Cancer services

Drinking Less Alcohol

Drinking alcohol can increase your risk of serious illnesses, including heart disease, diabetes, liver disease, pancreatitis and seven different types of cancer.

There is an added risk for those who regularly drink above the UK Chief Medical Officer's recommended limit of 14 units per week.

Many people don't realise how many units of alcohol they drink. Taking an alcohol self-assessment can help you to identify if the amount you drink is putting your health at risk.

The good news is that it's never too late to start reducing how much you drink. Cutting back on alcohol can have positive effects often within a few days.  In the longer term, drinking less will reduce your risk of a number of serious health issues.

Some of the benefits of reducing how much alcohol you drink include:

Sleeping better
Having more energy
Losing weight
Feeling happier
Being less anxious
Having brighter skin
Visit drinkaware at www.drinkaware.co.uk for facts, advice and support and to find out if you are drinking too much.

A cancer diagnosis and waiting to start treatment can be very distressing and unsettling for you and your family and friends. It is normal to go through a period where you might experience uncertainty and worries about the future, including:

Your prognosis and survival
Permanent physical changes
Discomfort or pain
Try to keep in mind that a big part of what you're feeling during this time is a normal response to a very stressful life experience.  It is also a way of coming to terms with it.

Getting ready for treatment and focussing on your mental wellbeing before treatment starts can help you feel prepared and stop the symptoms of anxiety or depression from getting worse

There are many services, organisations and apps that can support you in managing your mental and emotional wellbeing, including:

The Macmillan Information and Support Centres (located at Darlington, Bishop Auckland and Durham hospitals)
Cancer support groups - both local and national
Mental Health support such as the NHS 'Talking Therapies' service
Apps such as 'Headspace' or 'Daylight' (subscription charges may apply)
Complementary Therapies including massage, auricular acupuncture, reflexology and Reiki (contact the Macmillan Information and Support Centre for more information)

Fatigue is a feeling of significant physical or mental tiredness or exhaustion and is very commonly experienced by people with cancer.  As many as 9/10 people experience cancer related fatigue (CRF) at some time.

Fatigue is very different from everyday tiredness as it lasts longer and can come on without warning.

The causes of CRF are not fully understood. It may be caused by the cancer itself, the symptoms or be a side effect of treatment.

It is important to remember that your feelings of fatigue are unique and personal to you and managing it can be greatly helped by gaining a better understanding of what has a positive or negative effect on your energy levels.

Advice on reducing the impact of fatigue on your daily life can be found within the 'Fatigue Management' video on this page.

Nutrition

Uncertainty and anxiety following a recent cancer diagnosis can lead to a loss of appetite and weight. You may also have lost weight as a result of your cancer.  Being underweight can affect how well you cope with and recover from your cancer treatment.

If you have concerns that you might be underweight or are losing weight and at risk of being underweight, you can complete the 'BAPEN Malnutrition Universal Screening Tool' which can be found in these pages.

You can help yourself to get ready for cancer treatment by increasing your intake of calories, protein and other nutrients. You can do this by eating a wide range of foods from different food groups.  Choosing a varied diet and making it part of life with cancer can help you live well in the long term.

Eating well and maintaining a healthy weight can help you to keep your strength, improve your immune system and increase your energy levels.

Exercise and physical activity play an important role in maintaining a healthy body and mind.

In addition to improving general fitness, being more physically active can help you to prepare for your surgery or treatment by:

Improving physical resilience so that your body is better able to cope with the physiological stress of surgery or treatment
Reducing the impact of treatment side effects such as fatigue
Reducing the likelihood of surgical and treatment complications
It is now widely accepted that it is safe and beneficial for most patients to continue physical activity during and after cancer treatment. In some cases it may be necessary to adapt the type of exercise you participate in e.g. if you have a lowered immune system you may be advised to avoid activities in public places such as swimming pools or gyms.

If treatment or surgery are not part of your care plan, increasing physical activity will improve your general fitness, wellbeing and quality of life.

Most people will experience insomnia (difficulty sleeping) at some point during their lives. This can be due to lots of different reasons. Some things that can cause insomnia when you have cancer:

Symptoms caused by the cancer (such as pain or sickness)
Side effects of treatment
Worry, anxiety or depression
There are lots of resources that can help you to improve your sleep.  See the resources in these pages or visit My Wellbeing Space

Stopping smoking can make a big difference to your health and lifestyle - it is one of the best things you will ever do.

If you are having treatment or surgery for cancer, stopping smoking may help in the following ways:

Faster recovery
Improved wound healing
A shorter hospital stay
Fewer side effects from cancer treatment
Reduced the risk of your cancer coming back or a new cancer developing
Visit Smokefree for more information on how to quit smoking with a free Personal Quit Plan.  You're more likely to quit with the right support.  Find the combination that's right for you in just 3 easy steps.

A selection of "bitesize" videos have been produced to help you to prepare for your treatment, surgery and to live well with your condition.

They cover a range of topics, from the benefits of exercise and eating well, to advice around employment and finances.

• 5 Ways of Wellbeing
• Alcohol Reduction - The benefits
• Alcohol Units
• Appetite
• Benefits of Prehabilitation
• Box Breathing Exercise
• Breathing Exercise 1
• Breathing Exercise 2
• Changes in taste
• Dietary Myths
• Emotional Health & Wellbeing
• Emotional Resilience
• Employment & Cancer
• Exercise & Cancer - the benefits
• Exercise Cautions
• Fatigue & Food
• Fatigue Management
• Financial Support & Advice
• Hair Loss
• Holistic Needs Assessment
• Improving fitness prior to treatment
• Informal Emotional Support
• Keeping a diary
• Mindfulness
• Nausea
• Physical Activity - the benefits
• Physical Activity Guidelines
• Portion Sizes
• Preparation before surgery
• Preparation for cancer treatments
• Speech therapy (Oral Mucositis - mouth soreness)
• Speech Therapy (Xerostomia - dry mouth)
• Spiritual Support
• Stopping Smoking
• The Eat Well Guide
• Tips to improve sleep

This digital course covers the main components of prehabilitation which are physical activity, nutrition and emotional wellbeing.  The six sessions don't need to be viewed in a particular order however, we suggest you watch Session 4 after completing Session 1, as both focus on physical activity.

