Cancer Resource Guide

Transcription

1 Cancer Resource Guide 1 May 2017

2 Cancer Resource Guide A Guide for Macy s, Inc. Associates This resource guide is designed to: educate and provide awareness; encourage compliance with recommended cancer screenings; support individuals during treatment and recovery; optimize productivity during cancer treatment and recovery, or while providing care to a loved one; and support associates who are caregivers for loved ones with cancer. Please Note: This is an informational resource only, and is not to be used or relied on for any diagnostic or treatment purposes. This material is intended to be basic patient education. You should consult with your health care provider before making any healthcare decisions or for receiving diagnosis of, or guidance about, a specific medical condition. Designed to enhance the lives of Macy s, Inc. associates and their families. Live Healthy provides inspiration, incentives, and tools to create healthier lifestyles. 2 May 2017

3 Table of Contents What is Cancer?... 4 General Signs and Symptoms of Cancer... 4 Cancer Staging... 5 Common Types of Cancers... 6 Risk Factors... 7 Factors that are known to increase the risk of cancer:... 7 Factors that may affect the risk of developing and/or treating cancer include:... 8 Factors outside of one s control include:... 8 Treatment... 8 Preventive Screenings... 9 Choosing a Provider...11 Returning to Work...12 Tips for Caregivers...12 Resources Available through the Macy s, Inc. Cigna Medical Plans...13 Additional Resources May 2017

4 What is Cancer? Cancer is the general name for more than 100 diseases. Cancer begins when abnormal cells divide and multiply without appropriate control or regulation. The number of cancer patients varies significantly depending on the type of cancer, but the most common cancers in the U.S. are breast, colorectal, lung, and prostate. Cancer types can be grouped into several categories. The main categories of cancer include: Carcinoma cancer that begins in the skin or in tissues that line or cover internal organs. There are a number of subtypes of carcinoma, including adenocarcinoma, basal cell carcinoma, squamous cell carcinoma, and transitional cell carcinoma. Sarcoma cancer that begins in bone, cartilage, fat, muscle, blood vessels, or other connective or supportive tissue. Leukemia cancer that starts in blood-forming tissue, such as the bone marrow, and causes large numbers of abnormal blood cells to be produced and enter the blood. Lymphoma and myeloma cancers that begin in the cells of the immune system. Central nervous system cancers cancers that begin in the tissues of the brain and spinal cord. Cancer can spread in the body three types of ways: 1. Through tissues cancer invades the surrounding normal tissue. 2. Through the lymph system cancer invades the lymph system and travels through the lymph vessels to other places in the body. 3. Through the blood cancer invades the veins and capillaries and travels through the blood to other places in the body. General Signs and Symptoms of Cancer Unexplained Weight Loss Unexplained weight loss is when you lose weight for no known reason. An unexplained weight loss of 10 pounds or more may be the first sign of cancer. This happens most often with cancers of the pancreas, stomach, esophagus, or lung. Fever Fever is a body temperature of F or higher (when taken by mouth) that most often goes up and down over the course of a day. Having a fever is very common with cancer, but often happens after cancer has spread from where it started. Almost all patients with cancer will have a fever at some time, especially if the cancer or its treatment affects the immune system. Fatigue Fatigue is extreme tiredness that does not get better with rest. It may be an important symptom as cancer grows. It may happen early, though, in some cancers, like leukemia. Pain Pain may be an early symptom with some cancers like bone cancer or testicular cancer. A headache that does not go away or get better with treatment may be a symptom of a brain tumor. Back pain can be a symptom of cancer of the colon, rectum, or ovary. Most often, pain due to cancer means it has already spread from where it started. 4 May 2017

