Frequently Asked Questions
Can you tell me a little about the Infusion Center?
The Center features spacious, light-filled treatment bays, individual flat-screen TVs and relaxing décor. There are 20 reclining chairs in the unit along with chairs for anyone who may have accompanied you. There are curtains around each unit that can be used for privacy.
The Infusion Center tends to be cold. We can provide blankets if you are feeling chilly or feel free to bring a blanket from home if it will make you feel more comfortable.
Laptops and cell phones are permitted and can provide instructions on how to connect to the Internet through our Hospital Wi-Fi system, Jeff Guest.
Can I bring a family member with me?
On the day of treatment, we encourage you to bring one family member or friend with you. Depending on the length of treatment and medication administered, you may be too tired to drive home. Please understand that many of our patients are at an increased risk for infection from viruses due to compromised immune systems. It is for this reason that a strict policy has been implemented that no children under the age of 16 may be permitted in the Infusion Center unless they are receiving treatment themselves.
Am I allowed to eat before treatment?
There are no restrictions on what you can eat on the day of treatment and you can eat anything during the treatment process. You can bring in your own food or eat what is provided by the Infusion Center. We have snacks, juices, coffee, tea and sodas available at all times and sandwiches are available at lunchtime.
There are also many places outside of the Infusion Center where you may purchase food.
Am I allowed to take my medications on the day of treatment?
If you are taking any prescription medications for any conditions, you are permitted to take those on the day of treatment unless your oncologist has instructed otherwise. If you are unsure, contact your doctor.
Where can I park?
Valet parking is available on 10th street between Market and Chestnut Streets in the Rothman Building. The cost of parking is dependent upon the length of stay. Your parking ticket will be validated at the end of your stay and costs can range anywhere from $2.00 to $4.00. You may also self-park in the Laz Parking Garage on 10th and Chestnut Streets.
What is the check-in process at the Infusion Center?
Upon arrival you will check in on the 2nd floor. At the reception desk, you will see a computer monitor and you need to enter your name in the computer and take a seat in the waiting room. If you have any questions on how to do this, one of the receptionists can help you.
Within a short time, someone will call your name and you will be asked to verify your identity and contact information some questions and asked to provide copies of insurance cards, referrals if needed and any co-pays to complete your registration. Once you have completed the registration process, you take a seat in the waiting room until your name is called to have your lab work done. If you do not have a port, you will be brought back to have a phlebotomist or nurse draw your blood.
If you do have a port, you will be taken into the Infusion Center to have your labs done via your port by an assigned registered nurse.
If you are seeing your physician on the same day of your treatment, you will do that after your labs have been drawn. The physician offices are located on the 3rd or 4th floors.
Once you have completed your physician visit, you will come back to the Infusion Center where you will be seated and treatment will begin.
What lab work will I need done?
Your physician will order blood work to be drawn prior to each treatment to ensure that your lab values are within range to proceed with treatment. Labs will either be drawn from our highly skilled phlebotomists or by a registered nurse if you have an infusaport.
Once the labs are drawn and sent to the lab, it will take approximately 60 to 90 minutes for your physician to get the results. We encourage: You can ask your doctor to have your lab work done several days prior to treatment to avoid the wait time and to speed up your treatment process.
How long can I expect my treatment to take?
The length of your treatment is dependent on the type of chemotherapy your physician has ordered based on your type of cancer.
On your first visit, your chemotherapy is mixed specifically for you and your type of cancer at our onsite pharmacy. The pharmacist does not start mixing the chemotherapy until they receive a checklist from your assigned nurse.
This checklist contains your lab results and weight, which needs to be a certain range for you to receive treatment. If the lab values and weight are acceptable, the pharmacist will mix the therapy. This process can take approximately 30-60 minutes depending upon the type of chemotherapy you are receiving.
Overall you can expect to be there anywhere from an hour to several hours.
Will I need an IV to receive treatment?
When you come in for your treatment a registered nurse will be assigned to you. They will determine whether you require an IV or if you have a port that needs to be accessed.
What happens if I miss my appointment?
If you miss your appointment, please be sure to notify your physician so you can be rescheduled for another time. Please contact your physician’s office directly to reschedule.
What if I am running late for my appointment?
If you are running late, please notify the front desk. The telephone number is 215-955-8874. You will not be cancelled but you may be delayed in being seated.
How many times will I need to receive chemotherapy treatments?
Your physician will discuss your treatment and determine how often you will need to receive treatment. Depending upon your type of cancer, a chemo cycle could be every week, every two weeks or every three weeks.
What is a Complete Blood Count (CBC)?
This is a lab value that helps your physician determine if you are able to receive treatment. It looks at your white blood count, hemoglobin (the protein molecule in red blood cells that carries oxygen from the lungs to the body's tissues and returns carbon dioxide from the tissues to the lungs.) and platelets (important for blood clotting). If any of these values are extremely low, treatment may be delayed and you will be rescheduled in a week or so to give your counts time to recover.
