Cancer patients and their families often think they have to travel to large academic medical centers to get the expert care they need and access to the latest clinical trials.
That is not necessarily so.
Summit Medical Group’s specialists are on the cutting edge of cancer care from diagnosis and treatment to the at-home care patients often require as their disease progresses.
Tune into SMG radio to hear Dr. Biren Saraiya talk about best practices in oncology care, palliative medicine and clinical trials for cancer patients.
Selected Podcast
Palliative Care for Cancer Patients
Featured Speaker:
Learn more about Biren Saraiya, MD
Biren Saraiya, MD
Biren Saraiya, MD, specializes in lung cancer, leukemia, and lymphomas. Before joining Summit Medical Group, Dr. Saraiya was Medical Director of the Rutgers Cancer Institute of New Jersey in Hamilton, where he started the Lung Cancer Screening Program. He was previously a consultant oncologist and hematologist at Deborah Heart and Lung Center in Browns Mills, New Jersey, where he started a multidisciplinary cancer clinic that included thoracic surgery and pulmonology. Dr. Saraiya is an assistant professor for Rutgers Biomedical and Health Sciences - Robert Wood Johnson Medical School.Learn more about Biren Saraiya, MD
Transcription:
Palliative Care for Cancer Patients
Melanie Cole (Host): Palliative care is the care that’s given to improve the quality of life of patients who have a serious or life threatening disease such as cancer. My guest today is Dr. Biren Saraiya. He’s an oncologist at Summit Medical Group who specializes in lung cancer, leukemia and lymphomas. Welcome to the show, doctor. Tell us, what is palliative care? People hear “palliative” and then they think hospice and they are two different things, yes?
Dr. Biren Saraiya (Guest): Absolutely. So, in my mind palliative care is almost all doctors do this and just take the word palliation – it just means to alleviate symptoms. So, in essence, palliative care is aiming at alleviating patient’s symptoms, whether they be physical symptoms such as pain, nausea, vomiting or whether they be emotional symptoms such as depression or anxiety or spiritual symptoms. So, palliative care is professionals trying to address patient symptoms along with the oncology, the cancer care.
Melanie: So, now, tell us what’s involved with palliative care and who is a candidate for it.
Dr. Saraiya: Anyone who has symptoms is a candidate for it. That’s the broadest umbrella I can draw. Many times, patients with cancer already are very distressed by the fact that there is cancer. There are implications for themselves, their well-being, their family’s well-being, their financial well-being. So, working alongside the oncologist specialist, the palliative care team can help address and sometimes even alleviate many of the symptoms. So, any cancer patient with any symptoms is eligible for it.
Melanie: If a person gets palliative care, doctor, does that mean that he or she does not get cancer treatments?
Dr. Saraiya: Absolutely not. Palliative care team at Summit Medical Group works alongside the oncologist whether it be surgeons, medical oncologists, radiation oncologists to provide the care. So, a patient can continue to get the cancer direct therapy along with the symptomatic therapy. The easiest example I can give you is, many times someone has pain because of the cancer and we would recommend because radiation for the pain, that is palliative care. Sometimes, we recommend that they get medication for it. That is palliative care. Sometimes, we work with our colleagues who are experts in this to make sure we find the right solution. It is almost as if someone has chest pain and we ask our cardiologist colleagues to see the person to help us manage that, if necessary. We call the palliative care doctors with symptoms that are difficult to manage by ourselves and we need some additional help. That is alongside the cancer care. Everything is together.
Melanie: Besides symptom management what other kinds of issues are addressed in palliative care? There’s emotional, people have anxiety and stress or they need spiritual care. Are these considered palliative as well?
Dr. Saraiya: Absolutely. What I’ve learned over my career is that many times, patients see the oncologist in a very specific role and they worry that if they tell me all that’s bothering them that I’m not going to have enough time to pay attention to their cancer. So, they, many times, withhold telling me everything that’s bothering them. What I’ve learned is that when you work with the palliative care team, they are much more willing to tell their palliative care team about their symptoms. From my perspective, the best outcomes are when I address the entire patient, not just their cancer. The palliative care team working with me can accomplish that. That’s the optimal solution. So, working alongside to make sure the patient’s emotional, physical, spiritual, and even sometimes other distresses, like financial distresses, can be addressed. That’s helpful. We cannot alleviate every single problem but we can address them to the best of our ability.
Melanie: How is palliative care used at the end of life, doctor?
