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New collaborative care model benefits urology patients

Dayton Physicians NetworkLean process workflow. It sounds like something straight off an assembly line – not words you expect to hear in a medical setting – but that’s exactly what’s happening at Dayton Physicians Network urology.

Cutting-edge, lean management and optimizing work flow practices are at the forefront of an innovative approach in collaborative care to treat patients, in light of a shortage of urologists in Dayton and across the United States.

There should be approximately 17,000 urologists based on our population. Currently, there are less than 10,000 active urologists in the United States, and over the next two years, that number will decrease to 8,000, due to retirement.

Not only is retirement decreasing the number of practicing urologists, but as the population ages, urologists are in greater demand – a convergence Dayton Physicians urologist David Key, MD, and his colleagues have been strategizing for the past few years.

The solution came when Key was talking with a friend, who shared how she uses workflow mapping in her business. He recalls their conversation, “I said, ‘Workflow mapping? Show me what you’re talking about.’”

The conversation inspired Key to do more research, eventually following a trail that led him to discover the Virginia Mason Institute in Seattle, Wash., where lean management processes are translated into the healthcare setting, with great success.

“They took the Toyota model of production, looked at efficiencies, and actually applied those practices to the health care industry,” Key said. “They even went over and visited Toyota in Japan. Virginia Mason has perfected the system to the point that Japanese hospitals are now sending their folks to Seattle for training.”

Key and a team from DPN visited the Virginia Mason Institute in 2018 and brought back the methodology. Team members have since been trained, and the new system was launched in July.

Shorter wait times for new patients
Before implementing the new approach to patient care, Key and his Dayton Physicians colleagues together would see an average of 250 new patients a month. “In only two weeks, under this new model, I saw 112 new patients, which extrapolates to over 200 patients for just one doctor over the course of a month,” he said.

Providing fast care for acute needs, the collaborative care model means new patients aren’t waiting five to six weeks to be seen. Instead, patients are being seen within 48 hours of an emergency room visit.

“The problem we were trying to solve for was how to address the needs of our community and allow urologists to take care of patients with the most need, while continuing to serve new patients,” said Dr. Key.

With this as the primary driver, urologists at DPN are now paired with nurse practitioners in a collaborative care model. One doctor is paired with a nurse practitioner and two medical assistants. Nurse practitioners see established patients, under the plan of care laid forth by the urologist. The urologist then is able to focus on surgeries and creating care plans for new patients. The office currently has four nurse practitioners, and Key foresees that number increasing to around eight.

Before being independently involved in patient care, each nurse practitioner participates in a three-month training program. “The training program within our group is pretty strenuous,” Key said.  “We are very pleased with our nurse practitioners. They are outstanding.”

What started as a solution to solve the growing shortage of physicians has produced surprising results that are, most importantly, creating better patient care.

“This model allows you to overcome the shortage of physicians, addressing patients needs in shorter time, which increases patient satisfaction and, ultimately, outcomes because you’re treating them in a much quicker fashion,” Key said. “It’s changing the face of how we see patients.”

Click here to learn more about urology care at Dayton Physicians Network, or you can call 937-293-1622.

How a medically integrated pharmacy benefits our patients

Dayton Physicians NetworkWhen it comes to your health, you don’t want to take any chances. You select the best physician, a state-of-the-art facility, and cutting-edge treatments and practices, but don’t stop there. Ensuring that your care provider is working with a medically integrated pharmacy is another box to check when it’s time to make important decisions about your health.

Whether you’re working with a physician for a chronic illness, life-threating condition or one-time injury, pharmaceuticals can be a big part of healing, but managing your medications can become tricky. You want to be sure you’re working with a pharmacist who understands the team approach to your treatment, and the best way to do that is to make sure you’ve selected to work with a medically integrated pharmacy.

A medically integrated pharmacy is a pharmacy that is “in-house” or part of a medical facility or practice. Unlike stand-alone retail pharmacies, medically integrated pharmacies provide many benefits to patient care.

