February 5, 2015 | by Nicole White
A woman confronting metastatic breast cancer faces challenges that, at the outset, seem overwhelming. Research tells us these patients are especially vulnerable to anxiety, depression, hopelessness and other sources of distress. At the same time, they are asked to make complicated choices about their medical care — such as whether to participate in a clinical trial, choosing between available therapies and weighing a treatment’s effectiveness against quality-of-life issues.
The good news is, supportive care has been shown to successfully help these women through this difficult time. Even the healthiest of relationships or couples may struggle with knowing how to best support one another and maintain an emotional connection when women are diagnosed with metastatic breast cancer and they need it the most.
Despite the fact that a woman’s partner is a crucial source of support through her cancer treatment, few programs explicitly seek to promote strong relationships between couples facing this diagnosis together and strong communication with their doctors.
With the help of a $55,000 grant from the Avon Foundation, City of Hope is creating the most comprehensive program for metastatic breast cancer patients in Southern California. The program marries City of Hope’s existing leading-edge, innovative care and access to clinical trials with enhanced support services to serve the patient’s needs beyond the clinic and operating room. The grant will help establish the Supporting Metastatic Breast Cancer Patients and Partners Program, the first of its kind for metastatic breast cancer patients in the region.
“Data show that the two most important sources of support for women with metastatic breast cancer are a supportive partner and a physician who connects with them through open and honest communication,” said Matthew J. Loscalzo, L.C.S.W., the Liliane Elkins Endowed Professor in Supportive Care Programs and director of the Sheri & Les Biller Patient and Family Resource Center at City of Hope. “This is a new approach to patient- and family-centered care.”
Metastatic breast cancer is the most advanced stage of breast cancer and occurs when cancer spreads beyond the breast to other parts of the body, including the bones, lungs, liver and brain. Nearly three in 10 women who have had early breast cancer will eventually develop metastatic disease.
Assessing those unique needs, then documenting them
The new City of Hope program will include three key components. First, City of Hope’s SupportScreen — a tool developed six years ago to assess patients’ emotional, social, spiritual, physical and practical concerns — will be adapted with additional questions tailored to the unique needs of these patients. Patients take the survey and the results are reported in real time to the health care team, so supportive care specialists can immediately provide patients additional printed information and referrals to spiritual care, counseling, support and financial assistance. In addition, the information is reviewed by the doctor before the patient appointment, in order to identify any issues that might affect care.
Second, each patient will have her initial physician visit recorded and be given a CD with that information, so she can listen later or share information on her treatment with her family and loved ones. Waisman started recording visits with patients last year, and his patients have said this low-cost, low-tech tool eased anxiety about missing important information, increased their understanding and fostered trust in the doctor.
Third, the grant will also allow couples to have a recorded counseling session with Bitz. That session will help couples work together to cope with the cancer diagnosis and treatment. These sessions focus on problem-solving techniques to strengthen the relationship and build tools for confronting cancer together. This is an expansion of City of Hope’s Couples Coping with Cancer Together Program, and will be tailored to the needs of families specifically dealing with metastatic breast cancer.
“In these gender-sensitive meetings, the patient and partner learn how to best support each other,” Loscalzo said. “This strength-based approach is especially essential when the woman has metastatic breast cancer — and it’s a program that needs to be replicated nationally.”
Special grant, special institution
City of Hope is one of 23 grant recipients for the Avon-Pfizer Metastatic Breast Cancer Grants Program: Identify-Amplify-Unify, and its the only institution in Los Angeles County to be selected.
“City of Hope is honored to be part of this important national initiative for metastatic breast cancer patients and their families, which will offer tremendous benefits for women and their partners at our institution,” said Steven Rosen, M.D., provost and chief scientific officer at City of Hope.
The Avon-Pfizer Metastatic Grants Program was created to address the lack of programs available to support women confronting a late-stage breast cancer diagnosis.
“To date, the majority of public attention on and funding for breast cancer has centered on early-stage disease — such as screening strategies and survivorship — not on late-stage diagnosis. As a result, the Avon-Pfizer Metastatic Grants Program was established to address the gaps in support available to women and men living with metastatic disease, and to create new services for metastatic patients so they do not have to face this disease alone,” said Marc Hurlbert, executive director of the Avon Foundation for Women Breast Cancer Crusade. “Our hope is that one day, all patients can access the unique care and support services they need, regardless of their ability to pay.”
Learn more about becoming a patient or getting a second opinion at City of Hope by visiting our website or by calling 800-826-HOPE (4673). You may also request a new patient appointment online. City of Hope staff will explain what's required for a consult at City of Hope and help you determine, before you come in, whether or not your insurance will pay for the appointment.