Patient Guide to Pediatric Endoscopic Third Ventriculostomy (ETV) Surgery

This information will help you prepare for your endoscopic third ventriculostomy (ETV) surgery. For the rest of this resource, our use of the words “you” and “your” refers to you or your child.

Read through this guide at least once before your surgery and use it as a reference in the days leading up to your surgery. Bring this guide with you every time you come to MSK, including the day of your surgery. You and your healthcare team will refer to it throughout your care.

About Your Surgery

ETV is a surgery to drain extra fluid that circulates around the brain and spinal cord. This fluid is called cerebrospinal fluid (CSF). It is found in the ventricles of the brain and the spinal canal. If too much CSF is in the ventricles, it puts pressure on the brain and skull. This is called hydrocephalus (see Figure 1).

Figure 1. Brain with and without hydrocephalus

Symptoms of hydrocephalus

The most common symptoms of hydrocephalus include:

  • Headache
  • Nausea and vomiting
  • Fatigue or drowsiness
  • Irritability
  • Personality changes
  • Problems with thinking and memory (confusion)
  • Trouble with balance and walking
  • Poor coordination
  • Loss of control over urination
  • High pitched cry in infants
  • Visual disturbances, including blurred vision, diplopia (double vision), or downward deviation of the eyes (also called “sun setting”; this is when the eyes turn downward, with the whites of the eyes showing above)
  • Seizures
  • Increased head size and bulging soft spot in infants
  • Poor feeding in infants

During your surgery

Your ETV surgery will be done in the operating room while you are asleep. Once you are asleep, the hair along your incision line will be shaved. Your entire head will not be shaved. A tiny hole will be made in the third ventricle of the brain to allow the excess CSF to drain into another area of the brain to be absorbed (see Figure 2).

Figure 2. ETV
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Before Your Surgery

The information in this section will help you prepare for your surgery. Read through this section when your surgery is scheduled and refer to it as your surgery date gets closer. It contains important information about what you need to do before your surgery. Write down any questions you have and be sure to ask your doctor or nurse.

Preparing for your surgery

You and your healthcare team will work together to prepare for your surgery.

About drinking alcohol

The amount of alcohol you drink can affect you during and after your surgery. It is important that you talk with us about your alcohol intake so that we can plan your care.

  • Stopping alcohol suddenly can cause seizures, delirium, and death. If we know you are at risk for these complications, we can prescribe medication to help prevent them.
  • If you drink alcohol regularly, you may be at risk for other complications during and after surgery. These include bleeding, infections, heart problems, and a longer hospital stay.

Here are things you can do to prevent problems before your surgery:

  • Be honest with your healthcare provider about how much alcohol you drink.
  • Try to stop drinking alcohol once your surgery is planned. If you develop a headache, nausea, increased anxiety, or cannot sleep after you stop drinking, tell your doctor right away. These are early signs of alcohol withdrawal and can be treated.
  • Tell your healthcare provider if you cannot stop drinking.
  • Ask us any questions you have about drinking and surgery. As always, all of your medical information will be kept confidential.

Help us keep you safe during your surgery by telling us if any of the following statements apply to you, even if you aren’t sure.

  • I take a blood thinner. Some examples are heparin, warfarin (Coumadin®), clopidogrel (Plavix®), and tinzaparin (Innohep®). There are others, so be sure your doctor knows all the medications you’re taking.
  • I take prescription medications, including patches and creams.
  • I take any over-the-counter medications, herbs, vitamins, minerals, or natural or home remedies.
  • I have a pacemaker, automatic implantable cardioverter-defibrillator (AICD), or other heart device.
  • I have sleep apnea.
  • I have had a problem with anesthesia in the past.
  • I am allergic to certain medication(s) or materials, including latex.
  • I am not willing to receive a blood transfusion.
  • I drink alcohol.
  • I smoke.
  • I use recreational drugs.
  • I have a programmable ventriculoperitoneal (VP) shunt.

About smoking

People who smoke can have breathing problems when they have surgery. Stopping even for a few days before surgery can help. If you smoke, your nurse will refer you to our Tobacco Treatment Program. You can also reach the program at 212-610-0507.

About sleep apnea

Sleep apnea is a common breathing disorder that causes a person to stop breathing for short periods while sleeping. The most common type is obstructive sleep apnea (OSA). With OSA, the airway becomes completely blocked during sleep. It can cause serious problems during and after surgery.

