Heather Ly (Host): Hi there, everyone. Thanks so much for joining us for this latest episode of Medically Speaking. And my special guest today is Melissa Wanzer, who is the manager of survivorship and supportive services for the Great Lakes Integrated Network, otherwise known as GLIN. Thanks for being here. We appreciate your time.

Melissa Wanzer: Thanks for having me.

Host: And so, give us a little nutshell of what is GLIN? Because I feel like a lot of people hear about it, but they might not understand exactly what it is.

Melissa Wanzer: So, GLIN is an integrated network where there's pharmacy, there's care navigation. And all of those supportive individuals, supportive services connect with primary care pretty much. They work with primary care doctors and they help navigate patient care.

Host: Because there's so much that goes into patient care or, in this case, a cancer diagnosis, it's well beyond just an appointment here or a treatment there or a surgery there. It's the wrapping it up all together as one neat package.

Melissa Wanzer: Yeah. So, our team joined GLIN. We are the only non-primary care team. So, we are oncology support services, and our team aligns with them with their work in that we are removing patient barriers to care.

Host: What are some of those barriers?

Melissa Wanzer: So, the most common barrier to care is transportation. It's a significant, you know, problem when patients are trying to, you know, attend multiple appointments. They live far away. They're coming from an hour and a half or more, you know, to receive services. But our team aligns with GLIN in that we all support patient, you know, getting patients to their appointments, helping them navigate the financial barriers, transportation barriers. That's another barrier, obviously. But our team is made up of nurse navigators, so tumor site-specific navigators, a care navigator, a dietician, a social worker, a quality manager, and as well a cancer tumor registrar.

Host: It's a team effort.

Melissa Wanzer: Yes.

Host: Yes. And I think that your team includes so many people that perhaps people don't necessarily think of immediately when it comes to a cancer diagnosis and cancer care. This is that extra level that we add here.

Melissa Wanzer: Correct.

Host: Talk about some of the other support services that you offer, you know, whether it's at a particular facility or out in the community, because you are out and about in the community as well.

Melissa Wanzer: Right. So, you know, we talk about when patients are diagnosed with cancer, there is the treatment pathway, right? So, there's diagnosis, there's treatment, and there's survivorship. And at each step, at each phase, I'm going to call them phases, patients are going to need help. They're going to need help, for example, at diagnosis, setting up their biopsies, their screening. You know, they're going to have diagnostic screening, they're going to also need help setting up their appointments, right? Because it is suspected that they have cancer, they're going to hear the words, "You have cancer."

Host: And then, try to digest that with all of the work that comes along with it. And again, that's where your team comes in, right? It seems like as though you bring sort of a peace of mind and maybe relieve some of that worry that patients might have.

Melissa Wanzer: Yeah, I mean, one of the first people they're going to connect with once a cancer diagnosis is confirmed, is the navigator, right? So, they're going to have a subject matter expert in whatever their cancer is. If it's breast, they're going to have a breast navigator. And for example, they'll connect with that person, and that person will provide, first of all, you know, education around their cancer diagnosis and help them understand it, but then talk about, as we mentioned before, the barriers. What are the barriers that you might experience getting to your appointments?

And, you know, we talk about this pathway, right? Then, they're going to start their treatment. They're going to start their treatment, and throughout their treatment, they're going to have access to resources. What are some of those resources? So, they can have access to wigs, right? We have a wig program on Wednesday and Thursday at two different locations.

Host: What does that entail? It's like a group meeting, right?

Melissa Wanzer: So, patients come in. Typically, there's set almost like office hours that we have at both locations. And, you know, there are no appointments. They're walk-ins, right? They come in. And they usually have a family member, loved one with them. And they go through our book of hundreds of wigs, right? They select them. They try them on. And, you know, I say there's much more there than just the wigs. They're picking out wigs, obviously, that they take home and they can wear, you know, during their experience with cancer if they lose their hair or if their hair significantly thins. But they're also taking home hats and scarves and, importantly, information, right?

