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Better Health
CANCER CARE: Price of Progress, D3 MORNING STAPLE: Can your tea be too hot?, D4 TRAVEL: Oregon Wilderness, D5
The number of survivors of cancers has been on the increase in recent decades thanks to earlier detection and better treatment options. There were an estimated
15.5 million cancer survivors in the United
States in 2016, a number that is expected to increase to 20.3 million by 2026, according to the National Cancer Institute.
SURVIVORSHIP By Anne-Gerard Flynn
Special to The Republican
Baystate Medical Center’s Dr. Diane Dietzen is among the speakers at “Cancer Survivorship 101,” a day-long forum being presented Saturday, June 8, from 8:30 to 3 p.m. in Max’s Tavern conference room at the Naismith Memorial Basketball Hall of Fame. Survivorship refers to the growing number of individuals who have received a cancer diagnosis, have been or are in treatment and are living longer and thus raising the question – are they getting medical care informed by this history and their concerns? The event features presenters from some of the country’s top cancer centers addressing issues like fear of cancer recurrence, sexual intimacy after a cancer diagnosis and integrative medicine. It also features presentations by cancer survivors including former Boston Red Sox CEO Lawrence “Larry” Lucchino, principal owner and chair of the Worcester-headed Pawtucket Red Sox, who was treated in 1986 for non-Hodgkin’s lymphoma, a type of blood cancer, at Boston’s Dana-Farber Cancer Institute where he now chairs the Jimmy Fund. Organizer Dr. Jay Burton, an area primary care physician and blood cancer survivor as well, calls the event for survivors and caregivers “unique.” “This is a unique educational event,” said Burton, an Enfield-based primary care physician with Springfield Medical Associates and founder of the non-profit Survivor Journeys. “Having national leaders in
cancer survivorship gather together usually only happens at physician educational conferences. For them to gather to talk about survivorship to actual cancer survivors, their families and caregivers in a large forum really does not happen.” The number of survivors of cancers has been on the increase in recent decades thanks to earlier detection and better treatment options. There were an estimated 15.5 million cancer survivors in the United States in 2016, a number that is expected to increase to 20.3 million by 2026, according to the National Cancer Institute. The National Coalition for Cancer Survivorship has defined survivorship as something that starts at diagnosis and involves the patient’s loved ones. It can be an arduous journey and as it
focus for Dietzen who heads Baystate’s palliative care service. Her June 8th talk is on “What is Palliative Care and What Role Does It Play in Cancer Survivorship and Caregiving?” She is looking forward to sharing her perspective on taking care of survivors in the acute phase as well as hearing “what different people in this region can bring to bear to help survivors to have a coherent plan for what happens in follow-up.” “I am going to be interested to hear the other things that happen at the conference because I have seen at a national level people start to talk about the relation between palliative care and oncology care and survivor care and where does the primary care doctor fit into that and what does the continuum of that
some places their palliative care specialist may continue to follow them even if they do not have an active cancer diagnosis. It has grown up differently in each place just because they didn’t have a specific protocol or specific set of resources.” Palliative care grew out of hospice care and Dietzen noted that sometimes people confuse the two. Palliative care is given to support patients undergoing treatment or dealing with a chronic illness, while hospice care is given during the later stages of illness when disease-altering treatments are no longer considered beneficial. “There was a recognition many years ago now that doing really good comprehensive care for a patient and their family who had a life-limiting illness was
disciplinary care for patients and families who are dealing with chronic, serious illness regardless of whether it is imminently life-limiting or not. So that is what started the process of creating palliative care” She added, “Cancer patients were one of the first populations that palliative care was involved with although we now see lots of different kinds of patients with lots of different illnesses.” “Palliative care could be in the early stages of a cancer diagnosis or it could be intermediate stages of illness that might require dialysis or other aggressive treatments that can lead to discussions of what end of care might look like but it is by no means meant to focus on that,” Dietzen said. She said there are a “couple of different places in the Bay-
The National Coalition for Cancer Survivorship has defined survivorship as something that starts at diagnosis and involves the patient’s loved ones. It can be an arduous journey and as it moves away from treatment how a survivor should be monitored over the years has no one established medical protocol. How to comprehensively address the needs of cancer survivors has long been a focus for Dr. Diane Dietzen who heads Baystate’s palliative care service. moves away from treatment how a survivor should be monitored over the years has no one established medical protocol. How to comprehensively address the needs of cancer survivors has long been a
look like,” Dietzen said. “In different places, different people have that survivor long-term follow-up role. In some places it is clearly the primary care doctor. In other places they continue to be seen in oncology and in
helpful and beneficial on many levels,” said Dietzen of hospice care. “Then people said we should not be limiting that to the very last piece of life. We should try to do the same kind of comprehensive, inter-
state system where someone might come into contact with palliative care” as a cancer patient. “If the patient is being seen in our cancer center that is affiliated with the hospital there is a physician there that
they might be referred to or they could ask to be referred to if they wanted palliative care in that setting,” Dietzen said. “The Baystate VNA has a palliative care home nursing team that cares for patients with more complex illness at home under the direction of their physician or their cancer specialist. They might access palliative care in that way.” Dietzen said because she primarily works in the hospital “that is where I tend to see patients either when they have been admitted and a new diagnosis has been made or when they have developed a complication from their cancer and are admitted as a consequence.” She said it then becomes the job of the palliative care team “to pull everyone together” that the hospital team has called as needed to “help with the urgent symptoms” and to “try to help the patient and family understand” the possible implications of any recommendations for surgery, radiation or pharmacological management. “If you have surgery for this in addition to the other medical things you have going on, this is what that might look like,” said Dietzen of what members of her team might discuss with a patient. “If you have the treatment, this is how you might feel and this is what it might look like for you and your family.” Dietzen said this is done “so the patient can make the choice among the therapies that might be available to them of the one that feels most correct in terms of their goals.” SEE SURVIVORSHIP, PAGE D2