Support for complex medication regimens: As medical treatments advance, pharmaceuticals are becoming more complex. What used to be one pill with breakfast, and maybe another at dinner, can now be doses several times a day, and even different doses on varying days of the week.

“Often, the medications prescribed in oncology care are just as complex as traditional chemotherapy,” said Joshua Cox, Pharm.D., director of pharmacy for Dayton Physicians Network. “Because they are taken in pill form, people assume they are safer, but that’s not always the case.”

Having access to a pharmacist who understands the complexity of the medications you’re taking is an important part of the team of professionals working to help you heal. You need a pharmacist who will do more than just confirm your dose is reasonable and that it won’t interact with other prescriptions.

Access to real-time physician data: When your pharmacist is working in-house with your physicians, he or she has the ability to see to the same data as your doctors. “We can see all the physicians’ notes, lab values, imaging and scans, so we are seeing, in real time, the same information every other health care provider on your team is seeing,” Cox said.

Access to real-time information from a patient’s medical record means the pharmacist can help doctors and nurses make decisions that are the best for the patient.

Ensures better patient outcomes: Medication adherence and education is a large component of the medically integrated pharmacy method. With the team approach, pharmacists work with patients to counsel them about taking medications and what the side effects might be, which can help them monitor whether patients are taking medications correctly.

If side effects or a reaction does occur, the team approach allows these issues to be recognized quickly. With support from the physician, the medication can be safely stopped, if necessary, and side effects can be more effectively managed.

“If you can’t take a medication because of its side effects, it certainly cannot be effective,” Cox said. “With our robust medication adherence program, we can ensure patients are staying on their meds, making the medications more effective and leading to better outcomes.”

Provides cost savings and reduces waste: When it comes to complex medications with serious side effects, such as those administered for cancer treatment, physicians often make changes to help patients feel their best and heal more quickly.

“Doses are frequently changed by physicians, either because it’s intended or because the condition changes in some way,” Cox said. “When that happens, if the prescription is being filled at a pharmacy elsewhere, the delay in communication means the medication could be filled under orders that are no longer current.”

In situations like this with expensive drugs, one incorrectly filled prescription can equate to thousands of dollars thrown away. With a medically integrated pharmacy, pharmacists have access to information the moment the physician makes changes, meaning unnecessary prescriptions are never filled, reducing waste and saving money.

Don’t overlook the benefits of being able to include your pharmacist as a member of your health care team. With the integrated approach, you have the support you need for complex medications, could be better for the health of your body and your budget.

Click here to learn more about the pharmacy services available through Dayton Physicians Network, or call 937-245-6320.

Musician and physician: DPN urologist excels in both

When you hear about a surgeon who also is an outstanding musician, it shouldn’t surprise you. After all, both require a high level of technical skill, complex thinking and persistence to master. Some studies have even found increased grey matter in the brain, which is associated with increased skills, as a result of musical training.

For Michael Yu, MD, a urologist with Dayton Physicians Network and a first-generation Asian American, playing an instrument was a requirement set by his parents when he was a child.

“If I wasn’t a physician, I’d probably be a musician,” he observed. Dr. Yu can play seven instruments, including piano, clarinet, three saxophones, guitar and violin.

While playing an instrument was mandatory, having an actual career in music wasn’t a possibility he felt he could consider. Dr. Yu said he always knew he would become a doctor. His father, his aunts and uncles on his mother’s side, and his grandparents—all of them are physicians.

“For me, it was never really a question,” Dr. Yu said about his career path. He considered a career as a trauma surgeon for a short time before being influenced by two of his uncles to consider urology.

Dr. Yu said urology allows him not only to care for his patients, which is why he enjoys being a doctor, but also to develop lasting relationships with them. Many of the conditions Dr. Yu treats are chronic, allowing him to provide a continuum of care and to work with his patients in developing treatment plans that allow for their input. 