5 Skin Changes Along with cancers of the skin, some other types of cancers can cause skin changes that can be seen. These signs and symptoms include: Darker looking skin (hyperpigmentation) Yellowish skin and eyes (jaundice) Reddened skin Itching Excessive hair growth Cancer Staging Cancer staging describes the severity of a person s cancer based on the size and/or extent of the original (primary) tumor and whether or not cancer has spread in the body. Staging is important for several reasons: Staging helps the doctor plan the appropriate treatment. Cancer stage can be used in estimating a person s prognosis. Knowing the stage of cancer is important in identifying treatments that may be a suitable treatment option for a patient. Staging helps health care providers exchange information about patients; it also gives them a common terminology for evaluating the results of clinical trials and comparing the results of different trials. Staging is based on knowledge of the way cancer progresses. Cancer cells grow and divide without control or order, and they do not die when they should. As a result, they often form a mass of tissue called a tumor. As a tumor grows, it can invade nearby tissues and organs. Cancer cells can also break away from a tumor and enter the bloodstream or the lymphatic system. By moving through the bloodstream or lymphatic system, cancer cells can spread from the primary site to lymph nodes or to other organs, where they may form new tumors. The spread of cancer is called metastasis. Stage Stage 0 Stage I Stage II and Stage III Stage IV Definition Carcinoma in situ (Abnormal cells are present only in the layer of cells in which they developed) Higher numbers indicate more extensive disease: Larger tumor size and/or spread of the cancer beyond the organ in which it first developed to nearby lymph nodes and/or tissues or organs adjacent to the location of the primary tumor The cancer has spread to distant tissues or organs 5 May 2017

6 Common Types of Cancers There are many different forms and types of cancer. Below is a listing of the most common types. Breast Cancer Breast cancer is a malignant tumor that starts in the cells of the breast. A malignant tumor is a group of cancer cells that can grow into surrounding tissues or spread to distant areas of the body. Although most common in women, it can occur in men. Lung Cancer Lung cancer forms in tissues of the lung, usually in the cells lining air passages. The two main types of lung cancer are small cell lung cancer and non-small cell lung cancer. These types are diagnosed based on how the cells look under a microscope. Leukemia Leukemia starts in blood-forming tissue, such as the bone marrow, and causes large numbers of abnormal blood cells to be produced and enter the bloodstream. Bladder Cancer Bladder cancer forms in tissues of the bladder (the organ that stores urine). Most bladder cancers are transitional cell carcinomas (cancer that begins in cells that normally make up the inner lining of the bladder). Other types include squamous cell carcinoma (cancer that begins in thin, flat cells) and adenocarcinoma (cancer that begins in cells that make and release mucus and other fluids). The cells that form squamous cell carcinoma and adenocarcinoma develop in the inner lining of the bladder as a result of chronic irritation and inflammation. Kidney Cancer Kidney cancer forms in tissues of the kidneys. Kidney cancer includes renal cell carcinoma (cancer that forms in the lining of very small tubes in the kidney that filter the blood and remove waste products) and renal pelvis carcinoma (cancer that forms in the center of the kidney where urine collects). Melanoma Melanoma is a form of cancer that begins in melanocytes (cells that make the pigment melanin). It may begin in a mole (skin melanoma), but can also begin in other pigmented tissues, such as in the eye or in the intestines. Colon Cancer Colon (colorectal) cancer forms in the tissues of the colon (the longest part of the large intestine). Most colon cancers are cancers that begin in cells that make and release mucus and other fluids. Rectal cancer Rectal cancer forms in the tissues of the rectum (the last several inches of the large intestine closest to the anus). Lymphoma Lymphoma is cancer that begins in cells of the immune system. There are two basic categories of lymphomas. One kind is Hodgkin lymphoma, which is marked by the presence of a type of cell called the Reed-Sternberg cell. The other category is non-hodgkin lymphomas, which includes a large, diverse group of cancers of immune system cells. Non-Hodgkin lymphomas can be further divided into cancers that have an indolent (slowgrowing) course and those that have an aggressive (fast-growing) course. These subtypes behave and respond to treatment differently. Both Hodgkin and non-hodgkin lymphomas can occur in children and adults, and prognosis and treatment depend on the stage and the type of cancer. 6 May 2017