So, we use that as an opportunity to talk to them about navigation, "Have you been connected with a navigator?" To talk to them about the dietician. You know, are you having any concerns with your diet? So, it's more than that. Sometimes there are a group of women in there, and then it becomes what I would describe as kind of, you know, an impromptu support group where they're talking to each other and asking each other questions. And then, other times, you know, it's a one-on-one where we're just kind of, you know, holding people's hands and helping them understand what's going to happen to them.

Host: And certainly the physical changes are a part of a cancer diagnosis, but I can't help but think if you look good, you feel good. And that's got to lift your spirits as you're going through something that's pretty traumatic. You know, it's a small piece. But I feel like it could have a big impact. Like, to us, we might think of it as just a wig, but for a cancer patient, I feel like it could change their outlook on how things are going as well.

Melissa Wanzer: Yeah. And it's interesting, right? So, I would change the verbiage to look normal. Most of the women who come in want to look like they're themselves. They feel overwhelmed, losing your hair, losing your eyebrows, your eyelashes, and again, men as well. It's overwhelming. So, most people want to select a wig that looks exactly like, you know, their pre-cancer hair. And so, you know, it's all about helping them in this process find something that they feel comfortable in, that, you know, typically, it looks like their former hair or the hair they lost.

And then, also just talking to them about the other resources, and you had mentioned this as well. So, things that we have within Kaleida Health Cancer Care, we have a support group. We have regular educational seminars. We have, again, access to a dietician, palliative care, genetic testing. We treat the whole person, right? It's treating the whole person. And, you know, once they're finished with treatment, they then can move into our survivorship program. They can meet with an advanced practice practitioner who specializes in survivorship, or what I like to call healthy survivorship and wellness, right? Now, that you're finished with treatment, we want to help you stay well.

Host: Yeah. And what does that entail? What does healthy survivorship look like?

Melissa Wanzer: Right. Healthy survivorship involves addressing what I would describe as, like, pillars of health, right? So, that's going to be exercise. There's a significant substantial research on exercise, actually both during cancer treatment and after to dramatically reduce your risk of recurrence. Nutrition, right? You know, I mean, patients ask, you know, "What did I eat?" or, "What can I eat?" or "What should I eat?"

Host: "What can I do?" Yeah.

Melissa Wanzer: Having an oncology dietician, nutritionist specialist embedded in the practice is important, so we focus on nutrition. We're going to launch in 2026 a nutrition program that will have cooking classes.

Host: Oh, amazing.

Melissa Wanzer: So, patients can come and learn about, you know, how to make plant-based dishes. The other thing is sleep, right? You know, really important that both people in treatment and who are finished with treatment get regular healthy sleep, right, you know? And so, we talk about sleep hygiene. And then, the last thing is obviously mental health, right?

Host: Absolutely.

Melissa Wanzer: Really important to address it, because there's a lot of support around you when you're going through treatment. You're surrounded by your friends, your family, your team. And then, when you're finished with treatment, it's a little bit—it's not a little bit—it's a significant shock to have to kind of go back to your life, and just resume. Normal is very different, you know? It's a new normal.

Host: It's the new normal. Yeah. And what I find interesting, I think, is the fact that when the treatment is done, it's not like "Thanks for being a patient here," you know, and you wish them well. We continue on that journey with them because, as you said, it's so important to help patients adapt to that new normal, and to remove the anxiety, to help with their mental health, and then make sure, hopefully, that they're on the path to continued good health when their treatment is over.

Melissa Wanzer: Correct, yeah.

Host: Actually, let's rewind a little bit. You had mentioned transportation being a barrier. If somebody were to reach out to your team and say, "Hey, listen, I have all of these appointments. I'm having a hard time. I don't know how I'm going to get there. I don't know how I'm going to afford to get there," how do you guys step in to ensure that we get folks to their appropriate appointments?