Dr. Saraiya: This is when most people think about hospice care. The way I see it is when we are taking care of cancer, we do ask ourselves, “What’s our goal?” At every single junction whether we are trying to cure the cancer or manage the cancer, we try to make sure the symptoms from it are addressed. So, palliative care is delivered alongside cancer care. There may come a time in a patient’s life when we do not think that cancer care is appropriate or the program of the cancer treatment is too much for the benefit they may have and we focus on end of life care and that’s when hospice comes in. So, the palliative care team can arrange that. They can work with the hospice provider to make sure that what care they need is delivered in the manner they need it. So, if a patient wants to be at home, we can make sure that they are home. They have additional support for the caring of them or the caring for the family and we can make sure that those supports are there as much as possible. So, the palliative care team working with the oncology team ensures the transitions are as smooth as possible.
Melanie: Is palliative care covered under insurance?
Dr. Saraiya: Absolutely. Palliative care is covered. Just like a cardiologist visit, palliative care is covered. The interventions, the medications are covered just like my medications are covered. These are medical professionals working with our nursing staff, our social workers and we work with resources in the community, whether its religious and spiritual guidance. We try to meet what the patient’s needs are.
Melanie: How do people start that discussion about palliative care? Because some people would get defensive thinking its hospice and thinking they’re talking about end of life care. So, how do you help families to get that discussion going with the patient?
Dr. Saraiya: This is a very important point. I’m glad you asked that. When I think about discussing goals the patient has, the first time we talk about what are we trying to accomplish. What I try to do with my patients is have the conversation of how important it is for me to make sure that I take care of them as an entire person. I tell them in the front and I remind them along the way that I would love to know what’s bothering them; how are they living their day-to-day life? What can I do to make that better? Sometimes, that’s in my hands with the chemotherapy scheduling the dosages; sometimes it’s not. That’s when I can have additional resources for a palliative care team and I can introduce them at that point in time to say, “Here are some resources that can help me take better care of you.” So, that’s something that I, the physician, try to encourage patients and let them know and guide them along the way. Many times, patients are very fine with this. Patients and families will say, “I need help, how can I get that?” They will ask specifically for palliative care resources. We try to provide them at that time as well. Either myself, as a clinician, or the patient and the family can request a consultation with the palliative care team.
Melanie: In just the last few minutes, and its great information, doctor. It’s so beautifully put and you’re so well-spoken, please give your best information for palliative care and why they should come to Summit Medical Group for their care.
Dr. Saraiya: I think this goes back to what Summit Medical stands for. I think we provide care for the entire patient throughout their lifespan. It starts with our obstetrician to the pediatrics team to the adult medicine team to our subspecialties. This is taking care of our patients, our community, and our neighbors the way we want to be cared for. In my mind, taking care of the person and the family and having the team approach is so important. Our palliative care team works in the community. They provide the care in the community. They know what the resources are in the community. We work together to make sure the patient’s and the family’s needs are met. So, to me, this is not just about the cancer or the palliative care team but it’s the Summit Medical Group approach of taking care of the entire person.
Melanie: Thank you so much. You’re listening to SMG Radio. And for more information, you can go to summitmedicalgroup.com. That’s summitmedicalgroup.com. This is Melanie Cole. Thanks so much for listening.
Palliative Care for Cancer Patients
Melanie Cole (Host): Palliative care is the care that’s given to improve the quality of life of patients who have a serious or life threatening disease such as cancer. My guest today is Dr. Biren Saraiya. He’s an oncologist at Summit Medical Group who specializes in lung cancer, leukemia and lymphomas. Welcome to the show, doctor. Tell us, what is palliative care? People hear “palliative” and then they think hospice and they are two different things, yes?
Dr. Biren Saraiya (Guest): Absolutely. So, in my mind palliative care is almost all doctors do this and just take the word palliation – it just means to alleviate symptoms. So, in essence, palliative care is aiming at alleviating patient’s symptoms, whether they be physical symptoms such as pain, nausea, vomiting or whether they be emotional symptoms such as depression or anxiety or spiritual symptoms. So, palliative care is professionals trying to address patient symptoms along with the oncology, the cancer care.
Melanie: So, now, tell us what’s involved with palliative care and who is a candidate for it.
Dr. Saraiya: Anyone who has symptoms is a candidate for it. That’s the broadest umbrella I can draw. Many times, patients with cancer already are very distressed by the fact that there is cancer. There are implications for themselves, their well-being, their family’s well-being, their financial well-being. So, working alongside the oncologist specialist, the palliative care team can help address and sometimes even alleviate many of the symptoms. So, any cancer patient with any symptoms is eligible for it.
Melanie: If a person gets palliative care, doctor, does that mean that he or she does not get cancer treatments?
