellness

895 Washington Street, SW

Blacksburg, VA 24061

(540) 231-2233

https://hokiewellness.vt.edu/

 

Medication Assistance Program at RadfordCarilion New River Valley Medical Center-Medical Records

P.O. Box 5

Radford, VA24143

(540) 731-2413

https://www.carilionclinic.org/medication-assistance-programs

 

Micah’s Backpack

2308 Merrimac Road

Blacksburg, VA 24060

(540) 951-8951

http://micahsbackpack.org/

 

Montgomery County Emergency Assistance Program

110 Roanoke Street

Christiansburg, VA 24073

(540) 381-1561

http://mceap.com/

 

 

Montgomery County Health Department

210 Pepper Street, SE #A

Christiansburg, VA 24073

(540) 585-3300

http://www.vdh.virginia.gov/new-river/

 

 

Montgomery County Social Services

210 Pepper Street, NE # B

Christiansburg, VA 24073

(540) 382-6990

https://www.montgomerycountyva.gov

 

National Prescription Drug Take Back Pulaski County Sheriff’s Office

802 E Main Street

Pulaski, VA 24301

(540) 980-7800

https://www.sheriffsoffice.org/

 

New River Community Action

1093 East Main Street

Radford, VA 24141

(540) 633-5133

http://newrivercommunityaction.org/

 

New River Valley Agency on Aging

141 East Main Street

Pulaski, VA 24301

(540) 980-7720

http://www.nrvaoa.org/

 

New River Valley Community Service Board

700 University Blvd

Blacksburg, VA 24060

(540) 961-8400

http://www.nrvcs.org/

 

New River Treatment Center

140 Larkspur Lane

Galax, VA 24333

(276) 236-6341

http://www.crchealth.com/

 

Narcotics AnonymousSaint Thomas Episcopal Church

102 Roanoke Street

Christiansburg, Virginia 24073

https://www.na.org/

 

No Wrong Door VirginiaNew River Valley Aging on Aging

141 E Main Street, S 500

Pulaski, VA 24301

(540) 994-2620

https://www.nowrongdoorvirginia.org/

 

136Plenty FoodBank

192 Elephant Curve Road, NW

Floyd, VA 24091

(540) 745-3898

https://plentylocal.org/

 

Pulaski Area Transit

141 E Main Street

Pulaski, VA 24301

(540) 980-5040

http://www.pulaskitransit.org/

 

Pulaski County Youth Center

6671 Riverlawn Court

Fairlawn, VA 24141

(540) 731-4401

https://www.pcyouthcenter.org/

 

 

Radford-Fairlawn Daily Bread

501 E Main Street

Radford, VA 24141

(540) 639-0290

http://www.radfordfairlawndailybread.org/

 

Resource Mothers

http://www.vdh.virginia.gov/family-home-visiting/resource-mothers-program/

 

Shawsville Community Center

267 Alleghany Spring Road, Office 1

Shawsville, VA 24162

(540) 384-2801

 

Substance Abuse and Violence Education Support

http://www.mountainvalleycf.com/meadowbrook_community_center.html

 

Radford University

801 East Main Street

Radford, VA 24142

(540) 831-5000

https://www.radford.edu/content/saves/home.html

 

Virginia Tech Extension

755 Roanoke Street, Suite 1G

Christiansburg, VA 24073

(540) 382-5790

https://montgomery.ext.vt.edu/

 

WIC ProgramMontgomery County Health Department

210 South Pepper Street, Suite A

Christiansburg, VA 24073

(540) 585-3300

http://www.wicprograms.org/ci/va-christiansburg

 

Women’s Resource Center

1217 Grove Avenue

Radford, VA 24141

(540) 639-9592

https://www.wrcnrv.org/

 

 

Youth Mental Health First Aid Project

750 Imperial Street

Christiansburg, VA 24073

(540) 382-5100

http://www.mcps.org/departments/student_services/youth_mental_health_first_aid__ymhfa___project_aware

 

 

Franklin County

 

American Red Cross

1081 Spruce Street

Martinsville, VA

(276) 632-5127

http://www.redcross.org/local/virginia

 

Carilion Franklin Memorial Hospital

390 South Main Street

Rocky Mount, VA

(540) 483-5277

https://www.carilionclinic.org/locations

 

Celebrate RecoveryRedwood United Methodist Church

3001 Old Franklin Turnpike

Rocky Mount, VA 24151

(540) 420-8755

https://www.celebraterecovery.com/

 

Children Services

1255 Franklin Street

Rocky Mount, VA 24151

(540) 483-3030

http://www.franklincountyva.gov/csa

 

Disability Rights and Resource Center

300 Pell Avenue, A

Rocky Mount, VA 24151

(434) 791-2006

http://www.drrcva.org/

 

Family Access to Medical Insurance Security (FAMIS)

P.O. Box 1820

Richmond, VA 23218

https://www.benefits.gov/benefits/benefit-details/1363

 

 

Family Nutrition Program

200 Dent Street

Rocky Mount, VA 24151

(540) 483-5142

http://www.stepincva.com/services-programs/head-start-early-head-start

 

Focus on Response and Education to Stay Healthy (FRESH)

Franklin County Government Center

1255 Franklin Street

Rocky Mount, VA 24151

(540) 483-3030

http://www.franklincountyva.gov/

 

Franklin County Department of Aging

136 Tanyard Road

Rocky Mount, VA 24151

http://www.franklincountyva.gov/

 

Franklin County Health Department

365 Pell Avenue

Rocky Mount, VA 24151

http://www.franklincountyva.gov/residents/health-human-services/health-department

 

Franklin County Library

355 Franklin Street

Rocky Mount, VA 24151

(540) 483-3098

http://library.franklincountyva.org/

 

 

Franklin County Social Services Department

11161 Vigil H Goode Highway Rocky Mount, VA 24151

(540) 483-9247

http://www.franklincountyva.gov/social-services

 

Franklin County Parks and Recreation

2150 Sontag Road

Rocky Mount, VA 24151

(540) 483-9293

https://www.playfranklincounty.com/

 

Franklin Ride Solution

1255 Franklin Street

Rocky Mount, VA 24151

(540) 483-3030

http://www.franklincountyva.gov/transportation-local-trans

 

Free Clinic of Franklin County

1171 Franklin Street

RockyMount, VA 24151

(540) 489-7500

http://www.bernardhealthcare.com/

 

God’s Provision-Stepping Stone Mission

565 Diamond Avenue

Rocky Mount, VA 24151

(540) 483-9018

http://www.steppingstonemission.org/resources.php

 

Habitat for Humanity

1155 N. Main Street

Rocky Mount, VA 24151

(540) 483-8884

https://www.habitat.org/

 

Healing Strides of Virginia

672 Naff Road

Boones Mill, VA 24065

(540) 334 5825

http://www.healingstridesofva.org/

 

Heavenly Manna Inc. Food Bank

2211 S. Main Street

 Rocky Mount, VA 24153

(540) 483-3923

http://heavenlymanna.org/

 

Helping Hands of Franklin County(Food Bank as well)

200 Dent Street

Rocky Mount, VA 24151

(540) 483-2387

http://helpinghandsfc.com/index.html

 

Martinsville Henry Coalition for Health and WellnessWest

Piedmont Business Development Center

22 E Church Street

Martinsville, VA 24112

(276) 403-5007

https://healthycommunitymhc.org/

 

 

Medicine Assistance Program

13168 Meadowview Square

Meadowview, VA 24361

(276) 944-3999

http://www.svchs.com/services/medication-assistance-program/

 

 

Rocky Mount Lions Club

http://www.lionsofvirginia.org/

 

Meals On WheelsSouthern Area Agency on Aging

204 Cleaveland Avenue

Martinsville, VA 24112

(276) 632-6442

http://www.southernaaa.org/

 

New College Institute

191 Fayette Street

Martinsville, VA 24112

(276) 403-5600

http://www.newcollegeinstitute.org/

Office of Sheriff, Franklin County

70 E Court Street, #101

Rocky Mount, VA 24151

(540) 483-3000

http://www.franklincountysheriffsoffice.org/

 

Piedmont Community Services

30 Technology Drive

Rocky Mount, VA 24151

(540) 483-0582

http://www.piedmontcsb.org/pcs2018/index.html

 

 

SML Good Neighbors

P. O. Box 2Moneta, VA 24121

(540) 585-4912

https://www.smlgoodneighbors.org/

 

Southern Area Agency on Aging

204 Cleaveland Avenue

Martinsville,VA 24112

(276) 632-6442

http://www.southernaaa.org/

 

STEP, Early Head Start

200 Dent Street

Rocky Mount, VA 24151

(540) 483-5142

http://www.stepincva.com/services-programs/head-start-early-head-start

 

Stepping Stone Mission of Franklin County

1105 North Main Street

Rocky Mount, VA 24151

(540) 482-0775

http://steppingstonemission.org/

 

Total Action for Progress

302 2nd Street, SW

Roanoke, VA 24011

(540) 777-4673

https://www.tapintohope.org/HeadStartProgram.aspx

 

Tri-Area Community Health Center

40 Wiley Drive

Ferrum, VA

(540) 365-4465

http://triareahealth.org/locations/ferrum/

 

Unbridle Change

1176 White Oak Road

Boones Mill, VA 24065

(540) 334-2171

https://unbridledchange.org/

 

United Way of Franklin County

270 S Main Street # 204

Rocky Mount, VA 24151

(540) 483-4949

https://www.uwrv.org/franklin-county/

 

 

United Way of Southwest VirginiaBackPack Program

1096 Ole Berry Drive

Abingdon, VA 24210

(276) 628-2160

http://unitedwayswva.org/backpacks-unite/

 

Velocity Care-West Lake

13205 Booker T Washington Hwy

Hardy, VA 24101

(540) 719-1815

https://velocitycarebycarilion.com

 

Virginia Cooperative Extension-Franklin County

90 E Court Street

Rocky Mount, VA 24151

(540) 483-5161

http://www.franklincountyva.org/

 

Virginia Family Preservation Services

40 W Church Street

Rocky Mount, VA 24151

(540) 483-0312

http://www.pathways.com/

 

YMCA-Franklin County

235 Technology Drive

Rocky Mount, VA 24151

(540) 489-9622

http://www.franklincountyymca.org/

 

 

Rockbridge County

 

Appalachian Trail, Rockbridge Co.

101 Maury River Drive

Buena Vista, VA 24416(540) 261-7321

https://www.virginia.org/listings/

 

Outdoors And Sports/Appalachian Trail Rockbridge Co/Blue Phoenix Café and Market

110 W Washington St.

Lexington, VA 24450

(540) 461-8306

http://www.bluephoenixcafe.com/

 

Carilion Clinic Internal Medicine

108 Houston St. Suite A

Lexington, VA 24450

(540) 463-2181

https://www.carilionclinic.org/locations/carilion-clinic-internal-medicine-lexington?utm_source=GMB&utm_campaign=local-listing

 

 

Carilion Stonewall Jackson ER

1 Health Circle

Lexington, VA 24450

(540) 458-3300

https://www.carilionclinic.org/locations/carilion-stonewall-jackson-hospital

 

Chessie Nature Trail Physical Plant VMI

Lexington, VA 24450

(540) 464-7119

http://www.vmi.edu/about/for-visitors/chessie-trail/about-the-trail/

 

The Community Table, Rockbridge Area

350 Spotswood Avenue

Lexington, VA 24450

https://www.communitytablerockbridge.org

 

Cooking Matters Class (CSB)

241 Greenhouse rd.

Lexington, VA 24450

(540) 463-3141

https://www.racsb.org/form__map

 

Fitness your way Rockbridge

465 E Nelson St.

Lexington, VA 24450

(540) 817-9387

https://fitnessyourwayrockbridge.com/

 

Jordan’s Point ParkOld Mill Race

Lexington, VA 24450

(540) 463-3154

https://lexingtonvirginia.com/directory/attractions/jordans-point-park

 

Kendal at Lexington

160 Kendal DriveLexington, VA 24450

(540) 463-1910

https://kalex.kendal.org/

 

 

LEPC-Local Emergency Planning Committee

150 S. Main St.

Lexington, VA 24450

(540) 463-4361

https://www.co.rockbridge.va.us/543/LEPC---Local-Emergency-Planning-Committee

 

Lexington Farmers MarketMcCrum’s Parking lot

 Jefferson St.