Melissa Wanzer: Right. And so, one of the things that will happen is, as I said, upon diagnosis confirmation that the patient has cancer, they're going to be connected with a navigator, and that navigator will then go through all the different resources available, right? So whether it's a Medicaid cab or using the American Cancer Society Road to Recovery, right? Those are volunteers that offer patients rides to their cancer treatments. Or whether we, you know, help them utilize other transportation resources. We also have a lay navigator, whose entire responsibility is to arrange transportation.

Host: Okay.

Melissa Wanzer: So, she works when we have very complicated cases. She works to help us, you know, get patients where they need to be. It's important to note that with a cancer diagnosis, you are going to be visiting many providers in many different locations. And, you know, transportation, initially, I think patients think, "Oh, this isn't an issue," until, you know, their son or daughter has to go back to work. You know, the person who's driving them can't take off work all the time.

Host: Or if they're not well enough to drive themselves.

Melissa Wanzer: Exactly. Exactly.

Host: I think one exciting thing that we've done here recently at Kaleida, that maybe has helped a little bit with the transportation is the infusion center at Buffalo General. I've heard from patients that say, "I used to go to Spindrift, but it was farther from my home. But now, we have a place that's closer to home." So, that also does help.

Melissa Wanzer: Right. So, we have a great partner in the American Cancer Society. So, this is, I think, our fourth year of receiving transportation grants from the American Cancer Society. And with that grant, we are able to pay for parking vouchers so patients don't have to walk. Because from the parking lot to our clinic is a significant distance. And as you mentioned, patients don't feel well, they're tired. So, they can use the valet parking. We also, as I said, offer other types of transportation support through that grant. And that is such a relief because when you're facing a cancer diagnosis, you're already stressed and anxious. So, being able to cross that off your list is very nice.

Host: And there's some food assistance too. You and I have talked about that previously.

Melissa Wanzer: Yeah. So, we're very fortunate again to have a partner with the American Cancer Society. We have just been awarded an Addressing Barriers to Care grant from ACS for $100,000.

Host: Amazing.

Melissa Wanzer: Thank you. And that grant will cover kind of two big areas. Food insecurity, right? Providing people with home-delivered meals with our partner Feed More, and access to a food pantry, but also nutrition literacy, and that's where the classes will come in. Teaching people about, you know, nutrition and what should I eat and what should I avoid, right?

Host: Yeah, because food is medicine.

Melissa Wanzer: Because food is —yes, absolutely. Food is absolutely medicine, and I think that we have decided to make this one of our powerful initiatives for 2026 to help people, cancer patients, cancer survivors understand what they should and shouldn't eat.

Host: Yeah. Now, earlier this year, it was an exciting time here at Kaleida Health, because it was the official launch of Kaleida Health Cancer Care. Why, in your opinion, should somebody choose Kaleida for their care? I know you just mentioned so many things that we offer beyond just great care, beyond, you know, a prescription or a surgery or a particular doctor, the extras that go into that. But why should somebody come to us for their care?

Melissa Wanzer: Yeah. I think it's important to note, and this has not been, you know, communicated extensively to the public. I think that both of our acute care hospitals, Millard Fillmore Suburban and Buffalo General Medical Center, are accredited by the American College of Surgeons Commission on Cancer. We refer to it as COC. And about 25-30% of hospitals in the United States have COC accreditation, and that accreditation is very difficult to achieve, right? It takes an —I will use the word—an army of people who are involved in meeting these specific standards, right, that are put forth by the COC. And being accredited matters because the quality of care that you receive at these accredited sites is better and the cancer outcomes are better. So, that's important and that's not a well-known fact, I think.

Host: And I think that is important because it, to me, means that Kaleida Health is not just, you know, a regular hospital that's dabbling in cancer care. Cancer care is a big focus for us.

