Ch 3 - October 5th, 2015

MORTGAGE LOAN COMMITMENT

We are pleased to advise that, subject to our Solicitor being satisfied in all respects with the title to the property being offered as security, your application for a Fixed Rate mortgage has been approved as follows,

MORTGAGEE: RBC Royal Bank of Canada Ltd.
Address: 248 King St N, Waterloo, ON N2J 2Y7
Phone:
Contact Person: Melissa Dufresne
MORTGAGOR(S): ALEXANDRA RIDLEY
Address: 17 GREENBOUGH CT, KITCHENER, ON N2N 1L8, CANADA
Phone: 519 777 9352
Business Phone(s):
COVENANTOR(S) (If Any):
Address:
Phone:
Business Phone(s):
TYPE OF PROPERTY: RESIDENTIAL

PROPERTY TO BE MORTGAGED (include postal code) same as Mortgagor(s) address or:
17 GREENBOUGH CT, KITCHENER, ON N2N 1L8, CANADA

PAYMENT PROVISIONS
Principal Amount $ 130,000.00
Interest Rate 3.85 % per annum
Calculation Period Semi-annually not in advance
Interest Adjustment Date 15/10/16 (YY/MM/DD)
Payment Date and Period Semi-Monthly
First Payment Date 15/11/02 (YY/MM/DD)
Last Payment Date 25/10/16 (YY/MM/DD)
Amount of Each Payment (Principal & Interest) Dollars $ 438.03
Maturity Date 25/10/16 (YY/MM/DD)
Term: 120 months
Amortization: 180 months
Prepayment Provisions: SEE ATTACHED SCHEDULE 'A' and 'B'
Additional Provisions: FIXED RATE MORTGAGE EQUIVALENT RATE 3.809%

This commitment is null and void if not accepted by (Insert Date) OCTOBER 05/15, and if accepted by said date, may be cancelled or modified if the amount of the mortgage load is not fully advanced by (Insert Date) JANUARY 05/16. This commitment may not be assigned.

CONDITIONS OF ACCEPTANCE (Delete inapplicable conditions and have installed by Mortgagors)

1. TO BE PROVIDED BY MORTGAGOR:

Survey and Zoning Requirements

            An up-to-date survey of this property by a Manitoba Land Surveyor, showing the improvements located entirely within the property lines and with no material encroachments. A zoning memorandum indicating compliance with by-laws as to yards and alignments. Such survey and zoning memorandum to be satisfactory to our Solicitor.

Realty Tax Certificate

            A realty tax certificate confirming there are no outstanding taxes or such proof as is satisfactory to our Solicitor.

Taxes

            Payment of realty taxes in advance by adding to each payment an amount equal to the annual taxes estimated by the Bank, divided by the number of payments for each year.

Declaration As To Possession

            A signed declaration as to possession which will indicate occupancy of the encumbered property.

Order To Pay

            A signed order to pay document which will detail how the proceeds of this mortgage loan will be disbursed.

Fire/Hazard Insurance

            Insurance Policies with coverage for not less than the appraised value of the building(s) with (first/second) loss payable to us and with Standard Mortgage Clause attached must be delivered to our Solicitor.

Other

2. LEGAL AND APPRAISAL COSTS

            You are to pay all legal fees, appraisal fees, and expenses incurred with respect to the mortgage loan and in compliance with the provisions outlined herein, whether or not the mortgage loan is advanced.

3. DISBURSEMENT OF LOAN PROCEEDS

            The Bank will direct all funds in trust to our Solicitor to meet all charges, including retirement of prior indebtedness of any kind.

4. MORTGAGEE's SOLICITOR

            The legal work on our behalf will be done by the Solicitor named in attached Schedule 'C'. You should deliver as soon as possible to our Solicitor: your duplicate title (if applicable); the survey and zoning documents referred to above; the first insurance policy; and the realty tax certificate.

