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

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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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

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Patient Empowerment Team

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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

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

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

Evaluating Natural Therapies

Aminah Keats, ND, FABNO

Factors to Consider

• Drug-herb/nutrient interaction

• Condition-herb/nutrient interaction

• Published Evidence of Effectiveness

• Complementary vs. Alternative treatment

• Cost

© 2013 Rising Tide

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

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

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

Real World Example

• Patient X (example of how communicating with

their naturopathic doctor helped them receive

better results).

– Issue

– Solution

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Complementary vs. Alternative treatment

• Complementary: Used in conjunction with

conventional treatment

• Alternative: Used instead of conventional

treatment

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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?

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Safest Option

Seek advise from a licensed naturopathic physician

www.naturopathic.org

www.oncanp.org

© 2013 Rising Tide

SUB SECTION

Pablo Lavagnini, MD

Real World Example

• Patient X (example of how communicating with

their radiation oncologist helped them receive

better results).

– Issue

– Solution

© 2013 Rising Tide

Communicating with your Spiritual Care Team

Wendell Scanterbury, M.Div; CMC.

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

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

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

Real World Example

• Patient X (example of how communicating with

their pastoral care team helped them receive

better results).

– Issue

– Solution

© 2013 Rising Tide

Questions?

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Thank You

© 2013 Rising Tide