7 Pancreatic Cancer (also called exocrine cancer) Pancreatic cancer is a disease in which malignant cancer cells are found in the tissues of the pancreas. Prostate Cancer Prostate cancer forms in tissues of the prostate, a gland in the male reproductive system found below the bladder and in front of the rectum. Prostate cancer usually occurs in men over 50 years of age. Thyroid Cancer Thyroid Cancer forms in the thyroid gland (an organ at the base of the throat that makes hormones that help control heart rate, blood pressure, body temperature, and weight). Four main types of thyroid cancer are papillary, follicular, medullary, and anaplastic thyroid cancer. Risk Factors Factors that are known to increase the risk of cancer: Cigarette Smoking Cigarette smoking has been linked to various types of cancer including cancer of the lung, bladder, cervix, and kidney. Even if you don't use tobacco, exposure to secondhand smoke may increase your risk of lung cancer. Tobacco Use Tobacco use, such as chewing tobacco, has been linked to cancer of the oral cavity and pancreas. Avoiding tobacco or deciding to stop using it is one of the most important health decisions you can make. It's also an important part of cancer prevention. If you need help quitting tobacco contact your medical carrier to discuss what smoking cessation programs or other strategies for quitting are available. Infections Viruses and other infection causing agents may increase the risk of developing cancer. Examples of cancer-causing viruses and bacteria include: Human papillomavirus virus (HPV) increases the risk for cancers of the cervix, penis, vagina, anus, and oropharynx. Hepatitis B and hepatitis C viruses increase the risk for liver cancer. Epstein-Barr virus increases the risk for Burkitt lymphoma. Helicobacter pylori increase the risk for gastric cancer. Radiation Exposure to radiation has been a known cause of cancer. There are two main types of radiation that can be linked with an increased risk for cancer: Ultraviolet radiation from sunlight: This is the main cause of non-melanoma skin cancers. Ionizing radiation including: medical radiation from tests to diagnose cancer such as x- rays, CT scans, fluoroscopy, and nuclear medicine scans, and radon gas in our homes. Immunosuppressive Medicines Immunosuppressive medicines are linked to an increased risk of cancer. These medicines lower the body s ability to stop cancer from forming. Immunosuppressive medicines may be used to keep a patient from rejecting an organ transplant. 7 May 2017

8 Factors that may affect the risk of developing and/or treating cancer include: Diet Eat a balanced diet containing plenty of fruits, vegetables, and whole grains. Having a healthy diet will help you better tolerate treatment, lower your risk of infection, and help you heal and recover faster. Alcohol Heavy alcohol users are at higher risk for certain types of cancers. So, it is recommended to use alcohol in moderation. Physical Activity Exercise can be a tool to help you regain your sense of control over your body as well as improve your physical and mental health. Regular exercise can also provide enjoyment and an escape, perhaps, from the rigors of treatment. Factors outside of one s control include: Age Cancer risk increases with age. Family History It s very important to know your family s medial history and to share it with your medical provider. Race or Ethnic Background Some ethnic groups are at higher risk for developing certain types of cancers. Treatment There are several types of treatment options available but the options listed below may or may not be the right option for you. Please consult your physician before making any decisions about your treatment. Multimodality or Combined Modality Therapy Multimodality or Combined Modality Therapy is the use of a chemotherapy regimen along with surgery, radiation therapy, targeted therapy or a combination. Surgery Surgery can be used to diagnose, treat, or even help prevent cancer in some cases. Most people with cancer will have some type of surgery. It often offers the greatest chance for a cure, especially if the cancer has not spread to other parts of the body. Blood Product Donation and Transfusion Transfusions of blood and blood products temporarily replace parts of the blood when a person's body can't make its own or has lost them from bleeding. Lasers in Cancer Treatment Lasers, which are very powerful, precise beams of light, can be used instead of blades (scalpels) for very careful surgical work, including treating some cancers. Photodynamic Therapy Photodynamic therapy or PDT is a treatment that uses special drugs, called photosensitizing agents, along with light to kill cancer cells. The drugs only work after they have been activated or "turned on" by certain kinds of light. 8 May 2017

