Whole-Person Care for Cancer Survivorship Webinar Highlights
In Goodpath’s webinar on Whole-Person Care for Cancer Survivorship, panelists Dr. Mark Cunningham-Hill from NEBGH, Dr. Daniel Hall from Mass General Hospital and Dr. Akl Fahed from Goodpath discussed how employers can support and improve the health of their employees with a history of cancer.
Watch the video recording or read the summary below to:
Gain a better understanding of cancer survivorship, the patient experience, and the costs
Learn why a whole-person approach is the best way to improve the quality of life for cancer survivors
Discover innovative ways employers are addressing cancer survivorship through their benefits strategy
Background on Cancer Survivorship
What is a cancer survivor?
In cancer, a person is considered a survivor from the time of diagnosis until the end of life.
How many cancer survivors are there?
What is the financial impact?
Those with a history of cancer have much higher healthcare costs relative to those without a history of cancer, even years after the diagnosis. For survivors diagnosed within the past year, their healthcare costs are almost five times higher than those with no history of cancer. For survivors diagnosed over a year ago, their healthcare costs are nearly double those without a history of cancer.
What are examples of challenges cancer survivors phase, beyond the disease itself?
Cancer survivors face many quality of life issues, which vary in the cancer survivorship journey. The chart below highlights some physical and mental health issues a cancer survivor may deal with.
In the webinar, Dr. Hall shares some of the most common issues he sees as a cancer psychologist, including distress and insomnia. Up to 70% of cancer survivors report having distress or impairment from fear of cancer recurrence. Additionally, sleep is another common concern for cancer survivors, with the rate of insomnia significantly higher after cancer diagnosis.
Whole-Person Cancer Survivorship Care
What is whole-person care?
Whole-person care can mean many things and is used by many providers in different manners. For Goodpath, it is synonymous with integrative care. That means a blend of conventional and complementary treatments that address someone’s mental, physical and emotional needs.
How does whole-person care help cancer survivors?
Cancer survivors should be provided with whole-person care. This model of care is optimized to reduce undue costs, time and burden to patients, medical doctors and healthcare systems.
Whole-person care treats the short- and long-term side effects of cancer and cancer treatment. Cancer survivors are often managing multiple issues impacting their health and quality of life, like anxiety and sleep. A personalized approach to treat these conditions is crucial because the cancer experience is unique for every survivor.
In the webinar, Dr. Daniel Hall shares the story of a patient we will call Marcus. Marcus was a survivor of prostate cancer who completed surgery for his cancer one year before Dr. Hall met him. He was taking a hormone therapy daily and attended screening visits at the hospital every few months to check for signs of disease recurrence.
Marcus had trouble sleeping and was being treated with a combination of medications - hypnotics and antidepressants. Nothing worked. He had daytime fatigue, frequent nausea, unpredictable hot flashes, and nighttime sweats. The sedative sleep medications made him drowsy, and sometimes it would lead to falls. He found it harder to stick to his regular job hours and began taking sick days - usually a few per month - just to catch up on sleep.
Marcus - and his oncologist - had no idea that insomnia can be treated, with four to six sessions of evidence-based, behavioral treatment for insomnia. In 2 months, Marcus had tapered off his medications and successfully regained his sleep. I heard from him recently that he is still doing well!
Marcus’ story is not uncommon. Many cancer survivors are dealing with side effects and do not have the proper resources they need. Whole-person care can help survivors improve their symptoms and quality of life.
How does it work?
As mentioned, cancer survivors face many comorbid conditions, like anxiety, insomnia and constipation. Whole-person care acknowledges how these symptoms may be interrelated and works to solve them at the same time.
The cancer survivor is paired with a healthcare clinician, who is the central figure of their care. The clinician does a comprehensive health assessment, delivers evidence-based care over time and serves as the primary point of contact for the patient.
The care is custom for each person and addresses the quality of life issues a cancer survivor faces in a coordinated manner. For example, one survivor may be dealing with stress, fatigue, and body image issues. The healthcare clinician evaluates these symptoms, what may be causing them, and how they are interrelated. They develop a plan to address the symptoms.
For instance, personalized stress-reducing therapies could include meditation, mindfulness, and progressive muscle relaxation. For fatigue, the clinician may suggest supplements to improve energy levels, exercises to rebuild strength, and pacing programs. And for body image concerns, the program may include journaling and cognitive behavior therapy.
For more information on Goodpath’s cancer survivorship support, check out our Cancer Survivorship page.
Access to Whole-Person Care
There is widespread recognition of the value of providing care for the survivor - and their supporters - around that whole-person aspect but it's been a challenge to increase access. That’s due to a number of reasons:
A shortage of oncologists and primary care physicians who can be trained for this and/or made aware
Time-consuming nature of building and executing survivorship programs, especially since they must be personalized
Lack of reimbursement for survivorship care drives up costs for the healthcare provider
It’s a real problem and one that is only increasing as we see cancer diagnoses increasing. With up to 1 in 3 women and 1 in 2 men expected to get cancer in their lifetime, this is urgent.
To learn about how Goodpath helps employees access cancer survivorship care, check out our Cancer Survivorship page.
The Role of Employers
Why should employers offer whole-person care to employees with a history of cancer?
Employers are looking to offer whole-person care to their employees for a number of reasons. First, and they would say most importantly, it’s about wanting to do what’s right for their employees and their families by providing the support they need. Returning to work can often be an important step for survivors as it provides purpose, social and emotional benefits of being at work as well as access to benefits and salary. Second, this is a very costly condition. This will affect 19 million people in the US, but those people cost more in terms of both direct medical costs and indirect morbidity costs.
How can employers support cancer survivors?
As Dr. Mark Cunningham-Hill discussed, there are a number of ways employers can support survivors.
First, provide direct resources or benefits:
Provide health benefits that offer whole-person support for employees
Provide comprehensive mental health benefits and an EAP that supports cancer survivors and their return to work
Second, create a culture of support within and outside the workplace:
Set up an employee resource group (ERG) or cancer mentorship program so survivors can connect
Educate survivors about external resources for receiving support, counseling, and connections, many of which are free of charge
Ensure survivors have trustworthy information and education about their cancer and the many issues that surround it
Third, consider where and how survivors are working, such as:
Support cancer survivors in staying at work through flexibility and reasonable accommodations
Educate managers since they may have never supervised an employee who’s been diagnosed with cancer
Impact of Whole-Person Support
Whole-person care helps to address the numerous quality of life issues that come with being a cancer survivor.
Care that addresses areas like sleep, digestive and mental health will have the greatest impact on improving the life of cancer survivors. Dr. Hall also shares how stress and anxiety support also increases the odds that a patient completes their cancer treatment.
He dives into how whole-person care can help everyone, from those with reassurance-seeking behavior (who request additional doctors visits and screenings) to those with avoidance behavior (who skip screenings and follow-up visits).
Let’s wrap up with the key points.
Whole-person support addresses the short- and long-term effects of cancer, particularly in physical and mental health issues
Cancer centers are increasingly incorporating whole-person support, given its high impact, but access to solutions remains low
Employers have an opportunity to help fill this access gap with whole-person care as part of their benefits strategy to best support employees and reduce costs
To learn more about Goodpath’s cancer survivorship care, please check out our Cancer Survivorship page.