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Cancer Symposium Focuses on Patient Support, Cancer Research

The Sylvester Comprehensive Cancer Center’s second annual conference offered concurrent scientific and patient/caregiver tracks and attracted more than 300 attendees.

Thanks to continuing advances in treatments, more cancer patients are surviving this devastating disease, but survivors, family members and caregivers still face a wide range of challenges.

The 2023 Sylvester Cancer Survivorship Symposium, held Oct. 20 at the Ritz-Carlton Hotel in Coconut Grove, focused on finding solutions for these challenges.

“We are champions of survivorship,” said Stephen D. Nimer, M.D., director, Sylvester Comprehensive Cancer Center, part of UHealth—the University of Miami Health System, in welcoming more than 300 attendees to the daylong event. “We all have friends and family members dealing with cancer, and no one should go alone on this journey.”

Cancer Symposium for Providers, Researchers and Patients

Sylvester’s symposium included a scientific track for providers and researchers, and a supportive care, patient-focused track for survivors, family members and caregivers to provide the most relevant information on programs to mitigate the challenges of survivorship.

Headshot of Dr. Frank J. Penedo
Frank J. Penedo, Ph.D. lauds Sylvester’s emphasis on support programs that help cancer survivors.

“Sylvester continues to significantly invest in research and support programs designed to improve the lives of survivors,” said Frank J. Penedo, Ph.D., director, cancer survivorship and supportive care, who hosted the symposium. “The survivorship experience can be quite challenging. Therefore, we continue to expand our research programs, which in turn inform supportive care delivery services in an effort to advance cancer outcomes and health equity throughout South Florida.”

Andrea Cheville, M.D., professor of physical medicine and rehabilitation at Mayo Clinic in Rochester, MN, delivered the keynote address on digitalizing supportive cancer care, emphasizing the importance of combining human and digital resources to achieve the best experiences and outcomes for survivors by capitalizing on advances in health information technologies.

Earlier in the day, in a video message, U.S. Representative and breast cancer survivor Debbie Wasserman-Schultz highlighted Sylvester’s leadership in advancing survivorship research and care.

“You are an amazing lifeline for our community and our nation. Together, we will continue to deliver for cancer survivors and their families,” she said. “Digital empowerment tools can enhance the reach of cancer professionals and reduce barriers to care and costs, but supportive care requires human navigation, rather than a booklet or URL. It’s also important to use multiple outreach modes to reach patients who are older, disabled or members of a minority in order to avoid perpetuating health disparities.”

The Latest Cancer Research

Sylvester specialists presented the latest research and clinical care strategies for survivors in the symposium’s scientific track, whose topics ranged from childhood cancers to sexual health.

Tracy Crane, Ph.D., associate professor of medical oncology and co-leader of the Cancer Control Program, noted preliminary findings of a low-fat, high-vegetable, fruit-and-fiber eating plan for women who had completed treatment for ovarian. The Lifestyle Intervention for Ovarian Cancer Enhanced Survival (LIVES) study involved more than 1,200 women from across the United States in the largest non-pharmacologic trial to date in women with ovarian cancer.

She also summarized the ongoing Sylvester study, Trial of Exercise and Lifestyle (TEAL), aimed at understanding how ldiet and exercise can improve tolerability of treatment in women receiving chemotherapy for ovarian cancer.

Sylvester Comprehensive Cancer Center physician Kristin Rojas
Sylvester breast surgical oncologist Kristin Rojas, M.D., encouraged providers to validate cancer patient struggles with sex after diagnosis.

Breast surgical oncologist Kristin Rojas, M.D., director of Sylvester’s Menopause, Urogenital Sexual Health and Intimacy Clinic (MUSIC), presented her work on an often-neglected survivorship challenge along, with evidence-based recommendations for women survivors experiencing painful sex, vaginal dryness, low desire, or other treatment-related symptoms.

“It’s important for providers to acknowledge how common these issues are, validate patient concerns and offer our previvors, survivors, and thrivers mitigation strategies that are not only effective, but safe,” she said.

Support for Adult Survivors of Childhood Cancer

Thanks to advances in treating pediatric malignancies, about one in 900 adults in the U.S. is a survivor of childhood cancer, according to Daniel Armstrong, Ph.D., professor of pediatrics and psychology, special senior advisor to the chair of pediatrics and director of the Mailman Center for Child Development.

Sylvester Comprehensive Cancer Center physician Daniel Armstrong, M.D.
Daniel Armstrong, Ph.D., notes the unique needs of survivors of childhood cancer.

He cited the importance of studies now underway to track and manage the long-term impact on young patients as they develop into adulthood.

“Their questions and answers about survivorship will be quite different from those of adult survivors,” Dr. Armstrong added. “They need to be strong advocates for themselves.”

Carmen Calfa, M.D.,  medical co-director of the Cancer Survivorship Program and co-lead of the Breast Oncology Site Disease Group at Sylvester, moderated the morning sessions, while Matthew P. Schlumbrecht, M.D., M.P.H., also medical co-director of the survivorship program and co-lead of the Gynecologic Oncology Site Disease Group at Sylvester, moderated the afternoon sessions.

“It is so rewarding for us that our patients are not only living longer but also have better quality of their lives,” said Dr. Calfa. “We appreciate being able to share what we have learned to help survivors, families and caregivers.”

Fear of Recurrence for Cancer Survivors

Addressing the fear of cancer recurrence was a key topic in both the scientific and patient tracks.

