Dealing with the Unforeseen “Side Effects” of Cancer

LEXINGTON, Ky. (Feb. 20, 2014) – How would you react if you’d just been told you have cancer?

“You freak out,” said 57-year-old Tony Stone, a current patient at the University of Kentucky Markey Cancer Center. “You don’t know what to do.”

Stone, who hails from Liberty, Ky., came to Markey last fall after getting diagnosed with stage IV throat cancer at a local hospital. The diagnosis came just six months after he retired from a long career – 36 years – as an iron worker.

The timing wasn’t just poor because it put an end to Stone’s well-deserved break – it also meant a serious blow to his finances. Stone had elected to forego health insurance upon retirement because he couldn’t continue to afford the $900/month payments without his job.

Faced with what seemed like insurmountable expenses and a terminal disease, Stone made the initial trip to Markey on a friend’s recommendation. Though he knew to expect top-of-the-line medicine and treatment from the cancer center, he hadn’t expected the other aspect of cancer care he would receive at Markey – the emotional and personal support from Markey’s Psych-Oncology Services team.

Located on the third floor of Markey’s Whitney-Hendrickson building, the Psych-Oncology team is devoted to providing much-needed assistance to Markey’s patients. Every day, financial counselor Michele Ratcliffe, clinical dietitian Rachel Miller, American Cancer Society patient navigator Melanie Wilson, oncology social workers Jenny Delap and Angie Pennington, and licensed clinical social worker Joan Scales meet with new and ongoing patients to assess their needs on a more personal and emotional level.

In general, research shows that hospital patients who receive counseling and support for psychosocial distress have reduced hospitalizations, length of stays, physician visits, emergency department visits, and prescriptions. Markey’s Psych-Oncology team was assembled specifically to deal with the non-medical “side effects” of cancer – while oncologists, radiation medicine specialists and surgeons can recommend and perform specific medical treatments, this team focuses on fixing the everyday stressors that may impede a patient’s ability to get the full benefits of their medical care.

“The question we focus on is ‘What are the tangible, basic needs that we can get for the patient?’” said Delap.

For many patients, those needs includes assistance with paying for medication, getting insurance, creating a living will or an advanced directive, help with transportation or lodging costs, or referrals to national programs that may offer further assistance.

In Stone’s case, it first meant help with his finances – Delap helped him apply for disability and insurance coverage to help pay for the 35 radiation sessions and three rounds of chemotherapy he endured.

Because of the location of his cancer and subsequent radiation – the head and neck area – Stone was unable to physically eat his food during and following treatment, and a feeding tube was placed in his stomach. And that’s where Miller came in. As Markey’s dietitian, her job is to ensure that patients are getting the nutrition they need to stay strong through their treatments.

During her visits with patients, Miller counsels patients on what specific foods they should eat, how often to eat, and how to make foods taste better during chemotherapy (which can affect the taste buds, making previously appetizing foods seem bland or have an undesirable taste). Or, for patients like Stone, how to use the feeding tube and what to put in it for optimal caloric intake.

“Staying nourished can become a chore during cancer treatment, especially for patients who have lost their appetites or don’t feel well enough to eat,” Miller said. “It’s a catch-22, because you need to be fully nourished at the same time that you feel the least like eating.”

Sometimes, a patient’s needs are even more basic. Wilson, who is Kentucky’s only American Cancer Society patient navigator, said the first thing she was able to do for Stone was get him a bandanna to cover his head as his hair began to fall out. She often fulfills similar cosmetic requests by procuring wigs and other head coverings, or by referring patients to the ACS's Look Good... Feel Better program, which is facilitated on site by a licensed cosmetologist and helps patients combat the appearance-related side effects of cancer treatment. Additionally, she makes patient referrals to a variety of services that can assist with funding transportation or lodging during treatment.

Wilson has fulfilled some unique requests in her time at Markey – including making sure that an out-of-town patient’s dog was taken care of during a long stay at the cancer center – but she says that any little thing she can do to help ease the patient’s mind during their time at Markey is worth it.

“It may not seem like much, but it’s one less thing for them to worry about,” she said.

But perhaps the most important thing the Psych-Oncology team offers is the simplest of all – an ear to listen. Collectively, the team agrees that they provide an opportunity for patients to talk about their individual situations with no judgment, and to make requests or ask questions that they might feel uncomfortable asking of their physicians or nurses. Both Delap and Pennington note that they make an estimated 35-40 contacts per week – they regularly check in through in-person visits, texts, and phone calls to make sure the patients are continuing to get what they need on every level throughout the treatment process and beyond.

“We get to know certain patients really well,” Delap said. “We provide an outlet for them, an extra person to lean on during a hard time.”

It was that level of personal support that made all the difference for Stone, a self-described “tough guy” who found himself initially overwhelmed by his grim diagnosis.

“They’ve been there for me when I was scared out of my mind,” Stone said. “You just don’t find this kind of caring people out there in the world… it takes a special kind of person to do this.”

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For more information on the services and programs provided by Markey’s Psych-Oncology team, please contact supervisor Joan Scales at joan.scales@uky.edu.

MEDIA CONTACT: Allison Perry, (859) 323-2399 or allison.perry@uky.edu