Lexington, VA 24450

(540) 463-3777

https://www.virginia.org/listings/Shopping/LexingtonFarmersMarket/

 

 

Lexington Medicaid, Food Stamp and welfare

20 E. Preston St.Lexington, VA 24450

(540) 463-7143

https://medicaidoffice.us/virginia-medicaid-offices/lexington-va-medicaid-food-stamp-and-welfare-office/

 

Lexington Rx Center

800 S Main St

Lexington, VA 24450

(540) 463-9166

https://www.lexingtonrx.com/contact

 

Maury Express Transportation

P.O. Box 13825

Roanoke, VA 24037

(540) 343-1721

http://radartransit.org/ridership-information/maury-express/

 

(VPAS) Meals on wheels, Maury River Senior Center

2137 Magnolia Ave.

Buena Vista, VA 24416

(540) 261-7474

https://www.vpas.info/

 

 

MRSCMohawk Industries Inc.

404 Anderson St.

Glasgow, VA 24555

(540) 258-2811

http://mohawkind.com/

 

Natural Bridge

6477 S. Lee Hwy

Natural Bridge, VA 24578

(540) 258-2811

http://www.dcr.virginia.gov/state-parks/natural-bridge#general_information

 

Pro Careers, Inc.

393 East 29th St.

Buena Vista, VA 24416-1292

(800) 992-0566

http://procareersinc.com/Contact_Us.html

 

Rockbridge 20/20

8 East Nelson St. Suite 101

Lextington, VA 24450

(540) 463-5375

http://rockbridge2020.org/about-us

 

Rockbridge Area Community Services

241 Greenhouse Rd.

Lexington, VA 24450

(540) 463-3141

https://www.racsb.org/form__map

 

Rockbridge Area Health Center (FQHC): Dentistry, Transportation, Live Healthy etc.

25 Northridge Ln.

Lexington, VA 24450-3399

(540) 464-8700

http://rockahc.org/

 

 

Rockbridge Area Relief Association

350 Spotswood Dr

Lexington, VA 24450

(540) 463-6642

http://raralex.org/

 

Rockbridge Regional Central Library

138 S. Main St.Lexington, VA 24450

(540) 463-4324

http://www.rrlib.net/

 

Rockbridge Area YMCA

790 North Lee Highway

Lexington, VA 24450

(540) 464-9622

http://ymcavbr.org/locations/rockbridge/rockbridge-area-ymca/

 

Virginia Horse Center

487 Maury River Rd.

Lexington, VA 24450

(540) 464-2950

https://vahorsecenter.org/

 

Virginia Tech Campus KitchenDining Hall,

Wallace Hall

https://campuskitchens.org/

 

 

Giles County

 

AA Meetings

529 Wenonah Avenue

Pearisburg, VA 24134

 

Agency on AgingMeals on Wheels

141 East Main Street., STE 500

Pulaski, VA 24301

(540) 980-7720

http://www.nrvaoa.org/

 

Carilion Giles Community Hospital

159 Hartley Way

Pearisburg, VA 24134

(540) 921-6000

https://www.carilionclinic.org

 

CHIP of New River Valley

114 N Franklin Street

Christiansburg, VA 24073

(540) 394-3255

http://newrivercommunityaction.org/chip/

 

Community Health Center

219 South Buchanan Street

Pearisburg, VA 24134

(540) 921-3502

http://www.chcnrv.org/

 

Department of Social Services

211 Main Street., Suite 109

Narrows, VA 24124

(540) 726-8315; (540) 626-7291

https://www.gileshealthnet.org/GCSS.php

 

 

Family Center

701 Wenonah Avenue

Pearisburg, VA

(540) 921-3024

http://gileshealthandfamily.org/

 

FMRS Mental Health Counseling

Middle StreetUnion, WV 24983

(304) 772-5452

https://www.fmrs.org/

Giles County Administration FOCUS Program

315 North Main Street

Pearisburg, VA 24134

(540) 921-2525

http://virginiasmtnplayground.com/giles-county-health-community-outreach/

 

Giles Health and Giles Free Clinic

219 Buchanan Street

Pearisburg, VA 24134

https://www.gileshealthnet.org/freeclinic.php

 

County Health Department

120 North Main Street

Pearisburg, VA 24134

(540) 235-3135

http://www.vdh.virginia.gov/new-river/

 

Giles County Lion’s Club

315 North Main Street

Pearisburg, VA 24134

(540) 921-2525

http://virginiasmtnplayground.com/tag/lions-club/

 

Giles County Senior Citizen Center

1320 Wenonah Avenue

Pearisburg, VA 24134

(540) 921-3924

 

Giles County Wellness Center

140 Clendennin Rd

Narrows, VA 24124(540) 921-4292

http://gilescountywellness.com/GCWC/

 

Giles Life Saving and Rescue Squad

175 Industrial Park Road

Pearisburg, VA 24134

(540)921-4357

http://www.gilesrescue.com/

 

 

HEAD START-New River Community Center

516 B Wenonah Avenue

Pearisburg, VA 24134

(540) 921-2146

http://newrivercommunityaction.org/contact/

 

Monroe Health Clinic

200 Health Center Drive

P.O. Box 590

Union, WV, 24983

(304) 772-3064

http://monroehealthcenters.com/

 

 

NRV Cares

205 West Main Street #4

Christiansburg, VA 24073

(540) 381-8310

https://www.nrvcares.org/

 

New River Valley Community Center

New Life Recovery Center

7193 Warden Ct.

Radford, VA 24141

(540) 961-8400

http://www.nrvcs.org

 

NewRiver Valley Rotary Club

Addresses varies

https://newrivervalleyrotaryclubs.org/

 

Pearisburg Recreation Department

112 Tazewell Street

Pearisburg, VA 24134

(540) 921-0340

https://www.pearisburg.org

 

Virginia Cooperative Extension

507 Wenonah Avenue

Pearisburg, VA 24134

(540) 921-3455

https://giles.ext.vt.edu/

 

Virginia Department of Aging and Rehabilitative Services

Locations Varies

https://www.vadars.org/offices.aspx

 

WIC-Giles County

1 Taylor Avenue, #4

Pearisburg, VA 24134

(540) 235-3135

http://www.wicprograms.org/li/giles_county_health_department_wic_24134

Cancer Support Group

Hosted by Tim Collie

Occurs the 3rd Wednesday of each month from 2:00 - 3:00pm (Beginning in May 2024)

• If you have any issues joining please contact Tim Collie at tim.collie@usoncology.com or 540-354-1745 or Teresa Poole at tpoole@carilionclinic.org or 540-981-7377

Location

BRCC Roanoke Clinic

2013 S. Jefferson Street, Roanoke VA 24014, 2nd Floor

 

 

 

Prostate Cancer Support Group

Hosted by Tim Collie

Occurs the 2nd Wednesday of each month from 6:00-7:00pm

• If you have any issues joining please contact Tim Collie at tim.collie@usoncology.com or 540-354-1745 or Teresa Poole at tpoole@carilionclinic.org or 540-981-7377

Location

BRCC Roanoke Clinic

2013 S. Jefferson Street, Roanoke VA 24014, 2nd Floor

 

 

Caregiver Support Group

Occurs every 2nd Tuesday of each month from 2:00 - 3:00pm (Beginning in May 2024)

Open to caregivers who would benefit from group support and learning from others who are on the same journey with loved ones.  It will be a time to share our struggles and our victories with one another.

• If you have any questions or issues joining please contact Tim Collie at tim.collie@usoncology.com or 540-354-1745 or Teresa Poole at tpoole@carilionclinic.org or 540-981-7377

Location

BRCC Roanoke Clinic

2013 S. Jefferson Street, Roanoke VA 24014, 2nd Floor

Blue Ridge Cancer Care has been selected to participate in the Oncology Care Model, a care delivery model that supports and encourages higher quality, more coordinated cancer care. The Oncology Care Model is one of the first physician-led specialty care models from The Centers for Medicare & Medicaid Services and builds on lessons learned from other innovative programs and private-sector models. The Oncology Care Model encourages practices to improve care and lower costs through episode and performance-based payments that reward high-quality patient care. Here's a list of things that the practices may have to offer:

• Coordinating appointments with providers within and outside the oncology practice to ensure timely delivery of diagnostic and treatment services;
• Providing 24/7 access to care when needed;
• Arranging for diagnostic scans and follow up with other members of the medical team such as surgeons, radiation oncologists, and other specialists that support the beneficiary through their cancer treatment;
• Help making decisions on advanced care planning and survivorship planning; and
• Providing access to additional patient resources, such as emotional support groups, pain management services, and clinical trials.

Thank you for your career interest at Blue Ridge Cancer Care. Below is a listing of our open positions. You can apply by submitting your resume to http://careers-theusoncologynetwork.icims.com/.

Thank you for your payment.

There are several convenient options for you to make a payment.

• Make a payment during your next in-office visit
• Mail payments, with your patient account number on the Memo line to:
  Blue Ridge Cancer Care
  P.O. Box 601507
  Charlotte, NC 28260-1507
• Make a payment over the phone by calling 800-998-3450
• Pay Online

Pay My Bill

Malignant mesothelioma is a disease in which cancer cells are found in the pleura, the thin layer of tissue that lines the chest cavity and covers the lungs or the peritoneum, the thin layer of tissue that lines the abdomen and covers most of the organs in the abdomen.

Many people with malignant mesothelioma have worked or lived in places where they inhaled or swallowed asbestos. After being exposed to asbestos, it usually takes a long time for malignant mesothelioma to form. Other risk factors for malignant mesothelioma include:

• Living with a person who works near asbestos.
• Being exposed to a certain virus.

Visit the National Cancer Institute where this information and more can be found about Mesothelioma or ask your cancer care team questions about your individual situation.

Lo que usted necesita saber sobre el cáncer del mesotelioma maligno en español.

If you have symptoms that suggest liver cancer, your doctor will try to find out what's causing the problems. You may have one or more of the following tests:

• Physical exam: Your doctor feels your abdomen to check the liver, spleen, and other nearby organs for any lumps or changes in their shape or size. Your doctor also checks for ascites, an abnormal buildup of fluid in the abdomen. Also, your skin and eyes may be checked for signs of jaundice.
   
• Blood tests: Many blood tests may be used to check for liver problems. One blood test detects alpha-fetoprotein (AFP). High AFP levels could be a sign of liver cancer. Other blood tests can show how well the liver is working.
   
• CT scan: An x-ray machine linked to a computer takes a series of detailed pictures of your liver and other organs and blood vessels in your abdomen. You may receive an injection of contrast material so that your liver shows up clearly in the pictures. On the CT scan, your doctor may see tumors in the liver or elsewhere in the abdomen.
   
• MRI: A large machine with a strong magnet linked to a computer is used to make detailed pictures of areas inside your body. Sometimes contrast material makes abnormal areas show up more clearly on the picture.
   
• Ultrasound test: The ultrasound device uses sound waves that can't be heard by humans. The sound waves produce a pattern of echoes as they bounce off internal organs. The echoes create a picture (sonogram) of your liver and other organs in the abdomen. Tumors may produce echoes that are different from the echoes made by healthy tissues.