Please tell us if you have sleep apnea or if you think you might have it. If you use a breathing machine (such as a CPAP) for sleep apnea, bring it with you the day of your surgery.

Within 30 days of your surgery

Presurgical testing

Before your surgery, you will have an appointment for presurgical testing (PST). Depending on your age, your testing can take place in a variety of places. The date, time, and location of your PST appointment will be printed on the appointment reminder from your surgeon’s office. It will probably be at one of these two locations:

  • Pediatric Day Hospital (PDH)
    1275 York Avenue (between East 67th and East 68th Streets)
    B elevator to 9th floor
  • Presurgical Testing (PST)
    160 East 53rd Street (at Third Avenue)
    Elevator to 7th floor

You can eat and take your usual medications the day of your PST appointment. During your appointment, you will meet with a nurse practitioner who works closely with anesthesiology staff (doctors and specialized nurses who will give you medication to put you to sleep during your surgery). Your nurse practitioner will review your medical and surgical history with you. You will have tests, including an electrocardiogram (EKG) to check your heart rhythm, a chest x-ray, blood tests, and any other tests necessary to plan your care. Your nurse practitioner may also recommend you see other healthcare providers.

Your nurse practitioner will discuss which medications you should take the morning of your surgery.

Bring the following with you to your PST appointment:

  • A list of all the medications you are taking, including patches and creams.
  • Results of any tests done outside of MSK, such as a cardiac stress test, echocardiogram (echo), or carotid doppler study.
  • The name(s) and telephone number(s) of your doctor(s).
Parking at the PDH

The Pediatric Day Hospital (PDH) is located at the main hospital.

Memorial Hospital
1275 York Avenue
(between East 67th and East 68th Streets)
New York, NY 10065

Parking at the main hospital is available in the garage on East 66th Street between York and First Avenues. To reach the garage, turn onto East 66th Street from York Avenue. The garage is located about a quarter of a block in from York Avenue, on the right-hand (north) side of the street. There is a pedestrian tunnel that connects the garage to the hospital. If you have questions about prices, call 212-639-2338.

There are also other garages located on East 69th Street between First and Second Avenues, East 67th Street between York and First Avenues, and East 65th Street between First and Second Avenues.

Parking at PST

PST is located in the Rockefeller Outpatient Pavilion, also known as MSK 53rd Street.

Rockefeller Outpatient Pavilion
160 East 53rd Street (at Third Avenue)
New York, NY 10022

There are several options for parking during your PST appointment. The Bristol Garage offers discounts to patients. To receive the discount, have your parking ticket validated at the concierge desk in the Rockefeller Outpatient Pavilion. There is a shuttle that goes from the Bristol Garage to the Rockefeller Outpatient Pavilion every 20 minutes.

The Bristol Garage
300 East 56th Street (between First and Second Avenues)
New York, NY 10022

There are also other garages located on East 53rd Street between Second and Third Avenues and East 54th Street between Second and Third Avenues.

Housing

The Ronald McDonald House provides temporary housing for out-of-town pediatric cancer patients and their families. MSK also has arrangements with several local hotels and housing facilities that may give you a special reduced rate. Your social worker can discuss your options and make reservations.

Eat a healthy diet

Eat a well-balanced, healthy diet before your surgery. If you need help with your diet, talk with your doctor or nurse about meeting with a dietitian.

Tell us if you’re sick

If you develop any illness before your surgery, call the doctor who scheduled your surgery. This includes a fever, cold, sore throat, or the flu.

10 days before your surgery

Stop taking vitamin E

If you take vitamin E, stop taking it 10 days before your surgery. If you take aspirin, ask your surgeon whether you should continue. Aspirin, medications that contain aspirin, and vitamin E can cause bleeding. For more information, read Common Medications Containing Aspirin and Other Nonsteroidal Anti-inflammatory Drugs (NSAIDs).

7 days before your surgery

Stop taking certain medications

If you take aspirin, ask your surgeon if you should continue. Aspirin and medications that contain aspirin can cause bleeding. For more information, read Common Medications Containing Aspirin and Other Nonsteroidal Anti-inflammatory Drugs (NSAIDs).

Stop taking herbal remedies

Stop taking herbal remedies and supplements 7 days before your surgery. For more information, please read Herbal Remedies and Cancer Treatment located in this section. For more information, read Herbal Remedies and Cancer Treatment.