The above is accepted and agreed to:

Alexandra Ridley
Date: October 5, 2015
RBC Royal Bank of Canada Ltd.
Per: Melissa Dufresne
Date: October 5, 2015

***

Stock Transaction Order Form
Toronto Stock Exchange: IMUG
Immugene, Inc.

Delayed quote: $42.07
Today's change: -1.41 (-3.35%)
P/E: Negative
Market cap: 1.15B
Open: $43.48
Previous close: $43.78
High: $43.61
Low: $41.77
Bid / Ask: $42.05 / $42.07
YTD % change: -7.03%
Volume: 49,103
Average volume (10-day): 42,432
Average volume (1-month): 48,038
Average volume (3-month): 47,398
52-week range: $39.85 to $56.35
Trailing P/E: Negative, not meaningful
Indicated annual dividend: $1.32
Dividend yield: 3.14%
Trailing EPS: -$0.31

Market Order BUY 3000 issued at 06/10/15 14:51:24.178
            BUY 100 $42.10 ($4,210.00) 06/10/15 14:51:24.254
            BUY 250 $42.15 ($10,537.50) 06/10/15 14:51:24.389
            BUY 1000 $42.25 ($42,250.00) 06/10/15 14:51:24.572
            BUY 50 $42.60 ($2,130.00) 06/10/15 14:51:25.933
            BUY 75 $42.75 ($3,206.25) 06/10/15 14:51:27.361
            BUY 1400 $43.50 ($60,900.00) 06/10/15 14:52:01.521
            BUY 125 $44.00 ($5,500.00) 06/10/15 14:52:02.424
Market Order BUY 3000 completed at 06/10/15 14:52:02.424 ($128,733.75)

***

INVOICE

Regal Uniform Service

84 Elm St,
Toronto, ON M5G 1H3
1-800-605-1992
GST #: 83750 2833 RT0483
DATE: Oct 19/2015
INVOICE #: 00004352

Ship To: Pick-up
210 Drumlin Circle, Unit #7
Concord, ON L4K 3E3
1-866-238-2451
P.O. #: 20009834

Sales Rep. Name: D. Makie
Ship Date: n/a
Ship Via: Pick-up
Terms:
Due Date: Nov 19/2015

Item #DescriptionPriceQtyLine Total
9000134409/409 Men's Set - M - 2tone Postman Blu/Navy$48.951$48.95
9002008L407 - M - White$20.951$20.95
9006003Littmann Classic II Stethoscope: Grey 2203$93.301$93.30

Subtotal: $163.20
HST 13%: $21.22
Shipping & Handling: $0.00
TOTAL: $184.42
PAID: $184.42
TOTAL DUE: $0.00

***

01035384               10/14/15
PELKEY,MARIUS A
BD    11/08/63    M    75Y
BACHMAN,EMMANUELA H    S403-02
3845-432-452-AM

Princess Margaret Cancer Centre

Toronto, ON

PROGRESS RECORD

DATE / NOTE PROGRESS OF CASE, COMPLICATIONS, CONSULTATIONS, CHANGES IN DIAGNOSIS, CONDITIONS OF DISCHARGE, INSTRUCTIONS TO PATIENT, ETC.

10/19/15Neurology (cont) A. Adenocarcinoma w/ paraneoplastic syndrome, clinically C/W limbic encephalopathy P. No clearly beneficial treatment known and prognosis not good. Lung tumor cannot be eradicated, no other reasonable therapy. Disease is not reversible even if cancer was eradicated (which is not possible). Coping reasonably well for now, but cough and chest pain will likely grow worse. Palliative therapy and Hospice is indicated. Referral for psych assessment is recommended.
10/20/15Psych A. Subject meets DSM-5 criteria for major depressive disorder (MDD) with subthreshold manic symptoms including increased energy, increased speech, and inability to remain still. Classified as MDD with mixed features. DC 296.99 (F34.8) A-D, F, I w/ MDD A (1, 2, 5, 6, 8, 9), B, D - beyond expected norms for response to major illness - Sev. 296.32 (F33.1) with mixed features - A (3, 6), B, D - with melancholic features - A (2), B (1-3). Prescription for Sertraline 50mg 1/d 30d. Must be monitored closely for possible exacerbation of manic symptoms or emergence of additional symptoms presenting into full hypomania episode. P. Given a proscription for Zoloft - 1 tablet per day for 30 days. Any change ability to sleep, impulsive behaviour, wild swings in mood, or suicidal thoughts must be reported immediately. Scheduled for followup on 10/27.
10/21/15A/P: Provided clinical trial information for three active studies currently enrolling at PMCC, patient to review.
10/22/15A/P: Enrollment submitted for (NCT02857382, CA381-013) at patient and family's request.
 