Liver cancer is the fifth most common type of cancer among men, and ninth most common type of cancer among women. Around 28,000 Americans are diagnosed with liver cancer every year.

Risk factors for developing liver cancer include:

• Having hepatitis B and/or hepatitis C.
• Having a close relative with both hepatitis B and liver cancer.
• Having cirrhosis.
• Eating foods tainted with aflatoxin (poison from a fungus that can grow on foods, such as grains and nuts, that have not been stored properly).
• Obesity.

If you experience any of the following symptoms, you should contact your physician

• Hard lump on the right side just below the rib cage.
• Discomfort in the upper abdomen on the right side.
• Pain around the right shoulder blade.
• Unexplained weight loss.
• Jaundice (yellowing of the skin and whites of the eyes).
• Unusual tiredness.
• Nausea.
• Loss of appetite.

Visit the National Cancer Institute where this information and more can be found about Liver Cancer or ask your cancer care team questions about your individual situation.

Lo que usted necesita saber sobre el cáncer de hígado en español. 

People with early oral cancer may be treated with surgery or radiation therapy. People with advanced oral cancer may have a combination of treatments. For example, radiation therapy and chemotherapy are often given at the same time. Another treatment option is targeted therapy.

Surgery

Surgery to remove the tumor in the mouth or throat is a common treatment for oral cancer. Sometimes the surgeon also removes lymph nodes in the neck. Other tissues in the mouth and neck may be removed as well. You may have surgery alone or in combination with radiation therapy.

Surgery to remove a small tumor in your mouth may not cause any lasting problems. For a larger tumor, however, the surgeon may remove part of the palate, tongue, or jaw. This surgery may change your ability to chew, swallow, or talk. Also, your face may look different after surgery. You may have reconstructive or plastic surgery to rebuild the bones or tissues of the mouth.

Radiation Therapy

Radiation therapy can be used to treat the area where the patient is affected by oral cancer. This type of treatment focuses on treating the specific area(s) where the cancer was found.

Chemotherapy

Chemotherapy uses drugs to kill cancer cells. The drugs that treat oral cancer are usually given through a vein (intravenous). The drugs enter the bloodstream and travel throughout your body.

Chemotherapy and radiation therapy are often given at the same time. You may receive chemotherapy in outpatient therapy at a cancer center like ours.

Chemotherapy and radiation therapy can cause some of the same side effects, including painful mouth and gums, dry mouth, infection, and changes in taste. Some anticancer drugs can cause bleeding in the mouth and a deep pain that feels like a toothache.

Targeted Therapy

Some people with oral cancer receive a type of drug known as targeted therapy. It may be given along with radiation therapy or chemotherapy. Cetuximab (Erbitux) was the first targeted therapy approved for oral cancer. Cetuximab binds to oral cancer cells and interferes with cancer cell growth and the spread of cancer. You may receive cetuximab through a vein once a week for several weeks at the doctor's office.

For oral cancer, Stages I and II are combined and classified as “early cancer”. Stages III and IV are classified as “advanced cancer.” Here are the details of each class:

Early Cancer

Stage I or II oral cancer is usually a small tumor (smaller than a walnut), and no cancer cells are found in the lymph nodes.

Advanced Cancer

Stage III or IV oral cancer is usually a large tumor (as big as a lime). The cancer may have invaded nearby tissues or spread to lymph nodes or other parts of the body.

Many of the following symptoms are not from oral cancer. However, if you find any of these, you should contact your physician or dentist so they can diagnose and treat the areas of concern as soon as possible. Symptoms of oral cancer include:

• Patches inside your mouth or on your lips:
  • White patches are the most common and can become cancerous.
  • Mixed red and white patches are more likely than white patches to become malignant.
  • Red patches are brightly colored, smooth areas that often become cancerous.
• A sore on your lip or in your mouth that doesn't heal
• Bleeding in your mouth
• Loose teeth
• Difficulty or pain when swallowing
• Difficulty wearing dentures
• A lump in your neck
• An earache that doesn't go away
• Numbness of lower lip and chin

If you have symptoms that suggest oral cancer, your doctor or dentist will check your mouth and throat for red or white patches, lumps, swelling, or other problems. A physical exam includes looking carefully at the roof of your mouth, back of your throat, and insides of your cheeks and lips. The floor of your mouth and lymph nodes in your neck will also be checked.

The removal of a small piece of tissue to look for cancer cells is called a biopsy. Usually, a biopsy is done with local anesthesia. A biopsy is the only sure way to know if the abnormal area is cancer.

A few methods that are also used in the diagnosis process are as follows:

• X-rays: An x-ray of your entire mouth can show whether cancer has spread to the jaw. Images of your chest and lungs can show whether cancer has spread to these areas.
   
• CT scan: An x-ray machine linked to a computer takes a series of detailed pictures of your body. You may receive an injection of dye. Tumors in your mouth, throat, neck, lungs, or elsewhere in the body can show up on the CT scan.
   
• MRI: A powerful magnet linked to a computer is used to make detailed pictures of your body. An MRI can show whether oral cancer has spread.
   
• Endoscopy: The doctor uses a thin, lighted tube (endoscope) to check your throat, windpipe, and lungs.
   
• PET scan: You receive an injection of a small amount of radioactive sugar. The radioactive sugar gives off signals that the PET scanner picks up. The PET scanner makes a picture of the places in your body where the sugar is being taken up. Cancer cells show up brighter in the picture because they take up sugar faster than normal cells do. A PET scan shows whether oral cancer may have spread.

Each year in the United States, more than 21,000 men and 9,000 women are diagnosed with oral cancer. Most are over 60 years old.

• The oral cavity includes the following:
• The front two thirds of the tongue.
• The gingiva (gums).
• The buccal mucosa (the lining of the inside of the cheeks).
• The floor (bottom) of the mouth under the tongue.
• The hard palate (the roof of the mouth).
• The retromolar trigone (the small area behind the wisdom teeth).

Risk Factors

Tobacco and alcohol use can affect the risk of developing lip and oral cavity cancer.

Risk factors for lip and oral cavity cancer include the following:

• Using tobacco products.
• Heavy alcohol use.
• Being exposed to natural sunlight or artificial sunlight (such as from tanning beds) over long periods of time.
• Being male.
• Being infected with human papillomavirus (HPV).

Visit the National Cancer Institute where this information and more can be found about Lip and Oral Cancer or ask your cancer care team questions about your individual situation.

Lo que usted necesita saber sobre el cáncer del del labio y la cavidad oral.

Treatment options for people with cancer of the pancreas are surgery, chemotherapy, targeted therapy, and radiation therapy. You’ll probably receive more than one type of treatment.

The treatment that’s right for you depends mainly on the following:

• The location of the tumor in your pancreas
• Whether the disease has spread
• Your age and general health

At this time, cancer of the pancreas can be cured only when it’s found at an early stage (before it has spread) and only if surgery can completely remove the tumor. For people who can’t have surgery, other treatments may be able to help them live longer and feel better.

You may have a team of specialists to help plan your treatment. Specialists who treat cancer of the pancreas include surgeons, medical oncologists, radiation oncologists, and gastroenterologists.

Your health care team can describe your treatment choices, the expected results of each, and the possible side effects. Because cancer treatments often damage healthy cells and tissues, side effects are common. These side effects depend on many factors, including the type and extent of treatment. Side effects may not be the same for each person, and they may even change from one treatment session to the next. Before treatment starts, ask your health care team about possible side effects and how treatment may change your normal activities. You and your health care team can work together to develop a treatment plan that meets your needs.

Surgery

Surgery may be an option for people with an early stage of pancreatic cancer. The surgeon usually removes only the part of the pancreas that has cancer. But, in some cases, the whole pancreas may be removed.

The type of surgery depends on the location of the tumor in the pancreas. Surgery to remove a tumor in the head of the pancreas is called a Whipple procedure. The Whipple procedure is the most common type of surgery for pancreatic cancer. You and your surgeon may talk about the types of surgery and which may be right for you.

In addition to part or all of your pancreas, the surgeon usually removes the following nearby tissues:

• Duodenum
• Gallbladder
• Common bile duct
• Part of your stomach

Also, the surgeon may remove your spleen and nearby lymph nodes.

Surgery for pancreatic cancer is a major operation. You will need to stay in the hospital for one to two weeks afterward. Your health care team will watch for signs of bleeding, infection, or other problems. It takes time to heal after surgery, and the time needed to recover is different for each person. You may have pain or discomfort for the first few days. It’s common to feel weak or tired for a while. You may need to rest at home for one to three months after leaving the hospital.

Chemotherapy

Chemotherapy uses drugs to kill cancer cells. Most people with pancreatic cancer get chemotherapy. For early pancreatic cancer, chemotherapy is usually given after surgery, but in some cases, it’s given before surgery. For advanced cancer, chemotherapy is used alone, with targeted therapy, or with radiation therapy.

Chemotherapy for pancreatic cancer is usually given by vein (intravenous). The drugs enter the bloodstream and travel throughout your body. Chemotherapy is given in cycles. Each treatment period is followed by a rest period. The length of the rest period and the number of cycles depend on the anticancer drugs used.

Some drugs used for pancreatic cancer also may cause tingling or numbness in your hands and feet.

Targeted Therapy

People with cancer of the pancreas who can’t have surgery may receive a type of drug called targeted therapy along with chemotherapy.

Targeted therapy slows the growth of pancreatic cancer. It also helps prevent cancer cells from spreading. The drug is taken by mouth.

Side effects may include diarrhea, nausea, vomiting, a rash, and shortness of breath.

Radiation Therapy

Radiation therapy uses high-energy rays to kill cancer cells. It can be given along with other treatments, including chemotherapy.

The radiation comes from a large machine. The machine aims beams of radiation at the cancer in the abdomen. You’ll go to a hospital or clinic 5 days a week for several weeks to receive radiation therapy. Each session takes about 30 minutes.

Although radiation therapy is painless, it may cause other side effects. The side effects include nausea, vomiting, or diarrhea. You may also feel very tired.

If you have symptoms that suggest cancer of the pancreas, your doctor will try to find out what’s causing the problems. You may have blood or other lab tests. Also, you may have one or more of the following tests:

• Physical exam: Your doctor feels your abdomen to check for changes in areas near the pancreas, liver, gallbladder, and spleen. Your doctor also checks for an abnormal buildup of fluid in the abdomen. Also, your skin and eyes may be checked for signs of jaundice.
• CT scan: An x-ray machine linked to a computer takes a series of detailed pictures of your pancreas, nearby organs, and blood vessels in your abdomen. You may receive an injection of contrast material so your pancreas shows up clearly in the pictures. Also, you may be asked to drink water so your stomach and duodenum show up better. On the CT scan, your doctor may see a tumor in the pancreas or elsewhere in the abdomen.
• Ultrasound: Your doctor places the ultrasound device on your abdomen and slowly moves it around. The ultrasound device uses sound waves that can’t be heard by humans. The sound waves make a pattern of echoes as they bounce off internal organs. The echoes create a picture of your pancreas and other organs in the abdomen. The picture may show a tumor or blocked ducts.
• EUS: Your doctor passes a thin, lighted tube (endoscope) down your throat, through your stomach, and into the first part of the small intestine. An ultrasound probe at the end of the tube sends out sound waves that you can’t hear. The waves bounce off tissues in your pancreas and other organs. As your doctor slowly withdraws the probe from the intestine toward the stomach, the computer creates a picture of the pancreas from the echoes. The picture can show a tumor in the pancreas. It can also show how deeply the cancer has invaded the blood vessels.