2 days before your surgery

Stop taking certain medications

Stop taking nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (e.g., Advil®, Motrin®) and naproxen (e.g., Aleve®). These medications can cause bleeding. For more information, read Common Medications Containing Aspirin and Other Nonsteroidal Anti-inflammatory Drugs (NSAIDs).

1 day before your surgery

Note the time of your surgery

A clerk from the Admitting Office will call you after 2:00 pm the day before your surgery. The clerk will tell you what time you should arrive for your surgery. If you are scheduled for surgery on Monday, you will be called on the Friday before. If you do not receive a call by 4:00 pm, please call 212-639-7056.

Your surgery will be at one of the following locations:

  • Pediatric Day Hospital (PDH)
    B elevator to 9th floor
  • Presurgical Center (PSC)
    B elevator to 6th floor

Both locations are at 1275 York Avenue between East 67th and East 68th Streets.

The night before your surgery

Shower

Unless you are given other instructions, you may shower and wash your hair with your usual shampoo and regular soap. Rinse well. Do not use any lotion, powder, perfume, or deodorant.

Sleep

Go to bed early and get a full night’s sleep.

Eating

Do not eat or drink anything after a certain time on the night before your surgery. Your nurse practitioner will tell you when this is. This exact time is based on your age and any other medical problems that you may have. Your nurse practitioner will talk with you about what you can and cannot eat before surgery.

If you do not follow the instructions you are given, your surgery may be cancelled.

The morning of your surgery

Take your medications as instructed

If your doctor or nurse practitioner instructed you to take certain medications the morning of your surgery, take only those medications with a sip of water. Depending on what medications you take and the surgery you’re having, this may be all, some, or none of your usual morning medications. Starting 2 hours before your surgery, do not take any medications.

Things to remember

  • Wear loose-fitting clothing.
  • Don’t put on any lotion, cream, nail polish, deodorant, makeup, powder, or perfume.
  • Don’t wear any metal objects. Remove all jewelry, including body piercings. The equipment used during your surgery can cause burns if it touches metal.
  • Leave valuables, such as credit cards, jewelry, or your checkbook, at home.
  • Before you are taken into the operating room, you will need to remove your eyeglasses, hearing aids, dentures, prosthetic device(s), wig, and religious articles (such as a rosary).
  • If you wear contact lenses, wear your glasses instead.

What to bring

  • Only the money you may need for a newspaper, bus, taxi, or parking costs.
  • Your portable music player, if you choose. However, someone will need to hold this item for you when you go into surgery.
  • Your breathing machine for sleep apnea (such as your CPAP), if you have one.
  • A case for your personal items, such as eyeglasses, hearing aid(s), dentures, prosthetic device(s), wig, and religious articles, if you have it.
  • Your Health Care Proxy form, if you have completed one.
  • This guide. Your healthcare team will use this guide to teach you how to care for yourself after your surgery.

Parking when you arrive

Parking at Memorial Hospital

Parking at MSK is available in the garage on East 66th Street between York and First Avenues. To reach the garage, turn onto East 66th Street from York Avenue. The garage is located about a quarter of a block in from York Avenue, on the right- hand (north) side of the street. There is a pedestrian tunnel that you can walk through that connects the garage to the hospital. If you have questions about prices, call 212- 639-2338.

There are also other garages located on East 69th Street between First and Second Avenues, East 67th Street between York and First Avenues, and East 65th Street between First and Second Avenues.

Once you’re in the hospital

You will be asked to say and spell your name and date of birth many times. This is for your safety. People with the same or similar names may be having surgery on the same day.

Meet with your nurse

You will meet with your nurse before your surgery. Tell your nurse the dose of any medications (including patches and creams) you took after midnight and the time you took them.

Get dressed for surgery

When it is time to change for surgery, you will get a hospital gown, robe, and non-skid socks to wear.

Meet with your anesthesiologist

Your anesthesiologist will:

  • Review your medical history with you.
  • Talk with you about your comfort and safety during your surgery.
  • Talk with you about the kind of anesthesia you will receive.
  • Answer any questions you may have about your anesthesia.
Prepare for surgery

Once your nurse has seen you, 1 or 2 visitors can keep you company as you wait for your surgery to begin. When it is time for your surgery, your visitor(s) will be shown to the waiting area. Your visitors should read Information for Family and Friends for the Day of Surgery.

