A New Direction in Cancer Care
When the new Clinical Cancer Center at Froedtert & The Medical College of Wisconsin opens in May, patients and their families will cross the threshold into a new vision of cancer care.
Envisioning the FutureThe visionaries who created the new Clinical Cancer Center say it is the next step for an institution that sets the standard for cancer care. At Froedtert & The Medical College of Wisconsin, patients access expertise and innovation available nowhere else in the region – and a level of patient-centered care enjoyed by few people in the world.
If you are a cancer patient at Froedtert & The Medical College, you already receive this innovative care from physicians and nurses who have deep sub-specialty expertise in your particular kind of cancer. Doctors and other specialists work in teams to make sure every detail is planned and coordinated.
A recurring theme at the new Clinical Cancer Center is providing patients with truly individualized medicine. According to James Wade, MD, MPH, a Medical College of Wisconsin medical oncologist, sub-specialization is key. But what does that mean?
“As an individual, you have only one cancer,” Dr.Wade said, “and not all cancer is the same. If you have breast cancer, you’ll have optimal results with a surgeon whose primary interest is breast cancer, rather than someone who may do a breast cancer procedure today and a different type of surgery tomorrow.”
Dr. Wade, chief of Neoplastic Diseases and Related Disorders, noted each physician at the Clinical Cancer Center is not only an oncologist, but also an oncology sub-specialist. An oncology sub-specialist is an oncologist who focuses on cancer – but only on a narrow range of cancer diseases.
While this highly specialized level of care will continue at the new center, the vision of the future embraces a new level of coordination and a different way for patients to experience care. Everything will be available in one place – appointments, treatments, procedures and support – starting with a single phone call. And key contact people – an experienced cancer nurse coordinator and a journey coordinator for each type of cancer – will connect patients to every needed resource.
A New Vision for Coordinated CarePatients, visitors and staff at Froedtert & The Medical College have been watching the Clinical Cancer Center, a graceful structure on the southern edge of the campus, take shape for the past three years. On Monday, May 19, the center will fill with hundreds of physicians, nurses and other professionals dedicated to alleviating the suffering of cancer.
One of the people eagerly awaiting that day is John Balzer, vice president of Facility Planning and Development. Balzer has been living and breathing the project since early 2004. The new facility, he said, is much more than an impressive structure; it was designed to reflect a carefully thought out vision of coordinated care.
“Planning team members spent a lot of time figuring out what needs to happen in the Clinical Cancer Center before they even discussed the architecture,” Balzer said. The preparation included extensive research among patients, physicians and other caregivers at Froedtert & The Medical College. This research helped the team develop a unique model of care based on insight into the nature of cancer itself.
Disease-Specific, Patient-Centered Care“Cancer is not one disease but many diseases, and treating it requires the expertise of a wide variety of clinicians,” said Sue Derus, a member of the planning team and executive director of cancer services at Froedtert & Community Health. “Surgeons, radiation oncologists, medical oncologists, pathologists, imaging specialists – the list could go on and on.”
What makes the Clinical Cancer Center unique is that it will bring all of these caregivers together for each specific type of cancer – in a single location. Expert physicians, nurses and support staff are concentrated in a “hub” around the patient.
For example, patients with lung cancer are treated by a team of experts that focuses exclusively on lung cancer. Breast cancer patients receive care from a specialized breast cancer team. The same is true for patients with prostate cancer, kidney cancer, thyroid cancer and so on. In all, the Clinical Cancer Center includes 13 disease-specific hub teams that cover every kind of cancer.
One benefit for patients is a streamlined path of care. “When you call the Clinical Cancer Center and identify your cancer,” Derus said, “you will be transferred immediately to the new patient coordinator for that program.” Working closely with the nurse coordinator, the new patient coordinator gathers all medical records, sets up appointments with doctors and organizes support services.
The hub nurse coordinator makes sure everything that needs to take place happens in the right order, in a timely way. Most importantly, he or she serves as the single point of contact for all questions and concerns. “It makes things much easier,” Derus said. “You do not have to tell your story a million times.”