Some doctors use the following tests also:

• ERCP: The doctor passes an endoscope through your mouth and stomach, down into the first part of your small intestine. Your doctor slips a smaller tube through the endoscope into the bile ducts and pancreatic ducts. (See picture of ducts.) After injecting dye through the smaller tube into the ducts, the doctor takes x-ray pictures. The x-rays can show whether the ducts are narrowed or blocked by a tumor or other condition.
• MRI: A large machine with a strong magnet linked to a computer is used to make detailed pictures of areas inside your body.
• PET scan: You’ll receive an injection of a small amount of radioactive sugar. The radioactive sugar gives off signals that the PET scanner picks up. The PET scanner makes a picture of the places in your body where the sugar is being taken up. Cancer cells show up brighter in the picture because they take up sugar faster than normal cells do. A PET scan may show a tumor in the pancreas. It can also show cancer that has spread to other parts of the body.
• Needle biopsy: The doctor uses a thin needle to remove a small sample of tissue from the pancreas. EUS or CT may be used to guide the needle. A pathologist uses a microscope to look for cancer cells in the tissue.

If cancer of the pancreas is diagnosed, your doctor needs to learn the extent (stage) of the disease to help you choose the best treatment.

Staging is a careful attempt to find out the following:

• The size of the tumor in the pancreas
• Whether the tumor has invaded nearby tissues
• Whether the cancer has spread, and if so, to what parts of the body

When cancer of the pancreas spreads, the cancer cells may be found in nearby lymph nodes or the liver. Cancer cells may also be found in the lungs or in fluid collected from the abdomen.

When cancer spreads from its original place to another part of the body, the new tumor has the same kind of abnormal cells and the same name as the original (primary) tumor. For example, if pancreatic cancer spreads to the liver, the cancer cells in the liver are actually pancreatic cancer cells. The disease is metastatic pancreatic cancer, not liver cancer. It’s treated as pancreatic cancer, not as liver cancer. Doctors sometimes call the new tumor in the liver “distant” disease.

To learn whether pancreatic cancer has spread, your doctor may order CT scans or EUS.

Also, a surgeon may look inside your abdomen with a laparoscope (a thin, tube-like device that has a light and a lens for seeing inside the body). The surgeon inserts the laparoscope through a small incision in your belly button. The surgeon will look for any signs of cancer inside your abdomen. You’ll need general anesthesia for this exam.

These are the stages of cancer of the pancreas:

• Stage I: The tumor is found only in the pancreas.
• Stage II: The tumor has invaded nearby tissue but not nearby blood vessels. The cancer may have spread to the lymph nodes.
• Stage III: The tumor has invaded nearby blood vessels.
• Stage IV: The cancer has spread to a distant organ, such as the liver or lungs.

There are two main types of pancreatic cancer.

Most often, pancreatic cancer starts in the ducts that carry pancreatic juices. This type is called exocrine pancreatic cancer. Information will focus on this type of pancreatic cancer.

Much less often, pancreatic cancer begins in the cells that make hormones. This type may be called endocrine pancreatic cancer or islet cell cancer.

Each year in the United States, more than 43,000 people are diagnosed with cancer of the pancreas. Most are over 65 years old. Visit the National Cancer Institute where this information and more can be found about Pancreatic Cancer or ask your cancer care team questions about your individual situation.

Lo que usted necesita saber sobre el cáncer de páncreas en español.

People with early oral cancer may be treated with surgery or radiation therapy. People with advanced oral cancer may have a combination of treatments. For example, radiation therapy and chemotherapy are often given at the same time. Another treatment option is targeted therapy.

The choice of treatment depends mainly on your general health, where in your mouth or throat the cancer began, the size of the tumor, and whether the cancer has spread.

Surgery

Surgery to remove the tumor in the mouth or throat is a common treatment for oral cancer. Sometimes the surgeon also removes lymph nodes in the neck. Other tissues in the mouth and neck may be removed as well. You may have surgery alone or in combination with radiation therapy.

Also, surgery may cause tissues in your face to swell. This swelling usually goes away within a few weeks. However, removing lymph nodes can result in swelling that lasts a long time.

Radiation Therapy

Radiation therapy uses high-energy rays to kill cancer cells. It’s an option for small tumors or for people who can’t have surgery. Or, it may be used before surgery to shrink the tumor. It also may be used after surgery to destroy cancer cells that may remain in the area.

Doctors use two types of radiation therapy to treat oral cancer. Some people with oral cancer have both types:

• External radiation therapy: The radiation comes from a machine. Some treatment centers offer IMRT, which uses a computer to more closely target the oral tumor to lessen the damage to healthy tissue. You may go to the hospital or clinic once or twice a day, generally 5 days a week for several weeks. Each treatment takes only a few minutes.
• Internal radiation therapy (implant radiation therapy or brachytherapy): Internal radiation therapy isn’t commonly used for oral cancer. The radiation comes from radioactive material in seeds, wires, or tubes put directly in the mouth or throat tissue. You may need to stay in the hospital for several days. Usually the radioactive material is removed before you go home.

Chemotherapy

Chemotherapy uses drugs to kill cancer cells. The drugs that treat oral cancer are usually given through a vein (intravenous). The drugs enter the bloodstream and travel throughout your body. Chemotherapy and radiation therapy are often given at the same time.

Targeted Therapy

Some people with oral cancer receive a type of drug known as targeted therapy. It may be given along with radiation therapy or chemotherapy.

Cetuximab (Erbitux) was the first targeted therapy approved for oral cancer. Cetuximab binds to oral cancer cells and interferes with cancer cell growth and the spread of cancer. You may receive cetuximab through a vein once a week for several weeks at the clinic.

If oral cancer is diagnosed, your doctor needs to learn the extent (stage) of the disease to help you choose the best treatment. When oral cancer spreads, cancer cells may be found in the lymph nodes in the neck or in other tissues of the neck. Cancer cells can also spread to the lungs, liver, bones, and other parts of the body.

When cancer spreads from its original place to another part of the body, the new tumor has the same kind of abnormal cells as the primary (original) tumor. For example, if oral cancer spreads to the lungs, the cancer cells in the lungs are actually oral cancer cells. The disease is called metastatic oral cancer, not lung cancer. It’s treated as oral cancer, not lung cancer. Doctors sometimes call the new tumor “distant” or metastatic disease.

Your doctor may order one or more of the following tests:

• X-rays: An x-ray of your entire mouth can show whether cancer has spread to the jaw. Images of your chest and lungs can show whether cancer has spread to these areas.
• CT scan: An x-ray machine linked to a computer takes a series of detailed pictures of your body. You may receive an injection of dye. Tumors in your mouth, throat, neck, lungs, or elsewhere in the body can show up on the CT scan.
• MRI: A powerful magnet linked to a computer is used to make detailed pictures of your body. An MRI can show whether oral cancer has spread.
• Endoscopy: The doctor uses a thin, lighted tube (endoscope) to check your throat, windpipe, and lungs. The doctor inserts the endoscope through your nose or mouth. Local anesthesia is used to ease your discomfort and prevent you from gagging. Some people also may be given a mild sedative. Sometimes the doctor uses general anesthesia to put a person to sleep. This exam may be done in a doctor’s office, an outpatient clinic, or a hospital.
• PET scan: You receive an injection of a small amount of radioactive sugar. The radioactive sugar gives off signals that the PET scanner picks up. The PET scanner makes a picture of the places in your body where the sugar is being taken up. Cancer cells show up brighter in the picture because they take up sugar faster than normal cells do. A PET scan shows whether oral cancer may have spread.

Doctors describe the stage of oral cancer based on the size of the tumor, whether it has invaded nearby tissues, and whether it has spread to the lymph nodes or other tissues:

• Early cancer: Stage I or II oral cancer is usually a small tumor (smaller than a walnut), and no cancer cells are found in the lymph nodes.
• Advanced cancer: Stage III or IV oral cancer is usually a large tumor (as big as a lime). The cancer may have invaded nearby tissues or spread to lymph nodes or other parts of the body.

If you have symptoms that suggest oral cancer, your doctor or dentist will check your mouth and throat for red or white patches, lumps, swelling, or other problems. A physical exam includes looking carefully at the roof of your mouth, back of your throat, and insides of your cheeks and lips. The floor of your mouth and lymph nodes in your neck will also be checked.

An ear, nose, and throat specialist can see the back of your nose, tongue, and throat by using a small, long-handled mirror or a lighted tube. Sometimes pictures need to be made with a CT scan or MRI to find a hidden tumor. (The Staging section describes imaging tests.)

The removal of a small piece of tissue to look for cancer cells is called a biopsy. Usually, a biopsy is done with local anesthesia. Sometimes, it’s done under general anesthesia. A pathologist then looks at the tissue under a microscope to check for cancer cells. A biopsy is the only sure way to know if the abnormal area is cancer.

Cancer that forms in tissues of the oral cavity (the mouth) or the oropharynx (the part of the throat at the back of the mouth).

This includes areas under the tongue

• Lips
• Gums and teeth
• Tongue
• Lining of your cheeks
• Salivary glands (glands that make saliva)
• Floor of your mouth (area under the tongue

This includes areas of the throat

• Roof of your mouth (hard palate)
• Soft palate
• Uvula
• Oropharynx
• Tonsils

Visit the National Cancer Institute where this information and more can be found about Oral Cancer or ask your cancer care team questions about your individual situation.

Lo que usted necesita saber sobre el cáncer oral en español.

Common treatment options for people with kidney cancer are surgery, targeted therapy, and biological therapy. You may receive more than one type of treatment.

The treatment that’s right for you depends mainly on the following:

• The size of the tumor
• Whether the tumor has invaded tissues outside the kidney
• Whether the tumor has spread to other parts of the body
• Your age and general health

Surgery

Surgery is the most common treatment for people with kidney cancer. The type of surgery depends on the size and stage of the cancer, whether you have two kidneys, and whether cancer was found in both kidneys.

You and your surgeon can talk about the types of surgery and which may be right for you:

• Removing all of the kidney (radical nephrectomy): The surgeon removes the entire kidney along with the adrenal gland and some tissue around the kidney. Some lymph nodes in the area may also be removed.
• Removing part of the kidney (partial nephrectomy): The surgeon removes only the part of the kidney that contains the tumor. People with a kidney tumor that is smaller than a tennis ball may choose this type of surgery.

There are two approaches for removing the kidney. The surgeon may remove the tumor by making a large incision into your body (open surgery). Or the surgeon may remove the tumor by making small incisions (laparoscopic surgery). The surgeon sees inside your abdomen with a thin, lighted tube (a laparoscope) placed inside a small incision.

The surgeon may use other methods of destroying the cancer in the kidney. For people who have a tumor smaller than 4 centimeters and who can’t have surgery to remove part of the kidney because of other health problems, the surgeon may suggest:

• Cryosurgery: The surgeon inserts a tool through a small incision or directly through the skin into the tumor. The tool freezes and kills the kidney tumor.
• Radiofrequency ablation: The surgeon inserts a special probe directly through the skin or through a small incision into the tumor. The probe contains tiny electrodes that kill the kidney cancer cells with heat.

Targeted Therapy

People with kidney cancer that has spread may receive a type of drug called targeted therapy. Many kinds of targeted therapy are used for kidney cancer. This treatment may shrink a kidney tumor or slow its growth.Usually, the targeted therapy is taken by mouth. You may want to read the NCI fact sheet Targeted Cancer Therapies.

Biological Therapy

People with kidney cancer that has spread may receive biological therapy. Biological therapy for kidney cancer is a treatment that may improve the body’s natural defense (the immune system response) against cancer. The treatments used for kidney cancer can slow the growth of tumors or shrink them. The biological therapy is injected intravenously or under the skin. The treatment may be given at the hospital or a doctor’s office.

