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A Team Approach to Cancer Care

Kristen Wissbaum, FNP-C shares what multi-disciplinary care for cancer treatment is and what is involved in the treatment plan.
A Team Approach to Cancer Care
Featuring:
Kristen Wissbaum, FNP-C
Kristen Wissbaum, FNP-C is a certified nurse practitioner with NHRMC Physician Specialists – General Surgery Specialists. She practices at NHRMC Zimmer Cancer Center providing symptom management services for patients receiving a variety of treatments for all types of cancers. 

Learn more about Kristen Wissbaum, FNP-C
Transcription:

Alyne Ellis (Host):   When my best friend Karen was diagnosed with cancer, we all immediately needed information, support, and help. What were her medical options? Would there be more tests and then surgery? In shock it was hard to even hear or grasp the details of the complex multidisciplinary approach that might save her life. This is Healthy Conversations Podcast, the show by New Hannover Regional Medical Center. I'm Alyne Ellis. Kristen Wissbaum is a certified nurse practitioner who works with the oncology teams at NHRMC Zimmer Cancer Center. Welcome Kristen.

Kristen Wissbaum, FNP-C (Guest):   Thank you.

Host:   So let’s start with an overview of the complex place where you work. Tell us a little bit about NHRMC Zimmer Cancer Center and what cancer specialists are offered there.

Kristen:    Sure. So Zimmer is a comprehensive cancer center. That means we offer a multitude of oncology services to patients. We see patients from their diagnosis through their treatment and into survivorship.

Host:   And what is your role in Zimmer Cancer Center?

Kristen:    At Zimmer I am a nurse practitioner. So I work really closely with our surgical and medical oncologists to coordinate and provide care to our oncology patients. I see patients who are undergoing chemotherapy, patients who are under surveillance after completing treatments. I also often see patients that are having challenging symptoms, whether it be from chemotherapy or from surgery. I'm able to see these patients on the same day as they call our clinic with concerns. That hopefully prevents them from having to visit the emergency room or be admitted to the hospital.

Host:   Can you give me an example and specifics of what your role involves with a patient?

Kristen:    Yes. So when our patients are having symptoms or sometimes I see patients pre or post-operatively that maybe just have a lot of questions and want to talk in more detail. Then they come into our office and have a physical exam and a discussion and conversation about what are there concerns and what are their questions at that time.

Host:   So a lot of these patients are going through what is called a multidisciplinary approach in care. What does that mean?

Kristen:    So I work closely with our multidisciplinary clinics to help coordinate the care of newly diagnosed patients. Multidisciplinary care really means an integrated team approach to cancer treatment. Oncology is such a specialized area. That means that our physicians and our support staff are really experts in their discipline. So in order to give our patients the comprehensive care they need, we have to collaborate and bring all the disciplines together. We have specialists that work together from our clinical team of medical oncologists, radiation oncologists, GYN oncologists, surgical oncologists. The list can go on and on. We have just specialists in every area. Then also lots of support staff such as dieticians, navigators, social workers that all come together for this multidisciplinary approach.

Host:   Within the roles that the doctors play in this multidisciplinary approach, that might mean, for example, that you would have a specialist in chemotherapy and another specialist in that specific kind of cancer that you might have?

Kristen:    Exactly. So patients see several different providers. Typically, for example, if we have a patient that is newly diagnosed with pancreatic cancer, they will see our medical oncologists, our surgical oncologists, and also our radiation oncologists. They will each have their own kind of piece of the puzzle that will fit together in the treatment plan.

Host:   So how is this multidisciplinary approach better for the patients?

Kristen:    The multidisciplinary approach really gives a more individualized and holistic treatment plan for the patient. For example, we have multidisciplinary meetings called cancer conferences or tumor boards. At these meetings, our cancer registry team coordinates and organizes all the patient’s pertinent medical records. Then each patient is discussed by the treatment team. This includes our oncologists from their special disciplines. Then we also have clinical research nurses, palliative care, radiologists, pathologists, and then our oncology navigators. The team reviews the patient’s diagnostic tests, their pathology, all of their history and anything that’s really going to effect their treatment. This allows the providers to all be on the same page when it comes to the treatment plan and make sure that we’re looking at the patient from each discipline’s perspective. It’s a time when we discuss the patient and we brainstorm together, and we really talk through any unique or difficult cases. Kind of like having all the team members meet together before the playoff to get a game plan together.

Host:   How often do those meetings take place?

Kristen:    We have meetings every week. They are split up into their different disciplines. So we have a general tumor board that covers our GI cancers, our skin cancers. Then we have the gynecological cancer tumor board, lung, breast, neurology, and then also head and neck tumor board.

Host:   So you use the term oncology navigator. I want to know what those people do please.

Kristen:     Sure. So our oncology navigators are really our anchors of the multidisciplinary care. They coordinate the process starting with the new patient referral is received. They follow that patient through treatment and into their survivorship. So they do a little bit of everything from coordinating appointments to providing patient education and reviewing medical records. They are kind of the go to person, which is great because the patient knows who they are, and they know who to go to to ask questions. The navigator can kind of guide them to the correct discipline to ask their questions to.

Host:   Then in addition to the clinical services, what kind of support services are available for patients and their loved ones?

Kristen:    We have lots of services at the Zimmer Center. Cancer really effects every aspect of these patient’s lives. So we try to have as many resources as possible. We have wonderful social workers that help our patients find resources they need. We have dieticians that are just amazing educators and help patients learn how to support their body through nutrition and during their treatment. We have pharmacists that provide medication education to each patient going through chemotherapy. We also have a medication assistance team. They work with our patients to find grants and medication coverage. We have financial counselors that help the patients navigate through insurance and any financial concerns. We also have patients support groups. They are for patients and their family members to discuss what they're feeling and what they're going through. Another great resource we have is the library at the Zimmer Center that has patient education books and then also books written by other patients about their journey through their cancer treatment.

Host:   Thank you very much Kristen. It sounds like a lot of help at a time that people really need it.

Kristen:    Yes, yes. We try to be as supportive as we can and provide any resources that will help the patient through their journey.

Host:   That’s Kristen Wissbaum. Kristen is a nurse practitioner at NHRMC Zimmer Cancer Center. To learn more about Zimmer Cancer Center’s multidisciplinary approach to providing care visits nhrmc.org/cancer. Thank you for listening to this episode of Healthy Conversations Podcast, the show by New Hannover Regional Medical Center. I'm Alyne Ellis. If you found this episode helpful please share it on your social channels and be sure to check out our entire library of past episodes, which you can find at nhrmc.org. Thank you for listening.