It has been designed to support you to prepare for your treatment or surgery by:

• Providing tips to get the most from the course
• Encouraging you to think about what  changes to your lifestyle you would like to make
• Helping you to recognise when you have successfully made these changes
• Identifying some of the barriers to change that you might experience
• Helping you identify what support you will need along the way to help you to succeed.

A series of worksheets are available under the 'Related Publications' section.  We strongly recommend completing the corresponding worksheet after each session, as this will help you to get the most out of the programme.

Hear some feedback from a patient who took part in course.  Patients share feedback after completing the Facilitated Digital Prehabilitation Programme - YouTube.

Once you have completed the course, it would be helpful if you could complete the short evaluation form (you can find the link below the sessions).  This will help us to understand how you experienced the course and support its future development.

We really hope that you enjoy completing this course and wish you well in making some positive and lasting changes to your lifestyle which will not only benefit your health now but also in the future.

Sessions

• Introduction - Getting Ready for Treatment or Surgery (Prehabilitation)
• Session 1 - Physical Activity and Relaxation Practice
• Session 2 - Eating for Wellness
• Session 3 - Stress Management and Mindfulness Techniques
• Session 4 - Exercising at the Right Level and Tai Chi for Wellbeing
• Session 5 - Mood and Food, Myth Busting and Further Relaxation Practice
• Session 6 - Improving Sleep
• Podiatry and Foot Care
• Speech and Language - Exercises for Swallowing Difficulties (Dysphagia)
• Course Evaluation

Related publications

• Introduction Worksheet
• Session 1 Worksheet
• Session 2 Worksheet
• Session 3 Worksheet
• Session 4 Worksheet
• Session 5 Worksheet
• Session 6 Worksheet

Additional Information - Eating for Wellness

Session 2 - Eating for Wellness Recipes

Milkshake - (makes 1 200ml glass)

Skimmed milk powder 2 dessert spoons

Semi skimmed milk

Milkshake powder

Kcals = ~ 200kcals  Protein = ~ 15g protein

Banana pancakes (makes 2)

1 medium banana

2 medium eggs

1 dessert spoon skimmed milk powder and dash (30mls milk)

1 portion = Kcals = ~150kcals Protein = ~ 7g

Kedegree (makes 2-3 portions)

1 onion

1 sachet microwave rice (plain)

½ tsp curry powder and ½ turmeric

Smoked mackerel (tinned or ready cooked)

3 tablespoons of peas

1-2 eggs

Kcals per portion (based on 2) = ~ 430 and Protein = ~ 17g

Links to Further Information

• Managing Adult Malnutrition
• Patient webinars
• Bapen - 'Must' calculator

Dietary Myths

• BDA: Cancer diets - Myths and more
• BDA: Fad diets

Food and Mood

• MIND - Food and mental health
• BDA - Food and mood

Additional Information - Emotional Wellbeing

• Cancer and Your Emotions
  Understanding your emotions and looking after yourself
• MIND
  Mental Health Information and Support​​​​​​​

Talking Therapies

• Talking therapies for Stress, Anxiety and Depression
• Durham and Darlington Talking Therapies
  Call 0191 333 3300

Top Tips to Improve Your Mental Wellbeing

Managing Anxiety
Find out about the symptoms of anxiety and what to do when you are anxious

Low Mood and Depression
Identifying low mood and tips to improve mood

Dealing with Stress
Identifying the signs and symptoms of stress and tips to help manage it

Help and Support Services

• Macmillan Support Line
  Confidential support for people living with cancer and their loved ones
  Call 0808 808 0000 (free)​​​​​​​
• Samaritans
  Offering a safe place for people struggling to cope and providing someone to listen
  Call 116 123 (free)​​​​​​​
• Shout 85258
  A free and confidential 24/7 text messaging service for anyone struggling to cope
  Text 'SHOUT' to 85258​​​​​​​

Additional Information - Physical Activity and Cancer

• Macmillan Cancer Support - Physical Activity and Cancer
• The Royal Marsden NHS Foundation Trust - Staying Active

Lung Conditions

• Association of Chartered Physiotherapists in Respiratory Care - Patient Information Leaflet
• Asthma + Lung UK - Pulmonary Rehabilitation (PR) 
• Asthma + Lung UK - Your Exercise Handbook 

Heart and Circulatory Conditions

• British Heart Foundation - Information about Different Conditions and Exercise

Diabetes

• Diabetes UK - Information about Diet and Exercise

Developed by County Durham and Darlington NHS Foundation Trust, and endorsed by the Northern Cancer Alliance © 2024 County Durham and Darlington NHS Foundation Trust​​​​​

For many people diagnosed with cancer, money is one of the first things they think about.  In fact, four out of every five cancer patients are hit with additional costs as a result of their illness, for example transport to and from hospital and increased fuel bills.

If you are struggling to cope with the financial impact of cancer, help is available for you.