If your white blood count is too low, you may receiving an injection that will boost your count to prevent you from developing an infection or your physician may put you on antibiotics. If your hemoglobin level or platelet count are too low, you may require a blood transfusion.
Where do I go for blood transfusions if I need one?
If you need a blood transfusion because of a low hemoglobin level or platelet count, a blood specimen is drawn and sent to the Blood Bank so that they can match your blood type.
Once your blood type is matched, a bag is prepared and we are notified that it’s ready. Your physician may order pre-medication (Tylenol or Benadryl) prior to the infusion to avoid a possible blood transfusion reaction. Typically the doctor will order 2 units.
This entire process can take up to 4 hours.
What if I have a problem after I get home?
If you have any issues after you receive your treatment please call 215-955-8874 and you will be directed on what to do.
If it is an emergency, please call 911 immediately or go to the nearest hospital.
What are the side effects of chemotherapy?
You may experience some side effects after receiving your treatment. The most commonly reported symptoms are nausea, vomiting, diarrhea, hair loss, peripheral neuropathies, and fatigue. Before your treatment begins, you will be given anti-nausea medications, which will help you during your stay.
It’s important to remember that everyone is different and you may experience none of these effects, some or all. It’s important to share the side effects with your physician who may be able to help you manage the side effects with medications. If your symptoms are severe, please contact your physician immediately.
Also, the Jefferson-Myrna Brind Center of Integrative Medicine offers an Integrative Cancer Care Program that provides complementary therapies such as vitamins, special diets, herbs and acupuncture that may help with some of your symptoms.
You also have access to oncology social workers who are trained in individual and family therapy and are available to meet with you to assist with the psychosocial impact of cancer treatment, and can provide a valuable link to available community resources.
I understand I may lose my hair after treatment. Where can I purchase a wig?
Jefferson's Wig Program for Cancer Patients was created to help ease the stress and/or embarrassment of sudden hair loss experienced by our patients. If you are being treated for cancer, either as an inpatient or an outpatient at Jefferson, and you have hair loss, we are happy to provide you with a free synthetic wig, turban or hat.
To make an appointment, place call Patient Services at 215-955-7777 or 5-7777 (from inside the Hospital).
What is leukemia?
Leukemia occurs when abnormal white blood cells accumulate in the blood and bone marrow.
There are two main types of leukemia:
- Lymphocytic leukemia is marked by an increased number of white blood cells called lymphocytes. These cells are made chiefly in the lymph nodes (lymph glands). In leukemia, most lymphocytes produced are abnormal or immature.
- Granulocytic leukemia is marked by an increase in white blood cells called granulocytes. These are made in the bone marrow. Normal granulocytes are essential to the body's defense against infection, but abnormal leukemic cells lack this capability.
Both types of leukemia occur as acute (fast-growing) or chronic (slow-growing) diseases.
Acute leukemia can occur at any age, but it is most often seen in children. It accounts for about half of all leukemia cases.
Chronic leukemia occurs most often in adults, but can occur at any age. It accounts for about half of all leukemia cases.
What happens in leukemia?
Leukemia, like other cancers, is a disease of the body's cells. Cells of different shapes and functions make up various parts of the body: the skin, heart, lungs, bones and so forth. All cells reproduce themselves by dividing. Normal growth and repair of body tissues take place in this orderly manner. When cell division is not orderly, abnormal growth takes place.
Both acute and chronic leukemia affect three types of blood cells: red blood cells, white blood cells and platelets.
Red blood cells carry oxygen to all parts of the body. Made in the bone marrow, they number several million in each drop of blood. In leukemia, the red cell count drops, robbing the body of necessary oxygen. This results in anemia, causing paleness, weakness and fatigue.
White blood cells fight infections by destroying bacteria, viruses and foreign matter in the blood and help build immunity to disease. In leukemia, white blood cells don't function normally. This results in infections occurring repeatedly because the leukemic white cells are unable to fight off bacteria or viruses. An extremely high number of abnormal white blood cells accumulate, flooding the bone marrow and preventing normal blood formation.
Platelets are tiny blood components formed in the bone marrow. They are essential for clotting. They collect around a wound and form a “plug” (clot) to stop bleeding. In leukemia, platelet production goes down. This results in excessive bleeding, bruising and hemorrhaging because the blood won't clot.
Both acute and chronic leukemia cause the same effects, except those of chronic leukemia are less dramatic and typically occur later in the disease course.
In chronic lymphocytic leukemia, the main effect may be simply an increase in lymphocytes circulating in the blood and bone marrow. Multiple lymph node tumors may also develop. The condition may go for many years with few or no ill effects, but infections and bleeding or bruising eventually develop.
In chronic granulocytic leukemia, overgrowth and overproduction of abnormal bone marrow often causes an increase in platelets as well as white cells. The condition can be controlled for several years, but many cases eventually convert to an acute phase.
What causes leukemia?
