Monday, October 15, 2012

Cancer survivorship program improves patient outcomes

Marilyn Lehnerer says her students at St. Linus Catholic School provided inspiration during her cancer journey. Her treatment allowed her to return to her classroom.

Marilyn Lehnerer, a first-grade teacher who had a lumpectomy to treat her breast cancer, decided she was going to stay involved in her cancer care.

Eight years ago, at age 51, a screening mammogram revealed a very small tumor diagnosed as stage I breast cancer.

“I’m so glad they found it early. That mammogram saved my life,” she said. “My husband, Jim, helped me get through it all. He was my number one supporter and I also have had great friends who were unbelievably supportive.”

Lehnerer chose to make the one-hour drive to the Cardinal Bernadin Cancer Center for a mastectomy, the surgical removal of an entire breast. Like many patients facing a cancer diagnosis, Lehnerer wanted to make sure they “got it all.” But she said Loyola’s multidisciplinary team (see sidebar story, below) convinced her that a lumpectomy (surgical removal of a tumor) would remove all of the cancer and save her breast.

“I loved my surgeon and all of the doctors,” Lehnerer said. “Everyone was comforting, supportive and took the time to listen to me. And, I am happy I listened to them.”

Scott Smith, MD, PhD, associate professor, medicine, hematology/oncology at Loyola University Chicago Stritch School of Medicine, applauded Lehnerer for being “very involved in her ongoing care, which will help her remain as healthy as possible.”

Dr. Smith said, “If people set off on their cancer journey with a positive attitude, they are more likely to be compliant with their treatment plan. Adhering to the treatment plan improves outcomes.”

Lehnerer got some assistance in staying involved in her care: The Cancer Survivorship Program at Loyola, which helps patients return to ongoing care from a primary care physician and a referring oncologist.

The Cancer Survivorship Program at the Loyola’s Cardinal Bernardin Cancer Center, created in early 2008 as the first of its kind in the Midwest, includes physicians, nurses and psychologists, with additional support from social workers, genetic counselors, nutritionists and members of pastoral care.

The program physician meets with each patient post-treatment to review all aspects of the individual’s cancer therapies, including the types and amounts of administered chemotherapy drugs, radiation locations and doses, and surgical interventions.

The patient receives a personal written summary that highlights long-term potential complications, such as cardiovascular impairment associated with some chemotherapy drugs, or an increased risk of skin cancer due to some radiation treatments.

Since most primary care physicians are unaware of the details of a patient’s cancer journey, and since most cancer doctors do not specialize in a patient’s other medical issues, Loyola’s Cancer Survivorship Program serves as link between the patient and the physicians to optimize care.

This program is offered to all cancer survivors, including non-Loyola patients who received cancer care outside of Loyola University Health System and wish to get the comprehensive personal report to share with their primary care physician. The report informs the patient’s health care providers about the screenings and followup care most appropriate for that individual.

Equally important, the meeting and report empower the cancer survivor to play an active role in seeking or maintaining good health.

Dr. Smith said that Lehnerer did not require a chemotherapy drug that is associated with long-term complications, so she is at a lower risk for developing heart problems. “Therefore, she won’t need as intense of a screening plan as will many of my other patients,” Smith explained. “The Cancer Survivorship Program’s written assessment made that and other issues clear for my patient and all her doctors.”

“When cancer survivors understand that there is light at the end of the tunnel, they are motivated to take charge of their own care,” he said. “Being actively involved in your own care leads to better health.”

Multidisciplinary teams collaborate on breast cancer care

The decision to perform a lumpectomy on Marilyn Lehnerer was reached during one of the Loyola’s weekly, multidisciplinary breast cancer clinics. Every Friday afternoon, more than 25 Loyola experts in surgery, radiation therapy, medical oncology, cancer research, nursing, radiology, pathology and other departments review mammography images and detailed reports for new breast cancer patients.

“Our discussion following our analysis of Marilyn’s case led to an agreement on a personalized and comprehensive treatment plan best suited for her,” said Scott Smith, MD, PhD, associate professor, medicine, hematology/oncology, Loyola University Chicago Stritch School of Medicine.

Loyola has one of the most far-reaching multidisciplinary approaches of any cancer center in Chicago. Teams of specialists and sub-specialists collaborate on behalf of patients with breast, head and neck, lung, brain or gastrointestinal cancers.

A patient’s self-image is the primary focus of the Coleman Foundation Image Renewal Center, located in the Cardinal Bernardin Cancer Center. Social workers, pastoral care, psychologists, nutritionists, massage therapists, exercise specialists and beauticians offer their expertise to help patients cope during their cancer journey.

Marilyn Lehnerer says her first-grade students at St. Linus Catholic School in Oak Lawn provided inspiration during her cancer journey. Her treatment allowed her to return to her “passion in life.”

About Loyola University Health System

Loyola University Health System (LUHS) is a member of Trinity Health. Based in the western suburbs of Chicago, LUHS is a quaternary care system that includes Loyola University Medical Center (LUMC), located on a 61-acre campus in Maywood, Gottlieb Memorial Hospital (GMH), on a 36-acre campus in Melrose Park, and convenient locations offering primary and specialty care services throughout Cook, Will and DuPage counties. At the heart of LUMC is a 547-licensed-bed hospital that houses the Center for Heart & Vascular Medicine, the Cardinal Bernardin Cancer Center, a Level 1 trauma center, a burn center, a children's hospital, Loyola Outpatient Center, and Loyola Oral Health Center. The campus also is home to Loyola University Chicago Stritch School of Medicine, Loyola University Chicago Marcella Niehoff School of Nursing and the Loyola Center for Fitness. The GMH campus includes a 254-licensed-bed community hospital, a Professional Office Building with 150 private practice clinics, an adult day care program, the Gottlieb Center for Fitness, the Loyola Center for Metabolic Surgery and Bariatric Care and the Loyola Cancer Care & Research at the Marjorie G. Weinberg Cancer Center at Melrose Park.

Trinity Health is one of the largest multi-institutional Catholic health care delivery systems in the nation. It serves people and communities in 22 states from coast to coast with 93 hospitals, and 120 continuing care locations — including home care, hospice, PACE and senior living facilities — that provide nearly 2.5 million visits annually.