From removing kidney stones and helping older patients with enlarged prostates, to treating conditions like diabetes and high blood pressure, Dr. Yu truly enjoys the work he does.

“It gives me a good sense of satisfaction to be able to help people and show them the results of what we do,” Dr. Yu said, who often presents patients with kidney stones removed during their surgeries.

When Dr. Yu is in the operating room, music is still a part of his routine. “I listen to pretty much anything but rap and country music,” he said.

Choosing to practice in Dayton

Dr. Yu performed his undergraduate work at Dartmouth, his medical degree is from NYU, and he completed his residency at Washington University in Saint Louis. He was offered a job at the Cleveland Clinic and chose Dayton Physicians Network instead. Dr. Yu became the first urologist in Dayton to perform robotic pyeloplasty for ureteropelvic junction obstruction, which removes a blockage occurring where the kidney meets the ureter.

“I think Dayton is a very good medical community that is underrecognized nationally,” he said when asked why he settled in the Miami Valley. “I would put us up against Ohio State, Cincinnati and the Cleveland Clinic.”

At the end of a long day, of which there are plenty, Dr. Yu says he enjoys playing the piano, watching movies, hiking and even playing video games from time to time.

“I find myself with less and less free time to spend with my wife and kids,” said Dr. Yu, who recently celebrated his 20-year wedding anniversary and has two boys, ages 15 and 18. “Being involved in medicine isn’t easy…and it’s not really for everybody. You have to be completely committed to it.”

Between paperwork and preparing for his surgeries the next day, Dr. Yu said he often works two to three hours each night after his family goes to bed. With the amount of labor he puts in, he doesn’t see either of his sons carrying on the family tradition of becoming a physician. In fact, one of his sons is also interested in music, and Dr. Yu said he would support whatever direction their lives take them.

“People say, ‘You’re in it for the money,’” Dr. Yu said, “But I really do like what I do. Actually, I love what I do, and I think I’m pretty good at it. I’d like to keep doing it as long as I can.”

If you’d like to make an appointment with Dr. Yu, contact Dayton Physicians Network at 937-293-1622.

Dayton Physicians Urology is writing to announce an innovative change in our practice starting on July 8, 2019.

Dear Patients,

The entire United States is experiencing a shortage of Urologists. There should be approximately 17,000 Urologists based on our population. Currently there are less than 10,000 active Urologists in the United States and over the next two years that number will decrease to 8,000 due to retirement. In order to address this shortage and continue to give you and our community the best possible urologic access and care in Southwest Ohio, we have developed collaborative health care provider teams in Urology. These collaborating teams will consist of our physicians and our specialty trained nurse practitioners to provide ongoing care for you.

Our collaborating teams of Physicians and Nurse Practitioners are listed below:

  • Dr. David Key and Heather Shoup, CNP
  • Dr. Mark Monsour and Rachel Perretta, CNP
  • Dr. Blake Anderson and Kelsey Patterson, CNP
  • Dr. Michael Yu and Bonnie Loesch, CNP
  • Dr. Erik Weise and a soon to be announced Nurse Practitioner

We are excited to offer you this innovative model of Urology Collaborative Care and we look forward to seeing you in the office. As we transition to this new model, you may receive a phone call to change your appointment. We apologize for any inconvenience as we work hard to accommodate as many patients’ needs as possible to provide the best care and access.

For appointments at Dayton Physicians Urology, please contact our call center at (937) 293-1622.

We appreciate the opportunity to care for you.

Sincerely,
Dayton Physicians Urology Team

Breast cancer survivor says a positive attitude is the key

Dayton Physicians NetworkAt age 53, Patty* went from a stage three breast cancer diagnosis to complete remission in six months. She’ll tell you it wasn’t an easy road, but with the support of her doctors and Dayton Physicians Network, she is feeling better every day and thinking about the future again.

“I was the first female in my family to be diagnosed with breast cancer,” Patty said. “They say it’s genetic, but that’s not always true.”

