Lymphoma News by maclaren1


									                                          the leukaemia foundation of Queensland
                                               support services division presents

                         Lymphoma News
                         Caring for patients and their families living with lymphoma | Issue 1 2008

  in this
                           amy’s story
  issue...                 In 2006, I was sixteen and a half
                           years old and excitedly starting my
    mouth care for
                           final year of high school. A few
  lymphoma patients        weeks in, however, I started feeling
      page 2 - 3           sick, run down and losing weight. I
                           consulted a couple of doctors who
                           told me I simply had pneumonia.
                           They prescribed antibiotics but
                           when I didn’t seem to be getting any
                           better I went to see a third doctor.
                           This doctor did three blood tests
                           over three weeks and a chest x-ray
                           and finally he told us his suspicion,
                           lymphoma.                                 amy meets Bronco’s captain darren lockyer, when she was
                                                                     first diagnosed with lymphoma in 2006.
 hodgkin lymphoma
     page 4 - 5            I was admitted to Nambour General Hospital on the afternoon of March 31, 2006, going
                           straight from the medical centre to the hospital. By Sunday morning I was in the car on my
                           way to Royal Brisbane Hospital. It all happened so fast. My grandparents came to take care
                           of my younger brother and sister, my bags were packed, and in no time at all my residence
                           was the cancer ward. I had a bone marrow aspirate, biopsy, and a portacath inserted in less
                           than a week, and then played the waiting game - waiting for the specific diagnosis, waiting
                           to start treatment, waiting to get out of hospital.

                           Finally, the doctors came round with the news. It was Hodgkin’s lymphoma. For the
                           next six months I was to have chemotherapy fortnightly, which meant traveling from my
    what happens if
                           hometown, the Sunshine Coast, to Brisbane. This got to be quite tiring and expensive. I also
treatment gets delayed
                           got extremely sick with nausea throughout this treatment and was forced to postpone my
       page 6              studies, making me miss my school friends tremendously.

                           In November 2006, I began my twenty lots of radiation. This month I was meant to graduate
                           and, luckily enough I had radiation in the morning, got ready and made my way to the
                           ceremony. I, of course, didn’t graduate but to spend that night with the Class of 2006 was

                           In April of 2007 the doctors concluded that I was now in remission. I started my part time
                           job again and went back to school to continue my studies. I turned eighteen, hosting a big
                           party for my old and new school friends and had a fantastic time.
  fundraising update
       page 7              Routine check-ups have become a regular part of my life. Thanks to a routine check-up in
                           October 2007, my doctors found that I had relapsed. I was distraught and couldn’t believe
                           that it was happening all over again. I was just two months off graduating. I spent three
                           weeks in hospital having chemo and, on the day before my graduation, my stem cells were
                           harvested. The next morning, on graduation day, I made it home with only about two hours
                           to spare. It was a huge relief just to make it home, let alone to graduation.

                                                                                                    continued on page 5
                                                          mouth Care for
                                    from                  lymphoma patients
                                                          Information from lymphoma UK infosheets

