Friday, March 17, 2017

Familiar informations in Oncology clinic

Here are some of the informations that I learned and became more familiar with in my 3 month working for CIN KPNW Oncology and Hematology Department:

CANCER- a disease where abnormal cells uncontrollably grow and destroy the body.

ONCOLOGY- the study of cancer.

ONCOLOGIST- specialist of cancer

HEMATOLOGY- the study of the blood

HEMATOLOGIST- specialist of blood

METASTASIZE- cancer that spread to other parts of the body.

LOCAL RECURRENCE-  cancer that came back after treatment in the same place

DISTANT RECURRENCE-  cancer that came back after treatment in other part of the body.

CHEMOTHERAPY DRUGS- are used to treat cancer  either one chemo drug or combination with other drugs on treatment.

The WAY chemo treatment is administered to the patient is based on the following:

  • seriousness or stage of the cancer
  • patient choice
  • depends upon the effectiveness of the drug to the patient
ADMINISTRATION of chemo drugs:

  • Orally (oral pill)
  • IV (directly into the vein or intavenously)
                 a) PICC LINE ( Peripherally inserted central catheter) The catheter is placed in a large vein in arm. This remains in place for days or weeks. The dressing needs to be changed once a week.
                 b) PORT A CATH- has opening (septum) under the skin of the chest. Ports are flushed with heparin every 4 weeks when not in used to keep it from clotting. Ports are flushed with salin before, between meds and treatment.

CHEMO is given in CYCLES. Our patients see their Provider every start of their cycle to make sure that they are ready to pursue the next chunk of cycle.

ADJUVANT TREATMENT such as radiotherapy or systemic therapy is generally given after surgery to many types of cancer such as breast cancer, colon cancer, lung cancer, pancreatic cancer and prostate cancer.

PALLIATIVE CARE is prolonging life or reducing the symptoms. It is not curing the cancer but rather controlling the cancer cells to grow or spread.

HOSPICE. Some of our terminally ill patients are being refered here where they can be taken cared of.

HORMONE THERAPY is the use of drugs to prevent hormones from making cancer cells grow.

Our clinic administers ZOMETA, a strengthening bone drug to our patients who have hypercalcemia, osteoporosis and cancer. BISPHOSPHONATE DENTAL CLEARANCE is need before a patient is given zometa.

CT SCAN- images taken to diagnose disease.

DEXA/DEX (Dual X-ray Absorptometry) - scans the bone and measures bone mineral density (BMD). Our bone density decreases after age 35. Bone loss occurs faster to women after menopause.

MUGA (Multigated Acquisition Scan) a test that evaluates the ventricles of the heart. It tells if they are functioning properly.

Since I assist with Dr. Harvey who has a specialty in breast cancer, I am learning a lot about the mentioned disease. Women might choose BREAST RECONSTRUCTION for the following reasons:

  • make chest look balanced specially when wearing a bra or swimsuit
  • regain breast shape
  • so they do not have to use external prosthesis
  • to feel better about how she looks, regain confidence and to be happier with her body.
Reconstructed breast however is not a perfect match or substitute for the natural breast. If the tissue from the other part of your body will be used (tummy, shoulder or buttocks), they will look different after the surgery. Not all reconstructive surgery  is completely successful. The surgery will leave scars on the breast and areas where the tissue for the new breast mound was taken. The reconstructed breasts will not have the same sensation and feeling as the natural breast. the breast or flaps might die after reconstructive surgery or known as necrosis. This delays healing and more surgery is needed to fix it. Reshaping the other breast to match the reconstructive breast might be suggested.


  • PHYSICAL EXAM- 3 to 6 months visit with the Doctor for the first 3 years after first treatment,6-12 months for the next 2 years and then once a year thereafter.
  • GENETIC COUNSELING if you have family history of cancer
  • HORMONAL THERAPY- I learned that as part of the patient's treatment plan, she should continue hormonal therapy as per her oncologist. The purpose is to lower estrogen and progesterone to grow or block them from getting to any remaining cancer cells.
                     anastrazole (ARIMIDEX), exemestane (AROMASIN) and letrozole (FEMARA) are examples of Aromatase inhibitors (ALS) that are used to treat breast cancer in postmenopausal women. This stops the production of estrogen.

                      TAMOXIFEN is effective to both women who are premenopausal or postmenopausal women. Taken for 5  years up to 10 years by premenopausal women. 5 years up to 10 years or switch to an AL for the last 5 years for postmenopausal women.

Thursday, March 16, 2017

Work at Kaiser Permanente

Three months ago, I started working for Kaiser Permanente as an employee. I was assigned to be Dr. Harvey's medical assistant. She is an oncologist, with a specialty of breast cancer. But she also sees other cancer patients like lung cancer, colon cancer etc. I sometimes have the opportunity to work with other Providers when Dr. Harvey has no schedules to see patients. I have assisted Dr. Mansoor, Dr. Barnett and Dr. Boyle who are all Hematologist. I have also assisted Dr. Da Graca, Dr. Lackowski, Dr. Boriboonsomsin and Dr. Shohara who are all Oncologist. Working in this Oncology and Hematology Department is such a big blessing for me and my family. I'm definitely learning a lot in this field of medicine and science. 

Working with these wonderful medical assistants is a blessing! I belong to a great team as everybody is helpful, hard working, flexible and professionals.

L-R: Celeste, Bogdan, Stephanie, Irene, Eugene, Jeni, Liliana, Marina, John and Yvonne.

L-R: David, Roseann, Sergio, Alex, Heather and Robby.

I have finished the course

On October 14, 2016 I graduated in Medical Assisting program of Carrington College Portland Campus. It was a nine month course. I was blessed with a wonderful, skillful instructor, Ms. Laura Morrison. 

I thank Heavenly Father for blessing me with a supportive and loving Husband. "It is such a wonderful thing when someone you love believes in you" -Lucy Smith. During my half day schedules in school, Kevron works from home so he could take care of Miggie.

My Husband and children were my inspiration, strength and source of hope that helped me reached my goal.

At times, we needed Papa Rollie and Mommy's help. I am so grateful for having supportive and understanding parents. I am blessed for having them in my life.

I got a silver cord to hang in my neck as a token for obtaining a 3.9 GPA.

Here is our graduation ceremony program. I was one of the student speakers.

The proof of my success! I also was awarded a certificate for perfect attendance.

"To God, be the glory"