If kidney cancer is diagnosed, your doctor needs to learn the extent (stage) of the disease to help you choose the best treatment. The stage is based on the size of the kidney tumor and whether the cancer has invaded nearby tissues or spread to other parts of the body.

Your doctor may order one or more tests:

• Blood tests: Your doctor can check for substances in your blood. Some people with kidney cancer have high levels of calcium or LDH. A blood test can also show how well your liver is working.
• Chest x-ray: An x-ray of the chest can show a tumor in your lung.
• CT scan: CT scans of your chest and abdomen can show cancer in your lymph nodes, lungs, or elsewhere.
• MRI: MRI can show cancer in your blood vessels, lymph nodes, or other tissues in the abdomen.

When cancer spreads from its original place to another part of the body, the new tumor has the same kind of abnormal cells and the same name as the primary (original) tumor. For example, if kidney cancer spreads to a lung, the cancer cells in the lung are actually kidney cancer cells. The disease is metastatic kidney cancer, not lung cancer. It’s treated as kidney cancer, not as lung cancer.

These are the stages of kidney cancer:

• Stage I: The tumor is no bigger than a tennis ball (almost 3 inches or about 7 centimeters). Cancer cells are found only in the kidney.
• Stage II: The tumor is bigger than a tennis ball. But cancer cells are found only in the kidney.
• Stage III: The tumor can be any size. It has spread to at least one nearby lymph node. Or it has grown through the kidney to reach nearby blood vessels.
• Stage IV: The tumor has grown through the layer of fatty tissue and the outer layer of fibrous tissue that surrounds the kidney. Or cancer cells have spread to nearby lymph nodes or to the lungs, liver, bones, or other tissues.

If you have symptoms that suggest kidney cancer, your doctor will try to find out what’s causing the problems.

You may have a physical exam. Also, you may have one or more of the following tests:

• Urine tests: The lab checks your urine for blood and other signs of disease.
• Blood tests: The lab checks your blood for several substances, such as creatinine. A high level of creatinine may mean the kidneys aren’t doing their job.
• Ultrasound: An ultrasound device uses sound waves that can’t be heard by humans. The sound waves make a pattern of echoes as they bounce off organs inside your abdomen. The echoes create a picture of your kidney and nearby tissues. The picture can show a kidney tumor.
• CT scan: An x-ray machine linked to a computer takes a series of detailed pictures of your abdomen. You may receive an injection of contrast material so your urinary tract and lymph nodes show up clearly in the pictures. The CT scan can show cancer in the kidneys, lymph nodes, or elsewhere in the abdomen.
• MRI: A large machine with a strong magnet linked to a computer is used to make detailed pictures of your urinary tract and lymph nodes. You may receive an injection of contrast material. MRI can show cancer in your kidneys, lymph nodes, or other tissues in the abdomen.
• IVP: You’ll receive an injection of dye into a vein in your arm. The dye travels through the body and collects in your kidneys. The dye makes them show up on x-rays. A series of x-rays then tracks the dye as it moves through your kidneys to your ureters and bladder. The x-rays can show a kidney tumor or other problems. (IVP is not used as commonly as CT or MRI for the detection of kidney cancer.)
• Biopsy: The removal of tissue to look for cancer cells is a biopsy. In some cases, your doctor will do a biopsy to diagnose kidney cancer. Your doctor inserts a thin needle through your skin into the kidney to remove a small sample of tissue. Your doctor may use ultrasound or a CT scan to guide the needle. A pathologist uses a microscope to check for cancer cells in the tissue.
• Surgery: After surgery to remove part or all of a kidney tumor, a pathologist can make the final diagnosis by checking the tissue under a microscope for cancer cells.

Kidney cancer is a cancer that forms in tissues of the kidneys. Kidney cancer includes renal cell carcinoma (cancer that forms in the lining of very small tubes in the kidney that filter the blood and remove waste products) and renal pelvis carcinoma (cancer that forms in the center of the kidney where urine collects). It also includes Wilms tumor, which is a type of kidney cancer that usually develops in children under the age of 5.

Visit the National Cancer Institute where this information and more can be found about Kidney Cancer or ask your cancer care team questions about your individual situation.

Lo que usted necesita saber sobre el cáncer de riñón en español.

Treatment options for people with uterine cancer are surgery, radiation therapy, chemotherapy, and hormone therapy. You may receive more than one type of treatment.

Surgery

Surgery is the most common treatment for women with uterine cancer. You and your surgeon can talk about the types of surgery (hysterectomy) and which may be right for you.

The surgeon usually removes the uterus, cervix, and nearby tissues. The nearby tissues may include:

• Ovaries
• Fallopian tubes
• Nearby lymph nodes
• Part of the vagina

Surgery to remove lymph nodes may cause lymphedema (swelling) in one or both legs. Your health care team can tell you how to prevent or relieve lymphedema.

Radiation Therapy

Radiation therapy is an option for women with all stages of uterine cancer. It may be used before or after surgery. For women who can’t have surgery for other medical reasons, radiation therapy may be used instead to destroy cancer cells in the uterus. Women with cancer that invades tissue beyond the uterus may have radiation therapy and chemotherapy.

Radiation therapy uses high-energy rays to kill cancer cells. It affects cells in the treated area only.

Doctors use two types of radiation therapy to treat uterine cancer. Some women receive both types:

• External radiation therapy: A large machine directs radiation at your pelvis or other areas with cancer. The treatment is usually given in a hospital or clinic. You may receive external radiation 5 days a week for several weeks. Each session takes only a few minutes.
• Internal radiation therapy(also called brachytherapy): A narrow cylinder is placed inside your vagina, and a radioactive substance is loaded into the cylinder. This common method of brachytherapy may be repeated two or more times over several weeks. Once the radioactive substance is removed, no radioactivity is left in the body.

Chemotherapy

Chemotherapy uses drugs to kill cancer cells. It may be used after surgery to treat uterine cancer that has an increased risk of returning after treatment. For example, uterine cancer that is a high grade or is Stage II, III, or IV may be more likely to return. Also, chemotherapy may be given to women whose uterine cancer can’t be completely removed by surgery. For advanced cancer, it may be used alone or with radiation therapy.

Chemotherapy for uterine cancer is usually given by vein (intravenous). It’s usually given in cycles. Each cycle has a treatment period followed by a rest period.

Hormone Therapy

Some uterine tumors need hormones to grow. These tumors have hormone receptors for the hormones estrogen, progesterone, or both. If lab tests show that the tumor in your uterus has these receptors, then hormone therapy may be an option.

Hormone therapy may be used for women with advanced uterine cancer. Also, some women with Stage I uterine cancer who want to get pregnant and have children choose hormone therapy instead of surgery.The most common drug used for hormone therapy is progesterone tablets.

If uterine cancer is diagnosed, your doctor needs to learn the extent (stage) of the disease to help you choose the best treatment. The stage is based on whether the cancer has invaded nearby tissues or spread to other parts of the body.

When cancer spreads from its original place to another part of the body, the new tumor has the same kind of abnormal cells and the same name as the primary (original) tumor. For example, if uterine cancer spreads to the lung, the cancer cells in the lung are actually uterine cancer cells. The disease is metastatic uterine cancer, not lung cancer. It’s treated as uterine cancer, not as lung cancer. Doctors sometimes call the new tumor “distant” disease.

To learn whether uterine cancer has spread, your doctor may order one or more tests:

• Lab tests: A Pap test can show whether cancer cells have spread to the cervix, and blood tests can show how well the liver and kidneys are working. Also, your doctor may order a blood test for a substance known as CA-125. Cancer may cause a high level of CA-125.
• Chest x-ray: An x-ray of the chest can show a tumor in the lung.
• CT scan: An x-ray machine linked to a computer takes a series of detailed pictures of your pelvis, abdomen, or chest.
• MRI: A large machine with a strong magnet linked to a computer is used to make detailed pictures of your uterus and lymph nodes.

In most cases, surgery is needed to learn the stage of uterine cancer. The surgeon removes the uterus and may take tissue samples from the pelvis and abdomen. After the uterus is removed, it is checked to see how deeply the tumor has grown. Also, the other tissue samples are checked for cancer cells.

These are the stages of uterine cancer:

• Stage 0: The abnormal cells are found only on the surface of the inner lining of the uterus. The doctor may call this carcinoma in situ.
• Stage I: The tumor has grown through the inner lining of the uterus to the endometrium. It may have invaded the myometrium.
• Stage II: The tumor has invaded the cervix.
• Stage III: The tumor has grown through the uterus to reach nearby tissues, such as the vagina or a lymph node.
• Stage IV: The tumor has invaded the bladder or intestine. Or, cancer cells have spread to parts of the body far away from the uterus, such as the liver, lungs, or bones.

If you have symptoms that suggest uterine cancer, your doctor will try to find out what’s causing the problems. You may have a physical exam and blood tests. Also, you may have one or more of the following tests:

• Pelvic exam: Your doctor can check your uterus, vagina, and nearby tissues for any lumps or changes in shape or size.
• Ultrasound: An ultrasound device uses sound waves that can’t be heard by humans. The sound waves make a pattern of echoes as they bounce off organs inside the pelvis. The echoes create a picture of your uterus and nearby tissues. The picture can show a uterine tumor. For a better view of the uterus, the device may be inserted into the vagina (transvaginal ultrasound).
• Biopsy: The removal of tissue to look for cancer cells is a biopsy. A thin tube is inserted through the vagina into your uterus. Your doctor uses gentle scraping and suction to remove samples of tissue. A pathologist examines the tissue under a microscope to check for cancer cells. In most cases, a biopsy is the only sure way to tell whether cancer is present.

Grade

If cancer is found, the pathologist studies tissue samples from the uterus under a microscope to learn the grade of the tumor. The grade tells how much the tumor tissue differs from normal uterine tissue. It may suggest how fast the tumor is likely to grow. Tumors with higher grades tend to grow faster than those with lower grades. Tumors with higher grades are also more likely to spread. Doctors use tumor grade along with other factors to suggest treatment options.

Endometrial cancer is a cancer that forms in the tissue lining the uterus (the small, hollow, pear-shaped organ in a woman’s pelvis in which a fetus develops). Most endometrial cancers are adenocarcinomas (cancers that begin in cells that make and release mucus and other fluids).

Visit the National Cancer Institute where this information and more can be found about Endometrial Cancer including side effects of treatments, support information and more. Or ask your cancer care team questions about your individual situation.

Lo que usted necesita saber sobre el cáncer de endometrio en español.

Blue Ridge Cancer Care provides in-depth cancer risk assessment for individuals with a significant personal and/or family history of cancer. Although genetic testing cannot predict whether a patient will actually develop cancer, understanding the risk of developing the disease can be an important step in prevention. 

Frequently Asked Questions

What is genetic testing? 

Today, tests are available that can detect certain gene mutations. Genetic testing can determine if you have or do not have a hereditary predisposition that may put you at higher risk of developing cancer before any symptoms appear.

What are the benefits of genetic testing?

• Opportunity to reduce the risk of cancer and save lives.
• Early detection, which increases the chance of a successful outcome.
• Knowledge regarding ones cancer risk can help make medical and lifestyle choices.
• Information can be shared with family members, so they too can benefit and make choices about their health. 

Why is genetic testing important?  

Although genetic testing cannot predict whether you will actually develop cancer, understanding your risk of developing the disease can be an important step in making medical and lifestyle decisions that can help prevent cancer or about getting regular screenings that can detect cancer early, when it is most treatable.

What happens during the test?

While the actual test involves a simple blood draw and lab analysis, the pre- and post-consultation with your healthcare team is a key component of your cancer risk assessment. These consultations will prepare you for the pre-test interview, which involves a comprehensive family cancer history, and the post-test results discussion regarding the cancer risk options you have.