                                    editor                introduction
                                                          Good mouth care is important at all times to help ensure
                                                          that your mouth is kept clean, moist and free from
Welcome to our first edition of Lymphoma News             infections. However, when you have lymphoma it is
for 2008. Best wishes for the year ahead and I            essential to be extra vigilant with your mouth care as you
hope it is filled with health and good times with         may be more prone to a variety of problems including a
the ones you love.                                        sore or inflamed mouth, infections, bleeding gums and a
                                                          dry mouth.
It has been a busy start to the year for us here,
organising session topics for the Lymphoma                what are the causes of mouth problems?
Luncheon series and confirming the guest speakers.        When you have lymphoma you may have a weakened
The final page of the newsletter gives luncheon           immune system – both because of the disease itself and
dates, please also refer to the specific session          also as a result of some of the common treatments (e.g.
brochures for further details. Please ensure that         chemotherapy and steroids). This can mean that you are
you RSVP for the sessions to our Support Service          at an increased risk of picking up frequent or recurring
division for catering purposes and also, in the           infections. Common mouth infections include the fungal
unforeseen event that we have to postpone events,         infection known as thrush (or candidosis) and the viral
we can contact you to let you know.                       infection herpes simplex (which often results in cold sores).
                                                          Some of the chemotherapy drugs used in the treatment
We have an exciting year ahead with our seminar           of myeloma can cause a variety of mouth problems,
series. Our first luncheon in March featured              especially inflammation or ulceration of the lining of the
guest speaker Diana Moore, a Clinical Practice            mouth (known as mucositis). This is because chemotherapy
Nurse from the Mater Private Hospital who                 attacks the rapidly dividing cells throughout the body,
spoke on Stem Cell Transplantation: Making an             such as those in the lining of the mouth. Mucositis can
Informed Treatment Choice. Diana’s extensive              be extremely painful and can, especially after high dose
working history in the haematological setting and         chemotherapy and stem cell transplantation, make eating
experience of caring for both the patients and            and drinking very difficult.
their carers throughout this treatment ensured that
this session examined the process from all angles.        Some lymphoma treatments can, temporarily, lower your
Those who attended were very impressed with               platelet count. As a result of this you may notice that you
Diana’s ability to cover the topic so thoroughly in       bleed more easily – especially from your gums or the
an easy to understand way.                                corner of your mouth. This can sometimes lead to painful
                                                          cracks around your mouth. Another common side effect
We look forward to seeing you all throughout the          is a dry mouth as many drugs can interfere with saliva
year, either at one of our official events or in a more   production. Though unpleasant and uncomfortable, it is
personal setting. I would also like to remind you         worth remembering that most mouth problems are usually
that our team is here to offer support to the patient     a temporary and very treatable complication of lymphoma
as well as their loved ones and carers. If you have       or its treatment.
any feedback or suggestions on our newsletters,
luncheons or services please ensure you let us            what to look out for
know so we can continue to meet your needs. I             It is a good idea to get into the habit of inspecting your
hope you enjoy this edition of Lymphoma News              mouth every day so that you can detect any visible
where we have featured Hodgkin lymphoma.                  changes. To do this you will need to look closely at your
                                                          gums, your tongue and the lining of your mouth. Let your
Kathryn Huntley                                           doctor, or nurse, know if you are experiencing any of the
Support Services Coordinator                              following:
Leukaemia Foundation of Queensland
                                                          •	 Unusual dryness of the mouth
                                                          •	 Redness or swelling of the tongue, lips,
                                                             gums or the lining of the mouth
•	 Gums that bleed easily or are inflamed
•	 Sores on the lips or at the corners of the mouth
•	 Mouth ulcers
•	 Altered taste or sensation in mouth
•	 White plaques coating the tongue and the lining
   of the mouth – this may indicate oral thrush
•	 Pain or numbness in the jaw or surrounding area
•	 Loose or damaged teeth

mouthcare treatments available
It is important to inform your doctor or nurse as soon as
you notice any changes to your mouth so the appropriate
treatment can be prescribed. Treatments may include:
•	 Antibacterial mouthwash – to reduce the risk of
•	 Anaesthetic mouthwash – to relieve pain
•	 Antiviral medication – to treat, or prevent, cold sores
•	 Antifungal lozenges, drops or mouthwash – to treat
      and prevent oral thrush
•	 Artificial saliva spray – to help relieve the discomfort
      of a dry mouth
•	 Pain killers (e.g. codeine or morphine) may sometimes
      be required (often in liquid form or via a syringe driver)
      for severe mucositis.

