Petrelli, Nicholas

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Health Policy Newsletter ____________________________________________________________ Volume 16 Number 1    March, 2003               Article 8 ____________________________________________________________  A Multi-Disciplinary Approach to Cancer Care: The Beginning of a New Era  Nicholas Petrelli, MD*  * Thomas Jefferson  University  Copyright ©2003 by the author.  Health Policy Newsletter is a quarterly publication of Thomas Jefferson University, Jefferson Medical College and the Office of Health Policy and Clinical Outcomes, 1015 Walnut Street, Suite 115, Philadelphia, PA 19107. Suggested Citation:Petrelli N.  A multi-disciplinary approach to cancer care:  The beginning of a new era.  Health Policy Newsletter 2003; 16(1): Article 8.  Retrieved [date] from http://jdc.jefferson.edu/hpn/vol16/iss1/8.  Nicholas Petrelli:  A Multi-Disciplinary Approach to Cancer Care Health Policy Newsletter Vol. 16, No. 1 (March 2003), Article 8 A Multi-Disciplinary Approach to Cancer Care:  The Beginning of a New Era ___________________________________________________________________  With the opening of the Helen F. Graham Cancer Center in May of 2002, the Christiana Care Cancer Program began a new era toward the multi-disciplinary care of the cancer patient. Multi-disciplinary centers, which are oriented toward specific clinical diseases, have been established. Every patient who visits Christiana Care’s Helen F. Graham Cancer Center has the opportunity to meet with a site-specific team of physicians in one visit, including a medical oncologist, radiation oncologist and surgeon. Together with support services that include psychology, case care managers, cancer research nurses, nutritional support, social services and a developing program of integrated medicine, these three cancer specialists, in consultation with the patient’s primary care physician, create the most appropriate and effective plan of care in one visit.  The multi-disciplinary centers that have been established are:  1) Thoracic/Esophageal; 2) Hepatobiliary/Pancreatic; 3) Head And Neck; 4) Rehabilitation; 5) Genitourinary; 6) Rectal/Anus; 7) General Oncology; 8) Neuro Oncology; 9) Breast; and 10) Cancer Pain Consult Center. A Genetic Risk Assessment Center has been established under the direction of Zohra Ali Khan-Catts, a certified genetic counselor. In collaboration with Rita Meek, MD, Greg Griffin, MD, and Irving Berkowitz, DO, a Young Adult Follow-Up Center also has been established for cancer patients over the age of 19 years who are at risk for second primary cancers.  It’s important to mention that radiologists and gastroenterologists are also on-site at the Center to work with the surgeons, medical oncologists, and radiation oncologists in coordinating the most aggressive and timely treatment plans.  Together, this program makes it more convenient for the patient to make one visit to see three disciplines (medicine, surgery and radiation), provides for faster answers and, in sum, is a best practices approach to cancer care. This multi-disciplinary approach also allows the patient to have direct communication with the cancer research nurse for access to possible clinical trials, as sponsored by the National Cancer Institute (NCI).  Christiana Care’s Cancer Program has received NCI grant funding since 1987 to support its clinical trials program. This allows statewide accrual of patients to both prevention and treatment trials with high quality cancer care.  After the cancer plan has been discussed with the patient and his/her family, a preliminary report is sent back to the referring physician the same day that the patient is seen in the Multi-Disciplinary Center. Concurrently, an effort is made to make sure that the patient returns to his/her referring physician so that the Center does not turn into a black box for patient referrals.  There is a mechanism for physician participation in the Multi-Disciplinary Center that requires meeting certain performance expectations. For example, success with making clinical trial opportunities available to patients is an expectation. Another is specialty training in oncology and/or focused interest in one or two disease sites.  In order to educate the public about the support services available throughout the state of Delaware, representatives from such community friends as Hospice, The Wellness Community, Cancer Care Connection, Delaware Breast Coalition, Delaware Nicholas Petrelli:  A Multi-Disciplinary Approach to Cancer Care Health Policy Newsletter Vol. 16, No. 1 (March 2003), Article 8 Pain Initiative, Leukemia/Lymphoma Society, and the American Cancer Society are available to speak to patients and their families at the Center. Integrated medicine with journaling, Tai Chi and yoga are also available for patients as part of the total plan of cancer care.  The Center works in close collaboration with the Eugene duPont Preventative Medicine & Rehabilitation Institute under the direction of Gregg Sylvester, MD, MPH. One of the programs centers on increasing opportunities for global health screenings. The Women’s Health Screening van, a coordinated effort of Christiana Care, its Junior Board, Delaware Health and Social Services Division of Public Health, and the Screening for Life program, illustrates the potential for global health screening. The van travels around the state providing uninsured and underinsured women with low- and no-cost mammograms through the CDC-funded Screening for Life program. Efforts are on-going to increase the number of women being screened each month for breast cancer. The van will offer additional screenings, such as PAP tests and osteoporosis screenings, to help make global health screening more convenient, and prevention and early detection efforts more effective.  In summary, the Helen F. Graham Cancer Center has become the “headquarters” for the Christiana Care Cancer Program and, through the establishment of the disease site Multi-Disciplinary Centers, has brought a team approach to cancer care - surgeons, medical oncologists, and radiation therapists working together with support services to deliver high-quality care to the cancer patient. This care includes participation in clinical trials and access to organizations that can educate patients about the cancer services available in the state of Delaware.    About the Author  Nicholas Petrelli, MD, is the MBNA Endowed Medical Director of the Helen F. Graham Cancer Center and Professor of Surgery at Jefferson Medical College, Thomas Jefferson University.  Please address comments and questions to npetrelli@christianacare.org.  

A Multi-Disciplinary Approach to Cancer Care:  The Beginning of a New Era

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A Multi-Disciplinary Approach to Cancer Care: The Beginning of a New Era

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