Melanie Cole, MS (Host): Welcome to It's Your Health Radio with Henry Mayo Newhall Hospital. I'm Melanie Cole and we have a panel for you today with Alison Ambrose. She's an Oncology Nurse Navigator for Keck Medicine of USC and Henry Mayo Newhall Hospital and Dorinda Perez. She's a Breast Health Nurse Navigator at the Sheila R. Velos Breast Center and she's a Cancer Survivor and they're here today to highlight the Cancer Recovery Program and the journey forward. Ladies, thank you so much for joining us today. Alison, I'd like to start with you. The Cancer Recovery Program at Henry Mayo is part of the Keck Medicine of USC and Henry Mayo Joint Venture.

I'd like you to tell us a little bit about the program, some of the key elements. Just tell us a little bit how this is all coordinated to really help patients and their journey.

Alison Ambrose, BSN, RN: So this program is kind of adopted and started with trying to make sure that patients continue to get the resources and assistance they need even after their treatment. So typically these patients are referred to us once they are completed their either chemo, radiation, surgery, wherever they are with their treatment goals.

And then once they've been released by their physician, they let me know that they are ready to participate in this program. And really, we're here to wrap around, utilizing mental health, physical components that may happen from long term late effects of either of the treatments, whether it be radiation, chemo or surgery.

And then also, trying to get their energy and decrease the fatigue that they may have with deconditioned elements from these treatments, with utilizing routine exercise and creating a program to continue to boost up those energies in a six week program.

Host: What an excellent program. And Alison, sticking with you for a minute, identifying the needs of the cancer survivors is so important for these programs. You mentioned exercise and fatigue a little bit. Mention some of the support that patients really do need as survivorship continues to grow.

Where do you see that coordination of care between gynecologic oncologists, other healthcare providers, you know, medical professionals, nutritionists, exercise specialists, all of us working together for the survivors. Tell us a little bit about how you identify these needs.

Alison Ambrose, BSN, RN: Really, it's just providing the tools to our survivors within the program, making sure that they can create the questions they need. What are some of the questions they're going to have to discuss with whatever that specific staff member may be or clinical physician may be, whether it be gynecology, primary care physician.

If I have long term late effects that I'm enduring, currently, it's been like a year out of my treatment; who do I discuss this with? And so we really want them to make them feel comfortable and secure with knowing who to reach out to, how to go about discussing their concerns, and knowing how they can collaborate amongst, you know, all the different medical field professionals that's involved in their care going forward.

Host: Dorinda, tell us your story and your experience in the Cancer Recovery Program. Tell us a little bit about how you found breast cancer and about your experience there.

Dorinda Perez, BSN, RN: I discovered a lump in my right breast about ten days after my daughter's wedding, and I was very scared about what I thought it might be. So I immediately went to get screened and found out that it was indeed breast cancer. So I've been through surgery. I had a lumpectomy. I had chemotherapy and radiation therapy as well.

And I'll tell you, I was really relieved when I was first approached about the cancer recovery program. I had spent five months at home after the surgery and chemo and radiation. And honestly, towards the end of my treatment, I started to wonder, what do I do now? So the Cancer Recovery Program was a way for me to understand that survivorship doesn't stop when treatments stop.

 It provided me with the support and the resources to continue my recovery, and gave me the tools to move forward and really feel comfortable with that word, survivor. The program incorporates both physical and emotional aspects of recovery, and the team realized that how we feel mentally and emotionally affects us in a physical way, and these two elements were really seamlessly intertwined in the structure.

I was grateful for the information on mindfulness as well as the opportunity to improve my physical stamina and endurance. I was very deconditioned after my treatments, but after seeing Ben Taub, the specialist at the Henry Mayo Fitness and Health Center, he created a personalized program for me and I continue to utilize the gym to this day.

And I really want to emphasize that this is not a support group in the sense that most people may think. We did not sit around and talk about our feelings, although that opportunity is there if you wish, but it's more of an educational program that helps with any type of cancer. So I want to encourage those who may be apprehensive to talk to Alison to further understand the process. My support group really ended up being the women that I met who went on this journey with me, and I will be forever grateful for the friends that I made along the way.