You will either walk into the operating room or you can be taken in on a stretcher. A member of the operating room team will help you onto the operating bed. Compression boots will be placed on your lower legs. These gently inflate and deflate to help circulation in your legs.

Your anesthesiologist will place an intravenous (IV) line into a vein, usually in your arm or hand. The IV line will be used to give you fluids and anesthesia (medication to make you sleep) during your surgery.

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After Your Surgery

The information in this section will tell you what to expect after your surgery, both during your stay and after you leave. You will learn how to safely recover from your surgery. Write down any questions you have and be sure to ask your doctor or nurse.

What to expect

When you wake up after your surgery, you will be in the Post Anesthesia Care Unit (PACU). As soon as you are settled in the PACU, a nurse will bring your family members in to be with you. You may have a mask over your face that will give you air and help you wake up after surgery. You will be attached to machines that will monitor your heart rate and blood pressure. It is normal to feel very tired after surgery. Your PACU nurse will make sure you are comfortable and answer any of your questions.

Once you are awake and your pain is under control, you will be taken to your hospital room. Depending on your age and condition, you may be taken to the Pediatric Intensive Care Unit (PICU), the Adult Intensive Care Unit (ICU), or the Neurology Observation Unit (NOU) for close observation and monitoring. You may get a Magnetic Resonance Imaging (MRI) or Computed Tomography (CT) scan may be during this time.

After 24 hours, you will be taken to the pediatric or neurology floor for continued care. You will be asked to move your arms, fingers, toes, and legs frequently. You may be asked to grip your hands, shrug your shoulders, and identify soft or painful touches. If you have trouble with these things, a physical therapist may visit you and begin to work with you. Over the next couple of days, you will increase your activity until you are ready to go home.

About 48 hours after your surgery, the bandage covering your incision will be removed. Your incision will be left uncovered to help it to heal.

Commonly asked questions

How long will I be in the hospital?

Most people stay in the hospital for 1 night, but your stay will depend on your recovery.

Can family and friends visit me in the hospital?

Your parents, other family members, and friends are welcome to visit you during your hospital stay as long as they are in good health. No one with any signs of sickness, such as fever, cough, congestion, sore throat, or rash, is allowed to visit. Since visiting hours may vary depending on where you will be staying, please check with your nurse regarding the visitation policy. Visitors in the Pediatric Unit are limited to parents and 2 other visitors daily.

Parents can call the inpatient unit at any time. Ask your nurse for the phone number. Because of privacy concerns, staff will only give information to parents or spouses. Please tell friends and other relatives not to call the inpatient unit for information.

When will I be able to eat and drink?

You will most likely be able to drink liquids a few hours after your surgery. After that, you will slowly go back to your normal diet.

Will I have pain?

It is normal to have some pain near your incision and numbness or soreness in your neck or back after surgery. Your doctor and nurse will ask you about your pain often. You will be given medication to control your pain as needed. If your pain is not relieved, please tell your doctor or nurse.

You may be given a prescription for pain medication to take when you are at home. You should speak with your doctor about taking pain medication before you leave the hospital, as the car ride home may be uncomfortable.

You may be dizzy, nauseous, or have a headache after your surgery. You will be given medication to help with these symptoms.

You may have a sore throat after your surgery. This is caused by the breathing tube that was used during your surgery. Lozenges and cool liquids can make you more comfortable.

Do I need to change my diet?

When you return home, you may resume your normal diet. Eating a balanced diet high in protein will help you heal after surgery. Your diet should include a healthy protein source at each meal, as well as fruits, vegetables, and whole grains. For more tips on increasing the amount of calories and protein in your diet, ask your nurse for the resource Eating Well During and After Your Cancer Treatment. If you have questions about your diet, ask to see a dietitian.

How do I care for my incision?

Your incision will be closed with stitches under your skin. These stitches will dissolve on their own, so they don’t need to be removed. You may have small pieces of surgical tape (Steri-Strips™) on your incision. The tape will slowly peel off on its own.

If you have stitches or staples above your skin, your surgeon or nurse will remove them at your first follow-up appointment.

Your incision does not need to be covered. Mild swelling around your incision is normal. As your incision heals, it may burn, itch, or feel numb. Do not apply any cream, lotion, or ointment on your incision.

When can I shower?

You can shower 5 days after your surgery.