Melissa Wanzer: I mean, Kaleida's been treating cancer patients for years and, you know, saving people's lives. And that's really important to emphasize that people have been getting exceptional cancer care.

And the other thing to recognize is that what a gift it is to have choices in where you go to get care. And, you know, to be able to go to multiple cancer providers and get input on your treatment. We have cancer tumor boards, right, where, you know, patient cases are presented, multidisciplinary tumor boards. And again, we treat the whole patient. So, patients are getting access to support services, palliative care, genetic testing, nurse navigation, you know, all of the things that are necessary in treating the whole patient.

Host: Yeah. You are especially passionate about what you do because you have a personal connection to cancer. You're a cancer survivor yourself. Tell me about that and how that shapes the work that you do and the interactions that you have with the patients that you work with.

Melissa Wanzer: Yeah. I mean, there are kind of three things that led me to this work, right? The first is my own personal cancer experience and as a patient. And then, the second one is the research that kind of unfolded once I had that cancer experience on survivorship and identity, and how being a cancer survivor affects your identity and how you see yourself.

Host: Absolutely.

Melissa Wanzer: And then, the third piece of that is my work with nonprofit organizations that directly support cancer patients. So, the American Cancer Society, the Breast Cancer Network of Western New York. These organizations, their sole purpose is to help people in their darkest time. To help them get through something that I went through personally. All of us have been affected either directly or indirectly by cancer. And so, to have the opportunity now to create programs and resources for cancer patients and their family, it's a gift.

Host: When you have that conversation and share your own personal experience with patients, do you see something change in them where there's a greater connection? Maybe there's, you know, more trust, because there's nothing like having somebody who has walked in your shoes, to a certain extent. You might not know exactly how somebody is feeling, but you have a sense of what they're feeling because, again, you've been through it yourself.

Melissa Wanzer: Right. And I think what's interesting is that, you know, I'm a retired college professor when I took this job, I asked if I could be patient-facing. I said, "I want to do things like write grants and develop programs and assess them. But I really want to be with patients." And I will get messages saying, "We have someone who's incredibly nervous, incredibly anxious. Will you come talk to that person?" And, you know, I'm always, you know, excited to do that because when I say to them, "Look," you know, everyone around them is saying it's going to be okay. But when I say, "I went through this. I know what you're feeling."

Host: Remove the official title.

Melissa Wanzer: Right.

Host: As a person, you're on the other side of it.

Melissa Wanzer: Right. Right. And I also say, "I didn't get the same exact chemo. I didn't have the exact same—" right? "But I sat where you're sitting, and I understand that experience and why it's so overwhelming." And, you know, you kind of see a little bit of a shift, right? And a lot of patients, the first question they ask me is, you know, "How many years have I been alive," right?

Host: Yeah.

Melissa Wanzer: How many years since I had my diagnosis? And it's always great, and I say, "Nine years," and they say, "Praise be to Jesus." You know? And so, it's a great thing to be able—that's a little gift, right? It's an uplifting moment.

Host: Yeah. Yeah. And again, that's something that not everybody can offer to their patients. You know, that sort of first-hand experience. Early detection, let's talk about that. So crucial when it comes to so many different types of cancer. Just your thoughts on how people can be proactive, but then is there anything that we're doing to ensure that people in the community are getting that early detection and saving lives, spreading the word?

Melissa Wanzer: Yeah. I mean, I can't emphasize enough the importance of adhering to the screening guidelines, and talking to your primary care doctor about your risk, right? Because I'll use an example. I'll use this one, right? Colorectal cancer, okay? So, they shifted the age from 50 to 45.

Host: Yeah.

Melissa Wanzer: Right? Why did they shift it? Because sadly, we're seeing more and more young people diagnosed with colorectal cancer. It is alarming. It's beyond alarming. That's not even the right word. And so, if there is any risk, you know, you have to share health information with your primary care doctor, your family history, right? Understand your family history. And, you know, consider getting screened even earlier, right? Even earlier than those guidelines. You know, mammograms, right? If there's any family risk, any history of breast cancer, perhaps you should be screened earlier. And so, those are conversations to have with your primary care doctor.