Try to get into a routine with your mouth care and ensure
you comply with any treatment your doctor has given you.           Coping with a sore, dry
If your mouth is sore, ensure you take painkillers or an           or infected mouth
anaesthetic mouthwash before you eat.                              •	 Take painkillers regularly throughout the day – do not
If you do need any invasive dental treatment, it is important         wait until you are in pain.
your dentist knows about your lymphoma and any                     •	 Avoid spicy, acidic or salty foods as they can increase
treatment you are receiving. It is also advisable to discuss          irritation in your mouth.
any proposed dental treatment with your haematologist              •	 Avoid alcohol and tobacco as they too can irritate
prior to undergoing the procedure.                                    your mouth.
                                                                   •	 Eat soft or pureed foods or moisten foods with gravy,
tips for self-management                                              melted butter or sauces to make them easier to chew
preventative measures                                              •	 Try to keep drinking as much as possible – use a straw
•	 Try to keep your mouth clean by brushing your teeth                if necessary.
   at least twice a day. Use a soft toothbrush and only            •	 Eat ice cubes, ice-lollies or boiled sweets – they can
   brush very gently around your gums.                                soothe a sore mouth and help with dryness
•	 Avoid flossing your teeth unless you know that your             •	 Avoid wearing dentures for a while if your mouth is
   platelet count is normal.                                          very sore or inflamed.
•	 Keep your mouth moist and fresh and try to drink at             •	 Ask to be referred to a dietician if you are having
   least three litres of clear fluid a day.                           problems eating – they can prescribe supplements to
•	 Use vaseline or lip balm to help keep your lips moist.             boost your nutritional intake.
•	 Keep your dentures clean.                                       •	 Use mouthwashes regularly as they can provide
•	 Visit your dentist regularly, especially prior to the start        temporary relief.
   of any new treatment.
•	 Avoid smoking, and take alcohol only in moderation                 *The information in this article is not meant to replace the advice of
•	 Inspect your mouth daily and inform your doctor or                 your medical team. They are the people to ask if you have questions
   nurse of any changes.                                              about your individual situation.

                                                                                                          Lymphoma News
hodgkin lymphoma
extract from understanding Lymphomas - A guide for patients and families. Booklets are
available from the Leukaemia Foundation.

What Are Lymphomas?                                          What causes Hodgkin lymphoma?
Lymphoma is the general term for cancers that develop in     Many people who are diagnosed with lymphoma ask the
the lymphatic system. Lymphomas originate in developing      question “why me?” Naturally, they want to know what
B–lymphocytes and T-lymphocytes, which have undergone        has happened or what they might have done to cause
a malignant change. This means that they multiply without    their disease. The truth is that no one knows exactly what
any proper order forming tumours, which are collections      causes Hodgkin lymphoma. We do know that it is not
of cancer cells. These tumours cause swelling in the lymph   contagious. You cannot ‘catch’ Hodgkin lymphoma by
nodes and other parts of the body. Over time, malignant      being in contact with someone who has it. Like many
lymphocytes (called lymphoma cells) crowd out normal         cancers, damage to special proteins which normally
lymphocytes. Eventually, the immune system becomes           control the growth and division of cells may play a role in
weakened and can no longer function properly.                its development.