ch3-patient_barcode-sm.png

***

Atericorp Pharmaceuticals Inc.
Internal Memo

TO: Oncology Research Working Group
FROM: Themba Sibisi, VP of Oncology Research
DATE: October 28, 2015 11:32 AM EST
SUBJECT: Priority 1 Research Directive - MUG1 Immunotherapy Resource Redistribution

            Effective immediately staff and resources will be reassigned to a new Priority 1 research project ATX-I-014. Redistribution will primarily impact pre-trial immunotherapy and recombinant gene therapy projects including ATX-I-013, 011, 008, and ATX-G-007, 005. Projects currently conducting clinical trials will be minimally impacted with the exception of ATX-I-009 which will be suspended indefinitely when Phase I trials end in 8 weeks.

            ATX-I-014 will be responsible for developing a method to produce Ankara cultures carrying coded sequences for MUG1 (murinoglobulin 1 [Mus musculus]) into pancreatic adenocarcinoma, non-Hodgkins lymphoma, and leukaemia lines.

            The position of Project Director will be filled by Dr. Miriam Bilodeau with initial development taking place in our Montreal lab. Once MUG1-Ankara synthesis has been completed, furthur research into individual cancer strains and clinical trial oversight will take place in Rochester MN, Detroit MI, and Hamilton ON. Individuals assigned to this project will be notified by Dr. Bilodeau by the end of the week.

            We are playing catch up on this project, our competitors are already showing extremely promising results from Phase III clinical trials with their targetted treatment for lung and brain cancer. The purpose of this project is to apply the same techniques to our area of specialty where we have a golden opportunity to be first to market.

            This priority directive has been approved by R.G. Gladston, President and CEO of Atericorp Pharmaceuticals Inc.

***

Ontario Ministry of Government Services / Office of the Registrar General
Medical Certificate of Death - Form 16

You must use the Stillbirth Registration Form 8 when registering stillbirths. This form must be completed by the attending physician, coroner, or designated person before a burial permit can be issued. Please PRINT clearly in blue or black in as it is a permanent legal record.

INFORMATION ABOUT THE DECEASED

1. Name of deceased (last, first, middle): Pelkey, Marius, Anthony

2. Date of death [month - by name, day, year (in full)]: March, 03, 2016

3. Sex (M or F): M

4. Age: 52

5. If under 1 yr. (months, days):

6. If under 1 day (hours, minutes):

7. Gestation age:

8. Birth weight:

9. Place of death (name of facility or location): Princess Margaret Cancer Centre (Hospital)

10. City, town, village or township: Toronto

11. CAUSE OF DEATH
Part I
Immediate cause of death / Approximate interval between onset & death
            (a) Respiratory Arrest / hours
            due to, or as a consequence of
Antecedent causes, if any, giving rise to the immediate cause (a) above, stating the underlying cause last
            (b) Pneumonia / 2 months
            due to, or as a consequence of
            (c) Carcinoma of lung (primary) / 5 months

Part II
Other significant conditions contributing to the death but not causally related to the immediate cause (a) above
            (a) Smoking 1ppd / 40 years
            (b) COPD / 5 years

12. If decease was a female, did the death occur:
            During pregnancy (including abortion and ectopic pregnancy):
            Within 42 days thereafter:
            Between 43 days and 1 year thereafter:

13. Was the deceased dead on arrival at the hospital?: No

14. Was there a surgical procedure within 28 days of death?: Yes

15. Date of surgery (mm/dd/yyyy): 02/09/2016

16. Reason for surgery and operative findings: Repair of internal injuries sustained by being stabbed, successfully completed with no complications

Autopsy particulars

17. Autopsy being held?: No

18. Does the cause of death stated above take account of autopsy findings?: No

19. May further information relating to the cause of death be available later?: No

Accidental or violent death (if applicable)

20. If accident, suicide, homicide or undetermined (specify):

21. Place of injury (e.g. home, farm, highway, etc.):

22. Date of injury (mm/dd/yyyy):

23. How did injury occur? (describe circumstances):

CERTIFICATION
By signing below, you certify that the information on this form is correct to the best of your knowledge.

24. Your signature (physician, coroner, RN(EC), other): Emmanuela Bachman

25. Date (mm/dd/yyyy): 03/03/16

26. Your name (last, first, middle): Bachman, Emmanuela, Hene

27. Your title: Physician

28. Your address (street number and name, city, province, postal code): 108 Ewart Ave, York, ON, M6M 1M9

Personal information contained in this form is collected under the authority of the Vital Statistics Act, R.S.O. 1990, c.v.4 and will be used to register and record the births, still-births, deaths, marriages, additions or change of name, corrections or amendments, provide certified copies, extracts, certificates, search notices, photocopies and for statistical, research, medical, law enforcement, adoption and adoption disclosure purposes. Questions about this collection should be directed to the Deputy Registrar General at PO Box 4600, Thunder Bay ON P7B 6L8

***

WATERLOO REGIONAL POLICE SERVICE
MISSING PERSON RISK ASSESSMENT TEMPLATE

Incident #: WM16102943

Year (yyyy): 2016

INSTRUCTIONS

This form must be completed by the investigating officer upon initial contact with the complainant. In the event the missing person returns prior to initial contact with the complaintant, this form is not required.

If any of the questions in the Risk Assessment are answered "YES", the incident requires immediate review and consultation with a supervisor to assess and allocate appropriate response and resources.

A supervisor must review all missing person investigations.

Ongoing monitoring of all missing person investigations is required. Other factors may need to be considered and documented when determining risk and investigative response.

RISK ASSESSMENT

Missing Person Name (Surname, Given Name(s)): CENDRIC, Jacob Tomas
Date of Birth (yyyy-mm-dd): 2001-05-19
Missing Person Information Questions

  1. Is this person the subject of a crime in progress? E.g. abduction - NO
  2. Is this person emotionally distraught, suicidal, or likely to cause harm to self or others?    - YES
  3. Has this person been involved in a violent or threatening incident prior to going missing? E.g. domestic - NO
  4. Is this person vulnerable due to age, addition to drugs / alcohol, infirmity, inability to communicate, or other factors? - YES
  5. Are there inclement weather conditions, terrain, inadequate clothing, or lack of proper equipment that would seriously increase risk to health? - NO
  6. Does this person require essential medication? - NO
  7. Does this person have any physical illness, disability, or mental health problems? - NO
  8. Has this person been subject ot bullying / elder abuse? - YES
  9. If previously missing, did he / she suffer any harm at that time? - N/A
  10. Is this behaviour out of character? E.g. overdue and / or personal property has not been taken? - YES
  11. Is this person scheduled to testify in court either as a witness or victim? - NO
  12. Is this person involved in the sex trade, hitchhiking, gambling and / or transient lifestyle? - NO
  13. Is this person associated to gang members or other organized crime? - NO

COMPLETED BY

Rank: Constable
Surname: Tham
Given Name: Sheng
Number: #4823
Signature: Tham Sheng
Date of signature (yyyy-mm-dd): 2016-03-14

REVIEWED BY (SUPERVISOR)

Rank: Sergeant
Surname: Trottier
Given Name: Marc
Number: #4498
Signature: Marc Trottier
Date of signature (yyyy-mm-dd): 2016-03-14

***

Corporate Carcinoma

Accident or Assassination? A Toronto VP of Research at a Montreal-based pharmaceutical company was killed in a car crash while in possession of confidential documents from a competitor. The person responsible for the crash is the son of a man who died while participating in a study run by that same competitor. Eye-360 investigates allegations of corporate espionage and links to organized crime.