9 Stem Cell Transplant (Peripheral Blood, Bone Marrow, and Cord Blood Transplants) Stem cell transplants are used to restore the stem cells when the bone marrow has been destroyed by disease, chemotherapy (chemo), or radiation. Depending on the source of the stem cells, this procedure may be called a bone marrow transplant, a peripheral blood stem cell transplant, or a cord blood transplant. Hyperthermia The idea of using heat to treat cancer has been around for some time, but early attempts had mixed results. Today, newer tools allow more precise delivery of heat, and hyperthermia is being studied for use against many types of cancer. Immunotherapy Immunotherapy is treatment that uses your body's own immune system to help fight cancer. Get information about the different types of immunotherapy and the types of cancer they are used to treat. Targeted Therapy Targeted therapy is a newer type of cancer treatment that uses drugs or other substances to more precisely identify and attack cancer cells, usually while doing little damage to normal cells. Targeted therapy is a growing part of many cancer treatment regimens. Radiation Therapy Radiation therapy uses high-energy particles or waves to destroy or damage cancer cells. It is one of the most common treatments for cancer, either by itself or along with other forms of treatment. Chemotherapy Chemotherapy is the use of medicines or drugs to treat cancer. The thought of having chemotherapy frightens many people. But knowing what chemotherapy is, how it works, and what to expect can often help calm your fears. It can also give you a better sense of control over your cancer treatment. Preventive Screenings The choices you make about diet, exercise, and other habits can affect your overall health as well as the risk for developing cancer and other serious diseases. It is important to follow recommendations for cancer screening tests. Screening tests are used to find cancer in people who have no symptoms. Screening also gives you the best chance of finding cancer as early as possible while it is small and before it has spread. Depending on your age and/or gender, cancer screenings performed by an in-network provider are covered at 100 percent (under the Macy s, Inc. Health Plan) with no out-of-pocket cost to plan participants. 9 May 2017

10 Recommended Screenings Age as Determined by the United States Preventive Services Task Force (USPSTF) Cancer Type Gender Recommended Screening Age Breast Cancer Women Yearly mammograms are recommended starting at age 40 and continuing for as long as a woman is in good health. Some Women may need to be screened sooner based on their family history. Breast self-exams are encouraged for women beginning in their 20s and 30s. Women should know how their breasts normally look and feel and report any breast change promptly to their health care provider. Colorectal Cancer For Men and Women Beginning at age 50 and recommended every 5 years. Cervical Cancer Women Cervical cancer screening /testing should begin at age 21. Women under age 21 should not be tested. Women between ages 21 and 29 should have a Pap test every 3 years. Women between the ages of 30 and 65 should have a Pap test plus an HPV test (called co-testing ) every 5 years. Women over age 65 who have had regular cervical cancer testing with normal results should not be tested for cervical cancer. Once testing is stopped, it should not be started again. Women with a history of a serious cervical pre-cancer should continue to be tested for at least 20 years after that diagnosis, even if testing continues past age 65. A woman who has had her uterus removed (and also her cervix) for reasons not related to cervical cancer and who has no history of cervical cancer or serious pre-cancer should not be tested. A woman who has been vaccinated against HPV should still follow the screening recommendations for her age group. Lung Cancer Prostate Cancer Cancer Related Checkups Skin Cancer For Men and Women Men For Men and Women For Men and Women Individuals who are at high risk of lung cancer due to cigarette smoking should consider being screened if they meet all of the following criteria: o 55 to 74 years of age; o Have at least a 30 pack-year smoking history; and o Are either still smoking or have quit smoking within the last 15 years. At age 50, men should talk to a doctor about testing so they can determine what test option is best. Men who are African American or have a father or brother who had prostate cancer before age 65 should have this talk with a doctor starting at age 45. For people aged 20 or older having periodic health exams, a cancer-related check-up should include health counseling and, depending on a person s age and gender, exams for cancers of the thyroid, oral cavity, skin, lymph nodes, testes, and ovaries, as well as for some non-malignant (non-cancerous) diseases. It is recommended for anyone over the age of 20 to get your skin checked at your annual exam visit. If you have moles, freckles or other spots, become familiar with them and report any changes to your physician. 10 May 2017