Total Care in One PlaceThe Clinical Cancer Center’s interior reflects this vision. For example, a large, multi-specialty cancer clinic is divided into four quadrants – named Faith, Courage, Life and Hope. Each quadrant has its own reception area, and exam and consultation rooms. Only specific types of cancer are treated within each quadrant. For instance, liver cancer patients will always go to the Faith quadrant for appointments and follow-up care. (The Faith quadrant is devoted to liver and pancreatic cancers, along with gynecologic, colorectal and endocrine cancers.)
Patients will also receive the full range of treatments at the Clinical Cancer Center. The building features surgical procedure rooms, radiation bays and a special area for patients who need chemotherapy. Services also include MRI and CT imaging, a blood lab, a pharmacy and a cancer rehabilitation gym.
Because cancer patients need a wide range of support services, the building houses a Quality of Life Center where they can see cancer dietitians, social workers, a psychoncology nurse, complementary medicine specialists, chaplains, case managers and financial counselors. The Quality of Life Center also houses the world-class Palliative Care Program, which provides specialized care for major or terminal illness to patients and their families.
Patients can even visit the Small Stones Spa to learn about skin care, see a hairdresser or obtain items like wigs and breast prostheses.
The entire environment is designed to promote patient dignity, respect and a sense of well-being. Convenient underground parking and covered drop-offs lead into a welcoming reception space with a concierge desk. Visitors can relax in living-room-style sitting areas and enjoy special amenities like a café with wireless access.
Doctors Working Side by SideWhile the new Clinical Cancer Center provides patients with everything they need in one place, it also provides physicians with new opportunities for collaboration. According to Becky Massey, MD, a Medical College of Wisconsin otolaryngologist, physician teamwork is essential to delivering the best cancer care.
Dr. Massey is a sub-specialty surgeon with expertise in cancers of the head and neck. Treating these cancers involves a full team of physicians to provide not only surgical removal and reconstruction, but also radiation treatment and chemotherapy. “These physicians work closely together to create an individual care plan for each patient,” Dr. Massey said, “and we coordinate efforts through weekly tumor board meetings.”
According to Dr. Massey, this team approach provides patients with access to all treatment alternatives and ensures no nuance is overlooked. In addition, it helps reduce anxiety. “Sometimes, even a small difference of opinion between providers can make patients uneasy,” she said. “When a patient’s specialists are on the same page in the same location, the patient does better and feels reassured.”
While cancer physicians at Froedtert & The Medical College have always coordinated in care teams, they will literally work side by side as they come together to care for patients in the Clinical Cancer Center.
Does this kind of care lead to better outcomes? “I believe it does,” Dr. Massey said. “I think treatment proceeds in a more coordinated, consistent way. Even if the outcomes are the same, a big plus is that patients know they are getting cohesive care.”
“In cancer, there is such rapid movement and change in medical therapies, radiation techniques and surgical procedures,” Dr. Wade said, “that sub-specialization is the only way to consistently provide the most advanced options for a particular disease.” Sub-specialized cancer surgeons, he noted, are typically the most current on the latest procedures. For example, surgeons in the Thoracic Cancer Program offer a thoracoscopic lobectomy. This procedure, appropriate for some early stage lung cancer patients, involves removing an entire lung lobe and necessary lymph nodes through tiny incisions. It is as effective as traditional open surgery, but offers patients a much easier recovery.
According to Dr. Wade, sub-specialization allows physicians to take the lead in clinical research. The new Clinical Cancer Center will have space for cancer investigators, including the experts of the Center for International Blood and Marrow Transplant Research. Cancer program leaders believe bringing caregivers and researchers together in one place will ultimately lead to even better patient care.
Colleen Lawton, MD, FACR, a Medical College of Wisconsin radiation oncologist who specializes in prostate cancer, said physicians consistently involved in research do a better job of tailoring care to individual patients, because they can offer more options. “Take the patient with prostate cancer who drives in from a long distance,” she said. “If he requires multiple treatments, coming for radiation every day for eight weeks is not reasonable.”