Originally Broadcast on Saturday, April 2nd, 2016.

            Voiceover: "Tonight, on Eye-360. A fatal car crash on the 401 exposes the dark underbelly of Big Pharma in Canada including corporate espionage, falsified research, and links to organized crime. Please stay tuned."

[Eye-360 introduction plays followed by a break for commercials]

            Lauren Ashely: "Good evening. Tonight we cast our eye on pharmaceutical research in this country. It's a high stakes game that requires deep pockets, extraordinary patience, and a steely nerve to take big risks. The average cost to research and develop a new drug is nearly a billion dollars and takes 17 years from initial pre-clinical research to final government approval. But time and money aren't the only considerations, after spending half a decade in pre-clinical development fewer than 6% of new drugs ever make it through clinical trials. With so much riding on the outcome, can we really be surprised when someone looks for a shortcut?"

            Lauren: "Monday March 7th, 2015. A fourteen car pileup westbound on the 401 near Allen Rd leaves two dead and ten injured. The two who died are Louisa Evans, age 39, a Sales Consultant with Johnson & Johnson and three months pregnant, and Themba Sibisi, Vice-President of Oncology Research at Montreal-based Atericorp Pharmaceuticals Inc. Witnesses attest that the vehicle driven by Mr. Sibisi was following closely behind that of the Ms. Evans in the right-most lane of the 401 Express where it merges with the collector lanes in advance of the Allen Rd. overpass. They say that a third vehicle approached from behind at a high rate of speed before swerving across three lanes of traffic, directly into the vehicle driven by Ms. Evans."

            Lauren: "The impact forced Ms. Evans over far enough to collide head-on into the abutment where the Express and collector lane merge ends. Mr. Sibisi was unable to avoid the accident, colliding with Ms. Evans rear corner and the vehicle that caused the accident which proceeded to spin around and roll over. The driver of that vehicle was a man named Richard Pelkey, age 19, unemployed, never regained consciousness after the accident and later died in hospital."

            Lauren: "During the course of the investigation, RCMP investigators discover confidential documents belonging to Immugene Inc. in the wreckage of Mr. Sibisi's vehicle. Immugene Inc. is a research company focusing on gene therapy treatments for cancer, and a direct competitor with Atericorp. The documents were preliminary results on a Phase III trial of a new drug developed by Immugene that showed very promising early results in treating lung cancer, doubling the survival rate of patients over existing treatments."

            Lauren: "How did these documents get into Mr. Sibisi's possession? Why has the RCMP not pursued the investigation into possible corporate espionage against a competitor? Why has Immugene resorted to filing a lawsuit against Atericorp for patent infringement in what is potentially a criminal matter? More, coming up next."

[Break for commercials]

            Voiceover: "To learn more about corporate espionage, we interviewed a lawyer for a medical research company. The person did not want to be identified on camera, so their face has been hidden and their voice has been disguised."

                         "Can you tell me, how common is spying among medical research companies?"

                         "Well, I don't know if it's common, but it happens. It's a competitive business, being the first to market with a new drug is worth billions of dollars. So research, especially preliminary work is very carefully guarded. Early clinical results from a competitor for a drug that is promising can save a company five or ten years of work and hundreds of millions of dollars. It's a surprise that you don't hear about it happening more often, really."

            Lauren: "But, if the impact is so significant, why would the RCMP decide not to investigate?"