There are 35 different types of lymphoma currently           There is some evidence to suggest that people are more
recognised by the World Health Organisation’s                at risk of developing Hodgkin lymphoma if their immune
classification system for lymphoma. Five of these sub-       system has been weakened either by a viral infection
types belong to a group of diseases called Hodgkin           such as human immunodeficiency virus (HIV) or as a
lymphoma. All other sub-types are commonly grouped           result of the use of drugs which affect the function of the
together and called non-Hodgkin lymphomas or B and           immune system (immune suppressants). These drugs are
T-cell lymphomas.                                            commonly used when someone has a heart, lung or other
                                                             organ transplant. Infection with Epstein-Barr virus (EBV),
What is Hodgkin lymphoma?                                    the virus that causes glandular fever, may put some people
Hodgkin lymphoma is distinguished from all other types of    at a higher risk of developing Hodgkin lymphoma.
lymphoma because of the presence, under the microscope,
of a special kind of cancer cell called a Reed-Sternberg     In most cases, people who are diagnosed with Hodgkin
cell. When it is first diagnosed, Hodgkin lymphoma may       lymphoma have no family history of the disease. There
affect a single lymph node or a group of lymph nodes or      have been some cases however where a brother or sister
it may affect another part of the body such as the spleen,   also develops Hodgkin lymphoma, suggesting a rare
liver or bone marrow. In more advanced stages, Hodgkin       familial predisposition to the disease. This is related to
lymphoma can spread via the lymphatic system and the         genetic factors.
blood, to almost any part of the body.
                                                             What are the symptoms of Hodgkin
With treatment, most people with Hodgkin lymphoma can        lymphoma?
be cured; this is especially true for younger patients who   Some people do not have any symptoms when they are
are diagnosed with early-stage disease. Advanced stage       first diagnosed with Hodgkin lymphoma. In these cases
Hodgkin lymphoma can also be treated very successfully.      the disease may be picked up by accident, for example
                                                             during a routine chest x-ray.
Who gets it?
Hodgkin lymphoma can occur at any age but it is most         Hodgkin lymphoma usually presents as a firm, usually
common in adolescents and young adults with over a           painless swelling of a lymph node (swollen glands),
third of all cases diagnosed between the ages of 15 and      usually in the neck, under the arms or in the groin. It is
30 years. Around 25 children (0-14 years) are diagnosed      important to remember that most people who go to their
with Hodgkin lymphoma each year.                             doctor with enlarged lymph nodes do not have Hodgkin
                                                             lymphoma. Swollen glands often result from an infection,
How common is it?                                            for example a sore throat. In this case the glands in the
Hodgkin lymphoma is a relatively rare disease. It accounts   neck are usually swollen and painful.
for around 0.5 per cent of all cancers and 10 per cent of
all lymphomas diagnosed. Each year in Australia, around      other symptoms may include:
400 people are diagnosed with Hodgkin lymphoma.              • recurrent fevers
Hodgkin lymphoma occurs more frequently in males than        • excessive sweating at night
in females                                                   • unintentional weight loss
•   persistent fatigue and lack of energy                      A surgical or excision biopsy involves removing the entire
•   generalised itching or a rash                              swollen lymph node. You will need a general anaesthetic
                                                               for this and you will have a few stitches afterwards.
These symptoms are also seen in other illnesses such as
viral infections. So, most people with these complaints do     If the swollen gland is in your abdomen or pelvis, a
not have Hodgkin lymphoma. However it is important to          laparoscopy may be done to get a sample of the lymphatic
see your doctor if you have any symptoms that do not go        tissue involved. A laparoscopy is a surgical procedure
away so that you can be examined and treated properly.         in which a narrow tube with a tiny microscope attached
                                                               is inserted through a small cut in the skin. It allows the
                                                               surgeon to see the inside of your abdomen or pelvis, and
Which doctor?
                                                               to take a biopsy if needed. This is done under general
If your general practitioner (GP) suspects that you might
                                                               anaesthetic and you will have a few stitches afterwards.
have Hodgkin lymphoma you will be referred on to other
specialist doctors for further tests and treatment. These
                                                               Once the tissue samples are removed, they are examined
may include the following:
                                                               in the laboratory by a pathologist. A pathologist is a doctor
                                                               who is specially trained to examine tissue specimens and
Haematologist: a doctor who specialises in the care of
                                                               cells, to help diagnose diseases like cancer.
people with diseases of the blood, bone marrow and
immune system.
                                                               It can take a few days for the final results of the biopsy to
                                                               come through. This is because the doctors take great care
Oncologist: a doctor who specialises in the treatment of
                                                               to make an accurate diagnosis. An accurate diagnosis of
cancer. A medical oncologist specialises in chemotherapy.
                                                               the exact type of disease you have is important because
A radiation oncologist specialises in radiotherapy and a
                                                               this helps your doctor decide on the very best treatment
surgical oncologist specialises in surgery.
                                                               for you.

