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Up to half of all men and one-third of all women will face a cancer diagnosis in their lifetime, according to the Nevada Cancer Coalition. Chances are, you or someone you care about has been affected by cancer and has witnessed the ultimate fight for life. More than likely, your loved one’s cancer journey involved radiation therapy – and in fact, more than half of cancer diagnoses are treated in whole or in part with radiation. At first glance, this treatment plan can sound scary to any person. With a cancer care journey, it takes a village, and at Renown Health, we have top-notch leaders of the village roads that lead to radiation.  Meet our Radiation Oncology team at the William N. Pennington Cancer Institute. From intake to inpatient, this department of passionate physicians, radiation therapists, registered nurses, medical assistants, intake coordinators, schedulers and more are here to help every patient dealing with the intimidating diagnosis of cancer. Any patient that needs radiation as a part of their treatment is in the best of hands with this team, who will stop at nothing to ensure each patient under their care knows that they have a village Fighting the Good Fight right alongside them.  Teamwork in Tackling Tumors One of the most common forms of cancer treatment, radiation therapy uses high-energy X-rays to minimize cancerous cells. But with Renown’s Radiation Oncology department, the impressive cancer care doesn’t stop there – this team leverages advanced technology right at their fingertips. In fact, our cancer institute has the most state-of-the-art radiation therapy system of its kind – the ultra-precise Varian TrueBeam radiation therapy system – and is the very first program holding American College of Radiology accreditation in the entire region.  Given the advanced nature of their jobs and the high standard of care their patients expect them to uphold, it’s no question that the days-in-the-life of each team member is complex and can continually change every day.  “There are many moving parts in radiation oncology on any given day,” said Sandra Bailey, Manager of Radiation Oncology Services. “The radiation oncologists consult newly diagnosed patients, follow up with previously treated patients and oversee daily treatments for patients actively receiving treatments. Nurses and medical assistants move around the clinic to support the physicians with patients and provide education and other supportive care.”  The physics and dosimetry teams work diligently alongside the physicians to design the most beneficial treatment plan for each patient. Once a patient begins their treatments, the radiation therapists administer the daily treatments with the utmost precision. Intake coordinators, schedulers and patient access representatives make surethe patients have their insurance authorization and are processed through the system appropriately. Like any well-oiled machine, each part is necessary for the other to function at peak performance to ensure our patients receive the quality care they deserve and expect. Like many other clinical departments at Renown, teamwork coupled with education is crucial to best serve radiation therapy patients. Our nurses on this team are experts at exactly that, serving as a reminder of the transformative power of care in the face of a daunting disease.  “Radiation oncology is a unique world,” said Kristen Reed, Registered Nurse. “We have many different team members that play a role in how we function as a department. We all work together in some aspect to provide care for our patients. As a nurse, I provide patient education to all my patients before starting treatment to go over potential side effects and expectations on their treatment. Daily, we see new patients and follow-ups, plan simulations to start patients for radiation treatments and provide radiation treatments, among many other daily tasks.”  The unique role of our radiation therapists, the team members who are on the frontlines of giving radiation treatments, helps this department stand out from the rest with their tireless dedication to fighting against cancer with compassion and expertise. Not only are they armed with technology, but they are also armed with hands that deliver healing rays of radiation.  “As a radiation therapist, our daily tasks can vary pretty widely,” said Casey Johnson, Radiation Therapist. “We rotate between three radiation treatment machines called linear accelerators – one of which we use for stereotactic radiosurgery, a minimally invasive form of surgical intervention. We also staff the CT simulation room where we construct all the patients' treatment devices and perform their ‘mapping’ scan. We then coordinate with the dosimetrists and physicians to determine the specifics of the patients’ course of treatment. The most important parts of our job are patient care and education. Even though our job is very technical and requires tremendous attention to detail, the critical part is remembering that our average workday could be a monumental day for a new patient.”  “Our day-in-the-life in Radiation Oncology is centered around patient care,” added Haley Longfield, Radiation Therapist. “Although we do not spend a ton of time with our patients, we see them every day. We are able to build a wonderful rapport with our patients that is top-notch. We set up the room with their treatment devices, get them set up appropriately and administer their radiation treatment. On average, our patients are here for about 15 minutes.”  The bottom line: our Radiation Oncology team’s unified commitment to both excellence and innovation promises a brighter future for those battling cancer. No one is ever alone in their fight, and this team makes sure of that, no matter what.  Radiating Excellence in Cancer Care The Pennington Cancer Institute boasts a stellar reputation in our community for offering best-in-class, evidence-based care and cutting-edge research, improving outcomes for patients battling cancer. This fact is what inspired many Radiation Oncology team members to take their talents to this department in the first place.   “I chose to work at the Cancer Institute because I believe we offer the best patient care experience, along with the most advanced radiation treatments in the area,” said Casey Johnson.  "I am a fifth generation Reno resident, and I am part of this community through and through,” added Haley Longfield. “I always knew that I wanted to work here.” The success of our cancer institute starts with our people – and many members of the Radiation Oncology team witnessed this firsthand upon their arrival in this department. “I was initially inspired to move across the country to work in the Cancer Institute by the vision of the senior leaders and the future growth plans for the entire institute; once I arrived, I quickly realized what a great team I am now leading,” said Sandra Bailey. “The compassion and care the Radiation Oncology team provides our patients is second to none. Medical errors are rare in our department, and this can be attributed to not only the processes in place to prevent them, but everyone working together to deliver radiation treatments safely. Each day I witness a patient relationship being nurtured and developed. I am truly honored to be part of this team.”  Inspired by Renown's integral role in the northern Nevada community, several team members were drawn to this department because of the opportunity to make a meaningful impact on patients' lives in a quiet healing environment.  “As a student nurse, I had clinical and practicum on the cancer nursing unit here at Renown; I noticed the quiet, healing environment and a patient population enduring some of life’s most challenging hurdles,” said Rachel Bales, Registered Nurse. “It is in these moments that you can really make a difference as a nurse. After pursuing critical care as a new grad and working in Interventional Radiology with cancer patients, I knew that I had to find my way back to oncology. I applied to Radiation Oncology, and I am working towards my third year in this department. I have always known that I enjoy helping others, and the fulfillment that comes from working with this patient population is unmatched.”  “Renown is a huge part of the community in northern Nevada, and I knew while I was in nursing school that I wanted to have a career here,” added Kristen Reed. “I ended up joining the Cancer Institute about two years ago. My patients are a huge part of why I stay. We really get to know these patients and their families well, especially because they come in from Monday through Friday for up to six weeks for treatments. Building connections and being able to support these patients during a difficult time in their life makes my job fulfilling.”  From the initial consultation to the administration of therapy, the staff's commitment to personalized care remains strong. Patients and their families develop profound connections with these team members as they navigate through the challenges of treatment.  “We have knowledgeable and caring staff that help guide our patients through treatment,” said Kristen Reed. “This starts on the day of their consultation and continues even after completion of treatment. The patients and families get to know the staff through their treatment, and having a familiar face can be reassuring to them. We also take time every week to see how they are doing physically and mentally while undergoing treatment and we give them a chance to check in with their doctor. Taking this time helps reassure patients and allows them to ask questions, and in turn, reduce some anxiety and worry.”