Services you can access through our Macmillan Information Centres include Macmillan Durham County Council Welfare Rights Service and Citizens Advice Darlington.   They are free and confidential and can help with things like:

• Applying for social security benefits and tax credits
• Applying for housing benefits and council tax support
• Health costs and travel to hospital
• Accessing charitable grants
• Appealing against benefits decisions
• Applying for free prescriptions

For more information or to make an appointment for financial advice, call one of our Macmillan Information Centre Managers or drop in to see us at Darlington Memorial Hospital, Bishop Auckland Hospital or the University Hospital North Durham:

Telephone: 01388 455231

email: cdda-tr.macmillancddft@nhs.net

North East Knockers

A team of local volunteer crafters, situated in and around Barnard Castle, have come together to knit or crochet handmade breast prostheses for women who have undergone breast surgery. Offering, a comfortable, light alternative to the NHS silicone prosthesis.

Bra Fitting Service

Following breast surgery, many ladies experience tenderness, swelling or have sensitive scar tissue, which makes it very important to have a well-fitting and comfortable bra.  We can arrange for you to see a Breast Care Fitting Expert from Amoena, Trulife or Nicola Jane who are all experts in mastectomy and post-surgery prostheses, bras and swimwear.

All of the services listed above are by appointment only and take place in our Macmillan Information Centres at Darlington Memorial Hospital or Chester le Street Hospital in a comfortable, private room.

Telephone 01388 455231.

The Look Good Feel Better programme aims to provide positive and practical support women to help them cope with the side effects of cancer treatment.

Receiving a diagnosis of cancer can be devastating and the added stress of changes in physical appearance as a result of treatment can be demoralising and difficult to cope with, for example hair loss caused by some chemotherapy drugs.

Look Good Feel Better is dedicated to improving the self-esteem, confidence and wellbeing of women undergoing treatment for any sort of cancer.

The Look Good Feel Better Workshops together small groups of women in a relaxed and uplifting environment.  The two hour classes are free of charge and are led by volunteer beauty professionals who teach vital skincare and make up techniques to help improve confidence and appearance.  The groups are very informative but most of all, they are fun, interactive and supportive.

Our Look Good Feel Better Workshops is held once a month at Bishop Auckland or Darlington.

All of the sessions will take place from 11am to 1pm, unless otherwise stated.  To find out the date of the next workshop and book your place, contact your local Macmillan Information and Support Centre: Telephone: 01388 455231.

Look Good Feel Better have a number of tutorials for you to follow at home.

You can call the Macmillan Support Line FREE on 0800 808 00 00 (7 days a week, 8am to 8pm).

A diagnosis of cancer can be very difficult to come to terms with.  Many people find it hard to talk to their loved ones about cancer, or to talk about it at all.  The Macmillan Support Line offers the opportunity to chat with an expert, who can help you to find the words you need.  Sometimes, it can really help talking to someone outside of your family and group of friends.

There are a range of local services and support groups that can help anyone dealing with cancer, here is a list of some of them. However please call or email our centres if you need further help in finding the right service or support group to suit your needs.

Tel: 01388 455231

email: cdda-tr.macmillancddft@nhs.net

Age UK

Provides service and support for people aged 50 and over. Free confidential advice about benefits, housing and more.

• Age UK North Yorkshire and Darlington - 01325 362832
• Age UK County Durham - 0191 386 3856

Butterwick Hospice Care

Butterwick Hospice, Woodhouse Lane, Bishop Auckland, DL14 6JU

Tel: 01388 603003

CancerWeCan

Darlington Citizens Advice Bureau, The Core, Church Row, Darlington, DL1 5QD

Providing support to anyone affected by Cancer (patients and relatives/carers)

For more information, please call 01325 266888

Darlington and Bishop Auckland Lung Cancer Support Group

For people who have been affected by lung cancer in the Darlington and Bishop Auckland areas, including patients, carers and family members. Meets on the last Wednesday afternoon of each month and is supported by two cancer Clinical Nurse Specialists from County Durham and Darlington NHS Foundation Trust (CDDFT). For details please contact k.capenhurst@nhs.net.

East Durham Communities Cancer Support Group

Horden Hub House, Seventh Street, SR8 4LX

Open to anyone affected by cancer including patients, carers, family members or friends.  Come along to our monthly meeting, have a cuppa and a chat to others who have also been affected by cancer.

Wheatley Hill Workmen's Club Lounge, DH6 3RF

Open to anyone affected by cancer, including patients, carers, family members or friends.  Come along to our monthly meeting, have a cuppa and a chat to others who have also been affected by cancer and listen to advice from guests speakers.

For more information find us on Facebook or Email us on edccsg@outlook.com.

FACT Fighting All Cancers Together

Offers information, advice and advocacy.

For more information call 0191 442 0833 or 07878 007166, Email: info@fact-cancersupport.co.uk or visit the FACT cancer support website.

Lymphoma & CLL Support Group Darlington

Neasham Road Reading Room, Sockburn Lane, Neasham, Darlington, DL2 1PH.

Support group for people affected by lymphoma or CLL.

Meet on the second Wednesday of alternate months - every January, March, July, September and November.

For more information contact Karen on 07710 393891 or Lymphoma Action on 0808 808 5555. Check out their closed Facebook group - Lymphoma Action Support Yorkshire and North East.

Macmillan Joining the Dots

Free support and advice service for anyone affected by cancer in County Durham.

For more information please call 0800 876 6887, email cddft.joiningthedots@nhs.net or visit the Joining the Dots webpage.

Macmillan Support Line

Whether you're worried about money, or just practical issues, have questions about treatment, or just want someone to listen, you can speak to a Macmillan specialist advisor by calling 0808 808 0000, Monday to Friday, 9am to 8pm.

MIND

MIND is a charity offering talking therapies, crisis helplines, drop in centres, counselling and befriending

For more information visit the MIND webpage.

