michael j. callahan, m.d. gynecologic oncologist st. vincent cancer care st. vincent indianapolis...

MICHAEL J. CALLAHAN, M.D.GYNECOLOGIC ONCOLOGISTST. VINCENT CANCER CAREST. VINCENT INDIANAPOLIS

CARING FOR THE WHOLE PATIENT

What does it mean to “care for the whole patient?”

Often, we (healthcare providers) cannot control the disease or its consequences, but we can control how we interact with, communicate with, and care for patients and their families, in providing information and guidance in a caring and compassionate manner

Typically, PHYSICAL effects of ovarian cancer and its treatment garner the most attention

However, EMOTIONAL and SOCIAL needs are critically important

EMOTIONAL AND SOCIAL NEEDS

Lack of information and support/isolation

Emotional difficulties (depression/anxiety)

Lack of transportation, financial resources, socioeconomic barriers

Work, school, family disruptions

OVARIAN CANCER: BACKGROUND

Majority of women are diagnosed at an advanced stage

With aggressive surgery and chemotherapy, many women will achieve remission

However, many women will experience recurrence of their ovarian cancer; where the focus of treatment and care may shift from cure to palliative treatment and supportive care

The paradigm of ovarian cancer as a CHRONIC ILLNESS

AT THE TIME OF DIAGNOSIS

What interaction needs to occur between patient and physician?

Most patients do not hear beyond the word “CANCER”

Education session, pictures, different styles of learning, extra sets of “ears” (tape recorder)

Forming a partnership“What questions should I ask?”“What would you do?”

AS TREATMENT COMMENCES

Seek support and outlets (support group, family/friends)

Writing in a journalArtReflection/PrayingReadingOther hobbies/activities

DEPRESSION AND ANXIETY

Very common among women with cancerCan interfere with cancer therapy and

impede response to treatmentIncreasing fatigueInability to make decisions/choicesAffects quality of life

DEPRESSION AND ANXIETY

Treatment centers around:Reducing stressorsRelaxation techniquesCounselingMedicationCombinations of the above

SELF-IMAGE AND CANCER

Positive: appreciation of inner strength, life is special, shift in priorities

Negative: anger, lack of control, sadness, fear, frustration, guilt

Strategies: take control, humor, support groups, social services/counseling

AS TREATMENT IS COMPLETED

Coping with fear of recurrence:Accept fear, lessens over time (ways to

manage anxiety)Don’t worry in isolation (support groups)Partnership with physician, follow-up

schedule, etc. (taking control)Be well informed (symptoms, timelines)Healthy lifestyle (diet, exercise)Reduce stress

A WORD CONCERNING PALLIATIVE CARE

From the Latin palliare, meaning “to cloak”

PALLIATIVE CARE

Goal: improve quality of life, and relieve and prevent suffering

Compatible with ALL STAGES OF CANCER THERAPY (curable disease, chronic illness, nearing end of life)

Physicians, nurses, pharmacists, social workers, chaplains, psychologists, other health professionals

Multidisciplinary care to address physical, emotional, spiritual, and social needs

Support for patient AND family/friends/caregivers

CARING FOR THE WHOLE PATIENT

Often, we (healthcare providers) cannot control the disease or its consequences, but we can control how we interact with, communicate with, and care for patients and their families, in providing information and guidance in a caring and compassionate manner

THANK YOU