1. MICHAEL J. CALLAHAN, M.D. GYNECOLOGIC ONCOLOGIST ST. VINCENT CANCER CARE ST. VINCENT INDIANAPOLIS CARING FOR THE WHOLE PATIENT

2. What does it mean to “care for the whole patient?”

3. Often, we (healthcare providers) cannot control the disease or its consequences, but we can control how we interact with, communicate with, and care for patients and their families, in providing information and guidance in a caring and compassionate manner

4. Typically, PHYSICAL effects of ovarian cancer and its treatment garner the most attention However, EMOTIONAL and SOCIAL needs are critically important

5. EMOTIONAL AND SOCIAL NEEDS Lack of information and support/isolation Emotional difficulties (depression/anxiety) Lack of transportation, financial resources, socioeconomic barriers Work, school, family disruptions

6. OVARIAN CANCER: BACKGROUND Majority of women are diagnosed at an advanced stage With aggressive surgery and chemotherapy, many women will achieve remission However, many women will experience recurrence of their ovarian cancer; where the focus of treatment and care may shift from cure to palliative treatment and supportive care The paradigm of ovarian cancer as a CHRONIC ILLNESS

7. AT THE TIME OF DIAGNOSIS What interaction needs to occur between patient and physician? Most patients do not hear beyond the word “CANCER” Education session, pictures, different styles of learning, extra sets of “ears” (tape recorder) Forming a partnership “What questions should I ask?” “What would you do?”

8. AS TREATMENT COMMENCES Seek support and outlets (support group, family/friends) Writing in a journal Art Reflection/Praying Reading Other hobbies/activities

9. DEPRESSION AND ANXIETY Very common among women with cancer Can interfere with cancer therapy and impede response to treatment Increasing fatigue Inability to make decisions/choices Affects quality of life

10. DEPRESSION AND ANXIETY Treatment centers around: Reducing stressors Relaxation techniques Counseling Medication Combinations of the above

11. SELF-IMAGE AND CANCER Positive: appreciation of inner strength, life is special, shift in priorities Negative: anger, lack of control, sadness, fear, frustration, guilt Strategies: take control, humor, support groups, social services/counseling

12. AS TREATMENT IS COMPLETED Coping with fear of recurrence: Accept fear, lessens over time (ways to manage anxiety) Don’t worry in isolation (support groups) Partnership with physician, follow-up schedule, etc. (taking control) Be well informed (symptoms, timelines) Healthy lifestyle (diet, exercise) Reduce stress

13. A WORD CONCERNING PALLIATIVE CARE From the Latin palliare, meaning “to cloak”

14. PALLIATIVE CARE Goal: improve quality of life, and relieve and prevent suffering Compatible with ALL STAGES OF CANCER THERAPY (curable disease, chronic illness, nearing end of life) Physicians, nurses, pharmacists, social workers, chaplains, psychologists, other health professionals Multidisciplinary care to address physical, emotional, spiritual, and social needs Support for patient AND family/friends/caregivers

15. CARING FOR THE WHOLE PATIENT Often, we (healthcare providers) cannot control the disease or its consequences, but we can control how we interact with, communicate with, and care for patients and their families, in providing information and guidance in a caring and compassionate manner

16. THANK YOU