Alison Ambrose, BSN, RN: And if you don't mind, I'd love to chime in here as well. I noticed too, with our first cohort, that participated in this program that they were able to see how other individuals might be experiencing certain symptoms or fears and some things that they haven't even thought about. So this was a great way for them to also kind of re-examine themselves and ask those same questions or something similar. So that way they can, you know, figure out how they can manage those symptoms as they come along.

Host: Thank you, Dorinda, for telling us your story, and Allison, I think a big question, obviously finances are always such a huge concern and scare for people that are going through cancer treatments. Is this program covered by insurance?

Alison Ambrose, BSN, RN: It's not covered by insurance. This is actually a grant that USC has received and able to fund for the Henry Mayo Physical Fitness Center membership. And it's going to be for the duration of while they're in the program. So it's a six week program and then the fitness center membership actually lasts as long as eight weeks.

So they get two months of free exercise and they get full access to the fitness center's amenities. And so they really get to utilize and figure out how they can incorporate this into their everyday lives.

Host: Rock on! That's awesome. Now, how frequently is the program offered? Tell us a little bit about that and how, how somebody signs up for it.

Alison Ambrose, BSN, RN: So right now, we are currently taking in 10 members for each cohort. The cohort is, again, a duration of six weeks, and then we have a two week break before the next cohort begins. So, we're actually finishing up our second cohort since we launched this program during the summer. We are going to take a break over the holidays just because it's a busy timeframe. We want to make sure one, that both the clinical staff who are providing the education as well as our participants are able to come to as many meetings and educational seminars as possible. We will restart towards the end of January.

And so, as of right now, we're looking at about six cohorts throughout the year.

Host: Now, tell us Dorinda, what particularly stood out about the care you received in the Cancer Recovery Program? What are the staff like for you? Tell us a little bit about the positive experiences of all of this.

Dorinda Perez, BSN, RN: What I really liked about the program is that it incorporated a lot of different entities that I normally, personally, wouldn't even have thought would be helpful along my journey. Alison, for sure, introduced me to the program, talked to me about it. And, Dr. Tao, recommended me for the program.

We had a wonderful mindfulness person there who did some guided meditation with us. That was wonderful. Ben Taub, like I said, was instrumental in making sure that I was safe to exercise. He understood what it was like for someone to not have the endurance and how important it was to go through this in a specialized way that that was important. And I also spoke to a dietitian who was great in telling me, what things might contribute to cancer, what things I should incorporate into my diet. And I continue to follow those things today. So everybody had a purpose. I never felt like, I went to a class and it was not meaningful. I think the six weeks was a very good duration of time because it helped us to really grasp what we needed to do, and made us feel confident about being survivors.

Host: Thank you so much for telling us your story, and Alison, I'd like you to wrap up. What would you like listeners to take away from this very important podcast today about the Cancer Recovery Program and the journey forward at Keck Medicine of USC and Henry Mayo Newhall Hospital?

Alison Ambrose, BSN, RN: This program has been created for all patients at all different levels of their health and after their journey through the treatment process. So if you do have multiple medical concerns, we are able to adapt our exercise program to meet the needs of patients who may be wheelchair bound, have different, needs such as ostomy care that is still present as well as other comorbidities such as diabetes, hypertension. We try to tailor these exercise programs to meet all individuals so they could be able to really be able to accomplish and get to what their normal would be. And then, on top of that, our goal here really is to just wrap around in regards to the resources we have to offer. Mental health support, I know, can be very scary to ask for those services. And so, therefore, we're really here to kind of show you what we can do to offer to get you connected to your local community and try to make this as less scary as possible.

Host: That's lovely to me, is that that's the goal is to make it as less scary as possible and it's comprehensive. And thank you both so much for joining us today. For information about the Cancer Recovery Program at Keck Medicine of USC and Henry Mayo Newhall Hospital, please call 661 600-1785. You can also visit the free health information library at library.henrymayo.com. That concludes this episode of It's Your Health Radio, with Henry Mayo Newhall Hospital. I'm Melanie Cole. Thanks so much for joining us today.