It is believed that a change in gene structure causes the abnormalities and uncontrolled multiplication of white cells in leukemia. Genes are the “blueprints” for cell growth. They are located on the chromosomes, inside the nucleus of every cell. Scientists at Jefferson's Sidney Kimmel Cancer Center have been world leaders in describing the genes associated with many leukemia types, and new treatment approaches are being designed based upon this new information.
The cause of the change in gene structure is unknown, but several factors are suspected, such as certain birth defects, X-rays, other forms of radiation, viruses and chemical irritants from the workplace or environment.
What are the symptoms of leukemia?
Symptoms of acute leukemia are varied and can progress rapidly. Therefore it is important to consult a doctor promptly.
The lymph nodes, spleen and liver may be enlarged because they are infiltrated with white blood cells. Other common symptoms are bone pain, paleness, tendency to bleed or bruise easily and frequent infections.
With chronic leukemia, a patient most often seeks medical treatment because of increasing fatigue or weight loss. There may be a sense of fullness or heaviness under the left ribs, and the doctor may discover a mass in the abdomen. Less frequently, the complaints result from anemia, abnormal perspiration, fever, bleeding, pain in the spleen or an attack of gout. Sometimes the discovery of the disease may be accidental, in the course of routine clinical or laboratory examinations.
Chronic lymphocytic leukemia usually occurs in older people and develops slowly. In fact, symptoms are entirely absent in some cases, and the disease discovered accidentally when a patient is examined for another complaint. When symptoms do occur, they may be a general feeling of ill health, fatigue, lack of energy, fever, loss of appetite and weight, or night sweats. Enlarged lymph nodes in the neck or groin may be noticed in some patients. Some may show signs of anemia or infections.
How is leukemia diagnosed?
Leukemia can be diagnosed only by microscopic examination of the blood and the bone marrow. If leukemia cells are present in these tissues, they can be identified and the diagnosis made.
Blood tests may show low hemoglobin, low white cell levels and a low platelet level. Blast cells (immature cells) may also be present in the blood.
Because these findings suggest a diagnosis of leukemia, a bone marrow biopsy may be done. A sample of bone marrow is obtained by inserting a needle into the bone and withdrawing a tiny amount of tissue. The bone marrow is examined under the microscope by a pathologist. A pathologist is a physician who interprets and diagnoses the changes caused by disease in body tissues. The bone marrow biopsy establishes the specific type of leukemia, which is essential in determining the best form of treatment. It also is used as a way of checking on the progress of therapy.
When a diagnosis of leukemia is confirmed, it is best that a patient begin treatment in a hospital that has an expert staff and resources to apply all forms of effective treatment right from the beginning.
Do I need a second opinion?
Since treatment decisions are complex, a patient might want a second doctor to review the diagnosis and treatment plan before actually starting treatment.
- Patients can call the Jefferson Cancer Network at 1-800-JEFF-NOW.
- The patient's doctor may be able to suggest a doctor who has a special interest in leukemia.
- Patients can obtain the names of doctors from their local medical society, a nearby hospital or a medical school.
How is leukemia treated?
While treatment must be tailored to individual needs, leukemia can respond well to a program combining chemotherapy and a team approach for total care.
Chemotherapy uses powerful drugs in various combinations to kill abnormal cells and/or slow their growth, giving normal cells a chance. The goal of the therapy is remission, or the apparent disappearance of symptoms and evidence of leukemia. This enables a patient to return to apparently normal health and remain so for weeks, months or years.
Repeated chemotherapy can bring repeated remissions. Some patients have been in remission long enough to be considered cured. Since anti-leukemic drugs also affect normal cells, side effects are common. Therapy must be carefully administered and constantly monitored.
The best chance for a long-term remission is total care treatment in specially equipped medical facilities by a team of specially trained doctors, nurses and paramedics. Total care includes:
- Initial treatment, with drugs given daily to induce remission. Usually within four weeks, a patient is free from any signs of disease.
- Maintenance therapy is employed, sometimes for several months, with selected drugs used to extend and maintain remission.
- Sometimes a bone marrow or peripheral stem cell transplant is performed to maintain remission.
- Supportive therapy is required when disease is active. It may include blood transfusions, platelet transfusions or antibiotics.
The result of successful treatment means a longer life expectancy than ever for leukemia patients, with a significant number achieving a normal lifespan. Though recovery from leukemia was once considered hopeless, major treatment advances mean that acute leukemia is now considered a potentially curable disease.
What are clinical trials?
When laboratory research shows that a new treatment method has promise, patients with cancer have the opportunity to receive the treatment in clinical trials or protocols.
By participating in a clinical trial, you may have the first chance to benefit from improved treatment methods and the opportunity to make an important contribution to medical science. Many clinical trials take the best-known therapy and modify it a little in an effort to improve on it further.
To find out more about current clinical trials that you may be able to participate in, ask your doctor or call either the Sidney Kimmel Cancer Center at Jefferson's Research Management Office at 215-955-1661 or 1-800-JEFF-NOW.