What happens after the test?    

After the test results return from the lab, we will review the results with you and address your cancer risk options, which may include closer medical observation, more frequent test and therapy prevention, among others. Furthermore, as your life/needs change over time, so should your plan and our dedicated team will be with you every step of the way.

Will insurance cover genetic testing?

HIPAA protects patient privacy and prohibits health insurance providers from discrimination based on genetic information. Most laboratories determine coverage prior to testing and because the pre- and post-consultation is with a physician, most patients do have coverage. Our Benefit Specialists can help with this process and answer any questions you might have regarding coverage. 

Clinical laboratory tests play a crucial role in the detection, diagnosis, and treatment of many diseases including Cancer. Laboratory tests are provided to patients in connection with their chemotherapy and/or radiation treatments.

Clinical Laboratory Technologists and technicians, also known as Medical Technologists and technicians, perform most of these tests. They examine and analyze blood and other body fluids utilizing State of the art equipment to provide a vast volume of information to enable your physicians to prescribe the appropriate treatments and/or preventive measures to ensure the best therapy for you.

Advances in Laboratory Testing are continually occurring to enhance the early detection of many types of cancer. Along with detecting cancer, these tests will monitor the response of the therapy given and determine effective treatment options for you. 

Our laboratory is fully certified by the COLA (Commission on Laboratory Accreditation) and CLIA (Clinical Laboratory Improvement Act). 

Education

Many people think cancer is inevitable, but for some types of cancer, you can take steps to reduce the risk. Healthy lifestyle habits hold the key to cancer prevention. Up to two-thirds of all cancers may be preventable by avoiding tobacco and adopting other healthy lifestyle habits. Regular screenings can help detect many cancers in the earliest stages, when they can be treated successfully. Thorough cancer screening examinations include cancer risk assessment, screening exams based on age and gender, as well as personalized risk-reduction strategies. Prevention programs include genetic testing, chemoprevention and counseling for nutrition and tobacco cessation.

Here are ten things you can do to protect yourself from cancer:

1. If you are a smoker, make the effort to quite. If you are not a smoker, don't start. Smoking is the single most preventable cause of death and disease. It not only causes lung cancer, it also increases risk for heart attack and for cancers of the mouth, throat, bladder, colon, rectum, pancreas and cervix.
2. Avoid exposure to other people's smoke
3. Know the seven warning signs of cancer, and see your physician if you observe any of them:
   • A change in bowel or bladder habits
   • A sore that doesn't heal
   • Unusual bleeding or discharge
   • A thickening or lump in your breast or elsewhere.
   • Difficulty in swallowing or chronic indigestion.
   • An obvious change in a wart or mole.
   • A nagging cough or persistent hoarseness
4. Don't overeat, drink too much alcohol or eat too many fats. Instead, eat more whole grains, cereal, breads, pastas, fresh fruits and fresh or steamed vegetables – especially broccoli, cauliflower, cabbage and Brussels sprouts. Keep your intake of lean meat, skinless poultry or fish to no more than 6 ounces per day.
5. Exercise. A 30-minute walk each day is one of the simplest ways to incorporate exercise into your daily routine.
6. Know your family's medical history and pay attention to a possibly inherited disposition toward certain cancers.
7. Avoid getting a tan. If your skin will be exposed to the sun for more than 15 minutes, use a sun screen with a sun protection factor (SPF) of 15 or higher.
8. If you are a woman over 20, examine your breasts for lumps or changes at least once a month. If you are a woman over 40, follow your physician's advice for mammograms.
9. If you are a man or woman over 40, follow your physician's recommendations for digital rectal exams.
10. Follow your employer's policies for limiting exposure to harmful chemicals in the workplace. Always wear protective equipment when indicated, know what to do if there is a spill or accidental exposure, and report any hazardous conditions to your supervisor or safety committee representative.

What Is the Goal of Radiation Therapy?

The goal of radiation therapy depends on your specific type of cancer and your overall health. Generally, radiation therapy is designed to achieve one or more of the following results:

• Stop the growth of cancer cells to reduce their size before surgery or stop their growth after surgery.
• Improve your quality of life. Even if it’s not possible to cure certain cancer cases, radiation therapy may still improve symptoms and provide relief from pain and discomfort.
• Reduce the possibility of metastases, or disease spreading to other locations or organs within the body.

How Do I Get Radiation Therapy?

Radiation therapy is given in doses measured in grays or centigrays for several weeks. Radiation may be delivered either externally or internally.
   
External radiation is the most commonly used type. In external radiation, high-energy X-rays are directed at the cancer cells from the outside of your body.
  
Internal radiation, also called brachytherapy, is delivered from within your body in the form of precise amounts of radioactive material in an implanted device such as a catheter or other type of applicator. The radioactive material remains in place for the time required to destroy the cancer cells. That may be a short period of time or the material may be implanted permanently.

How Do Doctors Target the Radiation Therapy?

Today’s advanced technologies combine radiation delivery with different types of imaging, which allows the radiation oncologist to see a picture of the area to be irradiated. This means that the oncologist can more precisely target tumors with the radiation. More precise targeting results in a smaller area of healthy cells exposed to the radiation, which means fewer side effects. Two examples of advanced external radiation technologies are:

• Intensity Modulated Radiation Therapy (IMRT)
• Image-Guided Radiation Therapy (IGRT)

Intensity Modulated Radiation Therapy (IMRT) is an external radiation therapy that uses an imaging technology, such as Computed Tomography (CT), to build three-dimensional images of the treatment area. The oncologist can then make a treatment plan map to deliver tightly focused radiation beams directly to the tumor without needles, tubes, or catheters. Varying the intensity of the beams maximizes the amount of radiation delivered to the cancer cells while minimizing the effect on surrounding healthy cells.

Image-Guided Radiation Therapy (IGRT) is another external therapy. It uses ultrasound technology — called BAT®, or Bi-mode Acquisition and Targeting — to help locate the tumor prior to radiation therapy. BAT combines ultrasound with a 3D tracking system to pinpoint the tumor quickly and accurately, reducing the amount of healthy tissue exposed to radiation. BAT® is particularly effective on smaller or odd-shaped tumors.

High Dose Rate (HDR) brachytherapy is an advanced treatment for internal radiation. Like IMRT and IGRT, HDR allows doctors to deliver precise radiation therapy to your tumor. HRD is frequently used to treat cervical and uterine cancers and certain kinds of lung and esophageal cancers. Recently, it has also proven effective in treating early stage prostate cancer.

What is a Radiation Therapy Session Like?

A radiation therapy team consists of a radiation oncologist, a radiation therapist (who delivers the radiation therapy), physicists and dosimetrists, who all work together to develop your treatment plan and dosage calculations.
 
Before your treatment, you will have a simulation session where your team will map out the location(s) for your radiation therapy using either a CT scanner or x-ray positioning. Small reference marks called tattoos will be marked on your skin to help your team to target your treatment on a daily basis.
 
Your team will make sure you understand everything that will happen before you go in for your first treatment. Generally, you won’t feel anything during treatment, and many people arrange their treatment around their work schedules or other daily commitments.

Review a list of questions you may wish to ask your doctor about radiation therapy.

About half of all cancer patients will require radiation therapy during some phase of their cancer care (delivered in a Radiation Oncology department or facility).

This treatment is delivered in a number of different ways including x-ray or electron beams (from "clinical linear accelerators") and either temporary or permanent internal placement of radioactive sources (known as "brachytherapy" or implant therapy).

These treatments are often highly successful and generally have few side effects (toxicity). Radiation treatments may comprise one part of an integrated cancer management strategy involving surgery, chemotherapy and experimental drugs in addition to radiotherapy.

In general, it is best to receive radiotherapy treatments at a medical facility known for its medical expertise in the field of Radiation Oncology, its technical excellence, and its safety provisions. Large radiation oncology programs located at cancer centers (such as the Blue Ridge Cancer Center) are often ideal places to seek initial medical consultations and subsequent care. 

Hematology is a medical specialty concerned with the study of blood and blood-forming tissues. Physicians in this field are known as hematologists. They study, diagnose, and treat blood disorders such as leukemia, anemia, and hemophilia, as well as diseases of the organs that produce blood, including the lymph nodes, bone marrow, and spleen.

Blue Ridge Cancer Care (BRCC) hematologists use laboratory-based blood tests to diagnose a variety of disorders. Of particular importance are blood tests that provide information about the cellular components of a patient's blood. The most common test, called a complete blood count, indicates the number of red blood cells, white blood cells, and platelets in a given unit of blood.

BRCC hematologists treat chronic blood disorders such as leukemia, a broad group of cancerous diseases of blood-forming organs. The condition affects white blood cells and is usually diagnosed by blood tests that indicate abnormal numbers of these cells. Treatment, which often is coordinated by hematologists and cancer specialists called oncologists, typically involves a combination of drug and radiation therapy and may also include a bone marrow transplant.

An oncologist is a physician who specializes in the study and treatment of cancer. Since modern cancer care now requires a whole team of specialists to care for a person with cancer, there are often several cancer professionals involved from the very beginning. An oncologist can also be a surgeon, or a gynecologist, or a urologist or a radiation specialist. Pediatricians can train in the field as well, and are called Pediatric Hematologist-Oncologists. The names can be confusing, but understanding each one's role, may help explain why so many doctor visits are necessary in order to get the best result.

A "medical" oncologist is trained not only in Internal Medicine, but also in the subspecialty of Medical Oncology. He or she spends two or three extra years learning how to diagnose and treat cancer, and also benign diseases of the blood. The Medical Oncologist is sometimes called a "chemotherapist", but that name is too narrow, and a bit old-fashioned. The Medical Oncologist's role ranges from the front-line doctor who coordinates all care, to the "last in line" doctor who sees the patient after diagnosis and surgery have already happened.

The medical oncologist may use chemotherapy to treat a cancer, or hormonal manipulation commonly used in breast and prostate cancer, or a wide range of the newer "biological" remedies that are rapidly expanding our field. Some of the latest treatments are still in the research phase, and so a "clinical trial" may be offered or suggested. We, at BRCC, believe the opportunity to participate in clinical research is a vital part of moving the curability of cancer forward. 

The information provided within this web site is not intended as medical advice. It should never be substituted for a consultation with a health care professional.

Please contact your physician with questions or concerns about your health condition. Nothing in this site is intended to constitute medical advice, a clinical diagnosis or treatment, nor is the information intended as a recommendation or endorsement of any specific tests, products, procedures, opinions or other information that may be mentioned in this site.

Our web site also provides links to other organizations as a service to our readers. Blue Ridge Cancer Care is not responsible for, nor does it specifically endorse, the information provided within other web sites.

Effective Date: 10/01/2019

THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION.  PLEASE REVIEW IT CAREFULLY.

About Us

In this Notice, we use terms like “we,” “us,” “our” or "Practice" to refer to Blue Ridge Cancer Care, its physicians, employees, staff and other personnel. All of the sites and locations of Blue Ridge Cancer Care follow the terms of this Notice and may share health information with each other for treatment, payment or health care operations purposes and for other purposes as described in this Notice.

Purpose of this Notice

This Notice describes how we may use and disclose your health information to carry out treatment, payment, or health care operations and for other purposes that are permitted or required by law.  This Notice also outlines our legal duties for protecting the privacy of your health information and explains your rights to have your health information protected.  We will create a record of the services we provide you, and this record will include your health information.  We need to maintain this information to ensure that you receive quality care and to meet certain legal requirements related to providing you care.  We understand that your health information is personal, and we are committed to protecting your privacy and ensuring that your health information is not used inappropriately.

Our Responsibilities

We are required by law to maintain the privacy of your health information and to provide you notice of our legal duties and privacy practices with respect to your health information.  We are also required to notify you of a breach of your unsecured health information.  We will abide by the terms of this Notice.