How is Hodgkin lymphoma diagnosed                              Understandably, waiting for results can be a very
When you see your doctor, the first thing he or she will       distressing time for you and your family. It may help to
do is give you a full physical examination, looking and        talk about your feelings with someone you are close to or
feeling for any signs of swelling of the glands in your        feel comfortable with.
neck, armpits and groin. Your abdomen and chest will
also be examined for any signs of swollen organs or fluid
collection. The doctor will also ask you about any other
symptoms you might have.
                                                               amy’s story. continued from page 1
At this stage some blood samples may be taken to check         I had another lot of intense chemotherapy before Christmas
how well your bone marrow, liver and kidneys are               and in January 2008 I had a stem cell transplant, staying
functioning.                                                   in hospital for another three and a half weeks. This was
                                                               the toughest part of my whole ordeal. It drained me
Biopsy                                                         both physically and mentally. I did hit the bottom of my
If the doctor suspects that you might have Hodgkin             emotional pit but I am proud of the way I pulled myself up,
lymphoma, a biopsy will need to be done to help confirm        stayed positive and got through it.
the diagnosis. A biopsy involves removing a lymph node or
a sample of tissue from a suspicious lump for examination      I am currently hoping and waiting for my doctor to tell me
in the laboratory.                                             that I am again, in remission and this time, I hope it stays
                                                               away forever. I am extremely grateful to all of the nurses
There are different types of biopsies. A core or fine needle   and doctors that took care of, and continue to take care of
biopsy involves inserting a needle into a lymph node or        me. I am also very thankful to the Leukemia Foundation for
lump and removing a sample of tissue. This is usually          helping my family through its toughest times. And finally,
done under local anaesthetic, while you are awake. If the      I am grateful to my family and closest friends for being
affected lymph node is deep inside the body, the biopsy        supportive and putting a smile on my face when I was in
may be done with the help of ultrasound or specialised         my darkest hours.
x-ray (imaging) guidance.
                                                                                                Lymphoma News
what happens if my
treatment gets delayed?
dr supratik Basu, Consultant haematologist from warwick hospital, United Kingdom
extract from lymphoma association United Kingdom

The possible diagnosis of lymphoma brings with it (and understandably generates) a great deal of anxiety and
apprehension. So it can be even more frightening if, for some reason, the treatment gets delayed. Anxiety mainly
stems from the thought that any delay might adversely affect the treatment outcome. In this article I will try to
explain and explore why this delay might happen and whether (based on available evidence) it might adversely
affect the disease outcome.

delay in starting treatment                                     blood cells produced in the marrow, and leading to low
A proportion of patients may find themselves in a situation     white cell, platelet or blood counts. In medical jargon
where a possible diagnosis of lymphoma has been made            these drugs are called ‘myelotoxic agents’.
but further information is pending before treatment can
be started. This can be very frustrating as the natural logic   Unless the bone marrow sufficiently recovers before the
and inclination is to get the treatment started as soon as      next scheduled course the chemotherapy is often delayed
possible.                                                       to allow the bone marrow time to recover and blood counts
                                                                to reach a safe level. In particular, levels of white cells or
It is important to realize, however, that the best outcome      neutrophils (which prevent serious bacterial infections)
from lymphoma is critically dependent on giving the             and platelets (which prevent bleeding into skin, gums and
appropriate chemotherapy. Diagnosis of lymphoma can             internal organs) need to recover to a safe level to receive
be extremely complicated and this crucially depends on          the next treatment.
various factors, ie
•	 staging (finding out which parts of the body are             People often ask:
      involved),                                                •	 does this delay affect outcome,
•	 certain blood test results, but especially on the            •	 can anything be done so that my treatment won’t need
•	 histopathological variety (the category in which the            to be delayed,
      pathologist classifies the lymphoma by observing the      •	 if we did manage to prevent any delay in treatment,
      cells from the biopsy under the microscope).                 would this lead to any better outcome?
Histopathological diagnosis is very important, as there are
various subtypes of lymphoma. This subdivision involves         Surprisingly the answers are not clear-cut.
observing the microscopic appearance of the cells and using     A national UK audit on neutropenia (low neutrophil count)
various special stains; these investigations can sometimes      found that such neutropaenic events occur, overall, in
take time. In some cases the precise subcategory is still       approximately 43% of the patients receiving chemotherapy
not apparent and a panel of histopathological experts           for Hodgkin’s disease (HD) or non-Hodgkin’s lymphoma
may review the biopsy material, to agree on the precise         (NHL). It is believed that for elderly patients receiving
subtype.                                                        combination chemotherapy the incidence is even higher,
                                                                more than 50%, almost approaching 60%. So this is
Inevitably this will cause some delay, but it is worth          obviously a very widespread problem.
waiting for the precise diagnosis, as this will allow the
most suitable treatment to be given with the best possible      As a consequence of this predictable bone marrow
outcome.                                                        suppression, a number of preventative approaches have
                                                                been taken by clinicians. These include dose delay, that
Your consultant will often explain if this delay is expected    is increasing the interval between successive cycles of
and sometimes even consider giving some sort of ‘holding’       chemotherapy or dose reduction. However, the net effect of
treatment (for example some chemotherapy) if it is              this approach leads to decrease in the dose intensity (DI) of
appropriate. However, the type of treatment may change          chemotherapy and there is some unsubstantiated evidence
when the full diagnosis is made.                                which suggests that maintaining DI is important.