Dr. Saraiya: Absolutely not. Palliative care team at Summit Medical Group works alongside the oncologist whether it be surgeons, medical oncologists, radiation oncologists to provide the care. So, a patient can continue to get the cancer direct therapy along with the symptomatic therapy. The easiest example I can give you is, many times someone has pain because of the cancer and we would recommend because radiation for the pain, that is palliative care. Sometimes, we recommend that they get medication for it. That is palliative care. Sometimes, we work with our colleagues who are experts in this to make sure we find the right solution. It is almost as if someone has chest pain and we ask our cardiologist colleagues to see the person to help us manage that, if necessary. We call the palliative care doctors with symptoms that are difficult to manage by ourselves and we need some additional help. That is alongside the cancer care. Everything is together.
Melanie: Besides symptom management what other kinds of issues are addressed in palliative care? There’s emotional, people have anxiety and stress or they need spiritual care. Are these considered palliative as well?
Dr. Saraiya: Absolutely. What I’ve learned over my career is that many times, patients see the oncologist in a very specific role and they worry that if they tell me all that’s bothering them that I’m not going to have enough time to pay attention to their cancer. So, they, many times, withhold telling me everything that’s bothering them. What I’ve learned is that when you work with the palliative care team, they are much more willing to tell their palliative care team about their symptoms. From my perspective, the best outcomes are when I address the entire patient, not just their cancer. The palliative care team working with me can accomplish that. That’s the optimal solution. So, working alongside to make sure the patient’s emotional, physical, spiritual, and even sometimes other distresses, like financial distresses, can be addressed. That’s helpful. We cannot alleviate every single problem but we can address them to the best of our ability.
Melanie: How is palliative care used at the end of life, doctor?
Dr. Saraiya: This is when most people think about hospice care. The way I see it is when we are taking care of cancer, we do ask ourselves, “What’s our goal?” At every single junction whether we are trying to cure the cancer or manage the cancer, we try to make sure the symptoms from it are addressed. So, palliative care is delivered alongside cancer care. There may come a time in a patient’s life when we do not think that cancer care is appropriate or the program of the cancer treatment is too much for the benefit they may have and we focus on end of life care and that’s when hospice comes in. So, the palliative care team can arrange that. They can work with the hospice provider to make sure that what care they need is delivered in the manner they need it. So, if a patient wants to be at home, we can make sure that they are home. They have additional support for the caring of them or the caring for the family and we can make sure that those supports are there as much as possible. So, the palliative care team working with the oncology team ensures the transitions are as smooth as possible.
Melanie: Is palliative care covered under insurance?
Dr. Saraiya: Absolutely. Palliative care is covered. Just like a cardiologist visit, palliative care is covered. The interventions, the medications are covered just like my medications are covered. These are medical professionals working with our nursing staff, our social workers and we work with resources in the community, whether its religious and spiritual guidance. We try to meet what the patient’s needs are.
Melanie: How do people start that discussion about palliative care? Because some people would get defensive thinking its hospice and thinking they’re talking about end of life care. So, how do you help families to get that discussion going with the patient?
Dr. Saraiya: This is a very important point. I’m glad you asked that. When I think about discussing goals the patient has, the first time we talk about what are we trying to accomplish. What I try to do with my patients is have the conversation of how important it is for me to make sure that I take care of them as an entire person. I tell them in the front and I remind them along the way that I would love to know what’s bothering them; how are they living their day-to-day life? What can I do to make that better? Sometimes, that’s in my hands with the chemotherapy scheduling the dosages; sometimes it’s not. That’s when I can have additional resources for a palliative care team and I can introduce them at that point in time to say, “Here are some resources that can help me take better care of you.” So, that’s something that I, the physician, try to encourage patients and let them know and guide them along the way. Many times, patients are very fine with this. Patients and families will say, “I need help, how can I get that?” They will ask specifically for palliative care resources. We try to provide them at that time as well. Either myself, as a clinician, or the patient and the family can request a consultation with the palliative care team.
Melanie: In just the last few minutes, and its great information, doctor. It’s so beautifully put and you’re so well-spoken, please give your best information for palliative care and why they should come to Summit Medical Group for their care.
Dr. Saraiya: I think this goes back to what Summit Medical stands for. I think we provide care for the entire patient throughout their lifespan. It starts with our obstetrician to the pediatrics team to the adult medicine team to our subspecialties. This is taking care of our patients, our community, and our neighbors the way we want to be cared for. In my mind, taking care of the person and the family and having the team approach is so important. Our palliative care team works in the community. They provide the care in the community. They know what the resources are in the community. We work together to make sure the patient’s and the family’s needs are met. So, to me, this is not just about the cancer or the palliative care team but it’s the Summit Medical Group approach of taking care of the entire person.
Melanie: Thank you so much. You’re listening to SMG Radio. And for more information, you can go to summitmedicalgroup.com. That’s summitmedicalgroup.com. This is Melanie Cole. Thanks so much for listening.