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Sylvester Cancer Support Services Grow

Sylvester Comprehensive Cancer Center department features seven new specialists and incorporates a range of integrative oncology services and therapies to assist patients and caregivers.

Maria Rueda-Lara, M.D., is used to educating patients.

Maria Rueda-Lara, M.D., smiling in her white coat
Maria Rueda-Lara, M.D., helps people deal with the emotional toll of cancer.

As the medical director of psycho-oncology for Sylvester Comprehensive Cancer Center, part of the University of Miami Miller School of Medicine, her goal is to help patients suffering from the physical and emotional toll of cancer. However, she often must overcome hesitance from patients who are unfamiliar with mental health therapy or view it as a sign of weakness.

“It is challenging,” she said. “When we meet a patient, we do a lot of psychoeducation.”

After years of educating patients, Sylvester’s Cancer Support Services Department includes 38 specialists who help survivors and their caregivers get through a cancer diagnosis and treatment. As each therapist explains to their patients, complementary services are backed by a large and growing body of scientific research.

Sylvester’s second annual Cancer Survivorship Symposium incorporated a daylong patient/caregiver conference focused acutely on current research and finding solutions for the challenges many patients face.

Cancer Support Backed by Science

Dr. Rueda-Lara knows the impact her work provides firsthand. She is the co-author of a paper published in the International Review of Psychiatry nine years ago that showed how psychiatric and psychological interventions can help hematopoietic stem cell transplant patients who suffer from high levels of depression, post-traumatic stress disorder and other neurocognitive deficits, which can result in shorter survival rates.

In the years since, Dr. Rueda-Lara and other researchers have produced a steady stream of research that echoes those results across all types of cancer patients.

“Everything we do is based on science,” Dr. Rueda-Lara said. 

The success explains why the Cancer Support Services Department continues to expand, adding seven new specialists this year. The department has licensed specialists offering acupuncture, art therapy, exercise physiology, massage therapy, music therapy, spiritual care and yoga. A separate team provides wigs and head coverings. The department also features 26 social workers, patient navigators and clinic assistants who help patients juggle medical appointments, travel and lodging arrangements, finances and therapy sessions.

“I know that I work with a team, which was a huge draw that attracted me to this department,” said Zili Huma Khan, a psychotherapist who joined the Sylvester team in 2020. “We talk about how the patients are doing, who has been attending treatment regularly, how we can best serve each patient. I never feel like I’m alone.”

Art Therapy Encourages Cancer Patients to Express Inner Selves

When patients are first referred to Lindsey Weaver, a board-certified art therapist, some of them dismiss the idea because they think it’s arts and crafts or they’re scared of having their art judged. But Weaver assures them these preconceptions are wrong.

Female hand holding brush while painting with oil colors
Art therapy helps people get in touch with their inner feelings, a crucial component to living with cancer.

Weaver said patients can reveal so much about their inner selves through their art. For instance, she often asks them to draw a volcano. The drawing is then used as a tool for insight and communication, and can reveal certain emotions. If the volcano is spewing out lava, it could suggest a release of emotions. No lava may indicate suppressed emotions.

Weaver’s art exercises can also be used as treatment. She often encourages patients to use certain materials depending on how they’re feeling. With a patient who is feeling powerless, Weaver often suggests they use pens over watercolors because watercolors are more difficult to control.

“With this population, they’re not given many choices. A lot of people are making choices for them,” Weaver said. “This allows them to feel a little bit in control.”

Research demonstrates the benefits of art therapy for cancer patients. Weaver points to a study published in the Journal of Pain and Symptom Management that found cancer patients who participated in a one-hour art therapy session each week experienced significant reductions in eight of nine symptoms on the Edmonton Symptom Assessment Scale. A separate study published in BMC Cancer found that patients who underwent art therapy realized immediate reductions in pain, emotional distress, depression and anxiety.

Acupuncture for Cancer Patients

Claudia Marin points to 3,000 years of proof as evidence that acupuncture works.

Acupuncturist pinches the patient's neck with one hand to insert an acupuncture needle with the other hand.
Acupuncturist Claudia Marin says the practice can help take the edge off cancer pain.

The senior acupuncturist at Sylvester said there are two ways to explain acupuncture’s effectiveness. The Eastern understanding, which originated in China, says the body is lined with pathways carrying a flow of energy known as “chi.” When that energy is disrupted or destroyed, disease follows. Inserting needles into those pathways helps restore the natural flow.

The Western understanding is that needles tap into the body’s nervous system, improving blood flow and releasing endorphins and serotonin to help manage chronic pain. 

The proof that acupuncture works, Marin said, is so overwhelming the World Health Organization has published guidelines since 1999. But Marin uses another barometer. Her schedule is booked solid through January 2024.

“We notice a change in mood. It takes the edge off the pain. They’re sleeping better,” she said. 

Dialectical Behavior Therapy in Cancer Care

Khan sees a similar pattern play out with her patients. She specializes in dialectical behavior therapy (DBT), which arms patients with tools and skills they can use on their own to better manage their emotions, reduce their stress, and learn to accept their situation by being more mindful and present in each moment.

It’s “a survival guide to managing life,” said Khan, because it empowers patients to tackle mental health obstacles without becoming overly dependent on a therapist. 

Studies have long shown that DBT helps people who are contemplating suicide. In recent years, the practice has been extended to cancer survivors, with encouraging results. Sylvester recently opened the Fields Galley Cancer Survivorship Emotional Wellness Clinic for people in people in remission, who sometimes experience more cancer-related mental health issues than they did while in active treatment.

Khan said the studies that demonstrate the positive affect of support services are seen every day by caregivers.

“A patient may enter our services feeling distressed about their particular situation but leaves much more emotionally anchored and regulated,” she said.

Tags: Cancer Support Services, cancer survivorship, Dr. Maria Rueda-Lara, Sylvester Comprehensive Cancer Center