11 Choosing a Provider When choosing a provider you may want to ask questions to help determine who is going to be the best doctor based on your needs and/or condition. It is also important to ask yourself if you feel comfortable with the doctor. Are they someone who listens to you and answers your questions in a way that you can understand? If not, you should feel free to consider finding another doctor. Here is a list of questions that will assist you with finding the right medical provider. Please keep in mind there are no right-or-wrong answers to these questions; these are simply to help you determine which doctor is the best for you. However, it s worth finding out about a doctor s experience as long as it doesn t delay the start of treatment for too long. 1. Is the doctor in network that is, part of your health plan s network? By using an innetwork doctor, you ll reduce the amount that you have to pay out of pocket. It s important to know this about all the doctors who treat you, including anesthesiologists and radiologists. 2. Is the doctor Board certified? Doctors who treat people with cancer can choose to receive additional training and take exams to receive Board certification in specialties such as medical oncology (cancer), hematology (cancers and other diseases of the blood), gynecologic oncology (cancers of the female reproductive tract) or surgery. 3. Does the doctor have experience with the kind of cancer you have? If so, how many patients with your kind of cancer does the doctor treat each year? 4. How can I prepare for treatment? How long will the treatment take? Can I go to and from treatment alone? What are the side effects of the treatment? After treatment, what do I need to watch for? When should I call the doctor? 5. If you need surgery, how often does the surgeon perform the kind of surgery you need? How many surgeries like yours has the surgeon performed during the past year? 6. How often is this type of surgery performed at the hospital where your surgery will be done? The surgeon s experience is important, and so is the experience of the patient care team at the hospital. Hospital Safety Score provides information on hospital safety measures. For more information about Hospital Safety Score, go to 7. Can the doctor admit patients to a hospital that s in your medical plan s network? 11 May 2017

12 Returning to Work Although there are many challenges and obstacles in returning to work while going through your treatments, many find relief in returning back to work because it can take your mind off your diagnosis as well as remind you of the many things that you can control. Here are several things to consider before returning back to work: Go slow. Consider moving back into your routine gradually with options like flextime, part-time, or half-days. Decide if you need special accommodations, such as longer breaks or a different work location. Take into consideration the potential side effects from medications. Call HR Services ( MACY (6229)) to ask about return-to-work, disability, FMLA (Family Medical Leave Act) or the EAP program for help adjusting. These programs can help you find support groups or create strategies to resume your previous duties. Ask your doctor to write a letter to give to the Company if you are uncomfortable talking about your special medical accommodations. Schedule a meeting with your boss and later with your point person to review changes that have occurred while you were out. You may want to schedule multiple meetings in the first month, depending on how much has changed. Don't get discouraged if you feel out of the loop. Adjustment takes time, but you will fall back into the routine. You may want to ask about seminars or trainings to refresh your skills. Tips for Caregivers Being a caregiver may be one of the most important roles you will take on in your life. It is not an easy role, and most of us are never prepared for it. It challenges you both intellectually and emotionally. You may have become a caregiver without warning, or perhaps your role evolved slowly over time. Either way, you deserve reliable resources or helpful tips to take care of your loved one and yourself. Here are some helpful tips for caregivers: Seek support from other caregivers. Accept offers of help and suggest specific things that people can do to help you. While you are taking care of your loved one, don t forget to take care of your own health as well. Your health is just as important and you want to make sure you are strong enough to take care of your loved one. Pay attention to the signs of depression and don t delay in getting professional help when you need it. Make sure you keep your loved ones medical information organized, up to date and easy to find. Make sure the necessary legal documents are in order. Learn how to effectively communicate with the doctors. Being a caregiver for a loved one is one of the toughest jobs there is. Be sure to give yourself credit for doing the best job you can. 12 May 2017

