Another starfish in the sea...

For the last couple of days I have written about a roundtable meeting I had the privilege of moderating.  The meeting involved about a dozen non-profit groups, all working in the cancer (and mostly colorectal cancer) field.  The energy and passion in the room were palpable, and deeply gratifying. 

We discussed the benefits of a multidisciplinary team approach to treatment of patients with metastatic colorectal cancer, then outlined some of the barriers to this being the way care is offered everywhere.  At the end of the day we moved from theory to action, developing specific action items we can adopt to break down some of those barriers: 

·         We can develop a document for patients that describes the role and function of each member of the treatment team—oncologist, surgeon, interventional radiologist, physician’s assistant, nurse, and on and on (some people have over 50 different people involved in their care!).  We would then list questions the patient should ask each member of the team to help ensure that the team members are truly working together.

·         We can create a form on which patients can capture the name and contact information of their treatment team on one page.  This page can then be photocopied and provided to all the team members so they can easily communicate with others on the team.

·         We can work to change the guidelines for oncologists so they will specify that patients with metastases only to the liver be referred to a specialist in liver resection before chemotherapy begins.

·         We develop a network from the tertiary cancer centers that enables those teams to develop a treatment plan for patients from anywhere in their region, with the idea that the plan would be implemented at local care centers.

We believe these and other steps will change the landscape of care for this patient population.  But we left with some worries.

What about the patient on a ranch in west Texas, or the hills of Appalachian Kentucky?  What about the person living in the bayou of Louisiana or the far reaches of Alaska?  How will they access the care of a treatment team, when they may have only one oncologist within 100 miles?

Sometimes I feel that the work of the Colon Cancer Alliance is a bit like the man who was standing at the edge of the ocean, surrounded by hundreds of stranded starfish and, one by one, throwing them back into the safety of the sea.  A passerby observed him for a while, and then commented, “Why waste your time?  You can’t save them all.”  The man reached down, picked up another starfish, and tossed it into the water.  He then turned to the passerby and responded, “I saved that one!”  And then there were two people, standing at the edge of the ocean, throwing starfish into the sea. 

I guess I can live with that.

Comments

[Christa]

Oh, how I hope my sister is one of those starfish. She was diagnosed on Friday w/stage iv colon cancer. The website and this blog have already helped us to prepare for treatment options, questions to ask, etc. Thanks so much.

[Tim]

Christa:

I am sorry to hear about your sister, and join you in your hopes for succesful treatment. I am glad you are seeking out information. The decisions your sister makes in these first few days can be critical to the eventual outcome. Unfortunately, people have to make those decisions when they have had little time to get up to speed on the disease and their choices, and when they are emotionally numb from the diagnosis. If you haven't already done so, please call our help line or go to our online community. You will find a wealth of information and a great network of patients and caregivers who can provide inside information.

Tim