When Patty noticed her breasts began to look abnormal, she did a little internet research, only to discover she had all five of the classic signs of breast cancer. She contacted her doctor and was referred to a specialist.

“You feel distraught,” Patty said about her diagnosis. “You feel like your life is finished and wonder if the cancer is going to take over. You wonder how long you have to live. Whether it’s stage zero, one, two or three, it’s very distressing.”

For her treatment, Patty selected Dayton Physicians Network, a multi-specialty network that provides comprehensive cancer care and urologic care services at 12 locations throughout the Miami Valley.

Before treatments begin, patients with DPN are assigned a nurse to thoroughly review the treatment plan and possible side effects. Patty spent over two hours with her nurse, who walked her through the onslaught of new and overwhelming information and terms.

Treatment started almost immediately. In addition to surgery, Patty underwent six cycles of chemo, each lasting between four to six hours, every 21 days, and then endured 28 consecutive days of radiation.

No one wants to go through cancer treatment, but certain things can make the experience more manageable. The Dayton Physicians infusion room located in Miami Valley South is lined with windows and flooded with natural light. Patients are made comfortable in reclining chairs, with options for heated blankets, snacks and beverages.

“A lot of people like it there and request that location,” Patty said. “It’s convenient, with good access from the highway, and parking is great.”

Support system + positive outlook

If you ask Patty what got her through the treatment, she’ll tell you that, in addition to a great support system from her sister, close friends and DPN, she kept a positive attitude.

“I guess I didn’t want the cancer to take over – I wanted to beat it,” Patty said. “I didn’t sit and dwell on the fact that I had cancer. You have to think about things that make you happy.”

And it worked. On her birthday this year, Patty received the “all-clear” and had a whole new reason to celebrate. A few weeks later, her chemo port was removed.

“No more port means no more treatment,” Patty said of this major milestone in her care. “I’m done.”

Even with the all-clear, Patty will have routine meetings with her oncologist and surgeon. She’ll undergo regular blood checks and work diligently to maintain her health.

Patty’s after-care included her participation in the Dayton Physician Network survivorship program, which is designed to help patients navigate the challenges faced during recovery. Patients are made aware of late and long-term effects of treatment and are supported with after-care options specific to their type of cancer.

As a part of the program, Dayton Physicians screens for a variety of issues including anxiety, depression, distress, changes in cognitive function and memory, hormonal or sexual problems, even financial concerns. A survivorship care plan is created, documenting the patient’s cancer diagnosis and treatment, and the patient and all of their care providers receive copies.

Patty also works with a personal trainer to help her incorporate exercise into her post-treatment lifestyle. Not only does this have health and preventative benefits, but it also helps her overcome some of the muscle weaknesses caused by treatment.

Patty recommends advocating for yourself not only during your care, but also with your employer to be sure work is never a reason to delay or miss a treatment. She also says your attitude is paramount.

“Stay positive and don’t focus on the negative,” Patty said. “There are treatments that work. It takes longer for some than others, but doctors know so much more now than they used to.”

Ironically, Patty says she hasn’t always had such an upbeat outlook.

“Cancer changed that a lot,” she said. “I try to be more positive now. When I see an issue or a problem, I look at everything I’ve been through and think ‘I can handle this—I just beat cancer!’”

For more information about cancer treatment options with Dayton Physicians Network, call us at (937) 293-1622.

* Name changed to protect patient’s identity

Dr. Satheesh Kathula

Dayton Physicians Network

Dr. Satheesh Kathula was a representative at a Capitol Hill meeting organized American Association of Physicians from Indian Origin. He met with several US congressmen including Rep. Phil Roe of Tennessee, Rep Joe Wilson of South Carolin, Rp. Ami Bera of California and discussed with them on the following health care issues mainly affecting community oncology care:

  1. The consequences of pharmacy benefits managers (PBMs) on community oncology care, which are not only more expensive, but have delays in mailing life saving drugs.
  2. Lowering the Cost of Prescription Drugs: The exorbitant cost of prescription drugs is a critical health care issue, as some life-saving drugs are too expensive for many patients.
  3. How hospitals get preferential reimbursement over independent practices (340B) which is driving the healthcare cost up.