St Teresa's Hospice

Woodland Road, Darlington and Friary Community Hospital, Richmond

A friendly and informal place to share experiences and meet other people who are recently bereaved * A safe space to share feelings and issues raised by the death of a loved one * Support and advice from St Teresa's Hospice Family Support Team staff.

St Theresa's Hospice, Woodland Road, Darlington - every Monday (excluding bank holidays) from 10am to 11.30am.

Friary Community Hospital, Richmond - first Thursday of the month, The Day Room from 1pm to 2.30pm.

For more information contact St Theresa's Hospice on 01325 254321 or email enquiries@darlingtonhospice.org.uk.

Talking Changes

Talking Changes offers talking therapies and supported self-help services for people living in County Durham and Darlington.  Talking Changes can help with common problems such as stress, anxiety and depression.

More information about Talking Changes

The Bridge Young Carers Service

Works with young carers aged between 5 and 18 years and their families to remove or reduce the negative impacts of caring.  The service supports young carers and families through cancer, recovery and end of life.

For more information about the service please call 0191 383 2520.

The Solan Connor Fawcett Cancer Trust

The Solan Connor Fawcett Family Cancer Trust aims to improve the quality of life of people affected by cancer in County Durham. Based in Spennymoor, the charity provides help and advice and can offer discretionary grants for equipment purchases, short breaks or even visits to a beautician or hairdresser.

Find out more by visiting Solan Connor Fawcett Family Cancer Trust or email info@teamsolan.org.uk.

Macmillan Information Centre Volunteers

County Durham and Darlington NHS Foundation Trust has three Macmillan Information Centres based at:

• Darlington Memorial Hospital
• Bishop Auckland General Hospital
• University Hospital North Durham

We are always looking for enthusiastic, capable people to help make a difference to the lives of people affected by cancer in County Durham and Darlington.

As a volunteer at one of our centres, you might be involved in many different activities including meeting and greeting members of the public, answering the telephone, offering a listening service, signposting people for specialist support, completing administrative tasks or visiting the wards to tell people about the services we offer.

What we expect from our volunteers: You will:

• Be reliable, consistent and trustworthy
• Be able to work independently, with guidance and support
• Understand the boundaries of the role and the need for patient confidentiality
• Have good communication skills and be able to put people at ease
• Ideally, commit to volunteering for at least 3 hours per week for a minimum of 6 months

What you can expect from us:

We will:

• Welcome you to our team where you can make a real difference to the lives of people affected by cancer
• Provide a comprehensive induction programme through County Durham and Darlington NHS Foundation Trust
• Give you access to training opportunities relevant to your role
• Support you to develop existing skills and learn new ones
• Offer one to one support and regular supervision meetings

If you are interested or would like a volunteer information pack, please call our Macmillan Information Centre Facilitator, Susan Remillard on 01388 455231.

HOPE is a course developed by Macmillan Cancer Support and Coventry University to support you after cancer treatment.

You can share your experiences and get support from other people going through the same thing. It helps strengthen your coping skills for dealing with different problems like anxiety, fatigue and concerns for the future. So you can feel more like yourself again.

HOPE is a free six week course and each session runs for two and a half hours (usually on the same day and time each week).

HOPE can help you:

• regain your confidence so you feel more like yourself
• use relaxation techniques for your mind and body
• cope with anger, anxiety, depression and uncertainty
• handle stressful situations
• plan for your future
• use your potential to make the most of your life.

How to book

To book your place on the HOPE course, please contact your local Macmillan Information Centre. Telephone: 01388 455231.

Coping with Hair Loss

Some types of chemotherapy can make your hair fall out or become thinner.  Whilst this can be very distressing, it is usually temporary and will grow back when your treatment is finished.  To help you cope with hair loss, our Macmillan Information Centres offer advice, support and access to a range of products including bandanas and wigs.

Headwear

All of our Macmillan Information Centres stock a range of bandanas, turbans and head caps in different colours and materials.  Specially trained staff and volunteers can help you decide which style to choose and offer demonstrations and tips on how to wear it.

Wigs

If you feel that a wig is the right option, we can book you an appointment to see an expert wig specialist from Brown's who, will assess your needs and give you the opportunity to try on some of their products.  Many people are able to take home their chosen wig on the day but if it has to be ordered, it will arrive within a week.  Please speak to a member of our team for information about funding, as you may be exempt from charges.

The Acute Oncology Service (AOS) aims to improve the quality of care for patients who are unwell due to complications of their cancer, suspected cancer or its treatment by providing rapid assessment and initial management of symptoms. It also provides advice and support to patients who have a cancer or metastases of unknown primary origin (known as CUP).

Services offered by the team include:

• Helping patients to manage the side effects of cancer treatments
• Providing advice to other health professional involved in the patient's care
• Offering ongoing support to patients and their families
• Making rapid referrals to other specialties (if needed)
• Helping to facilitate an early discharge from hospital wherever possible

The team has strong links with all wards and departments within County Durham and Darlington NHS Foundation Trust hospital sites as well as with community health care providers.

There are four Acute Oncology Clinical Nurse Specialists who work at the University Hospital of North Durham and Darlington Memorial Hospital.  They work Monday to Friday between 9am and 5pm and can be contacted as follows:

Darlington Memorial Hospital - 01325 380 100 (switchboard)

University Hospital of North Durham -  0191 333 2333 (switchboard)

Please ask for the Acute Oncology Clinical Nurse Specialist.

Breast Care Nursing Service

The Breast Care Nursing Service is a team of Breast Care Nurses who are experienced in the care and support of patients with breast cancer and breast care related problems.