                         "Because if it's one Canadian company stealing from another, the politicians really don't care. If one or the other benefits, the money is still coming into Canada so why does it matter? The public doesn't have much sympathy when you are talking about multi-billion dollar companies, and a politician isn't going to win much in the way of popular opinion if they promise to crack down on corporate espionage. If it was a foreign company then that's a different matter. If, say, it was China coming in and stealing secrets from Canadians then the RCMP and CSIS would be all over it. But if it's local, they don't give a rat's ass. It's up to a company to defend themselves in court."

[Back to studio]

                         "Our investigators spent some time digging into Atericorp's finances, and they uncovered something interesting. Although corporate donations are banned in municipal politics in Montreal, in 2001, 2005, and 2009, 9 out of 12 of Atericorp's board members and every senior executive in the company donated the maximum allowable contribution for individuals to the municipal political party Union Montréal. Each of the three elections saw Union mayoral candidate Gérald Tremblay win. Tremblay served as mayor of the city until November 2012 when he resigned from politics on the heels of the Charbonneau Commission which was investigating potential corruption in the management of public construction contracts in Quebec. During one hearing, it was alleged that Union Montréal received a percentage of a sewerage rehabilitation contract awarded by the City of Montreal to a mafia-linked cartel. Further allegations against the Mayor included linking him to illegal financing with the mafia."

[Break for commercials]

            Lauren: "Whether or not Atericorp has connections to organized crime isn't yet clear, but why did the crash happen in the first place? Was it really an accident, or was it intentional? And who is Richard Pelkey? Eyewitness accounts lead us to believe that the crash resulting from reckless driving was far from unintentional."

            Lauren: "As it turns out, Richard Pelkey did have a connection to Themba Sibisi and Atericorp, though an indirect one. During the months prior to the accident, Richard's father, Marius Pelkey was suffering from terminal lung cancer and had been participating in a drug trial being run by Immugene, the very same drug trial that Mr. Sibisi had the preliminary results for in his car. In fact, on the day of the accident, Richard Pelkey had just finished burying his father who had passed away a few days before. Did Richard know who Mr. Sibisi was? Was he aware of the stolen study results? Did he intentionally crash his vehicle in order to kill Mr. Sibisi? Or was the whole thing a simple, poorly timed accident? Unfortunately, Richard Pelkey's true motivation will forever remain a mystery."

            Lauren: "There is one final twist to this story. The study results at the heart of the whole affair are only a summary excerpt from what is presumed to be a larger document. The pages are not dated, but they do contain information reporting on the 1-year and 5-year survival rates of patients participating in the study, a standard measure of survivability and effectiveness of treatment. The twist is that the study itself commenced in December 2013, only 2 1/2 years ago. Which leads us to question Immugene's role in this. Is the study a fake? Is it being used to frame Atericorp? Or are they falsifying results?"

            Lauren: "Thank you for joining us, I am Lauren Ashely and this has been Eye-360."

***

Post-Cancer Care Plan

            This Care Plan will facilitate cancer care following active treatment. It includes important contact information, a treatment summary, recommendations for follow-up care testing, a directory of support services and resources, and other information.

Post-Cancer Care Plan for Lung Cancer

Prepared by: Amanda Miner on 04/07/16 at Grand River Regional Cancer Centre

GENERAL INFORMATION

Patient name: Matthew Cendric
Medical record number: 01433583
Phone (home): (226) 236-8826
Date of birth: 06/21/1978
Age at diagnosis: 37
Gender: Male
Support contact: Cheryl Cendric, (226) 236-7342

Care Team
Medical oncologist: Dr. Hurst, (519) 749-4300 ext. 3843
Primary care physician: Dr. Halabi, (519) 777-9352
Nurse/nurse practitioner: Amanda Miner, (519) 777-9352
Mental health/social worker: Nicholas Glass, (519) 635-7254
Surgeon: Dr. Forsythe, (519) 573-7763

