Adena Health Focus October 28, 2020

Adena oncologist, nurse advocate tout ‘extended family’ approach to breast cancer care

When Adena Cancer Center opened in 2012, it promised cancer patients, their friends and families quality, comprehensive cancer care close to home.

Within that promise, the word comprehensive is key because a cancer diagnosis creates turmoil inside a patient beyond the obvious physical challenges. Uncertainty over future prospects, whether anything could have been done to prevent it, how family will respond to the diagnosis, whether it will be fatal – all are among questions that patients grapple with and family members struggle to answer without having a shared understanding of what their loved one is going through.

That’s where healthcare providers such as oncologist Dr. Shylaja Mani, who believes providing critical emotional support is almost as important as the physical care she delivers, come into play.

 “I  know empathy is the biggest thing for these patients, just listening to their problems and trying to address their problems, whether it’s physical or emotional or psychological, whatever it takes to get them through these treatments because breast cancer is a multi-disciplinary treatment – it involves surgery, radiation, hormone therapy and chemotherapy sometimes,” Dr. Mani said. “The treatment itself lasts six to nine months – it’s a long time to go through treatment for your cancer. My approach to them is to be empathetic and be a listener to their problems.”

That need may be even greater in the age of COVID-19, as restrictions put in place to limit the spread of the virus also have limited patients to just one family member accompanying them on visits to the Cancer Center. Dr. Mani, who has been an oncologist for five years and is in her second year with Adena, said the emotional support role was among the factors that led her into cancer treatment.

“Sometimes (cancer) strikes you all of a sudden and the devastating news forms a deep bond (with those providing care),” Dr. Mani said. “We become their family member and hold their hands through to the end (of treatment) and it gives you a lot of job satisfaction.”

That satisfaction does come with a risk. Since she develops an almost familial connection with her patients, Dr. Mani says “it really hits you hard” if something goes wrong, especially if the downturn is unexpected.

Dr. Mani is quick to point out that physicians are far from the only ones who step up to provide the various levels of support cancer patients need. Everyone from the social workers and financial counselors, who deal with any transportation or financial hardships that may impact patient treatment, to nurse navigators like Holly Hooks and Carrie North, who follow patients from diagnosis through the end of treatment, help bring hope and relief to patients.

“We have a comprehensive (breast cancer) program in our cancer center,” Dr. Mani said. “When they get their mammogram and are diagnosed with breast cancer, their care starts at that point. The nurse navigators are involved from the very beginning and make sure the patients get their appointments with the different specialists they’re supposed to see.”

The Cancer Center also utilizes a multidisciplinary tumor board conference that provides a comprehensive evaluation of patients with a new diagnosis of breast cancer to make sure the course of treatment is in line with what the most current guidelines recommended. That way, if a patient is facing significant challenges, more than one person will be involved in making decisions about what is best for that patient. 

Hooks, a nurse for 28 years – the last 25 of which have been spent at Adena – is an integral part of the patient care process. Immediately prior to becoming a nurse navigator for the Cancer Center, she was working as a nurse navigator with patients primarily over the telephone. She realized through that experience how badly she missed the direct personal contact with patients and the accompanying bonds that form from that contact.

“I usually will call the patients and touch base with them on their diagnosis, so I feel like we connect right at that moment that we tell them they have breast cancer,” she said. “I tell them I’m there to listen, that I’m here to help them. I identify any barriers that might inhibit their care and I’m here to help break those walls down.”

Hooks is thankful for her opportunity to work with breast cancer patients because the number of different treatment options when compared with other types of cancer give her the opportunity to provide them with one of the greatest needs of all – hope.

The relationships formed between patient and provider generally don’t end with the completion of a treatment program. It’s not uncommon for patients to surpass the five-year mark with no recurrence, which Dr. Mani said constitutes being “cured,” and then to keep following up with their physician for the next 10, 15 or 20 years.

“They’ve developed that bond with us and they feel in a safe place that the oncologist is kind of watching over things for them,” Dr. Mani said. “They’re doing their part getting their annual mammogram, which is all it takes to monitor (their progress), but just seeing us and meeting with us that once a year makes them feel secure and safe. We also screen and treat for long-term complications from their cancer therapy. Even though it’s been a long time since I’ve treated them, I still remember how remarkable their journey was – how strong they were, what the hardships were, how they somehow got through all that.

“I do share some of these experiences without revealing any personal information with my patients who are currently being treated and have challenges. To know that somebody else was in the same boat as them instills more hope and confidence and a light at the end of the tunnel.”

At the end of the day, it’s that endurance and hope that are important, she concluded. Those traits, coupled with promising discoveries and remarkable treatment advances in the field of breast cancer, should result in growing numbers of women making the transition from cancer patient to cancer survivor.

The Adena Cancer Center holds accreditations from the American College of Surgeons’ Commission on Cancer and American College of Radiology – the latter for its radiation oncology work -- demonstrating that it is truly providing comprehensive care for patients and their families in the community.