The Breast care nurses can help in many ways including:

• Providing information
• Counselling and support
• Discussion of treatment options
• Support with the physical and psychological effects following breast cancer treatments
• Practical advice regarding bras, clothing and breast prosthesis
• Information about breast reconstruction
• Support for family and carers

The Breast Care Nurses can be contacted by telephone as follows:

Darlington Memorial Hospital - 01325 743290

University Hospital of North Durham - 0191 333 2481

Our normal working hours are Monday to Friday 9am to 5pm

Clinical Lead - Mr Amir Bhatti

An answerphone is available for you to leave a message when there is no one in the office.

The Breast care nurses work very closely with the specialist breast surgeons and other clinicians involved in your care to ensure that you are kept fully informed and supported throughout your care.

You will have a dedicated Breast Care Nurse who is sometimes referred to as your key worker but you may see any member of the team.

The breast care nurses are available in the breast and oncology clinics and will provide expert advice and both written and verbal information as required throughout your treatment.

They work closely with the Clinical Research Team and may also be involved in discussing whether you may be eligible for participation in a Clinical Trial.

You will have contact with your breast care nurse from diagnosis and throughout any treatments. This may be at an outpatient appointment or on the telephone.

The Breast Care Nurses also run clinics for:

• Routine Breast Follow up
• Family history
• Breast Reconstruction

The team is committed to providing quality care and strives to continually improve the service in response to audit results, patient comments/feedback and current clinical evidence.

You will have regular contact with the Breast Care Nurses until approximately three months after you have finished all treatments. However if you have any concerns following this time you may still contact the service.

We have three chemotherapy units located at Bishop Auckland Hospital, Shotley Bridge Community Hospital and the University Hospital of North Durham.

Chemotherapy is the treatment of cancer using drugs to destroy cancerous cells. There are many different types of chemotherapy drug that may be given individually or in combination.  They work by damaging any cancer cells so they can't grow and multiply.  Eventually, the cells will die and the cancer will shrink or go away completely.  Unfortunately, chemotherapy may also damage normal cells, which may cause side effects.  These are usually temporary because healthy cells are able to grow back to normal quite quickly.  Your chemotherapy team can offer help to reduce most side effects, so please talk to them if you feel different from usual.

Chemotherapy may be given as a standalone treatment (on its own) or used with other treatments including surgery and radiotherapy.  The treatment intent may be to cure the cancer by destroying all the cancer cells or reduce the possibility of it coming back by destroying any cancer cells that may be present within the body but are too small to detect.  It can also be used to control cancer where a cure is unlikely, by preventing the cancer from growing quickly and to control the symptoms of cancer if a tumour is causing any symptoms.

There are different ways to deliver chemotherapy including intravenously (directly into the bloodstream via an injection or drip), intramuscularly (deep into muscle), subcutaneously (under the skin), intrathecally (into the spinal space) and orally.

Usually, you will come into one of our units as a day patient, which means you can go home afterwards.  Your treatment will be administered by one of our experienced chemotherapy nurses, who work as part of a team with consultants, doctors and other staff.

The atmosphere on all of our chemotherapy units is very relaxed and friendly.  Drinks and snacks are offered to all patients and you are encouraged to bring a book or something else to do with you, as you may be in the unit for several hours.

Our staff will be happy to listen to any worries you might have and answer any questions.  They can also provide advice and support to help you stay as well as possible during your treatment.

Contact Information

We offer chemotherapy in the following locations across County Durham and Darlington:

• Bishop Auckland Hospital, Mara Unit - 01388 455000
• University Hospital of North Durham, Joan James Unit - 0191 333 2333
• Shotley Bridge Community Hospital, Woodland Unit - 0191 333 2333

Your Colorectal Clinical Nurse Specialists covering Bishop Auckland Hospital and Darlington Memorial Hospital are Sharron Berezanskij and Sarah Dixon and for the University Hospital of North Durham they are Julie Smith and Louise Chalmers.

Sharron, Sarah, Julie and Louise are specialist nurses with skills and experience in caring for people with colorectal cancer.  They will be your key point of contact with the hospital during your cancer treatment and will provide support to you and your family.  Most people are diagnosed with a colorectal cancer after first visiting a GP for symptom management or through the Bowel Cancer Screening Programme.  We are aware that this is a difficult and often confusing time and are available to answer your questions and offer support to you throughout your journey.

What you can expect from your Colorectal Clinical Nurse Specialists:

• Written information about your cancer, investigations, treatments or symptoms
• Assurance that the investigative process will run smoothly and efficiently
• Identification of your needs and concerns through the use of a Holistic Needs Assessment and Personalised Care and Support Planning to help address any issues
• Emotional support, advice and referral to external agencies when appropriate for additional support in the community
• Access to welfare and financial support through the Macmillan information centres
• Liaison with other centres/health care professionals who may be involved in your care.

You will be seen in the outpatient department when your treatment is planned and afterwards, during your follow up care.

Clinical Nurse Specialist Contact Information

Bishop Auckland Hospital and Darlington Memorial Hospital

Sharron Berezanskij and Sarah Dixon - Telephone 01325 743511

University Hospital of North Durham

Julie Smith and Louise Chalmers - Telephone 0191 3332071

Working hours 8am to 4.30pm Monday to Friday

We have an answer phone and return any calls when we are back in the office.

The Gynaeoncology team at County Durham and Darlington NHS Foundation Trust looks after and supports people who have, or are suspected of having a gynaecological cancer.  We work closely with consultants and healthcare professionals from the Queen Elizabeth Hospital in Gateshead and James Cook University Hospital in Middlesbrough, which manage and treat many gynaecological cancers.

Our two Gynaeoncology Clinical Nurse Specialists (CNSs) are based at Darlington Memorial Hospital and the University Hospital of North Durham, but also work from Bishop Auckland Hospital, Chester le Street Community Hospital and Shotley Bridge Community Hospital.  Their role is support patients, their families and carers from the point of diagnosis, through treatment and beyond. They also provide education and advice to patients and other healthcare professionals.