Dr, Anderson Attends Ohio Urologic Society Annual Meeting in Columbus

Dayton Physicians Network

In mid-April was the Ohio Urologic Society Annual Meeting in Columbus. At this meeting, Dayton Physicians Network’s Blake Anderson, MD took part of a panel about Management of Complex Stone Disease. The moderator for the discussion was Sri Sivalingam and other panelists were Mantu Gupta, MD, Smita De, MD, PhD, Michael Sourial, MD.

Dr. Anderson said “I really enjoyed being on the moderator panel for management of complex stone disease.” In the discussion several cases were presented and the panelists all weighed in on different approaches. One case discussed was, how to treat 10 cm of bladder stones in a man with BPH (enlarged prostate). Also discussed, was a case of a septic woman with recent chemotherapy for breast cancer with bilateral obstructing stones.

All the Panelists noted that there were multiple options for treatment but many factors had to be considered. Below is Dr. Anderson take on the discussion, treatment options, and considerable factors.

“How to treat 10 cm of bladder stones in a man with BPH (enlarged prostate. Options are: shockpulse and laser lithotripsy, then holmium laser enucleation of the prostate.
For the bladder stone cases in general, I am in favor a of combination approach to obstructive prostate tissue under the same anesthetic when feasible as bladder stones typically only form in the setting of obstruction. KUB should be done or can check scout film of CT if that has already been done to see if bladder stones are visible, if not may contain uric acid and preoperative medical therapy with potassium citrate could significantly decrease stone burden.

Kidney stone cases were numerous, incomplete left duplex kidney with large upper pole stone burden, difficult renal access and discussed special techniques to do this and accomplish PCNL.
Another case was of a septic woman with recent chemotherapy for breast cancer with bilateral obstructing stones, discussed ureteral stents or bilateral nephrostomy tubes as options, each with own advantages but both effective in prior studies. This decision involves a lot of patient specific variables, stone size, stone location, anticoagulation status and other anatomic considerations. In patients with low urine pH and low stone Hounsfield units on CT, especially in setting of recent chemotherapy, suspicion for uric acid stones should be high and stone dissolution therapy should be considered (medication, potassium citrate, raises urine pH and can dissolve uric acid stones).”

Cancer 101: Understanding the basics

“You have cancer.”

Dayton Physicians NetworkThose are the words that no one wants to hear from their doctor. Unfortunately, far too many do.

According to The American Cancer Society, an estimated 1,685,210 new cases of cancer were expected to be diagnosed in the United States in the last year alone.

The good news is that, with early diagnosis and treatment, the number of people living beyond a cancer diagnosis is expected to rise to almost 19 million by 2024 (up from nearly 14.5 million in 2014).

Dayton Physicians NetworkKnowledge is power
One of the scariest things about being diagnosed with cancer is all the unknowns. Gaining some understanding about the various stages of cancer and how it’s generally treated can go a long way toward alleviating some of the fear and anxiety.

Cancer staging
“Staging helps doctors to know where a cancer is located, if and where it has spread, and whether it is affecting other parts of the body,” explained Mark Marinella, MD, FACP, a specialist in the hematology and medical oncology department of the Dayton Physicians Network. “With this information, doctors can plan a course of treatment, including the type of surgery and whether chemotherapy or radiation are needed.”

Most cancers have four stages: stage I (one) to IV (four), with four being the most advanced.

  • Stage I: Often called early-stage, Stage I is usually a small cancer or tumor that has not grown too deeply into nearby tissue and also has not spread to the lymph nodes or other parts of the body.
  • Stage II and III: These stages indicate larger cancers or tumors that have grown more deeply into nearby tissue and may have also spread to lymph nodes but not to other parts of the body.
  • Stage IV: Also called advanced or metastatic cancer, this stage indicates that the cancer has spread to other organs or parts of the body

Treatment
“Treatments for cancer vary greatly, with the most common being surgery, chemotherapy and radiation. The stage of the cancer will help to determine the best course of treatment,” said Dr. Marinella.