“Management of fear of recurrence is the number one unmet need of survivors,” said Wendy Lichtenthal, Ph.D., associate professor of public health sciences and director of Sylvester’s Center for the Advancement of Bereavement Care.

When unaddressed, this fear can lead to paralyzing worries, depression and a lower quality of life.

“But the nature and the level of fear varies from person to person,” Dr. Lichtenthal said. “Some dread the thought of further treatment while others are worried about pain or increasing the burden of caregiving on their loved ones.”

She said a brief, digital intervention called cognitive bias modification can help survivors retrain their thinking and shift their attention.

“Anxiety serves a purpose, but we don’t want it to rule a survivor’s life,” Dr. Lichtenthal said. “But turning down the volume can make a big difference in an individual’s outlook.”

In the patient-focused supportive care sessions, Joycelyn M. Lee, Ph.D., M.B.A., assistant professor of clinical psychiatry and behavioral sciences, noted that fear of recurrence tends to lessen over time, but can peak in advance of follow-up scans or visits. Adolescents and young adults may also be at higher risk for more severe levels of fear compared to other survivors, she added.

Dr. Lee gave several suggestions for coping with the fear of recurrence based on the available research:

  • Check the facts and know the level of risk
  • Understand treatment options if the cancer returns
  • Know the most important physical signs of recurrence
  • Stay in communication with the health-care team and keep up with regular appointments

“Use your imagination to rehearse what you might experience and how you can effectively cope during an upcoming exam,” Dr. Lee said. “Then, practice relaxing afterward. Think about dropping a mental anchor, so you can stay engaged with what you’re doing right now, rather than giving all your attention to your fear.”

Support for Cancer Survivors and Caregivers

Supportive therapies, “chemo brain,” cannabis, nutrition and fitness were among the topics discussed in the supportive care for survivors track.

“You are considered a survivor from the time of your cancer diagnosis through the balance of life,” said Jessica MacIntyre, D.N.P., M.B.A., APRN, Sylvester executive director, clinical operations. “At Sylvester, we offer support services to help you thrive – not just survive.”

Craig Moskowitz, M.D., physician-in-chief at Sylvester and professor at the University of Miami Miller School of Medicine, added that Sylvester is expanding its network of satellites to improve access for cancer patients and families.

“We are bringing our programs and doctors to help you manage survivorship closer to home for you,” he said.

The Changing Cancer Survivorship Profile

Dr. Moskowitz noted that survivorship programs have traditionally been geared toward women treated for breast and ovarian cancers.

Sylvester Comprehensive Cancer Center physician Craig Moskowitz, M.D.
The effectiveness of immunotherapy has led to a changing profile of cancer survivorship, says Craig Moskowitz, M.D.

“That has changed dramatically in the era of immunotherapy,” he said. “More types of cancers can be targeted with drugs, and newer therapies are more effective or less toxic than before. In addition, there are far more men and women survivors living rewarding lives with active cancers that are under control.”

Paola Rossi, M.D., clinical program director of lifestyle medicine, and Adrienne Vazquez-Guerra, APRN, outlined Sylvester’s vast survivorship services, including lifestyle modification, cancer screening, health assessments, coordination of care, weight management and survivorship care plans.

“Nearly 40 percent of cancers, as well as treatment-related symptoms, are related to modifiable risk factors like smoking, excess weight, poor nutrition and physical inactivity,” said Dr. Rossi. “If you make changes to any of these risk factors, you can reduce the odds of recurrence and improve quality of life.”

At the end of the supportive care sessions, Dr. Calfa moderated a panel with survivors who used their experiences to become patient advocates.

“I was a new mom when I felt a lump in my breast,” said Melissa McFarlane. “After my diagnosis, I pushed hard for surgery. Fortunately, Dr. Calfa was able to coordinate my care and the tumor was removed before it hit the lymph nodes.”

Ashlee Cramer lost her husband in 2014 to lymphoma at a time when she had three young children. But in 2020 her 19-year-old son, Michael, began experiencing fevers and night sweats that turned out to be symptoms of a different type of lymphoma. After undergoing a bone marrow transplant at Sylvester, Michael and his mom have focused on building an online community.

“I believe the best way to help yourself is to help others,” Ashlee said.

In the past 12 years, John McGuire has undergone surgery, radiation treatments and chemotherapy for recurring prostate cancer. Now, he is a Sylvester’s Patient Advisory Council member who enjoys telling other survivors about support programs.

“I’ve taken advantage of complementary exercise sessions and met with a dietician,” he said. “Next, I’ll try music and art therapy as well.”

Reflecting on the impact of the symposium, Jayne S. Malfitano, chair of Sylvester’s Board of Governors and the daughter of Harcourt Sylvester, Jr., whose gifts launched the center in 1992, said, “I have learned so much today from listening to these survivors and family members. We will bring back their comments and insights to our board as we continue to build our vital support programs.”

Tags: cancer research, Cancer Support Services, Cancer Survivorship Symposium, Dr. Carmen Calfa, Dr. Craig Moskowitz, Dr. Daniel Armstrong, Dr. Frank Penedo, Dr. Joycelyn Lee, Dr. Kristin Rojas, Dr. Matthew Schlumbrecht, Dr. Paola Rossi, Dr. Stephen Nimer, Dr. Tracy Crane, Dr. Wendy Lichtenthal, Sylvester Comprehensive Cancer Center