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Injuries happen to everyone. They are caused by participating in sports, recreational activities like hiking, and even by accidentally stepping off a curb wrong. If you experience a sprain or strain, the first few days are often the most painful. Renown Sports Medicine physicians Luis Palacio, MD and Brandon Hockenberry, MD walked us through what to do after an injury.  Listen to Your Body See a medical professional right away if: You know or suspect that a bone is broken You are having difficulties putting full weight on a joint of the leg Pain or swelling is severe There is a sign of an infection, such as redness and warmth in the joint  The First 24-72 Hours Joint sprains tend to swell more than muscle strains. You can use ice as needed for comfort and to relieve any pain, but do not use ice for more than 15-20 minutes at a time. Ice and NSAIDs (such as ibuprofen) can help prevent excessive swelling and mask the pain, but they do not speed recovery. Some research shows that overuse of ice actually delays recovery.    During the first 24-72 hours, your injury will go through an inflammation phase. Inflammation is your body’s natural way to dispose of dead tissue cells, build new healthy structures, and hopefully heal even stronger than before.

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Katherine Bunker, Physical Therapist and Certified Lymphedema Therapist (PT, DPT, CLT) at Renown, discusses how patients can manage lymphedema with changes to daily routines along with diet and exercise. Lymphedema is a condition that affects millions of people around the world. It is a chronic and progressive disorder that results in swelling of the arms, legs, or other parts of the body due to an accumulation of lymph fluid. Lymphedema can occur because of cancer treatments, surgery, or other medical conditions.   Managing Lymphedema Treatments to help reduce symptoms such as pain, swelling and discomfort associated with lymphedema can include compression garments, exercise, skin care, manual lymphatic drainage and pneumatic compression.  The goal is to avoid triggering the onset of lymphedema. Lymphedema can present itself immediately after surgery or radiation. It can appear months later or even years later. There are many factors that influence the development of lymphedema which is why prevention is so important. If you have had injury or disruption to your lymphatic system, then:  Avoid injuries to the skin near the affected area. For example: wearing gloves during gardening, using bug spray to ward off mosquitos, covering your limbs while playing with pets, keeping nails clean and avoiding cutting too close to cuticle, utilizing electric razors at the armpit (instead of a traditional razor).,   Avoid blood pressure readings to the affected limb or request blood pressure to be taken manually, not by a machine.   Avoid heat like saunas, hot tubs, sunburns, hot packs, and even massages.    Avoid tight jewelry like rings or bracelets, which can be too tight.

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When your child has a fever, worrying about their discomfort and illness is natural. However, fevers are part of the body's defense against infections, aiding your child's recovery. While rest and home remedies often help, it's important to know when to seek medical attention to keep your little ones safe and healthy. Symptoms of a Fever Fevers can be caused by infections, teething, vaccinations, hot environments, and autoimmune diseases. During a fever, your child may experience visible symptoms such as: Chills Disinterest in food Fussiness Headache Sore throat Cough/Congestion Feeling warm to touch Vomiting/Diarrhea Providing Comfort to Your Child Use these recommendations to make your child feel more comfortable as they recover. Use lightweight clothing and blankets to help regulate their body temperature. Encourage hydration by providing clear fluids and offer soft, easy-to-digest foods. Sponge bath with lukewarm water (do not use cold water as it can worsen symptoms.) Offer restful and quiet activities. Check with your child’s pediatrician to see if you can give them acetaminophen or ibuprofen. Continue to monitor symptoms and temperature. When to Seek Medical Attention Trust your instincts and always lean on the side of caution. In certain situations, a fever may need medical attention and treatment.

