Early practice: treating oncology patients

The Fountain Centre is an independent charity supporting cancer patients and their loved ones – from diagnosis, through treatment and beyond. Established in 1998, it’s part of the Royal Surrey County Hospital which houses the fourth biggest cancer centre in the UK.

I first heard about volunteering at the Fountain Centre through one of my fellow alumni at the CCA – she had been treating oncology outpatients there during the COVID lockdown. During my final year, I came across the Fountain Centre again – when shadowing another acupuncturist as part of our clinical observations and learning curriculum.

To volunteer at the Centre you have to meet NHS recruitment guidelines. Being a member of the British Acupuncture Council (BAcC) made the process so much smoother as membership is recognised as a mark of high standards. You’re also asked to commit to the position on a regular basis, as patients tend to be assigned to the same practitioner as much as possible – to enable consistent care management.

Other complementary services such as aromatherapy, massage, reflexology, reiki and hypnotherapy are also available. However, acupuncture is the only treatment that can address such a range of symptoms. Because of this, acupuncture is in high demand and oncology outpatients are only allowed up to eight sessions each –  whereas they can have as many sessions with other therapies as they like.

Ongoing learning and development

Volunteering for such a well-established charity inside an NHS hospital gives me the opportunity for continuous learning and training. When I first joined, I shadowed a few acupuncturists treating both inpatients and outpatients. I also had the chance to shadow the front desk reception, which gave me a bigger picture of how the charity works. Given the NHS setting, there is also a constant emphasis on health and safety, which heightens my awareness of the need for safe practice.

Other learning and training opportunities include first aid training, a tour of the oncology department to view treatment machines, and courses to learn more about cancer. As a volunteer participating in these activities, I also have access to flu vaccines and immunisation shots as part of the in-house occupational health setup – which also helps with learning more about how the NHS works.

Symptoms and treatment

Most patients have already had treatments such as surgery, chemotherapy or radiotherapy. Breast cancer patients are also likely to be taking hormone suppressing medication to keep the breast cancer at bay – the key side effects being hot flushes and night sweats.

The most common symptoms I am treating outpatients for are anxiety, hot flushes, night sweats, peripheral neuropathy, and joint pain. Those who I see for peripheral neuropathy have had either radiotherapy or chemotherapy. Joint pain can sometimes be from medication, and once a patient changes the brand of medication, the pain may disappear.

Acupuncturists at the Fountain Centre are given the freedom to treat according to TCM diagnosis. We can also use ancillary therapies including cupping, ear seeds, and electro or heat lamp, as appropriate to a patient’s diagnosis.

The importance of questioning and observation

From a diagnostic perspective, for the outpatients I have found that questioning and observation are better tools than tongue and pulse. Given the treatments, medications and stress that oncology patients go through, tongue and pulse diagnosis can be information overlaod. In many patients, the tongue is almost always showing signs of heat – either peeled, yellow or even black – and the pulses will mostly show liver qi stagnation, as most are highly stressed.

Questioning and observation becomes very important for deciding on treatment. For example, if movement helps with reducing pain, this indicates to me there is qi stagnation, especially in the mornings. The nature of the pain also gives me good information.

One patient told me she had ‘burning pain on my right shin’ – so I knew she had liver fire. Another patient described how the pain would come on when she tried to open a jar lid – but lifting a cup up and down was fine. The specific location and action told me which meridian to explore, suggesting stagnation in the shaoyang.

Unexpected extras

I find working in a hospital environment fascinating, from the moment I enter the building and for so many different reasons. The first and number one topic of conversation is always parking, as space is so limited. Closely followed by the weather!

Then, as I walk through the hospital, I pass many sick patients along the way – some in wheelchairs, some in a bed being pushed along, many carers accompanying their loved ones for their hospital appointments. Along the corridor are consultants, nurses and lots of hospital support staff – some on their break, sitting eating from their take-away lunch boxes.

I pass the maternity unit, the maxillofacial unit, and the pastoral care service before reaching the cancer unit where the Fountain Centre is located.

There is always another acupuncturist on my shift, which has been great from a learning perspective. At the same time as relying on my TCM training for diagnosis, in terms of treating cancer patients, I have learnt a lot about red flags and contraindications from my fellow acupuncturist. Moreover, as some patients can be treated by more than one practitioner, I love reading and learning from the treatment notes of others.

Alongside volunteering, I also run two private acupuncture clinics in Surrey. What I find interesting, is that what happens at the Fountain Centre charity also happens at my private clinic. Noticeably, there are seasonal variations with appointment bookings. Come the holidays – Easter, Christmas, school holidays – there are fewer acupuncture bookings in both settings. And when there is a spate of cancellations at my private clinic, I also find this happening with my appointments at the Fountain Centre – even oncology outpatients need holidays and have more pressing needs, it seems!

A final reflection

Giving back is such a rewarding experience in so many ways.

In medical terms, I have learned more about the world of oncology and how to treat such a specialist area. And despite the challenges these patients are going through, deep down they have a fighting spirit inside of them, which I find very inspirational.

My questioning diagnostic skills have also been refined. In addition, given that I only have eight sessions with each patient, I value the importance of yang sheng advice to help patients with ongoing self-management of their symptoms.

Moreover, volunteering is a great way to simply just be a clinician for a day – to get on with treating patients without having the pressure of managing a business at the same time.

As well as volunteering at the Fountain Centre, Sarah San runs two private acupuncture clinics in Esher and Cobham, Surrey. She also assists in teaching anatomy and acupuncture points at the City College of Acupuncture. Sarah is currently undertaking additional studies in TCM nutrition to help further her skills in providing yang sheng advice.

If you’d like to find out more about treating oncology outpatients, please get in touch with Sarah via www.SarahSanAcupuncture.co.uk