How We May Use or Disclose Your Health Information

The following categories describe examples of the way we use and disclose health information without your written authorization:

For Treatment:  We may use and disclose your health information to provide you with medical treatment or services.  For example, your health information will be shared with your oncology doctor and other health care providers who participate in your care.  We may disclose your health information to another oncologist for the purpose of a consultation.  We may also disclose your health information to your primary care physician or another healthcare provider to be sure they have all the information necessary to diagnose and treat you.

For Payment:  We may use and disclose your health information to others so they will pay us or reimburse you for your treatment.  For example, a bill may be sent to you, your insurance company or a third-party payer.  The bill may contain information that identifies you, your diagnosis, and treatment or supplies used in the course of treatment.  We may also tell your health plan about a treatment you are going to receive to obtain prior approval or to determine whether your health plan will cover the treatment.

For Health Care Operations:  We may use and disclose your health information in order to support our business activities.  These uses and disclosures are necessary to run the Practice and make sure our patients receive quality care.  For example, we may use your health information for quality assessment activities, training of medical students, necessary credentialing, and for other essential activities.  We may also disclose your health information to third party "business associates" that perform various services on our behalf, such as transcription, billing and collection services.  In these cases, we will enter into a written agreement with the business associate to ensure they protect the privacy of your health information.

Individuals Involved in Your Care or Payment for Your Care and Notification:  If you verbally agree to the use or disclosure and in certain other situations, we will make the following uses and disclosures of your health information.  We may disclose to your family, friends, and anyone else whom you identify who is involved in your medical care or who helps pay for your care, health information relevant to that person's involvement in your care or paying for your care.  We may also make these disclosures after your death.

We may use or disclose your information to notify or assist in notifying a family member, personal representative or any other person responsible for your care regarding your physical location within the Practice, general condition or death.  We may also use or disclose your health information to disaster-relief organizations so that your family or other persons responsible for your care can be notified about your condition, status and location.

We are also allowed to the extent permitted by applicable law to use and disclose your health information without your authorization for the following purposes:

As Required by Law:  We may use and disclose your health information when required to do so by federal, state or local law.

Judicial and Administrative Proceedings:  If you are involved in a legal proceeding, we may disclose your health information in response to a court or administrative order.  We may also release your health information in response to a subpoena, discovery request, or other lawful process by someone else involved in the dispute, but only if efforts have been made to tell you about the request or to obtain an order protecting the information requested.

Health Oversight Activities:  We may use and disclose your health information to health oversight agencies for activities authorized by law.  These oversight activities are necessary for the government to monitor the health care system, government benefit programs, compliance with government regulatory programs, and compliance with civil rights laws.

Law Enforcement:  We may disclose your health information, within limitations, to law enforcement officials for several different purposes:

• To comply with a court order, warrant, subpoena, summons, or other similar process;
• To identify or locate a suspect, fugitive, material witness, or missing person;
• About the victim of a crime, if the victim agrees or we are unable to obtain the victim’s agreement;
• About a death we suspect may have resulted from criminal conduct;
• About criminal conduct we believe in good faith to have occurred on our premises; and
• To report a crime not occurring on our premises, the nature of a crime, the location of a crime, and the identity, description and location of the individual who committed the crime, in an emergency situation.

Public Health Activities:  We may use and disclose your health information for public health activities, including the following:

• To prevent or control disease, injury, or disability;
• To report births or deaths;
• To report child abuse or neglect;
• Activities related to the quality, safety or effectiveness of FDA-regulated products;
• To notify a person who may have been exposed to a communicable disease or may be at risk for contracting or spreading a disease or condition as authorized by law; and
• To notify an employer of findings concerning work-related illness or injury or general medical surveillance that the employer needs to comply with the law if you are provided notice of such disclosure.

Serious Threat to Health or Safety:  If there is a serious threat to your health and safety or the health and safety of the public or another person, we may use and disclose your health information to someone able to help prevent the threat or as necessary for law enforcement authorities to identify or apprehend an individual.

Organ/Tissue Donation:  If you are an organ donor, we may use and disclose your health information to organizations that handle procurement, transplantation or banking of organs, eyes, or tissues.

Coroners, Medical Examiners, and Funeral Directors:  We may use and disclose health information to a coroner or medical examiner.  This disclosure may be necessary to identify a deceased person or determine the cause of death.  We may also disclose health information, as necessary, to funeral directors to assist them in performing their duties.

Workers’ Compensation:  We may disclose your health information as authorized by and to the extent necessary to comply with laws related to workers’ compensation or similar programs that provide benefits for work-related injuries or illness.

Victims of Abuse, Neglect, or Domestic Violence:  We may disclose health information to the appropriate government authority if we believe a patient has been the victim of abuse, neglect, or domestic violence.  We will only make this disclosure if you agree, or when required or authorized by law.

Military and Veterans Activities:  If you are a member of the Armed Forces, we may disclose your health information to military command authorities.  Health information about foreign military personnel may be disclosed to foreign military authorities.

National Security and Intelligence Activities:  We may disclose your health information to authorized federal officials for intelligence, counterintelligence, and other national security activities authorized by law.

Protective Services for the President and Others:  We may disclose your health information to authorized federal officials so they may provide protective services for the President and others, including foreign heads of state.

Inmates:  If you are an inmate of a correctional institution or under the custody of a law enforcement official, we may disclose your health information to the correctional institution or law enforcement official to assist them in providing you health care, protecting your health and safety or the health and safety of others, or for the safety of the correctional institution.

Research:  We may use and disclose your health information for certain research activities without your written authorization.  For example, we might use some of your health information to decide if we have enough patients to conduct a cancer research study.  For certain research activities, an Institutional Review Board (IRB) or Privacy Board may approve uses and disclosures of your health information without your authorization.

Other Uses and Disclosures of Your Health Information that Require Written Authorization:

Other uses and disclosures of your health information not covered by this Notice will be made only with your written authorization. Some examples include:

• Psychotherapy Notes:  We usually do not maintain psychotherapy notes about you.  If we do, we will only use and disclose them with your written authorization except in limited situations.
• Marketing:  We may only use and disclose your health information for marketing purposes with your written authorization. This would include making treatment communications to you when we receive a financial benefit for doing so.
• Sale of Your Health Information:  We may sell your health information only with your written authorization.

If you authorize us to use or disclose your health information, you may revoke your authorization, in writing, at any time.  If you revoke your authorization, we will no longer use or disclose your health information as specified by your revocation, except to the extent that we have taken action in reliance on your authorization.

Your Rights Regarding Your Health Information

You have the following rights regarding the health information we maintain about you:

Right to Request Restrictions:  You have the right to request restrictions on how we use and disclose your health information for treatment, payment or health care operations.  In most circumstances, we are not required to agree to your request.  If we do agree, we will comply with your request unless the information is needed to provide you emergency treatment.  To request restrictions, you must make your request in writing and submit it to Rachel Hale, Privacy Officer, Blue Ridge Cancer Care 2013 South Jefferson St., 2nd Floor, Roanoke, VA 24014.  We are required to agree to a request that we restrict a disclosure made to a health plan for payment or health care operations purposes that is not otherwise required by law, if you, or someone other than the health plan on your behalf, paid for the service or item in question out-of-pocket in full.

Right to Request Confidential Communications:  You have the right to request that we communicate with you in a certain manner or at a certain location regarding the services you receive from us.  For example, you may ask that we only contact you at work or only by mail.  To request confidential communications, you must make your request in writing and submit it to Rachel Hale, Privacy Officer, Blue Ridge Cancer Care 2013 South Jefferson St., 2nd Floor, Roanoke, VA 24014.  We will not ask you the reason for your request.  We will attempt to accommodate all reasonable requests.

Right to Inspect and Copy:  You have the right to inspect and copy health information that may be used to make decisions about your care.  To inspect and copy your health information, you must make your request in writing by filling out the appropriate form provided by us and submitting it to Rachel Hale, Privacy Officer, Blue Ridge Cancer Care 2013 South Jefferson St., 2nd Floor, Roanoke, VA 24014.  You may request access to your medical information in a certain electronic form and format if readily producible or, if not readily producible, in a mutually agreeable electronic form and format.  Further, you may request in writing that we transmit a copy of your health information to any person or entity you designate.  Your written, signed request must clearly identify such designated person or entity and where you would like us to send the copy.  If you request a copy of your health information, we may charge a cost-based fee for the labor, supplies, and postage required to meet your request.

We may deny your request to inspect and copy in certain very limited circumstances.  If you are denied access to your health information, you may request that the denial be reviewed by a licensed health care professional chosen by us.  The person conducting the review will not be the person who denied your request.  We will comply with the outcome of the review.

Right to Amend:  If you feel that your health information is incorrect or incomplete, you may request that we amend your information.  You have the right to request an amendment for as long as the information is kept by or for us.  To request an amendment, you must make your request in writing by filling out the appropriate form provided by us and submitting it to Rachel Hale, Privacy Officer, Blue Ridge Cancer Care 2013 South Jefferson St., 2nd Floor, Roanoke, VA 24014.

We may deny your request for an amendment.  If this occurs, you will be notified of the reason for the denial and given the opportunity to file a written statement of disagreement with us that will become part of your medical record.

Right to an Accounting of Disclosures:  You have the right to request an accounting of disclosures we make of your health information.  Please note that certain disclosures need not be included in the accounting we provide to you.

To request an accounting of disclosures, you must make your request in writing by filling out the appropriate form provided by us and submitting it to Rachel Hale, Privacy Officer, Blue Ridge Cancer Care 2013 South Jefferson St., 2nd Floor, Roanoke, VA 24014.  Your request must state a time period which may not be longer than six years, and which may not include dates before April 14, 2003.  The first accounting you request within a 12-month period will be free.  For additional accountings, we may charge you for the costs of providing the accounting.  We will notify you of the costs involved and give you an opportunity to withdraw or modify your request before any costs have been incurred

Right to a Paper Copy of This Notice:  You have the right to a paper copy of this Notice at any time, even if you previously agreed to receive this Notice electronically.  To obtain a paper copy of this Notice, please contact Rachel Hale, Privacy Officer, Blue Ridge Cancer Care 2013 South Jefferson St., 2nd Floor, Roanoke, VA 24014.You may also obtain a paper copy of this Notice at our website, http://www.blueridgecancercare.com.

Changes to this Notice

We reserve the right to change the terms of this Notice at any time.  We reserve the right to make the new Notice provisions effective for all health information we currently maintain, as well as any health information we receive in the future.  If we make material or important changes to our privacy practices, we will promptly revise our Notice.  We will post a copy of the current Notice at the front desk of each office. Each version of the Notice will have an effective date listed on the first page.  Updates to this Notice are also available at our website,

www.blueridgecancercare.com.

Complaints

If you have any questions about this Notice or would like to file a complaint about our privacy practices, please direct your inquiries to Rachel Hale, Privacy Officer, Blue Ridge Cancer Care 2013 South Jefferson St., 2nd Floor, Roanoke, VA 24014. You may also file a complaint with the Secretary of the Department of Health and Human Services.  You will not be retaliated against or penalized for filing a complaint.

Questions

If you have questions about this Notice, please contact Rachel Hale, Privacy Officer, Blue Ridge Cancer Care 2013 South Jefferson St., 2nd Floor, Roanoke, VA 24014.