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Bacterial meningitis is probably the last thing on your mind as you help your child prepare for college. Buying books and stocking up on necessities may top your list, but it’s a good idea to ensure your student is up-to-date on their meningitis vaccine. How Bacterial Meningitis Spreads According to the Centers for Disease Control and Prevention, people living in close quarters are more likely to spread this illness to one another. For example, you may have heard about the higher risk of meningococcal (or bacterial) meningitis for new college students. The risk is so serious that many colleges and universities require proof of a vaccine for new students moving into campus housing. This includes the University of Nevada, Reno. To clarify, all incoming freshmen under 23 years of age must show proof of their up-to-date meningitis shot. “Bacterial meningitis is considered a medical emergency, and anyone with the signs and symptoms should be evaluated in the emergency room immediately,” says Vanessa Slots, MD, Renown pediatrician. Symptoms of Bacterial Meningitis Fever Nausea Vomiting Irritability Headache Confusion Back pain Stiff or painful neck Leg pain Light sensitivity Rash on the torso or lower extremities It’s important to know many of these symptoms for both bacterial and viral meningitis are the same. However, the viral type is more common, often clearing up in seven to 10 days without complications. Nonetheless, you should go to the emergency room to be looked at, as the signs are similar for both illnesses. Why is Bacterial Meningitis Dangerous? This illness moves quickly, and in some cases, it can seem like the flu or severe strep throat and take a few days to develop. Or, it can hit in just hours. “Bacterial meningitis has an overall death rate of 10 to 15 percent despite treatment with antibiotics,” Dr. Slots warns. Another critical point is problems after recovery can also be severe. Frequently these include brain damage, amputations, infections around the heart, seizures and shock.

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Cancer is challenging, but no one has to go through it alone. Patients and their loved ones can navigate the journey towards healing and recovery with the proper support and resources from Renown Health.  When faced with a cancer diagnosis, access to reliable and comprehensive cancer resources is key. These resources provide vital information, support, and guidance for patients, caregivers and loved ones throughout cancer treatment and recovery. Cancer Resources Breast Cancer Newly Diagnosed Orientation Class  Cancer Support Groups  Caregiver Support  General Cancer Support Group  Lymphedema & Physical Therapy  Men’s Prostate Cancer Support Group  Newly Diagnosed Breast Cancer Workshop  Smoking Cessation  Spiritual Center Activities & Programs  Sterling Silver 55+ Club Facebook Group  At Renown and in collaboration with community partnerships, we offer a variety of resources and specialty care programs focused on improving the quality of life after cancer including:  Cancer support groups play a crucial role in providing emotional, psychological, and practical assistance to those affected by cancer   These groups often consist of individuals who have been through similar experiences and can offer guidance, empathy, and understanding.   They provide a safe space for individuals to share their feelings, concerns, and experiences with others who truly understand what they are going through.

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Sepsis happens when a person's body reacts too strongly to an infection. Usually, our bodies fight infections with help from our immune system. But with sepsis, the body fights too hard, and that can be dangerous. Dr. Julianne Wilke, Pediatrics and Critical Care Medicine, examines pediatric sepsis's causes, symptoms and treatments and provides tips on preventing this potentially fatal condition. Most Common Causes Pediatric sepsis is a particularly concerning form of sepsis that can occur in children and infants. Therefore, it is vital for parents and caregivers to be aware of the indications of pediatric sepsis and to understand the causes. Bacterial infections are the most common cause of pediatric sepsis, accounting for over 80% of cases. Common Bacterial Causes: Staphylococcus infections (including Methicillin Resistant Staphylococcus Aureas - MRSA) Streptococcal infections (including those causing pneumonia and group B strep) Escherichia coli, or more commonly; E. coli Klebsiella and Pseudomonas infections Viral Infection Causes: Respiratory syncytial virus (RSV) Influenza Parainfluenza Adenovirus Human metapneumovirus Coronaviruses (including COVID-19) Other Causes: Fungal infections (but are relatively rare) Parasites, such as Giardia lamblia Pediatric Sepsis Symptoms Parents and caregivers need to be observant of sepsis symptoms in children and can include: Fever Extremely fast heart rate Rapid breathing Lethargy Pale or discolored skin Low blood pressure Confusion Slurred speech Abdominal pain Diarrhea & Vomiting Decreased urination Difficulty breathing Use the acronym SEPSIS: S – Slurred speech and confusion E – Extreme shivering or muscle pain/fever P – Passing no urine all day S – Severe breathlessness I – “I feel like I might die.” S – Skin mottled or discolored If any of these symptoms are present, seeking immediate medical attention is imperative.

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