Cancer center focuses on treating the whole person, not just the disease
Outpatients and inpatients share amenities
Patient-focused care takes on a whole - or perhaps holistic - new meaning at the Cancer Treatment Centers of America, where the mission is to "fight cancer body, mind, and soul," says Sandra Jackson, president and CEO of the Tulsa, OK, facility.
"Our goal is to create an atmosphere of healing 24 hours a day, for both outpatients and inpatients," she says, explaining both groups have access to such complementary therapies as massage, tai chi, nutritional counseling, meditation, visualization, imagery, and prayer sessions.
The impetus for this type of center came about in 1988, when Richard J. Stephenson, president and CEO, watched his mother experience what he perceived as abysmal treatment at the hands of conventional providers. Unable to find a facility that offered patient centered care with alternative options, he started one. Today, Cancer Treatment Centers of America are located in Zion, IL, and Tulsa. At both facilities, physicians are carefully screened before hiring to determine if they are open to holistic care, he says.
Providing patient-focused care actually begins before the patient arrives, says Patti Berens, oncology information specialist. For patients covered by private insurance, the center offers free round-trip airfare and affordable accommodations and meals. A guest, perhaps the spouse or an adult child, also travels at no charge.
"We provide this service because cancer produces stress and anxiety about finances," Berens says. "We encourage the guest to attend so he or she can support the patient, who will be introduced to new ideas and must absorb a lot of information as well as make important decisions. So they need someone else to be there to listen."
During the initial four-day consultation, each new patient is evaluated by care team members from medical oncology, nutrition, nursing, pain management, and the Mind-Body Connection Program, which is based on "psychoneuroimmunology" and explores the influence of the mind on the body and immune system.
"Then, a treatment plan is individualized based on factors such as the type of cancer, what type of treatment the patient has had in the past, how sick the patient is upon arriving, and the patient's choice of available options," Jackson says.
Classes and group sessions are free, but medical treatment, individual consults with physical therapists, nutritionists, or counselors, massage, and supplements are billed to insurance and/or paid out-of-pocket by the patient.
Outpatients may choose to stay in one of 70 guest rooms located on the premises for about $10 out-of-pocket expense. (They may eat in the cafeteria for $3 per meal; this service is for patients only, not employees.) This concept of affordable, on-site housing originated in a weekly focus group in which both inpatients and outpatients are invited to answer the question, "What can we do to improve our services?" says Jackson
When patients first asked to stay at the hospital instead of the hotel across the street, the administration considered renovating one floor at a cost of a $250,000. "But when we took this information back to the focus group, they said they didn't care about fancy hotel-like renovations. All they wanted was a bed, a private phone, a bath, a lock on the door and an alarm clock," she says. "So we were able to give them what they want at a much lower expense to the hospital."
Some outpatients also receive a pager, which allows for more flexibility for both the patient and the physician. "We don't want them to spend a lot of time waiting for the physicians," Jackson explains. "Physicians may vary times they see each patient according to his or her needs. Meanwhile patients may take part in the many activities and support groups [available at the hospital] until they are called to the clinic or lab."
For example, cooking, tai chi, and craft classes are offered on the weekdays, and on weekends, patients participate in various field trips.
"It is part of our philosophy to teach patients to get on with living, rather than concentrating only on the cancer," explains Gerri Ellison, RN, PhD, co-director of the Mind-Body Connection Program.
Healing, she explains, is a process that comes from within the person and takes place on many levels, not just the physical one. "By focusing on healing - bringing thoughts, images, feelings, and relationships into the whole, the cancer patient has the best chance to recover and live his or her life to the fullest," she says.
The program offers, at no additional charge, support groups for patients, family members and courses in stress management, relaxation, and spiritual meditation.
Family members may attend separate sessions. "If we have family members who are really hurting, patients don't need to see them work through their issues," Ellison stresses.
Ellison points out that such a program must take into consideration other various spiritual practices of the patients and their loved ones. For example, most patients are Christian and some are uneasy about words like "relaxation and imagery," she says. So Ellison offers Christian meditation as well as alternative groups for patients of other faiths.
Feeding the stomach as well as the soul
Nutrition support also plays a key role in recovery, says Rebecca Wright, RD, who points out that the center's kitchen serves fresh food instead of canned and uses few production shortcuts; for example, mashed potatoes are made from real potatoes instead of instant ones. "It's time-consuming and expensive, but we feel it is essential," she explains.
Yet Wright doesn't force changes in diet on the patients. "I stress to all new patients that the odds of beating cancer are better if they change their diet. In the initial evaluation I ask them about their dietary habits, explain what nutritional support can do for them, and find out how far they want to go with changing their habits," she says.
Her rationale is twofold, she explains. "Demanding an immediate transition to organic foods, supplements, and proper eating regimen adds another stress to the burden of having cancer. We've also found that we get much better compliance if we allow patients to choose how much they want to change," she says.
Her basic message is to increase the intake of fresh fruits, vegetables, and whole grains and decrease intake of fats, sugar, and canned or processed foods. "Helping the patient to set small goals for better nutritional habits is more effective than changing too much at once,' she says. "If they're drinking a six-pack of soda a day, switching to bottled water or juice is an accomplishment."
Wright also starts patients on a regimen of supplements and vitamins. All patients are encouraged to take at least a basic core prescription: a multivitamin, selenium, beta carotene, eicosapentaenoic acid (fish oil), and vitamins C and E.
"The other supplements recommended depend on what type of cancer they have and how many pills they want to swallow in a day," she says.
Wright adds that the center is in the process of creating disease-specific packets of vitamins for patients with breast and prostate cancer.
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