Contact details for your Gynaeoncology CNS's are as follows:

Darlington Memorial Hospital - Suzanne Coverdale 01325 380100 (switchboard)

University Hospital of North Durham - Amy Brown 0191 333 2033 (switchboard)

Clinical Lead - Mr Remko Beukenholdt

Your Haematology Clinical Nurse Specialists are based at Darlington Memorial Hospital and the University Hospital of North Durham but also deliver clinics at Bishop Auckland Hospital and Shotley Bridge Community Hospital.  We work closely with other health care professionals as part of a multi disciplinary team (called an MDT) to ensure you get the best possible care and treatment.

As part of our role, we provide information and support for patients, their family, close friends and carers from diagnosis through to treatment and beyond.  We can help people diagnosed with blood cancers to manage the side effects of treatment, drug therapies, coordinate care and provide access to wide range of help and support services.

Contact Details

Darlington Memorial Hospital/Bishop Auckland Hospital

Clinical Nurse Specialists: Nicola Best and Shirley Bone extension 01325 743933

University Hospital of North Durham/Shotley Bridge Community Hospital

Clincial Nurse Specialists: Deborah Grimes and Jill Kelsey 0191 333 2263

The Clinical Nurse Specialist's usual working hours are Monday to Friday 9am to 5pm.   We have an answerphone service and will call you back if you leave us a message.

Head and Neck Cancer (Darlington)

Head and Neck Specialist Nurses are Registered Nurses, with specialist training in care for cancers affecting the mouth, larynx (voicebox), pharynx (throat), nose, sinuses, salivary glands and thyroid.  They can offer:

• Information, emotional support and advice to patients/carers living with cancer, from diagnosis and throughout the course of the illness
• Advice on treatment options
• Guidance on management of pain and other symptoms
• Advice on sources of practical and financial help
• Provide a link between the hospital and community care teams
• Liaise with consultants, GPs, District Nurses, Hospital Nurses, Hospice Colleagues, Social Services and other agencies involved in patient care.

Your Head and Neck Specialist Nurse works as part of the team responsible for your care and treatment (called a multi-disciplinary team or MDT for short).  The team works closely with James Cook University Hospital in Middleborough which is a specialist centre providing treatment for patients with a cancer diagnosis. It offers some of the most advanced and cutting-edge methods of radiotherapy and chemotherapy and provides specialised cancer surgery.

Contact Information

Your Head and Neck Clinical Nurse Specialists at Darlington Memorial Hospital (sometimes referred to as a 'CNS') are Julie Newman and Heather Morrison.  Julie and Heather can be contacted on 01325 743592.

Lead Clinician - Mr Rajeev Srinivasan

Hours of work-Monday to Friday 08.00am to 04.00pm.

Lung Cancer

Lung Cancer Clinical Nurse Specialists are experienced nurses with specialist training to support people with lung cancer, or those who are suspected of having lung cancer, from investigation through to treatment and beyond.

They are part of a multi-disciplinary team (MDT) involved in the care and treatment of people who have a diagnosis of lung cancer, coordinating patient care and acting as the first point of contact for queries.  They can help with important issues relating to diagnosis, care and treatment including:

Explaining Diagnosis and Treatment Options

Answering questions and providing information to help people affected by lung cancer to take part in important decisions about their care.

Emotional Support

Dealing with a diagnosis, or potential diagnosis of cancer can be very difficult and cause anxiety.  For many people, it can be helpful to talk about their feelings and concerns with their Lung Cancer Clinical Nurse Specialist.

Symptom Control

Helping people with lung cancer to manage symptoms, for example difficulty with breathing, coughing or pain (not everyone will experience these symptoms).

Financial Advice and Signposting to Other Services

Providing information on how people affected by cancer can access practical support, benefits or grants. They can also provide information about other service, for example benefits advice or local support groups.

Your Lung Cancer Clinical Nurse Specialists are:

Darlington Memorial Hospital

Karen Capenhurst - 01325 743425   k.capenhust@nhs.net

Sophie Hope - 01325 743046   sophie.hope@nhs.net

Lead Clinican - Dr Sophie Wyn Jones

University Hospital of North Durham

Joanne Willis - 0191 333 2331   joanne.willis2@nhs.net

Jackie Fletcher - 0191 332 731   j.fletcher11@nhs.net

Lead Clinician - Dr Cummings

The skin cancer nursing and support team provides information, help and education to people affected by skin cancer, as well as their family and friends.  They work across the dermatology and plastics teams in County Durham and Darlington, liaising with surgeons, oncologists, dermatologists and other specialists who may be involved in your treatment and care.

The team is made up Clinical Nurse Specialists (CNSs) and a Cancer Care Coordinator.  They are based at the University Hospital of North Durham but also deliver clinics at Bishop Auckland Hospital, Chester le Street Community Hospital, Darlington Memorial Hospital, Sedgefield Community Hospital, Shotley Bridge Community Hospital, South Tyneside Hospital and Sunderland Royal Hospital.

Ways the team can help:

• Explaining a diagnosis and treatment in detail
• Listening to any worries or fears people diagnosed with skin cancer may have
• Being the first point of contact for patients and health professionals regarding diagnosis, treatment and care
• Delivering follow up clinics after treatment
• Supporting people affected by cancer to identify their worries or concerns and helping them to get the right support, for example with emotional, practical, social, financial or spiritual issues
• Offering practical advice with issues including sun protecting and checking your body and skin

Contact Information

• Sara Alderson - Plastics Clinical Nurse Specialist in Skin
• Emma Weatherburn - Plastics Clinical Nurse Specialist in Skin
• Kerry Osborne - Dermatology Clinical Nurse Specialist in Skin
• Helen Potts - Skin Cancer Clinical Nurse Specialist
• Lead Clinicians - Mr Richard Chalmers (Plastics) and Dr Maneesha Vatve (Dermatology)

Their usual working hours are Monday to Friday 9am to 5pm (excluding bank holidays) and they can be contacted on 0191 333 2307.  An answerphone service is available; please leave a message together with your name and a contact number so that one of the team can return your call.