Blue Ridge Cancer Care is a practice in The US Oncology Network (The Network). This collaboration unites the practice with more than 1,200 independent physicians dedicated to delivering value-based, integrated care to patients — close to home. Through The Network, these independent doctors come together to form a community of shared expertise and resources dedicated to advancing local cancer care and to delivering better patient outcomes. The Network is supported by McKesson Corporation, whose coordinated resources and infrastructure allow doctors in The Network to focus on the health of their patients, while McKesson focuses on the health of their practices. Blue Ridge Cancer Care also participates in clinical trials through US Oncology Research, which has played a role in more than 100 FDA-approved cancer therapies, approximately one-third of all cancer therapies approved by the FDA to date. For more information, visit usoncology.com

ALLEGHANY OFFICE
(540) 862-2400
Hours of Operation:
Monday through Thursday 8:30 am to 4:30 pm

BEDFORD OFFICE
(540) 586-5770
Hours of Operation:
Tuesdays & Thursdays 8:30 am to 4:30 pm 

BLACKSBURG OFFICE
(540) 381-5291
Hours of Operation:
Monday through Friday 8:30 am to 4:30 pm 

LEXINGTON OFFICE
(540) 464-3226
Hours of Operation:
Tuesdays 8:30 am to 4:30 pm

PULASKI OFFICE (Radiation)
(888) 678-0622 or (540) 994-8545
Hours of Operation:
Monday through Friday 8:30 am to 4:30 pm 

ROANOKE OFFICE
(540) 982-0237
(540) 981-7377 Radiation
Hours of Operation:
Monday through Friday 8:30 am to 4:30 pm 

ROCKY MOUNT OFFICE
(540) 489-6522
Hours of Operation:
Monday, Wednesday & Thursday 8:30 am to 4:30 pm 

SALEM OFFICE
(540) 774-8660
(540) 776-4160 Radiation
Hours of Operation:
Monday through Friday 8:30 am to 4:30 pm 

WYTHEVILLE OFFICE
(276) 228-7665
Hours of Operation:
Monday through Friday 8:30 am to 4:30 pm 

To make your first visit as easy as possible, you can complete your forms before arriving. We know that patients who complete their paperwork prior to seeing the doctor feel more at ease during their first appointment. You can take your time at home to fill in as many of the fields as possible. Giving us a complete picture of your heath makes it possible for the oncologist to provide you with the best care possible.

You can fill in the PDF forms online and then print them, sign them and bring them with you to your first visit. If you're not sure how to fill them out online, simply print each page and fill in by hand to bring with you to your first visit. 

We are pleased to have Alan Repasky as our Oncology Liaison. In this role, Alan establishes comprehensive physician outreach programs to help facilitate the referral process while improving communication between Blue Ridge Cancer Care and referring physician's practice's.

We are confident that you will find Alan's outreach beneficial to you, as well as to the patients that you have entrusted in our uncompromising care. Please feel free to contact Alan at (540) 589-5773 or via email at alan.repasky@usoncology.com.
 

We strongly believe patient education leads to better outcomes for our patients during their treatment process.  Here we  Below is a list of websites related to health, oncology and hematology medical issues.

American Cancer Society

American Society of Hematology

American Association for Cancer Research (AACR)

Cancer.net

Cancer Detection and Prevention Online

CancerGuide: Steve Dunn's Cancer Information Page

Cancer Prevention Information from AICR - Online

Cancer Research Institute

CancerTrials: A service of the National Cancer Institute

Carilion Cancer Center

Coping University

Haematologica - The Hematology Journal Website

Hereditary Cancer Quiz

Institute of Cancer Research

Lewis Gale Cancer Center

National Cancer Institute

National Coalition for Cancer Survivorship

National Comprehensive Cancer Network

OncoLink: A University of Pennsylvania Cancer Center Resource

Patient Advocate Foundation

Phillip West Memorial Cancer Resource Center

Society of Gynecologic Oncologists

The Cedars-Sinai Comprehensive Cancer Center

UCSF Comprehensive Cancer Center 

Women's Cancer Network - Find a doctor in your State

 

Clinical Trials

Kansas City Clinical Oncology Program

 

Cancer Drugs

OncoLink: Angiogenesis and Anti-Angiogenic Factors

Medicines and Financial Resources

Financial Resources

HelpingPatients.org

RX Savings Plan

The Medicine Program

 

Breast Cancer Resources

Avon Foundation for Women

Breast Cancer Trials

Living Beyond Breast Cancer

Men Against Breast Cancer

Sisters Network, Inc.

Susan G. Komen for the Cure

Triple Negative Breast Cancer Foundation

Y-Me National Breast Cancer Organization

Young Survival Coalition

The doctor considers the following to determine the stage of Hodgkin lymphoma:

Your doctor can describe your treatment choices and the expected results. You and your doctor can work together to develop a treatment plan that meets your needs.

Doctors sometimes find multiple myeloma after a routine blood test. More often, doctors suspect multiple myeloma after an x-ray for a broken bone. Usually though, patients go to the doctor because they are having other symptoms.

Myeloma begins when a plasma cell becomes abnormal. The abnormal cell divides to make copies of itself. The new cells divide again and again, making more and more abnormal cells. These abnormal plasma cells are called myeloma cells.

People with multiple myeloma have many treatment options. The options are watchful waiting, induction therapy, and stem cell transplant. Sometimes a combination of methods is used.

If the biopsy shows that you have multiple myeloma, your doctor needs to learn the extent (stage) of the disease to plan the best treatment. Staging may involve having more tests:

Your doctor needs to know the extent (stage) of non-Hodgkin lymphoma to plan the best treatment. Staging is a careful attempt to find out what parts of the body are affected by the disease.

Your doctor can describe your treatment choices and the expected results. You and your doctor can work together to develop a treatment plan that meets your needs.

If you have swollen lymph nodes or another symptom that suggests Hodgkin lymphoma, your doctor will try to find out what’s causing the problem. Your doctor may ask about your personal and family medical history.

This information is about non-Hodgkin lymphoma, a cancer that starts in the immune system. Non-Hodgkin lymphoma is also called NHL.

Hodgkin lymphoma is a cancer that begins in cells  of the immune system. The immune system fights infections  and other diseases.

People with leukemia have many treatment options. The options are watchful waiting, chemotherapy, targeted therapy, biological therapy, radiation therapy, and stem cell transplant. If your spleen is enlarged, your doctor may suggest surgery to remove it. Sometimes a combination of these treatments is used.

Your blood is living tissue made up of liquid and solids. The liquid part, called plasma, is made of water, salts and protein. Over half of your blood is plasma. The solid part of your blood contains red blood cells, white blood cells and platelets.

The types of leukemia also can be grouped based on the type of white blood cell that is affected. Leukemia can start in lymphoid cells or myeloid cells.  Leukemia that affects lymphoid cells is called lymphoid, lymphocytic, or lymphoblastic leukemia.  Leukemia that affects myeloid cells is called myeloid, myelogenous, or myeloblastic leukemia.

Doctors sometimes find leukemia after a routine blood test. If you have symptoms that suggest leukemia, your doctor will try to find out what’s causing the problems. Your doctor may ask about your personal and family medical history.

Leukemia is cancer that starts in the tissues that forms blood.

People with thyroid cancer have many treatment options. Treatment usually begins within a few weeks after the diagnosis, but you will have time to talk with your doctor about treatment choices and get a second opinion.

To plan the best treatment, your doctor needs to learn the extent (stage) of the disease. Staging is a careful attempt to find out the size of the nodule, whether the cancer has spread, and if so, to what parts of the body.

If you have symptoms that suggest thyroid cancer, your doctor will help you find out whether they are from cancer or some other cause. Your doctor will ask you about your personal and family medical history. You may have one or more of the following tests:

The treatment that’s right for you depends mainly on your age, the grade of the tumor (the Gleason score), the number of biopsy tissue samples that contain cancer cells, the stage of the cancer, your symptoms, and your general health. Your doctor can describe your treatment choices, the expected results of each, and the possible side effects. You and your doctor can work together to develop a treatment plan that meets your medical and personal needs.

Your doctor can describe your treatment choices and the expected results. Most women have surgery and chemotherapy. Rarely, radiation therapy is used.

To plan the best treatment, your doctor needs to know the grade of the tumor and the extent (stage) of the disease. The stage is based on whether the tumor has invaded nearby tissues, whether the cancer has spread, and if so, to what parts of the body.

Each year, more than 186,000 American men learn they have this disease. Prostate cancer is the second most common type of cancer among men in this country. Only skin cancer is more common.

There are several types of thyroid cancer:

* Papillary thyroid cancer: In the United States, this type makes up about 80 percent of all thyroid cancers. It begins in follicular cells and grows slowly. If diagnosed early, most people with papillary thyroid cancer can be cured.

* Follicular thyroid cancer: This type makes up about 15 percent of all thyroid cancers. It begins in follicular cells and grows slowly. If diagnosed early, most people with follicular thyroid cancer can be treated successfully.

* Medullary thyroid cancer: This type makes up about 3 percent of all thyroid cancers. It begins in the C cells of the thyroid. Cancer that starts in the C cells can make abnormally high levels of calcitonin. Medullary thyroid cancer tends to grow slowly. It can be easier to control if it's found and treated before it spreads to other parts of the body.

* Anaplastic thyroid cancer: This type makes up about 2 percent of all thyroid cancers. It begins in the follicular cells of the thyroid. The cancer cells tend to grow and spread very quickly. Anaplastic thyroid cancer is very hard to control.

Visit the National Cancer Institute where this information and more can be found about Thyroid Cancer or ask your cancer care team questions about your individual situation.

Your doctor can check for prostate cancer before you have any symptoms. During an office visit, your doctor will ask about your personal and family medical history. You’ll have a physical exam. You may also have one or both of the following tests:

Melanoma is the most serious type of cancer of the skin. Each year in the United States, more than 53,600 people learn they have melanoma.

In some parts of the world, especially among Western countries, melanoma is becoming more common every year. In the United States, for example, the percentage of people who develop melanoma has more than doubled in the past 30 years.

Visit the National Cancer Institute where this information and more can be found about Melanoma or ask your cancer care team questions about your individual situation.

When prostate cancer spreads, it’s often found in nearby lymph nodes. If cancer has reached these nodes, it also may have spread to other lymph nodes, the bones, or other organs.

If the doctor suspects that a spot on the skin is melanoma, the patient will need to have a biopsy. A biopsy is the only way to make a definite diagnosis. In this procedure, the doctor tries to remove all of the suspicious-looking growth. This is an excisional biopsy. If the growth is too large to be removed entirely, the doctor removes a sample of the tissue. The doctor will never “shave off” or cauterize a growth that might be melanoma.

Ovarian epithelial cancer is the most common type of ovarian cancer. It begins in the tissue that covers the ovaries. This information is not about ovarian germ cell tumors or other types of ovarian cancer. To find out more about all types of of ovarian cancer, please visit the National Cancer Institute Web site or ask your cancer care team about your individual situation.

If the diagnosis is melanoma, the doctor needs to learn the extent, or stage, of the disease before planning treatment. Staging is a careful attempt to learn how thick the tumor is, how deeply the melanoma has invaded the skin, and whether melanoma cells have spread to nearby lymph nodes or other parts of the body. The doctor may remove nearby lymph nodes to check for cancer cells. (Such surgery may be considered part of the treatment because removing cancerous lymph nodes may help control the disease.) The doctor also does a careful physical exam and, if the tumor is thick, may order chest x-rays, blood tests, and scans of the liver, bones, and brain.

If you have a symptom that suggests ovarian cancer, your doctor must find out whether it is due to cancer or to some other cause. Your doctor may ask about your personal and family medical history.

If you have a change on the skin, the doctor must find out whether it is due to cancer or to some other cause. Your doctor removes all or part of the area that does not look normal. The sample goes to a lab. A pathologist checks the sample under a microscope. This is a biopsy. A biopsy is the only sure way to diagnose skin cancer.

There are different types of treatment for patients with small cell lung cancer.