  • Surgery can be used to take out the cancer (tumor) and occasionally to remove some or all of the body part(s) affected by the cancer.
  • Chemotherapy (also called “chemo”) is the use of drugs to kill cancer cells or slow down their growth. It can be given intravenously or as pills to swallow. Chemotherapy treatment is useful in treating cancers that have spread.
  • Radiation also is used to kill or slow the growth of cancer cells and can be used alone or with surgery or chemo. Having radiation treatment is similar to getting an x-ray.
  • Immunotherapy: Newer drugs, called “checkpoint inhibitors,” are now available that stimulate the immune system to fight cancers such as melanoma, lung cancer, kidney cancer, bladder cancer, and head and neck cancers.
  • Targeted therapies are antibody treatments and other oral drugs that attack a certain abnormality in the cancer cell.

Dayton Physicians Network

During diagnosis, Dayton Physicians Network routinely checks genomic profiling on many patient tumors. This procedure looks for genetic changes and abnormalities that may help determine a course of treatment and allows DPN to find trials in which a patient can participate.

Should I get a second opinion?
“Unless a patient really wants one, I generally don’t recommend it,” said Dr. Marinella. “Where I might recommend a second opinion is more of a physician-driven thing. For example, if I see something that is very rare or if a patient has received all the treatment I can give, I might consult with another physician on a possible clinical trial.”

The diverse areas of expertise and specialties in cancer care that exist among the doctors, as well as the access they have to cutting-edge technology and clinical trials, allows Dayton Physicians Network to provide patients with timely and comprehensive, patient-centered care. In addition, with 13 practice locations from Greenville to Middletown, patients can receive cutting-edge cancer care while remaining close to home.

Click here to learn more about Dayton Physicians Network cancer care, or call 937-293-1622937-293-1622.

Dayton Physicians Network’s Jhansi Koduri, MD has been nominated for Leukemia and Lymphoma society Woman of The Year

 
Dear Friends,

As an oncologist of 15 years, my work has been transforming. I have been a part of many cancer journeys, the fright and the fight, the hurt and the healing, the stress of finances and the journey of hope. I often succeed in the fight for my patients, but sadly even in this era of modern medicine and advanced research, I have to idly stand by and watch a few succumb.
Dayton Physicians Network
I have humbly accepted the nomination to be a candidate for The Leukemia & Lymphoma Society’s (LLS) Man & Woman of the Year, 2019 fundraising campaign. The generous funding of LLS to my own patients has enabled them to receive the latest treatments without the stress of losing their homes. A young patient of mine is now undergoing CAR-T-cell immunotherapy, and due to the innovative therapies of LLS research, will survive in spite of recurrent aggressive Non-Hodgkin’s lymphoma. Since 2000, over 40% of all U.S. Food & Drug Administration (FDA) approved cancer drugs were for blood cancer, some even used to treat other forms of cancer and non-malignant diseases.  A “win” for blood cancers, therefore, is a win for the cancer community overall.  I run this campaign along with my patients Cynthia, Betty, Jeff, Ken, Chalonda, John, Edward, Tatyana, Bobbie, Toni, Jowana, Minnie, Patricia, Essie, Joan & many more; I run in honor of Tim, Anita & Donna.

I dream to erase the connotation of death from the word cancer one day. Every dollar raised in this campaign funds the work of LLS.  Cancer research has come a long way. In the 60s, a blood cancer patient’s survival rate was 3%; today, it is 90%. Although 90% is remarkable, someday that 10% must be accounted for. With your support we are well on our way to making that someday today.

