cancer treatment centers of america - pa breast cancer ... · 86 pts with metastatic colorectal...
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Cancer Treatment Centers of America® Communicating with your Healthcare Team
Presented to: PA Breast Cancer Coalition
Presented by:
Aminah Keats, ND, FABNO
Pablo Lavagnini, MD
Wendell Scanterbury, M.Div; CMC.
Date: Tuesday, October 15, 2013
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Communicating with your Healthcare Team
© 2013 Rising Tide
• Communication starts with understanding
your healthcare team’s model of care.
• How does your healthcare team
communicate?
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© 2013 Rising Tide
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Integrative Care Model
• Integrative care model allows for open communication between the patient and multiple care providers
• Each patient is provided with a Patient Empowerment Care Team (PEC Team) which consists of a medical oncologist, naturopathic physician, registered dietitian, a nurse care manager, and clinic nurse
• Other integrative specialties include: – Radiation Oncology
– Surgical Oncology
– Interventional Radiology
– Chemotherapy
– Pastoral Care
– Mind/Body Medicine
– Acupuncture
– Chiropractic Medicine
– Physical Therapy
© 2013 Rising Tide
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Patient Empowerment Team
© 2013 Rising Tide
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What does it mean to be an empowered patient?
• Taking responsibility for your health
• Having full access to your health information to
make informed decisions about your treatment
– How?
• Communicating effectively with all
members of your healthcare team
• Getting all of your questions answered
© 2013 Rising Tide
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The Empowered Patient Checklist Your Guide to Becoming an Empowered Patient
Do you fully understand your medical condition?
Have we explained all your treatment options?
Have we addressed any symptoms you may be experiencing?
Have we addressed all your pain issues?
Do you know what medications you are on as well as how to take
them?
Have we explained the “do’s” and “don’ts” of your treatment?
Have you asked about potential side effects of treatment or
medication?
Have you asked us how we can improve your quality of life?
Have we helped coordinate your care for when you return home?
Do you know where you are going for your next appointment?
Have we answered all your questions?
© 2013 Rising Tide
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Being an Empowered Patient
• Don’t hesitate to ask questions, take notes and
be sure you are provided clear information.
• If you answered “no” to any of the above
questions, ask questions of your doctor and
other care providers to gain clarity.
© 2013 Rising Tide
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Evaluating Natural Therapies
Aminah Keats, ND, FABNO
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Factors to Consider
• Drug-herb/nutrient interaction
• Condition-herb/nutrient interaction
• Published Evidence of Effectiveness
• Complementary vs. Alternative treatment
• Cost
© 2013 Rising Tide
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Drug-herb/nutrient Interaction
• Certain supplements may effect the
pharmacokinetics of certain medications
-Decrease in effectiveness
i.e. St. JohnsWort and Taxol
-Increase in side effects
i.e. Folic acid and Xeloda
© 2013 Rising Tide
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Condition-herb/nutrient Interaction
• Licorice root can potentially increase blood
pressure when large doses are taken over
extended periods
• Phytoestrogenic herbs are not advised in
patients with breast cancer due to
theoretical concerns
i.e. Licorice, Red clover
© 2013 Rising Tide
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Published Evidence of Effectiveness
Is there scientifically validated evidence of effectiveness?
Example: L-glutamine and oxaliplatin-induced peripheral neuropathy
86 pts with metastatic colorectal cancer received oxaliplatin/5-
FU/leucovorin on days 1, 8, and 15
Pts were randomized to receive or not receive glutamine
Lower percentage of grade 1-2 peripheral neuropathy was observed in glutamine group after 2 cycles
Lower incidence of grade 3-4 peripheral neuropathy was noted in glutamine group after 4 cycles and 6 cycles
Interference with activities of daily living was lower in glutamine group
Need for oxaliplatin dose reduction was lower in glutamine group
No difference in response to chemo or survival
Oncologist. 2007 Mar;12(3):312-9.
© 2013 Rising Tide
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Real World Example
• Patient X (example of how communicating with
their naturopathic doctor helped them receive
better results).
– Issue
– Solution
© 2013 Rising Tide
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Complementary vs. Alternative treatment
• Complementary: Used in conjunction with
conventional treatment
• Alternative: Used instead of conventional
treatment
© 2013 Rising Tide
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Cost
Consider cost vs. likely benefit
• Supporting research available?
• Do claims sound too good to be true?
• Is product primarily supported by testimonials?
© 2013 Rising Tide
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Safest Option
Seek advise from a licensed naturopathic physician
www.naturopathic.org
www.oncanp.org
© 2013 Rising Tide
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SUB SECTION
Pablo Lavagnini, MD
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Real World Example
• Patient X (example of how communicating with
their radiation oncologist helped them receive
better results).
– Issue
– Solution
© 2013 Rising Tide
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Communicating with your Spiritual Care Team
Wendell Scanterbury, M.Div; CMC.
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Spiritual Care
Conduit for:
• restoration
• validation
Your Spiritual Care Team should be present to help confront those questions and concerns that can become burdensome barriers to hope.
© 2013 Rising Tide
Hope gives us the courage to confront our circumstances and the
capacity to surmount them. Jerome Groopman
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Overcoming the Barriers
© 2013 Rising Tide
• Be honest about the faith
challenges
• Ask the difficult/sensitive
relationship oriented
questions
“To hope under the most extreme circumstances is an act of
defiance that…is part of the human spirit to endure and give a
miracle a chance to happen.” Jerome Groopman
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Landing on Solid Ground
• Open the emotional
door
• Is there a larger
picture to be seen with
acceptance?
• Harnessing the power
of Hope.
© 2013 Rising Tide
“I see hope as the very heart of healing. For those who have
hope, it may help some to live longer, and it will help all to live
better.” Harold Koenig
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Real World Example
• Patient X (example of how communicating with
their pastoral care team helped them receive
better results).
– Issue
– Solution
© 2013 Rising Tide
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Questions?
© 2013 Rising Tide
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Thank You
© 2013 Rising Tide