More than 160 attendees took part in a day of learning and collaboration as Sylvester Comprehensive Cancer Center hosted the inaugural Cancer Survivorship Symposium.
Stephen D. Nimer, M.D.The event, held on November 11 at the THesis Hotel in Coral Gables, featured 17 program sessions, eight exhibitors, and a distinguished keynote address highlighting various aspects of cancer survivorship in research and clinical services.
Because of early detection and treatment advances, the number of cancer survivors increases each year. Currently, there are 18 million cancer survivors in the U.S., with 26 million survivors projected by 2040, according to the National Cancer Institute. Cancer survivors face unmet care needs that are complex, including physical and emotional symptoms, concerns about finances and social roles, and limited care coordination. Sylvester organized the symposium to bring together the clinicians and researchers who are dedicated to meeting the unique needs of the growing number of survivors within the community Sylvester serves.
“The Sylvester survivorship team exemplifies principles of excellence, teamwork, and the importance of community,” said Stephen D. Nimer, M.D., director of Sylvester, Oscar de la Renta Endowed Chair in Cancer Research, and executive dean for research at the University of Miami Miller School of Medicine, in his opening remarks. “We have recruited tremendous individuals who bring the most cutting-edge research to patient care. The way we take care of our patients today impacts future survivors, their families, and caregivers.”
Frank J. Penedo, Ph.D.“This symposium provides an opportunity to come together to discuss innovative and transformative research programs and robust clinical services, as well as gain perspectives and guidance from our survivors,” added Frank J. Penedo, Ph.D., associate director of Cancer Survivorship and Translational Behavioral Sciences and director of Cancer Survivorship and Supportive Care at Sylvester. “These meetings create a forum for exchanging ideas, discussing opportunities, and planning for the future of cancer survivorship research and care.”
Survivorship Technology
Kicking off the morning program were various talks on technology-delivered psychosocial interventions and assessments. The implementation of Sylvester’s My Wellness Check has proven to be associated with lower rates of emergency room visits and hospitalizations in survivors since its launch in June. The assessment is also the first electronic health record-integrated symptom and supportive care needs assessment for ambulatory oncology care with Spanish-speaking patients.
Technology such as the Video-Conference Stress Management and Relaxation Training (VSMART) was utilized with older breast cancer survivors to assist in their stress management. VSMART has been effective in lowering stress levels up to 50% and improving mood for more than five years. Mobile health apps may also lead to benefits for survivors. One example is the Con Cariño, Abuelita (With Love, Grandma) app, presented to promote healthy lifestyle behavior engagement in cancer survivors and their families, with features such as step tracking through Fitbit devices, recipes, videos, and a podcast.
(From left) Carmen Calfa, M.D.; Jessica MacIntyre, APRN, NP-C, AOCNP; Frank J. Penedo, Ph.D.; and Matthew Schlumbrecht, M.D.Diverse Research
In serving the diverse communities of South Florida, Sylvester researchers have made great progress in understanding the differences in diagnoses, treatment responses and outcomes in different races, ethnicities, and patient populations.
Paulo S. Pinheiro, M.D., Ph.D., research associate professor at Sylvester and the Miller School’s Department of Public Health Sciences, opened the session addressing Hispanic cancer patients’ worse survivorship outcomes relative to other ethnicities.
Dr. Pinheiro’s research showed how many Hispanics face challenges in their survivorship journey because of economic inequalities, access to care, and receiving less screening. To better understand factors that promote optimal adjustment and survival among Hispanics diagnosed with cancer, Dr. Pinheiro will be one of the co-investigators in the Sylvester Study Avanzando Caminos (Leading Pathways), currently in its second year of recruitment.
Matthew Schlumbrecht, M.D., medical co-director of survivorship clinical research programs at Sylvester, continued the conversation, bringing attention to the South Florida Caribbean Black community. His presentation showed how Black men and women born in the U.S. have different cancer survival rates than those born in the Caribbean and Africa. Providers can significantly impact patient risks and outcomes by increasing Afro-Caribbean participation in clinical trials, understanding the patient environment, and providing supportive services.
(From left) Vandana Sookdeo, M.D., EMBA, director of administrative operations, Cancer Survivorship and Translational Behavioral Sciences; Todra Anderson, M.D., CMO, Memorial Health System; Akina Natori, M.D., research assistant professor, medical oncology, Sylvester“It is incumbent upon us as practitioners to understand the unique patterns of cancer diagnoses and outcomes in this group of men and women,” Dr. Schlumbrecht said. “By doing so, we can learn so much about causes of disease, reasons for variations in treatment outcomes, and unique psychosocial needs that can inform the development of future programs at Sylvester.”
Marc Puccinelli, Ph.D., assistant professor of clinical psychology, wrapped up the diversity research session as he addressed the need for more health equity in the LGBTQ community. His work evaluated specific disparities and barriers in LGBTQ individuals’ cancer care and further discussed how HIV positivity in LGBTQ communities has been associated with greater risks for lung, anal, and colorectal cancers, among others.
Oncology and Primary Care Integrations
Concluding the symposium were several talks on the importance of the relationship between a survivor’s primary care physician (PCP) and their oncologists. Kevin Oeffinger, M.D., founding director of the Duke Cancer Institute at Duke University School of Medicine, delivered the keynote address, emphasizing the need for co-management strategies to address the unique needs of cancer survivors in primary care. He provided several models of survivorship care in primary care settings that target late effects of treatments, surveillance for recurrences and/or secondary cancers, and the psychosocial needs of survivors.
“PCPs look at survivorship as part of a patient’s story in their overall health,” Dr. Oeffinger said. “The relationship between both parties needs to be built accordingly, through collaboration, as cancer care isn’t linear but circular.”
Elaine Warren, SurvivorPlan CEO and founderCarmen Calfa, M.D., medical co-director for the survivorship clinical program at Sylvester, presented the multidisciplinary care model in use at Sylvester’s breast cancer clinic. She emphasized that survivorship starts at the time of diagnosis, continues throughout life, and includes the caregivers. Dr. Calfa discussed the value of addressing patients’ physical, emotional, spiritual, and other needs as they occur, comprehensively, by a team of experts under one roof. The model was found successful by patients and providers and is being expanded to other locations and cancer types.
“We use conventional medicine as well as music, exercise, nutrition, acupuncture, massage, yoga, and so on to promote better physical and emotional health, reduce risk of recurrence and new cancers, and improve quality of life and survival,” Dr. Calfa said. “Although no one model is perfect, the risk-stratified approach that we are taking at Sylvester aims to offer a personalized and coordinated approach to cancer survivorship.”