Clean your incision with soap and water and pat it dry with a clean towel. You can gently massage the area around your incision to wash off any dried blood or drainage. You can let the water and soap run over the incision, but do not spray water directly on it. You do not need to put a bandage on your incision after you shower.

Do not let your incision soak in water. Avoid baths, hot tubs, and swimming pools for at least 2 weeks after your surgery.

When can I resume my normal activities?

You can participate in all noncontact sports (i.e., swimming, running), exercise, and go to the gym 2 weeks after your surgery. You cannot participate in any contact (collision) sports (i.e., football, boxing, wrestling) until your neurosurgeon says it’s okay. Remember to wear a helmet to decrease the risk of head injury, if needed. Ask your neurosurgeon for specific guidelines on wearing a helmet.

How should I sleep after my surgery?

  • You can sleep in any position that you find comfortable. In general, it is best to sleep on your back or side. Try not to sleep on your stomach because it can strain your neck or back.
  • If you sleep on your back, you may find it comfortable to bend your knees and place a pillow underneath them.
  • If you sleep on your side, you may find it comfortable to bend your knees and place a pillow in between your legs.
  • Sleep on a firm mattress.

When can I go back to school or work?

You can return to school or work as soon as you feel ready. If your work requires heavy physical activity, you may need more time to recover. Ask your doctor when it will be safe to return to school or work. Tell your school nurse that you have an ETV.

When can I swim?

Do not swim for at least 2 weeks after your surgery.

When can I drive?

Do not drive for at least 2 weeks after your surgery. Do not drive if you are having problems with your reflexes. You should also not drive while you are still taking the prescription pain medication given to you after your surgery. These medications can make you drowsy and make it unsafe for you to drive. You can ride in a car, but you should avoid long trips because sitting increases the pressure on your incision. While riding in a car, you should stop often so that you can stretch your legs.

When can I travel?

Do not travel on an airplane until your doctor says it’s okay.

What follow-up care will I receive?

You will have regular visits with your neurologist, neurosurgeon, or both. They will monitor the function of your ETV over time.

Do I need to take any precautions when I have an MRI?

No. The magnet in the MRI scanner will not affect your ETV.

What other precautions do I need to take?

You should always wear a MedicAlert® bracelet or necklace stating that you have hydrocephalus with an ETV.

If you are ever seriously ill or hurt and need medical help, it will inform emergency services workers about your ETV. You can purchase this type of bracelet or necklace at most drug stores. For more information, visit the MedicAlert® website at: www.medicalert.com You should also carry a wallet card at all times that states you have hydrocephalus with an ETV. Your nurse will give you a wallet card to fill out.

Call your doctor or nurse if you have:

  • A temperature of 100.4° F (38.0° C) or higher
  • Vomiting with little or no nausea
  • A constant, unrelieved headache
  • Vision problems (blurry, double vision, or loss of vision)
  • Irritability
  • Fatigue
  • Personality changes
  • Loss of coordination or balance
  • A bulging soft spot on an infant’s head
  • Difficulty waking up or staying awake
  • Decrease in school performance
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Resources

This section contains a list of MSK support services, as well as the resources that were referred to throughout this guide. These resources will help you prepare for your surgery and recover safely. Write down any questions you have and be sure to ask your doctor or nurse.

MSK resources

MSK support services

Anesthesia
212-639-6840
Call with any questions about anesthesia.

Blood Donor Room
212-639-7643
Call for more information if you are interested in donating blood or platelets.

Bobst International Center
888-675-7722
MSK welcomes patients from around the world. If you are an international patient, call for help arranging your care.

Chaplaincy Service
212-639-5982
At MSK, our chaplains are available to listen, help support family members, pray, contact community clergy or faith groups, or simply be a comforting companion and a spiritual presence. Anyone can request spiritual support, regardless of formal religious affiliation. The interfaith chapel is located near the main lobby of Memorial Hospital, and is open 24 hours a day. If you have an emergency, please call the hospital operator and ask for the chaplain on call.

Counseling Center
646-888-0200
Many people find counseling helpful. We provide counseling for individuals, couples, families, and groups, as well as medications to help if you feel anxious or depressed.

Integrative Medicine Service
646-888-0800
Offers patients many services to complement traditional medical care, including music therapy, mind/body therapies, dance and movement therapy, yoga, and touch therapy.