The Upper Gastro Intestinal (UGI) Clinical Nurse Specialists are nurses with training and experience in caring for people with gastrointestinal cancers.  They work as part of a large team of people involved in your care and treatment, including consultants, doctors, nurses, dieticians and other health care professionals.  This is called a Multi- Disciplinary Team, or 'MDT' for short.

Your UGI Clinical Nurse Specialists can work with you in the following ways and will:

• Be a central point of contact
• Provide information about UGI cancer, staging, investigations, surgery and other treatments
• Offer you the time to discuss any worries or concerns
• Give ongoing advice and support to people with a diagnosis of UGI cancer and to the people closest to them
• Assess your needs and help to ensure you get the right care and support
• Refer you to different services as needed

Some people may need to have treatment at other hospitals.  If this is the case, your UGI Clinical Nurse Specialists will provide you with details of who to contact for support at the hospital you attend.

UGI Clinical Nurse Specialists

Leigh Davison (University Hospital of North Durham) - telephone 0191 333 2610

Their usual office hours are 8.30am to 4.30pm Monday to Friday.  An answerphone service is available and they will return all calls as soon as they can.

Reducing how much alcohol you drink can have many benefits

Over the long term, drinking alcohol can increase your risk of serious illnesses, including heart disease, diabetes, liver disease, pancreatitis and seven different types of cancer.

There is an added risk for those who regularly drink above the UK Chief Medical Officer's recommended limit of 14 units per week.

Many people don't know how much alcohol they drink and whether it could have an impact on their health.  Taking an alcohol self-assessment can help you to identify if the amount your drink is putting your health at risk.

The good news is that it's never too late to start reducing how much you drink. Cutting back on alcohol can have positive effects often within a few days.  In the longer term, drinking less will reduce your risk of a number of serious health issues.

Some of the benefits of reducing how much alcohol you drink include:

• Sleeping better
• Having more energy
• Losing weight
• Feeling happier
• Being less anxious
• Having brighter skin

Visit drinkaware for facts, advice and support and to find out if you are drinking too much.

Eating a balanced diet

Eating a healthy, balanced diet is an important part of maintaining good health, and can help you feel your best.  This means eating a wide variety of foods in the right proportions, and consuming the right amount of food and drink to achieve and maintain a healthy body weight.

After a cancer diagnosis, many people find making the decision to follow a healthy, balanced diet helps give them back a sense of control. It can also help you feel that you are doing the best for your health.  Eating well and keeping to a healthy weight will help you keep up your strength, increase your energy levels and improve your sense of well-being.

Some cancer treatments can increase the risk of other health problems, including diabetes, heart disease or osteoporosis (bone thinning). If you have been told that you may be at an increased risk of any of these conditions, it is especially important to follow a healthy diet to help prevent them.

Food groups in your diet

The Eatwell Guide shows that to have a healthy, balanced diet, people should try to:

• Eat at least 5 portions of a variety of fruit and vegetables every day (see 5 A Day)
• Base meals on higher fibre starchy foods like potatoes, bread, rice or pasta
• Have some dairy or dairy alternatives (such as soya drinks)
• Eat some beans, pulses, fish, eggs, meat and other protein
• Choose unsaturated oils and spreads, and eat them in small amounts
• Drink plenty of fluids (at least 6 to 8 glasses a day)

If you're having foods and drinks that are high in fat, salt and sugar, have these less often and in small amounts.

Try to choose a variety of different foods from the 5 main food groups to get a wide range of nutrients.

Most people in the UK eat and drink too many calories, too much saturated fat, sugar and salt, and not enough fruit, vegetables, oily fish or fibre.

Before making changes to your diet, it can help to talk to a dietitian, your GP or a specialist nurse. This may be particularly useful if you have any special dietary requirements or medical needs.

Physical activity and cancer

Being more active is a positive change when you are living with or after cancer. It is safe for you to be active before, during and after treatment. Being active has many benefits when you have cancer. It can:

• Reduce tiredness (fatigue)
• Reduce anxiety and depression
• Help you keep to a healthy weight
• Strengthen your muscles
• Improve bone health
• Improve your flexibility and ability to stretch
• Improve balance.

Being physically active can mean doing simple, daily activities, such as housework, gardening or walking to the shops. But it can also mean exercising more energetically, for example dancing, running or cycling.

The type of exercise you do will depend on what stage you are at with cancer treatment. It will also depend on which activities you enjoy. Your level of fitness will also affect the amount of activity you can do.

You might be nervous about starting a physical activity plan, especially if you were not very active before your cancer treatment. You may worry that you are too tired or that you might injure yourself. But research shows that even a little activity is better than no activity at all. As you start to feel more confident, you can slowly build up the amount of physical activity you do.

The Wellbeing for Life team have developed a selection of easy to follow workouts you can do at home. 

We Are Undefeatable - Being Active with Health Condition

When you're managing a health condition at the current time, being active is about finding what works for you, as well as what's in keeping with the latest health advice. This can include ways to move that many people don't realise count.

Visit the We Are Undefeatable webpage for ideas on how you can be more active.

Smoking and Cancer Treatment (Source: Macmillan)

How does smoking affect cancer treatment?

