New Mental Health Clinic for Cancer Survivors Opens
The Fields Galley Cancer Survivorship Emotional Wellness Clinic helps people who are vulnerable to anxiety, depression and suicide.
When cancer patients complete radiation or chemotherapy treatments, they are often hailed as heroes. This milestone is sometimes marked with a celebratory bell ring, or with nurses and doctors who provide rounds of applause as patients leave the clinic.
But the end of these treatments rarely means the end of the emotional distress. Survivors must still cope with multiple life changes: physical changes, financial difficulties, work or school interruptions, or changes in social roles or relationships.
“People think you’re done with cancer treatment and you’re going to pick things up right where you left off,” said Ingrid Barrera, Psy.D., director of clinical operations for cancer supportive services at Sylvester Comprehensive Cancer Center,part of UHealth – the University of Miami Health System. “But you’re not the same person you used to be.”
Newly diagnosed cancer patients are seven times more likely to commit suicide within the first six months of their diagnosis than the general population, according to an American Cancer Society study published in The Cancer Letter. Those who suffer from cancers that carry long-term quality-of-life impairments also face increased risks of suicide.
Frank J. Penedo, Ph.D., associate director for Cancer Survivorship and Translational Behavioral Sciences at Sylvester, said that suicide risk data has shown the medical community that cancer patients must be closely monitored and helped even after they’re done with their treatment or go into remission. In the past, patients received significant assistance to deal with their emotions throughout their diagnosis and treatment phases, but as they transitioned into survivorship after their primary treatments, resources to cope with their emotions and survivorship challenges, such as symptom burden, financial concerns and reintegration into social and work roles, were limited at best. “They didn’t get a lot of attention in terms of managing the challenges they face right after the completion of primary treatment,” Dr. Penedo said. “Several influential reports have coined this challenging experience for survivors as ‘lost in transition.’”
That’s why Sylvester opened the Fields Galley Cancer Survivorship Emotional Wellness Clinic this month. As director, Dr. Barrera, who is also the director of UHealth’s Therapeutic Suicide Prevention Program and an assistant professor of clinical psychiatry and behavioral sciences at the University of Miami Miller School of Medicine, assembled an interdisciplinary team including a psychologist, psychiatrist, licensed social worker, music therapist and an art therapist who form the core of the clinic’s innovative programming.
The Fields Galley Private Foundation, a charitable organization founded by the family of Nat Galley Fields, a St. Petersburg, Fla., philanthropist, is supporting the clinic. Fields’ father committed suicide in 1984, leaving him and his family to deal with the “huge collateral damage” of that agonizing event. “I believe that for my father, the fear of life became stronger for him than his fear of death,” Fields said. “I would like to spare others from the same.”
That prompted Fields to work with Sharon Hartman, now the co-trustee of his foundation, to learn about dialectical behavior therapy (DBT), an evidence-based program of psychotherapy that teaches skills to manage emotional distress. The foundation first donated money to start a DBT-based suicide prevention program for adolescents at Jackson Memorial Hospital. Then it donated nearly $400,000 to the Miller School’s Department of Psychiatry and Behavioral Sciences to implement a suicide prevention program for adults. Dr. Barrera ran that program, and her work impressed Fields and Hartman.
However, Dr. Barrera felt more needed to be done and proposed the idea to expand therapy to all cancer survivors. She explained the critical need, and the foundation agreed to donate an additional $428,000 to start the program.
“Like most people, we did not realize that often people in remission can have more cancer-related mental health issues than they experienced while actually fighting the cancer,” Fields said. “Their life focus changes from ‘fighting and survival mode’ to ‘What do I do now?’”
A New Approach
Fields and Hartman believe that traditional foundations are often hesitant to fund new approaches like those offered through UM. “Our foundation prefers to fund new, somewhat experimental mental health programs that approach an old problem in new ways,” Fields said. “We believe that Dr. Barrera’s program design is doing this. It makes it easier to tweak details to accommodate needed changes very quickly when process is not dictated by the past, making success more likely.”
The Fields Galley Cancer Survivorship Emotional Wellness Clinic operates through Dr. Barrera’s office at Sylvester Medical Office Building and several of Sylvester’s satellite facilities, in addition to offering remote services. The team uses DBT and other psychotherapy programs, and is part of a broader initiative at Sylvester, and across the country, to holistically address all issues cancer patients face.
National organizations including the National Cancer Institute and the American Cancer Society have advocated for the term “cancer survivor” to extend from diagnosis throughout the life of any cancer patient. This way, Dr. Penedo said, care teams can address the challenges of the survivorship experience early on, coordinate access to available resources, and monitor how patients are coping and adjusting.
Dr. Barrera has been instrumental in developing emotional wellness programs for cancer survivors and has big plans to grow the clinic. For now, she is thrilled that Fields and Hartman have entrusted her and Sylvester with the resources to implement this critically needed service.
“We’re so grateful,” Dr. Barrera said. “This program can save lives, and none of this work would be possible without the Fields Galley Private Foundation.”
Fields and Hartman believe Dr. Barrera and her team deserve all the credit. “We have been working with Dr. Barrera for years and have come to trust that when she speaks, there is a real need, and we listen,” Fields said. “We see these funds as giving Dr. Barrera and UM an opportunity to create something fantastic.”