delay in scheduled chemotherapy                                 so what can we do apart from reducing
Very commonly this will happen when the blood count
                                                                the dose or delaying chemotherapy?
is too low to administer the next course of chemotherapy
                                                                One can use a ‘growth factor’ (G-CSF or granulocyte
safely. Some commonly used chemotherapy drugs cause
                                                                colony stimulating factor), which stimulates neutrophil
bone marrow suppression, reducing the number of new
Brave natalie loses
her locks for wgs
It was the tenth year Queenslanders were challenged to be brave and shave and
they most certainly rose to the challenge with over 40, 000 shaving, colouring
and waxing their hair for this year’s World’s Greatest Shave.

Among the brave was Natalie James, Support Services Co-ordinator at the Clem
Jones Sunland Leukaemia Foundation Village, who raised an astounding $20,000
for those living with leukaemias, lymphomas, myeloma and related blood

“When women are diagnosed, one of their big concerns is losing their hair. They
have no choice, so shaving my head was nothing compared to what they go

“I was so thrilled with the support I got. I had raised $16,000 and a patient came
to me and donated the last $4000 – it was overwhelming,” Ms James said.

Leukaemia Foundation of Queensland CEO, Peter Johnstone said staff and
volunteers all over Queensland are now busy collecting the funds raised from
the hundreds of different shave events held throughout the state.
                                                                                                                     Natalie James
“Although it is too early to predict how much has been raised, we are certainly
on target to reach our goal of $3 million.”

    production, and which can be given between courses of
    chemotherapy as an injection just under the skin. However,
    we are still unsure whether the use of G-CSF in this way
    leads to a better outcome for patients.

    so where does this lead us now?
    Excitingly, in 2002 a German study reported that a two
    weekly cycle of chemotherapy, instead of conventional                Doorknock Appeal 19 July – 1 August 2008
    three weekly, resulted in significantly better survival of
    patients, particularly elderly patients with high grade NHL.       Over 30,000 volunteers will be knocking on 700,000
    This dose intensity and scheduling was made possible by            Queensland doors to raise $1.2 million during the Leukaemia
    using G-CSF to support the patients.                               Foundation’s Doorknock Appeal. Please give generously to
                                                                       help find cures.
    This supports the notion that dose delivery and scheduling
    are important and may have an impact on survival.
    The BNLI trial for elderly patients (60 + trial) with high         lavender for leukaemia,
    grade NHL is also looking into this question of whether
                                                                       lymphoma and
    adding G-CSF support to allow higher dose intensity
    results in significantly better survival.                          myeloma
                                                                       7-13 July 2008
    Current other ongoing BNLI trials for NHL and HD also
    make provision and recommendations for use of G-CSF                The scent of lavender is set to waft
    especially when dose delay or reduction becomes                    through the streets of Queensland
    frequent.                                                          from 7-13 July, when the Leukaemia
                                                                       Foundation holds its annual Lavender
                                                                       for leukaemia, lymphoma and myeloma
    ‘take home message’                                                week.
    1.Delay in scheduled chemotherapy is often due to
    inadequate recovery of white cell or platelet count from           For more information on Lavender for Leukaemia or
    the previous cycle of treatment.                                   to become a volunteer, please contact the Leukaemia
    2.Excessive delay or dose reduction can sometimes be               Foundation on 1800 804 444.
    avoided by use of growth factors.