If you are having treatment for cancer, stopping smoking may help the treatment work better. It can help your body respond to the treatment and heal more quickly.

If you stop smoking before having surgery:

• You are likely to recover more quickly
• You are more likely have a shorter stay in hospital
• Your wound is likely to heal more quickly. It is best to stop smoking 8 weeks before having surgery. But even stopping a few weeks before and not smoking after surgery will reduce the risk of complications.

Research has shown that stopping smoking during and after radiotherapy may make the treatment more effective. It can also reduce the side effects of radiotherapy.

You are likely to have fewer side effects from cancer treatment if you do not smoke and they also tend to be less severe. Stopping smoking may also lower the risk of cancer coming back after treatment.

Quitting smoking is the best thing you'll ever do (Source: Smokefree)

Stopping smoking can make a drastic improvement to your lifestyle and health in ways you might not expect. Once you stop smoking, some of the benefits are immediate and some are longer-term.

Your body with start to feel better after 20 minutes, when pulse rate returns to normal. After 8 hours, nicotine and carbon monoxide levels in blood reduce by more than half and oxygen levels return to normal.

Within just 2 days:

• Carbon monoxide will be eliminated from the body
• Lungs start to clear out mucus and other smoking debris
• There is no nicotine in the body
• Your ability to taste and smell is improved

 After 72 hours:

• Breathing becomes easier
• Bronchial tubes begin to relax
• Energy levels increase

After 2 to12 weeks, your circulation improves. In just 3 to 9 months, coughs, wheezing and breathing problems improve as lung function increases by up to 10%.

Your health will keep improving. The benefits of quitting smoking increase over a longer time. After:

1 year, your risk of heart disease is about half compared with a person who is still smoking

10 years, the risk of lung cancer falls to half that of a smoker

15 years, risk of heart attack falls to the same as someone who has never smoked

Visit Smokefree for more information on how to quit smoking with a free Personal Quit Plan.  You're more likely to quit with the right support. Find the combination that's right for you in just 3 easy steps.

Advice for adults and children on sunscreen and sun safety in the UK and abroad.

Sunburn increases your risk of skin cancer. Sunburn does not just happen on holiday. You can burn in the UK, even when it's cloudy. 

There's no safe or healthy way to get a tan. A tan does not protect your skin from the sun's harmful effects.

Aim to strike a balance between protecting yourself from the sun and getting enough vitamin D from sunlight.

The advice below from Macmillan, will help make sure that your skin does not burn:

• Protect your face and neck with a wide-brimmed hat.
• Wear sunglasses with a guaranteed ultraviolet (UV) light filter.
• Use a sunscreen with a high sun protection factor (at least SPF 30). Follow the instructions on the bottle and reapply as recommended, particularly after swimming.
• If you have to apply bite or mosquito repellent cream, apply the sunscreen first, followed by the repellent cream.
• Wear clothing made of cotton or natural fibres. These have a closer weave and offer more protection from the sun.
• Stay out of the sun during the hottest part of the day, usually between 11am and 3pm. Try to sit in the shade, even at other times of the day.
• If you have had radiotherapy, keep the treated area completely covered.

What is Wellbeing for Life?

Wellbeing for Life is a service commissioned by Durham County Council and delivered by County Durham and Darlington NHS Foundation Trust and Pioneering Care Partnership (PCP) who have years of knowledge and experience of working and supporting local people across County Durham.

Our service aims to empower you to tell us what's important to you and to support you to make choices that will benefit you and your life.

One-to-one support

Our Wellbeing Practitioners will work with you over eight to twelve sessions to set a health plan, which will include small achievable goals that you would like to achieve. The one to one sessions typically last for one hour and is time for you to focus on yourself and what support you would like from the service:

• Eat healthier / lose weight / gain weight
• Be more active
• Stop Smoking
• Educate you in alcohol and drug awareness
• Access services in your local community

Group Support

Our Wellbeing Practitioners will work with you in a friendly group session, which typically lasts for one hour- in order to:

• Be more active
• Improve your mental wellbeing

"Wellbeing is about your health, happiness, opportunities and your overall quality of life"

Visit Wellbeing for Life or call 0800 87 66887 to find out more.

Visit the Wellbeing for Life Youtube channel to access free virtual workshops.

Whether you want to learn about healthy cooking, manage your stress and resilience levels, get creative with crafts or you want to increase your physical activity - there's something here for everyone's abilities!

Supporting your emotional wellbeing

Being diagnosed with cancer is a very frightening and anxious time. It's normal to experience feelings of sadness, anger or loneliness. Help and support is available to you. We found some information and resources that might help.

Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust

A wide range of mental health self-help guides on issues such as anxiety, bereavement, depression and low mood, sleeping problems and stress can be accessed free of charge by clicking on the Trust's website

Mind

Mind is a mental health charity that supports over 370,000 people across England and Wales. Their services include talking therapies, crisis helplines, drop-in centres, employment and training schemes, counselling and befriending.

NHS

The NHS website has lots of resources to help people who are feeling stressed, anxious or depressed.  It includes sections on mental wellbeing, managing stress and anxiety, mental health at work, improving low mood, information about therapy and counselling and a mood self-assessment.

Talking Changes

Talking Changes is a self-help and talking therapies service designed to help anyone living in the County Durham and Darlington area to deal with common mental health problems such as stress, anxiety or depression, as well as panic, phobias, obsessive compulsive disorder (OCD) and post traumatic stress disorder.

Wellbeing for Life - County Durham

Visit the Wellbeing for Life Youtube channel to access free virtual wellbeing workshops.

Whether you want to learn about healthy cooking, manage your stress and resilience levels, get creative with crafts or you want to increase your physical activity - there's something here for everyone's abilities!