July 28, 2003
The Reason For Establishing A Cancer Supportive Care Program (CSCP) Is The Need For An Improved Quality Of Life For Cancer Patients
Ernest H. Rosenbaum, MD
The crusade to conquer cancer through new research and therapy has been ongoing for most of this century. The number of new cancer diagnoses has recently started to decline. There is now a need for a pioneering effort to improve cancer supportive care as a complement to cancer prevention, diagnosis and therapy. New therapies have improved the prognosis over the past 25 years. The cancer supportive care program may help to improve and prolong the lives of cancer patients.
As an oncologist, I can attest to the emotional devastation which occurs with a cancer diagnosis. There is a lot of stress, fear, anger, guilt, and confusion. Making decisions and choices about types of therapy are often difficult for patients. The chance for a cure is about 50% and the remaining 50% can often be treated successfully to achieve a remission and longer life. I have found that a cancer supportive care approach can help relieve many of the physical symptoms of cancer and the side-effects of its therapies, as well as the emotional process involved in living with cancer.
During my career over the past 40 years, I have been devoted of finding ways to improve patient care. In 1963, I started a practice at Mount Zion Hospital in San Francisco. I was appointed director of the Medical Oncology service in 1965. I developed a Medical Oncology Service and Fellowship and a national and a local oncology lectureship. Together with members of the Zellerbach-Saroni Tumor Institute at Mount Zion Hospital, I helped to develop a comprehensive cancer care program. In 1969, I gave my first paper on the value of the medical team approach for total patient care. This paper helped introduce an innovative concept whereby a team of medical professionals (surgeon, radiation therapist, and medical oncologist) collaborate to help enhance patient care. At Mount Zion, I also developed a psychosocial research program and an active immunology program to treat patients with melanoma and breast cancer.
By the 1970s, it became obvious that supportive care was the fifth therapeutic dimension. I developed supportive services with our nurses and patients. My first book, Living with Cancer, was published in 1976. In 1977, my wife and I published our first book on supportive care called Mind and Body. We subsequently published several books on nutrition and exercise with Jack LaLanne. In 1979, The National Cancer Institute of Health distributed our book Health Through Nutrition. This book provided comprehensive nutritional information on ways to reduce therapy side effects and general advice to promote acceleration of patient rehabilitation and recovery.
By 1980, our ideas and work had evolved into The Comprehensive Guide For Cancer Patients and Their Families, a book on total patient supportive care. This book won 2nd Prize Honorable Mention from the American Medical Writers' Association. A second edition, Cancer Supportive Care (1998) now includes new information and updated developments in total supportive care.
The Cancer Supportive Care Program is based on the ideas found in the book Cancer Supportive Care. The Cancer Supportive Care Program addresses the many facets of supportive care, including the emotional, psychosocial, nutrition, and exercise needs of patients. There are also lectures, classes, workshops and specific patient support programs on pertinent topics such as fatigue, sleep problems, pain control, spirituality, and diversion--which emphasizes a way to increase enjoyment of life by using art and music.
New information has been added on the Web Site, www.Cancer Supportive Care. The CSCP is being implemented at Cancer Centers with weekly lectures, an exercise class, nutrition classes, and a fatigue reduction support program.
The program's informational service includes:
- Book- Cancer Supportive Care
- Web Site- www.cancersupportivecare.com
- CSCP lecture course
- A weekly lecturer series include for example classes on stress reduction, mindful meditation, biofeedback, fatigue reduction, will to live, coping with cancer, pharmacological support, nutrition and exercise.
Preventive rehabilitation programs are needed to restore patient function, palliate (relieve) symptoms and provide supportive care to help patients regain the functional status which existed before a diagnosis of cancer.
The CSCP utilizes a series of educational modules, lectures and workshops covering supportive care related to cancer and therapy. The programs also provide information and literature, practical one-on-one teaching/support and group classes to promote health and coping skills. Video programs have been produced to enhance the education on various cancer topics. This will be provided to newly diagnosed patients, undergoing therapy as well as patients in remission.
The goals of the program are as follows:
- To reduce the morbidity and toxicity of disease and/ or related therapy and to improve general physical and mental health.
- To improve the quality of life for cancer patients on therapy as well as for long-term cancer survivors.
- To expand currently available support modalities and address specific problems confronted by cancer patients and their families and friends.