BACKGROUND INFORMATION

Diagnosis: NSCLC Undifferentiated Carcinoma
Tobacco use-past: No
Tobacco use-current: No
Other heath concerns: Brain metastases, two tumors < 3cm
Location: RUL (Right Upper Lobe)
Relevant preoperative findings: n/a
Definitive surgery: On 03/17/2016 of non-small cell carcinoma via Wedge resection
Completeness of resection: R1 (Microscopic residual tumor)
TNM stage: T2 (Tumors greater than 3 cm but less than 7cm), N1 (The tumor has spread to nearby nodes on the same side of the body), M1b (Distant metastasis (in extrathoracic organs))
Pathologic stage: IV (The tumor has spread to distant organs outside of the chest)
Final pathologic details: Undifferentiated

TREATMENT PLAN & SUMMARY

Patient's Height: 71 in

Pre-treatment
Patient's weight: 172 lbs
Patient's BSA: 1.975 m^2
Patient's BMI: 24.1
ECOG performance status: 0 (Mildly symptomatic)

Post-treatment
Patient's weight: 164 lbs
Patient's BSA: 1.936 m^2
Patient's BMI: 23.0
ECOG performance status: 1 (Restricted in physically strenuous activity, but ambulatory and able to carry out work of a light or sedentary nature, e.g. light house work, office work)

Regimen: Participant in IG-11820 Immunotherapy Study (CA381-013), patient treatment identifier: IG11820-C164
Treatment on clinical trial: Yes
Chemotherapy treatment period: 10/26/2015 - 02/15/2016
Major side effects of treatment: Nausea/vomiting, Neuropathy, Low blood count, Fatigue, Diarrhea, Pneumonia
Reason for stopping treatment: Completed therapy
Treatment-related hospitalization: Yes
Ongoing toxicities: Yes: Peripheral neuropathy
Radiation therapy: 60Gy administered 02/18/2016 - 03/31/2016

FOLLOW-UP CARE

Upon screening, the patient has been determined to have the following issue(s):
Patients - Please consult your health care provider for medical advice specific to you before using any medications, supplements, or other products, and before beginning any lifestyle program.

Needs, concerns / Suggested intervention(s)
Memory problems and/or confusion
Patients should know that 25% of cancer patients have cognitive dysfunction after treatment and it usually gets better over time

  • Rule out depression, sleep disturbance
  • Wellness (e.g. diet, exercise, smoking cessation)
  • Maintenance of body weight as weight gain is associated with recurrence
  • Regular physical activity (e.g. walking 20 minutes daily)
  • Avoidance of smoking/smoking cessation counseling, if appropriate
  • Limitation of alcohol intake to less than 1 drink, 2-3x per week

Surveillance / When and how often / Coordinating provider
Medical oncology visits / Every 6-12 months for 2 years / Dr. Hurst
Imaging: Chest CT with contrast / Every 6-12 months for 2 years / Dr. Hurst
Imaging: Heat CT / Every 6-12 months for 2 years / Dr. Hurst
Colonoscopy / Every 5 years / Dr. Halabi

Referrals provided
Social worker: Nicholas Glass

POST-TREATMENT
            It is very important to keep all follow-up appointments. During these visits, your doctors will ask about symptoms, do physical exams, and may order blood tests or imaging tests such as CT scans or x-rays. Follow-up is needed to check for cancer recurrence or spread, as well as possible side effects of certain treatments. Almost any cancer treatment can have side effects. Some may last for a few weeks to several months, and others may be permanent.

Managing Memory Changes

            25% of people with cancer report memory and attention problems after chemotherapy which is often called "chemo brain". Most patients describe this as a fog, or having their head stuffed with wool, which can lead to problems with speech, memory formation, or attention. These effects can start soon after treatment, or may not appear until months later.

            If you have memory and concentration problems, contact your doctor and ask about seeing a specialist (a neuropsychologist) to help you with these problems.

            If you think you suffer from depression or anxiety, these problems can also affect your attention, concentration, and memory.

            If you develop a feeling of pain (stabbing or burning) or persistent tingling, weakness, or numbness in your hands or other extremities, your doctor may proscribe medication to manage the symptoms of peripheral neuropathy.

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