Possible alternatives include a single surgery or a prostate seed implant. “And through clinical trials, he may be able to receive radiation 12 times instead of 40 – with the same effectiveness.”
Because it is part of an academic medical center, Dr. Lawton noted, the Clinical Cancer Center has the resources, expertise and patient volumes to conduct trials in a very sound, scientific manner. “We offer options that may not be widely available,” she said.
Options and More ControlOne option available only at Froedtert & the Medical College is the Day Hospital, a unique concept developed for chemotherapy and other patients who need more complex care. (The Day Hospital is currently available at Froedtert & The Medical College, but will be much larger in the new facility.)
Many patients, Dr. Wade explained, tolerate chemotherapy well and receive treatment on an outpatient basis. But others are more ill and need the equivalent of inpatient care. That’s where the Day Hospital comes in. It meets the intensive needs of sicker patients, but does so on an outpatient basis. Day Hospital patients go home each evening.
According to Dr. Wade, receiving intensive services in the Day Hospital affects outcomes. “We learned that if patients go home each day after treatment, they take on more independence,” he said. “And that simple factor impacts recovery positively.”
The Day Hospital also gives patients more flexibility. “Many juggle family and professional needs with treatment,” Dr.Wade said. The Day Hospital is open seven days a week with extended morning and evening hours. “A patient may receive treatment after work Friday and recover on Saturday – or may even get treatment over the weekend.” If it is well-tolerated, he or she could return to work Monday. “We accommodate patient schedules, instead of patients accommodating ours. It really is a patient-centered model of care.”
John Balzer noted the entire chemotherapy clinic will give patients greater control over their care environment. “Our research showed chemotherapy patients want the option of having infusion in either a private or a more open setting,” Balzer said. “Some days they don’t want to see anyone and other days they want contact.”
The Clinical Cancer Center offers both options. “Open” infusion stations allow patients to interact with others, see outdoor views and feel the activity of the clinic. Private infusion rooms offer treatment in seclusion, but also feature accommodations for family or friends.
Dr. Lawton affirms the patient-centered care model of the new Clinical Cancer Center will make a big difference. “Good care always means a lot to patients,” she said. “But if you provide world-class care while making the experience easier for patients, it’s a winner.”
The people who envisioned the new Clinical Cancer Center are confident it will make advanced, sub-specialist care available in a way that will make the treatment experience more reassuring for each cancer patient. And it will all be delivered in a comfortable, supportive and safe environment. Sue Derus is optimistic: “For people who have cancer, getting highly specialized care at diagnosis is critical. It’s important to start off knowing you have a full range of top-notch options.”
According to Dr.Wade, this difference is what patients can expect from a top-tier cancer center. “Patients at Froedtert & The Medical College get the greatest level of expertise, the newest therapies and innovations, and the most individualized care plans,” he said. “We set the standard of cancer care.”
Blood and Lymph Node Cancer Program
Blood and Marrow Transplant Program
Include leukemia, lymphoma, multiple myeloma, aplastic anemia, myelodysplastic syndrome
Bone and Connective Tissue Cancer Program
Brain and Spine Tumor Program
Breast Cancer Program
Colorectal Cancer Program
Includes colon, rectum, stomach, anus
Endocrine Cancer Program
Includes thyroid, adrenal gland
Eye/Orbital Cancer Program
Gynecologic Cancer Program
Includes cervix, ovaries, uterus
Head and Neck Cancer Program
Liver, Pancreas and Bile Duct Cancer Program
Prostate and Urologic Cancer Program
Includes bladder, kidneys, prostate, testes
Skin Cancer Program Thoracic Cancer Program
Includes esophagus, lung
Cancer-Related Programs and Services
Genetic testing and counseling for heredity-related cancers
Image Guided Therapy Program
Includes Interventional Radiology, Image Guided Radiation Therapy, Prism, Cryosurgery
Palliative Care Program
Includes pain management, medical planning, other special assistance for people facing major or terminal illness
Plastic and Reconstructive Surgery Program
Source: Froedtert Today
Date: March 2008