And the other thing I'm just going to say is you know your body better than anyone else. You know yourself. And if you really don't feel right about something, advocate for yourself.

Host: A lot of times trusting your gut is—

Melissa Wanzer: Advocate. Yes. And I think that that's an important message from this work that I've seen. I've had patients come in who've said, "I really knew that something was wrong, but I didn't meet those guidelines". And so, you know, for me to be screened, I would've been an outlier. And the doctor put it off, and I had to see several different doctors until finally somebody listened to me."

Host: I did that for myself. My mom died of colon cancer. So obviously, there was a family history there, and I technically wouldn't have fallen under the screening guidelines and would not have for a very long time. And I talked with, you know, several doctors, several providers, explained the situation, and they really fought for me to get the screenings.

And so, you know, I went, and I've gone a couple of times. And the best thing that you can get is that peace of mind to say, "You know what? I was proactive. We've got a clean bill of health. And now, my job is to spread the word to other people," as it is to you. And you talked about talking to your doctors. I think it's also important to talk to your friends, to talk to your family, and to be that voice of reason or that gentle nudge that sometimes people need, maybe if they're on the fence or don't think they need to go. I think about the amount of times that I nag, you know? I nag some friends. I nag some family because it's that important, I think, to start those conversations.

Melissa Wanzer: Right. And you know, this is not a fun topic, right?

Host: No.

Melissa Wanzer: I mean, you know, this is not, you know, "Hey! Let's talk about cancer screening." You know, this is not a lighthearted, you know, easy topic. But I think about, you know, what you're saying. You know, you have this family history. You can't tuck that away and live in fear. You have to use that as, you know, something that informs your health.

Host: Yeah. Knowledge is power.

Melissa Wanzer: Yeah.

Host: Yeah. Absolutely.

Melissa Wanzer: Absolutely.

Host: The overarching message, I think, is treating the whole patient and treating them like a person as well, as they go through this journey.

Melissa Wanzer: Right. And that is the beauty of having an entire group of people in our existence is to support those patients, like I said, at diagnosis, treatment, and through survivorship, and provide them with both internal resources, things that we have available for them, transportation, food, support group, access to genetic testing, palliative care, all those things, but then also connect them with the larger community.

And I think that because we are a smaller organization, you know, we get to know our patients well. We get to know their families, their caregivers, and they're much more than a number. You know, they become in some ways like family.

Host: When you hear from patients that say, "Thanks to you and your team, I was able to get the food that I needed. I was able to make it to the appointments that I previously couldn't have made it to," what is that like? How does that make you feel? I would imagine it's, you know, "We're doing great work here."

Melissa Wanzer: Yeah, I mean, I think about, and again, my own experience that I was so fortunate that I didn't need transportation—sorry—or food.

Host: Yeah.

Melissa Wanzer: And that these patients, some of them, it's tough for some to realize for some folks that cancer is the least of their worries.

Host: Yeah. And again, you and your team serve as the folks that are breaking down those barriers and removing those hurdles, those obstacles so that their focus can be on their care. You guys are doing absolutely great work. I don't think that we can stress just how important this is, and we wish you and your team continued success. And again, it is a team effort. It takes a village.

Melissa Wanzer: Yes, absolutely.

Host: And glad that you are doing well, and you're able to share, you know, your personal journey, your personal knowledge. And I think, most importantly, the passion behind your work is very evident. So, thank you. Melissa Wanzer, our manager of survivorship and supportive services for GLIN. Thank you so much for being here, and I hope that we can chat again as you continue to expand and as more and more exciting things come through the pipeline.

Melissa Wanzer: That'd be wonderful. All right.

Host: Thank you. Thank you. And thank you for listening to this latest episode of Medically Speaking. We will see you next time.