Patient Billing
646-227-3378
Call Patient Billing with any questions about preauthorization from your insurance company. This is also called preapproval.

Patient Representatives Office
212-639-7202
Call if you have any questions about the Health Care Proxy Form or if you have any concerns about your care.

Perioperative Clinical Nurse Specialist
212-639-5935
Call if you have any questions about MSK releasing any information while you are having surgery.

Social Work
212-639-7020
Social workers help patients, family, and friends deal with issues that are common for cancer patients. They provide individual counseling and support groups throughout the course of treatment, and can help you communicate with children and other family members. Our social workers can also help referring you to community agencies and programs, as well as financial resources if you’re eligible.

Tobacco Treatment Program
212-610-0507
If you want to quit smoking, MSK has specialists who can help. Call for more information.

For additional online information, visit LIBGUIDES on MSK’s library website at http://library. mskcc.org. You can also contact the library reference staff at (212) 639-7439 for help.

External Resources

Access-A-Ride
web.mta.info/nyct/paratran/guide.htm
877-337-2017
In New York City, the MTA offers a shared ride, door-to-door service for people with disabilities who are unable to take the public bus or subway.

Air Charity Network
www.aircharitynetwork.org
877-621-7177
Provides travel to treatment centers.

American Cancer Society (ACS)
www.cancer.org
800-227-2345
Offers a variety of information and services, including Hope Lodge, a free place for patients and caregivers to stay during cancer treatment.

Cancer and Careers
www.cancerandcareers.org
A comprehensive resource for education, tools, and events for employees with cancer.

CancerCare
www.cancercare.org
800-813-4673
275 Seventh Avenue (Between 25th & 26th Streets) New York, NY 10001
Provides counseling, support groups, educational workshops, publications, and financial assistance.

Cancer Support Community
www.cancersupportcommunity.org
Provides support and education to people affected by cancer.

Caregiver Action Network
www.caregiveraction.org
800-896-3650
Provides education and support for those who care for loved ones with a chronic illness or disability.

Corporate Angel Network
www.corpangelnetwork.org
866-328-1313
Offers free travel to treatment across the country using empty seats on corporate jets.

fertileHOPE
www.fertilehope.org
855-220-7777
Provides reproductive information and support to cancer patients and survivors whose medical treatments have risks associated with infertility.

Gilda’s Club
www.gildasclubnyc.org
212-647-9700
A place where men, women, and children living with cancer find social and emotional support through networking, workshops, lectures, and social activities.

Good Days
www.gooddaysfromcdf.org
877-968-7233
Offers financial assistance to pay for copayments during treatment. Patients must have medical insurance, meet the income criteria, and be prescribed medication that is part of the Good Days formulary.

Healthwell Foundation
www.healthwellfoundation.org
800-675-8416
Provides financial assistance to cover copayments, health care premiums, and deductibles for certain medications and therapies.

Joe’s House
www.joeshouse.org
877-563-7468
Provides a list of places to stay near treatment centers for people with cancer and their families.

LGBT Cancer Project
http://lgbtcancer.com/
Provides support and advocacy for the LGBT community, including an online support groups and a database of LGBT friendly clinical trials.

National Cancer Institute
www.cancer.gov

National Cancer Legal Services Network
www.nclsn.org
Free cancer legal advocacy program.

National LGBT Cancer Network
www.cancer-network.org
Provides education, training, and advocacy for LGBT cancer survivors and those at risk.

Needy Meds
www.needymeds.com
Lists Patient Assistance Programs for brand and generic name medications.

NYRx
www.nyrxplan.com
Provides prescription benefits to eligible employees and retirees of public sector employers in New York State.

Partnership for Prescription Assistance
www.pparx.org
888-477-2669
Help qualifying patients without prescription drug coverage get free or low-cost medications.

Patient Access Network Foundation
www.panfoundation.org
866-316-7263
Provides assistance with copayments for patients with insurance.

Patient Advocate Foundation
www.patientadvocate.org
800-532-5274
Provides access to care, financial assistance, insurance assistance, job retention assistance, and access to the national underinsured resource directory.

RxHope
www.rxhope.com
877-267-0517
Provides assistance to help people obtain medications that they have trouble affording.

SHARE
www.sharecancersupport.org
866-891-2392
Offers support groups for survivors of breast, metastatic breast, and ovarian cancer in Manhattan, Queens, Brooklyn, and Staten Island.

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