The Cancer Supportive Care Program and Website, www.cancersupportivecare.com
The Breast Oncology Program UCSF Comprehensive Cancer Center Retreat, February 7, 2001
Ernest Rosenbaum, MD, Alexandra Andrews, Robert Ignoffo, PharmD, FASHP, Holly Gautier, RN, BSN, Pat Fobair, LCSW, Kathleen Dzubur, MS, Pat Kramer, RN, MSN, AOCN, Margaret Hawn, RN, Bernadette Festa, RD, MS, David Spiegel, MD
Stanford Hospital and Clinics, Stanford, CA and The University of California at San Francisco, San Francisco, CA
Abstract: Cancer patients who are recently diagnosed, undergoing therapy or post therapy often face an uncertain future with multiple problems including fear, isolation, anxiety, depression, fatigue and pain. To help meet these needs we have established a free Cancer CSCP at Stanford Medical Center.
The Cancer Supportive Care Website was started May 1999 providing education and support to a world wide audience. The main goal of the CSCP is to improve the quality of life for cancer patients through a rehabilitation program, to help reduce the morbidity and toxicity of cancer and cancer therapy, and regain their physical and functional status.
The program is divided into three parts:
A four-part overview course discussing information including how to use the Internet, a review of psychological problems, nutrition, exercise, reduction of fatigue and pharmacological control of treatment side-effects.
Weekly educational classes and workshop discussing patients needs. Topics include coping with cancer, depression, will to live, sleep problems, intimacy and sexuality, nutrition, pain control and how to reduce fatigue. Programs at Stanford include: exercise for recovery, qi gong, restorative yoga, healing imagery, 15 minute chair massage within the Oncology Day Care Center, Stanford, group support, nutritional consultation, managing the chemotherapy experience, newsletter.
There are sixteen educational modules presented on www.cancersupportivecare.com: psychological support, nutrition, exercise, fatigue, anemia, pain control, sleep disorders, sexuality, creativity and coping, spirituality, "end of life", pharmacy, second opinions, web tutorial, and frequently asked questions.
Clinical research is now in progress to evaluate the CSCP assessing quality of life, functional capacity and symptom recovery. The lecture series and program had 1300 plus patient visits in 12 months with an 89% patient approval rating. The weekly exercise classes showed an increase in the Karnofsky score from 80 to 90% for the most frequent attendees. An analysis of the results will be presented covering coping skills, controlling pain, improved ability to exercise and better nutrition.
Since coming on-line May 1999, www.cancersupportivecare.com has served more than one hundred thousand visitors from over 50 countries. This outreach enables those touched by cancer to access the Cancer Supportive Care Program world wide. We have added new programs to the website: Pharmacy Issues on Drugs Used in Oncology; The Value of Second Opinions; The Web Tutorial ; Frequently Asked Questions.
The Pharmacy Program is written by Doctors of Pharmacy from the University of California Department of Clinical Pharmacy that specialize in consultation regarding the management of side effects from anticancer drug treatment, issues regarding Complementary Medications, Access to Chemotherapy through Indigent Programs, and Questions on Tamoxifen. This program receives an average of 1000 page requests per month.
Conclusion: The goal of the CSCP is to improve quality of life by implementing A multidisiplinary supportive care program to complement standard medical therapies. A series of lectures, workshops and consultations address subjects related to supportive care. Hopefully this program can become a model for developing similar programs in various parts of the country.
The CSCP website, www. cancersupportivecare.com is an invaluable asset in acheiving our goals. We pioneered website accessibility to allow everyone no matter physical limitation, location or isolation, to improve their quality of life. It is a constantly evolving source of new and timely information.
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