Please join the team and help us to cure every cancer patient. Donations can be made starting on February 28, 2019 through May 11, 2019 via credit card at https://pages.mwoy.org/soh/dayton19/jkoduri

 or by mailing a check made out to  LLS with Team Koduri in the memo and send it to 1029 Whispering Pine Lane, Dayton Oh 45458.  Click here to know the impact of your donations. Thank you in advance for helping save lives through your generosity.

 

Sincerely,

Jhansi Koduri, MD

Hematology/Oncology,

Associate Professor, Wright State University

Cancer survivorship program provides continued support after treatment

Dayton Physicians NetworkDealing with cancer can be difficult enough, but often the aftermath can be just as troubling. Survivors not only have to deal with the disease, but also may struggle with lasting physical and emotional effects of treatment. Patients who felt they had a great deal of support throughout treatment often find it hard to adjust to a new way of life and the challenges they may face in the recovery phase.

Dayton Physicians Network offers a survivorship program to help patients navigate these difficulties and continue supporting them after treatment. Elizabeth Delaney, DNP, APN, FNP-BC, is a nurse practitioner with the program.

“We have had the opportunity to witness people experiencing the long-term effects of therapy, as well as impacts to their quality of life from their treatments,” Delaney said. “Cancer survivorship is about addressing the impact of cancer and treatment for the individual, particularly after those initial therapies are completed.”

Rotating through four Dayton Physicians Network locations, Delaney sees patients who are in stages 0 through 3 with curative therapy at the Survivorship Clinic. Right now, that includes only patients of breast and colon cancer, but DPN hopes to expand to include lung and prostate cancer patients in the near future.

Once curative therapy is completed, patients have the opportunity to complete a National Comprehensive Cancer Network (NCCN) survivorship assessment to determine what issues may need to be addressed post-treatment. Dayton Physicians screens for a variety of issues including anxiety, depression, distress, changes in cognitive and memory, hormonal or sexual problems, even financial concerns.

For example, some treatments have delayed impacts to the heart and lungs, so patients may need to be aware of the potential for shortness of breath or swelling in the arms. And breast cancer patients might experience lymphedema, a swelling in one of the legs or arms. The patient may not even be aware of these conditions, but they all affect long-term recovery.

The next part of the visit is to create a tailored Survivorship Care Plan, a summary document about everything regarding the patient’s cancer diagnosis and treatment. A copy is given to the patient and all of their care providers, such as the surgeon or other specialists.

Finally, staffers review the current national recommendations for healthy lifestyle choices and ways to reduce the potential for recurrence of the patient’s original cancer or development of other types. For example, helping them to stop smoking, integration of a healthier diet and exercise, mental health counseling, and regular spirituality practice. Research has shown that all of these practices improve quality of life, reduce anxiety and depression, and in some cases, reduce recurrence of cancer.

Delaney says that patient response to the Survivorship Clinic has been overwhelmingly positive, and they are grateful to have the plan review. “I articulate common concerns for cancer patients, like emotional and mental health, weight gain, smoking cessation, fertility issues, and so on,” she explained. “We go through all of those and, often, just showing people that these are common concerns can help reduce the ‘suffering in silence.’ It feels good to them to know they’re not uncommon.”

“Being able to articulate their story and have someone listen to them can make a big difference,” Delaney said. “Sex, for example, is a big topic that comes up. Women who have had mastectomy may suffer with body image changes, and the effects of chemotherapy and hormonal drugs can lead to other related complications.”

The most common concerns and questions from patients tend to depend on the stage of cancer and the age of the patients. Understanding the common concerns, however, is helpful across the board. Many are interested in the impact of healthy lifestyle and want input from the providers on those choices.

The greatest barrier to helping survivors through the challenging time following treatment is that they often do not schedule the visit. Patients have expressed the value of the service, from the information provided and the overall support offered, to keeping office visits to a minimum. When a provider says you may be eligible for a survivorship visit, take advantage of it.

For more information about the Dayton Physicians Network Cancer Survivorship Clinic, call 937-293-1622.