Cancer Treatment Gets an Integrative Approach at Stockman Institute
Last December, at the age of 32, Caitlin O’Connell was diagnosed with two different types of breast cancer. Her breast surgeon recommended Frederick Regional Health System because of the availability of social workers and an integrative clinic that offers non-traditional practices to complement standard medical treatments for cancer. “She felt it was a bigger source of support for me and felt that personalitywise it would be a better fit,” the Laytonsville resident says.
O’Connell’s first round of chemotherapy in February had made her so ill she was couch-bound for more than a week after each treatment. Now, in her second round, she is taking reiki classes at the integrative clinic in the James M Stockman Cancer Institute once a week for about an hour. Reiki is a Japanese technique focusing on healing, stress-reduction and relaxation that O’Connell believes has helped her combat chemo’s side effects. “I am a very spiritual person and a faithful person and a prayerful person,” she says. “I feel that [the instructor] always comes from a place of love and positivity and light. I feel that, if anything, she can only help me and add to treating things chemo is doing to me [and] give my body some attention. O’Connell is considering adding tai chi and mediation as well. “I’ve been very happy with the care,” she says. “[I’m] very blessed to be under that system. I’m a grateful patient for receiving such good care.”
Not too long ago, when a patient was diagnosed with cancer, the focus would usually center on ridding the body of the disease, often through surgery, radiation and chemotherapy, which continue to be the most popular treatments used by oncologists. But in recent years there has been a push to add complementary, integrative therapies to help patients’ mental and emotional well-being as well as manage treatment-related side effects.
The Stockman Cancer Institute’s integrative medicine clinic serves both patients and survivors and features yoga, acupuncture, massage, reiki, meditation, tai chi, Chinese medicine and naturopathic medicine. “There is increasing evidence from clinical trials and experience in cancer treatment that some of the modalities that are part of integrative therapy can help in supporting patients going through treatment and recovering from treatment,” says Dr. Patrick Mansky, medical director for medical oncology with Frederick Regional Health System. “That understanding has fostered this whole movement of integrative oncology. Basically [it’s] an understanding that if you are trying to offer your patients state-of-the-art comprehensive integrative care … you want to have the option available if they need additional help by offering them some of those modalities.”
Mansky, who came to Frederick Regional Health System after previously working at the National Institutes of Health, notes a majority of large academic cancer treatment centers such as Memorial Sloan Kettering, Dana-Farber, UCLA and Duke offer patients integrative services. In 2016, Frederick Regional Health System became a certified member of the MD Anderson Cancer Network—the 14th hospital system in the country to be given the distinction—and opened Stockman a year later.
“What I think sums up the integrative clinic [is] you are not just treating the cancer, you are treating the whole person,” O’Connell says. “I think [reiki] services are able to complement Dr. Mansky’s treatment plan because [the instructor] is addressing things the chemo is not addressing or is creating issues for me. [Reiki] is able to correct those issues.”
“A Sense of Normalcy”
Depending on needs, patients can benefit from a number of integrative services. Acupuncture may aid those with chemo-induced nausea, some neuropathic pain and dry-mouth from radiation. Massage has helped some who suffer from cancer-related stress and difficulty sleeping. Deep, intense massage pressure is not performed.
Through stretching and holding poses, yoga assists patients in decreasing frequency and intensity of nausea, lowering anxiety and stress. Combining physical movement, breath control and meditation, tai chi benefits participants by reducing fall risks, improves balance and lowers stress. Mindfulness-based stress reduction is one of the most studied forms of meditation for oncology patients, which can improve mood and decrease stress.
New visitors at the clinic will find spacious rooms that house treatments like yoga and tai chi with large, long windows that let in lots of natural light with views of Oppossumtown Pike, while massage and reiki rooms are smaller for a more one-on-one experience. For those wanting to go outside, there is a quiet healing garden featuring a small water feature, multiple benches and a variety of plant life. “Creating an optimal healing environment also includes optimal healing efforts for the patient to recover wholeness and wellness after going through a major illness like this,” Mansky says.
Each integrative service is offered on a referral-based system with staff meeting twice a month to discuss what would be best for each patient. “One of the main drivers of [starting the clinic] is we want to be able to advise our patients on what should be safe and hopefully also effective,” Mansky says. “That is how it was set up. It’s not a spa where people come in and look at the menu and say, ‘This looks good today, so why don’t we try this?’ It’s really meant to be something that is based on the evidence we have. [The clinic’s offerings] should be meaningful for them.”
Colleen Bal was diagnosed with stage 4 breast cancer in her mid-20s. First hearing about the clinic’s offerings through her physician, she is now taking massages and yoga four times a month. “My experience at the integrative medicine clinic has decreased my stress and anxiety and has improved my overall wellbeing,” she says. “This enables me to better live each day with a sense of normalcy, which is something I’ve craved after a cancer diagnosis.”
The Frederick resident notes she would recommend these services to other cancer patients/survivors. “I would also encourage other cancer patients to explore other services offered through the integrative clinic for options best suited to them.”
“Treating the Whole Person”
Since the clinic’s opening in April, Mansky says the feedback has been positive. “People are fairly enthusiastic about the fact that this is an approach that we take here,” he says.
“I think overall what we are trying to do is to get the patients to focus on themselves so that while they are going through [cancer treatment] they find ways to focus on themselves as a whole—rather than just being a treatment patient,” says Debra Fuller, a nurse navigator at the clinic who works to inform patients about the treatments, while dispelling fears and preconceived notions.
Some patients believe the integrative treatments involve vigorous activity and flexibility, like the ability to stand on your head for yoga. Fuller explains what each involve. “I want to try to encourage [patients] to come because these exercises or these movements or these breathing [techniques] hopefully will make [them] feel better,” she says. “I am diving a little more deeply into what each modality is so the patients aren’t scared going in because patients are scared when they come in here. If you don’t know what yoga, tai chi, massage and acupuncture are, we don’t want to add that additional level of fear of the unknown that they are already facing through treatment.”
The hospital hosted a Cancer Survivors Day in early June and many new patients signed up for massage, yoga and tai chi, although some expressed concern over the rigor of the treatments. After they finished their first treatment, Fuller asked the patients what they thought. “I will tell you, every one of the patients … came out and I said, ‘Did you like it?’ and they said, ‘We loved it! We didn’t think that was what it was it was!’ Our goal is to educate the patients. … I want to get the message out.
It is not only safe, but it is very effective. I believe in it wholeheartedly because I think it is very important to treat your whole being as opposed to just the disease. It helps toward a better outcome.”
Fuller believes the clinic is important because it focuses on emotional and mental well-being. “You have your physical disease but we are also trying to take care of your mind and body and to stay emotionally healthy throughout the treatment,” she says. “As we know, the [traditional] treatments can have many potential side effects. Part of treating the side effects are treating your body. Treating the whole person is what we are trying to do. We are treating your cancer. We are treating your [side effects]. We don’t want you to have social isolation. We don’t want you to be awake every night. All of these things that come along with a cancer diagnosis, we are trying to treat the whole person to achieve optimal healing.”
Fuller hopes patients will continue to use the integrative treatments after their traditional treatment ends, to remain healthy and maintain their overall wellness “because not only were they extremely helpful during treatment, but my goal is that they find they will be truly helpful as a lifestyle change.”