                                                                                                    Lymphoma News
                    support services seminars
Brisbane                                                                        Grief Brunch
The following educational seminars will be held at ESA Village,                 14 June 10.30am (parents)
South Brisbane. For more information or to make a booking                       9 August
phone 07 3840 3844.                                                             11 October

Lymphoma seminars                                                               Celebration of Life
Maximising lymphoma treatment: the role medicines play,                         Sunday 24 August
Timothy Dunn (Clinical Pharmacist), Wednesday, 23 July, 11.30am                 A special event for family and friends to reflect and
Getting my life in order following a lymphoma diagnosis, Graham                 celebrate the lives of those who have died from
Walker (Financial Counsellor), Tania Carvalho (Solicitor) & Liz                 leukaemias, lymphomas, myeloma and related blood
Dwyer (Centrelink), Tuesday, 12 August, 11.30                                   disorders in the past 12 months.
World Lymphoma Day – from diagnoisis to survivorship, Dr Jason
Butler and patient forum, Monday 15 September, 3pm
Carers Group                                                                    The following educational seminars will be held
(4 week course on Thursday mornings 10am)                                       at Freemason Village, 41/100 Angus Smith Drive,
The Role of the Carer – 12 June or 7 August or 2 October                        Douglas 4814. For more information phone 4727
Emotional roller coaster ride – 19 June or 14 August or 9 October               8000.
Carer burnout – 26 June or 21 August or 16 October
Strategies for coping – 3 July or 28 August or 23 October                       Caring for the Carer
                                                                                (3 week course)
Taking Control Program                                                          Course 1 – 18 January, 25 January, 1 February
Adapting to Change – 2 August, 9am-3pm                                          Course 2 – 1, 11 & 18 April
                                                                                Course 3 – 4 June, 11 July, 18 July

                                                                                World Lymphoma Day - 15 September

 Brisbane support services                                                   townsville support services team
 Barbara Hartigan - Director of Support Services                             Angela Daly - Support Services Coordinator
 Dean King - Support Services Coordinator
 Kathryn Huntley - Support Services Coordinator
 Kris Murphy - Support Services Coordinator                                     for help call...
 Maryanne Skarparis - Support Services Coordinator
 Natalie James - Support Services Coordinator                                   Brisbane: 07 3840 3844
 Pat Neely - Amyloidosis Services Coordinator
 Jenny Gallagher - Grant - Grief Support Services Coordinator
                                                                                Townsville: 07 4727 8000
 Shirley Cunningham - Grief Support Services Coordinator              
 Noeleen Schulte - Support Services Administration Officer

                          Our vision to cure and mission to care.
                          The Leukaemia Foundation of Queensland is a not for profit organisation focused on the care and support
                          of patients and their families living with leukaemias, lymphomas, myeloma and related blood disorders.

                          The Foundation does this by providing emotional support, accommodation, transportation and practical
                          assistance for patients and their families. The Leukaemia Foundation also funds research into cures and
                          better treatments for leukaemias, lymphomas, myeloma and related blood disorders.

                          The Leukaemia Foundation receives no direct ongoing government funding, and relies on the continuous
                          support of individuals and corporate partners to expand its services.

                          To find out more about the work of the Leukaemia Foundation of Queensland and how you can help,
GPO Box 9954              phone 1800 620 420 or visit the Foundation’s website:
Brisbane QLD 4001
ph: 1800 620 420
                          Disclaimer: No person should rely on the                 If you do not wish to receive future editions of this
                          contents of this publication without first               publication please contact the Leukaemia Foundation
                          obtaining advice from their treating specialist.         Support Services Division on 07 3840 3844.

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