13 Resources Available through the Macy s, Inc. Cigna Medical Plans Preventive Screenings Preventive screenings are a key factor to early detection of any cancer or illness. When visiting your doctor to receive your preventive screenings, you are taking steps that could lead to prevention and early detection of health issues. Associates and spouses enrolled in a My Choice Plan medical option can each earn a $50 preventive care incentive for completing an approved preventive screening. Additionally, these annual preventive screenings are covered at 100% if you are enrolled in a Company-sponsored medical option and visit an in-network doctor. For more information on the preventive services that are covered at 100%, please contact Cigna at the number listed on your ID card. For more information on preventive care and available screenings, visit the Helpful Tools page of My Benefits on My IN-SITE. 24-Hour Health Information Line Cigna participants can access support 24/7 when you need answers to your health care questions or help understanding treatment options. The 24-Hour Health Information Line number is listed on the back of your medical ID card; your call is always confidential and no-cost to you. Employee Assistance Program (EAP) The Cigna Employee Assistance Program (EAP) provides confidential, 24/7 support for those everyday challenges, more serious problems and everything in between at no-cost to you. This program is available to associates (and their household members) who average at least a 20- hour work week. And, you don t have to be enrolled in a Cigna medical option. Through the EAP, you can access help and resources for situations such as: chronic condition support; securing credit and financial counseling; managing marital issues; depression; parenting and/or work-related stress; and coping with the loss of a loved one. You may receive this assistance over the telephone, or make arrangements to meet face-to-face with a licensed clinician in your area, and receive up to five covered visits. To access the EAP: or visit Under the I want to section, click log on to access your benefits, then enter macys for the Employer ID. 13 May 2017

14 Express Scripts, Inc. (ESI): Express Scripts is the prescription drug administrator for the My Choice Plans and the HMSA medical options. Plus, if you re enrolled in a My Choice Plan medical option, you have access to great pharmacy benefits such as no-cost and deductible waived medications! The annual deductible applies when you need to get most prescriptions, but for brand-name diabetes medications and supplies (including injectables), the deductible is waived and you just pay the 20% coinsurance. If you take a preventive, maintenance and/or diabetic prescription medication that is used to manage health care conditions such as high blood pressure, cholesterol and diabetes, review the prescription drug listings (available on the Helpful Tools page of My IN-SITE) and talk to your doctor about switching to one of the no-cost or deductiblewaived medications to save your money! To access this cost-saving benefit from your My Choice Plan medical option, simply fill a 90-day supply prescription at a Walgreens or Duane Reade, or through Express Scripts convenient home-delivery service! ; Accredo Accredo, an Express Scripts specialty pharmacy provides specialty medications and related services for patients with certain complex and chronic conditions. Specialty medications treat chronic illness (cancer, immune deficiency, multiple sclerosis etc.), and include injectable and other complex high-cost medication. For a complete list of conditions or more information please visit or call Financial Assistance: Specialty medications can be very costly. If you have a financial hardship and need assistance with paying your specialty copayment, contact Accredo to find out more information about the various programs they may be able to help you with. Nurse Advisor Program The Nurse Advisor program is available to all Cigna participants and offers personalized support for complex or chronic conditions. The Nurse Advisor team includes trained nurses, coaches, nutritionists, clinicians and counselors who will listen and understand your needs and help you find solutions even when you are not sure. If you suffer from certain uncontrolled conditions such as diabetes, cardiovascular disease, metabolic syndrome, or you have health risks identified through Know Your Numbers and/or pharmacy and medical claims, a Cigna Nurse Advisor can help; nurses may reach out to you directly about the Disease Management Program. Associates and covered spouses, enrolled in a Macy s, Inc. Cigna medical option can actively engage in disease management coaching sessions that address specific health risks and goals to be eligible for a $100 incentive.* In order to receive the incentive, participants must complete program goals, including a preventive screening. *Only one incentive per enrolled participant per plan year Cigna: ; 14 May 2017

15 Using Cost and Quality Tools to Select a Provider Visit to shop around and compare the costs for services in advance to get a true estimate of your payment responsibility based on the medical plan you are enrolled in. When looking for mental health providers look for the quality designation that is only given to providers that have met specific clinical performance and efficiency standards. Second Opinion The first recommendation for treatment may not always be the best option from a cost and quality standpoint. Make informed decisions about your healthcare by seeking alternate opinions. For participants enrolled in a Cigna medical option, Cleveland Clinic s MyConsult service provides secure online access to Cleveland Clinic s physician specialists for second opinions that may impact your quality of life and allows you to make the most informed decisions about your healthcare at no-cost to you. To access MyConsult, log on to or visit the website at Quit Today Tobacco Cessation Tobacco use puts individuals more at risk for high blood pressure, heart disease, kidney disease and many other health problems. If you use tobacco, quitting can help lower your chances of getting kidney disease or help slow the disease s progression (if already diagnosed). If you are enrolled in a Macy s, Inc. medical option and would like to learn more about the confidential and no-cost to you Tobacco Cessation program and how to develop a quit plan that is right for you, contact: Cigna Participants: ; For all other plan participants call Cigna: or visit (password: macys) Family Medical Leave Act (FMLA) An associate is eligible for FMLA if, at the time the request is made, the following requirements are met: Service Requirement: The associate must have been employed with the Company (any Macy s, Inc. division) for 12 months. While these 12 months need not be consecutive, service performed prior to a break in service of seven years or more does not count (with limited exceptions). The associate may be required to provide evidence of prior service, if the prior service occurred outside the Company s record retention period. Hours Worked Requirement: The associate must have worked a minimum of 1,250 hours during the 12-month period immediately preceding the date the leave is scheduled to begin. FMLA and State leave eligibility may vary for married couples who both work for the Company. To learn more about FMLA call HR Services at MACY (6229) or visit My IN-SITE. Summary Plan Descriptions (SPDs) Available on My IN-SITE SPDs are documents that include important information regarding the Macy s, Inc. medical plans. The documents include information on how the plan works, eligibility requirements, what benefits the plan provides (including what services and treatments are covered), and how those benefits may be obtained. Be sure to review the applicable SPDs available on My IN-SITE or by calling HR Services. 15 May 2017

16 Additional Resources American Cancer Society ACS provides information about cancer and its treatment, how to talk with others about cancer (including children), and how to manage medical costs among other topics Cancer Care CancerCare provides free education and a one-on-one counseling hotline for all types of cancer. CancerCare assist specifically helps with financial issues HOPE (4673) LIVESTRONG Foundation LIVESTRONG looks at the experiences of the cancer community, finds problems and develops solutions. This website offers many ways to connect with others and to learn about comprehensive cancer support National Cancer Institute (NCI) NCI is the highly credible federal agency responsible for providing cancer information, research, resources, and 24/7 telephone support CANCER ( ) Cancer Support Community (CSC) CSC provides support, education, and hope at no cost to anyone affected by cancer. CSC offers online and face-to-face support groups, one-on-one counseling, workshops and other services at over 100 locations worldwide and online National Family Caregivers Association (NFCA) NFCA reaches across boundaries of diagnoses, relationships and life stages to help transform family caregivers lives by removing barriers to health and wellbeing Sources: American Cancer Society, Cleveland Clinic, National Cancer Institute and the Mayo Clinic 16 May 2017