Cancer Care During COVID-19
From the Show: UK HealthCast
Summary:
Air Date: 7/7/20
Duration: 10 Minutes
Dr. Freherick Ueland discusses Markey Cancer Center's response to COVID-19.
Transcription:
Melanie Cole (Host): Welcome to UK HealthCast with the University of Kentucky Healthcare. Today, we’re talking about cancer care during COVID-19. I’m Melanie Cole and joining me is Dr. Frederick Ueland. He’s the Clinical Operations Leader for the University of Kentucky Healthcare Markey Cancer Center. Dr. Ueland, thank you so much for joining us today. these are unprecedented times for medical care across the board really. But for cancer patients, this can be an especially difficult time to navigate. With this pandemic changing how clinics and offices are operating at Markey Cancer Center; tell us a little bit about how you’re providing care for cancer patients at this time and how this care has evolved.
Frederick Ueland, MD (Guest): Thank you Melanie. Happy to. And thank you for hosting. So, several things that the Cancer Center has done, and that other cancer centers and clinics are doing across the country is introducing Telehealth as an option for patients and prior to COVID several of our cancer services were providing forms of Telemedicine but they were limited to these provider to provider settings. Meaning that the patient had to actually drive to a local facility that had an established Telemedicine connection with the Cancer Center. But with the COVID pandemic came a relaxing of some of these Telehealth restrictions across the nation and the Markey has been very quick to transition to what’s called patient to provider connections and that’s been a real breakthrough. Because now the patient can connect with their doctor anywhere provided, they have a cellular or internet connection and can use their Smart Phone, their tablet, their desktop computer for their visit. So, it has enabled us to reach more patients at their convenience and they are very satisfied with that experience.
Certainly, not all appointments are appropriate for Telehealth visits but when they are, it saves the patient travel time and money and it keeps both the providers and the patients healthy and safe from unnecessary exposure.
Host: So, what types of visits are appropriate for Telehealth appointments?
Dr. Ueland: That’s a great question. Because certainly not all visits are appropriate but a lot of the well patient visits, they may be annual follow up visits or six month routine check visits can be established and performed by Telehealth. Cancer survivorship visits which are really useful for our patients once they’ve completed their therapy, are perfect for Telehealth visits. And other routine surveillance visits following say infusion or following hospital discharge or following a procedure; we can connect with our patients through Telehealth without having them get in the car and drive all the way to Lexington. And in some cases, since patients travel sometimes four or five hours to get here, it can be a really helpful way to begin a new patient visit. Because we can coordinate if they have to see several other consultants or they are going to have an operation or a diagnostic procedure; we can get all that arranged through a Telehealth visit first and then their one in-person visit can be very comprehensive in nature.
So, those are the specific Telehealth appointments that we are utilizing right now.
Host: So, before I ask you about some strides made across the commonwealth; tell us a little bit about what cancer treatments people have had to come in for. Infusions, radiation, chemotherapy. These thing have not stopped, correct and how has that been working?
Dr. Ueland: Yeah, so you’re exactly right. Many medical specialties can sort of reduce dramatically the number of visits but when you are caring for a cancer patient, many if not most can’t be delayed because the radiation treatments have to be given on time. If there’s a delay in the radiation treatment, there’s a repopulation of cancer cells and it can be very detrimental to the patient. So, making sure our patients get in as scheduled for those treatments is critical. Same is true for their chemotherapy infusions or immunotherapy infusions or operations. I mean we are able to delay a few low risk cancer operations for a month or so and not have any detrimental effects to the patient, but most are very, very important.
So, we’re doing several things to try to keep our patients safe in that setting during this COVID pandemic. Screening, screening all employees and screening all patients and all the visitors, testing everyone prior to surgery or prior to receiving high risk infusions like bone marrow transplantation are just a few of the things we’re doing to really help our patients get the care they need in a very safe environment if they need to come see us at the Cancer Center.
Host: Well thank you for that. So, Dr. Ueland, as Chief of the Division of Gynecologic Oncology; take a few minutes for us to discuss the strides Markey Cancer Center has made across the commonwealth as it pertains to gynecologic cancers.
Dr. Ueland: GYN Oncology, we are very fortunate. We have a wonderful diverse group of talented doctors to treat female cancers across the state and we’ve got six faculty and a nurse practitioner. We’ve got great supportive services, social workers, genetics, physical and occupational therapy and financial counseling et cetera. So, we really have a great team to work with to help the women in Kentucky. We believe in our Tri part mission, clinical care and research and education all three are very, very important to us. We perform about 1000 surgical procedures every year here and half of which are minimally invasive, and some are very challenging operations which we do with our surgical colleagues in the Cancer Center. We’ve got all kinds of opportunities for clinical trials which includes novel immunotherapy and chemotherapy and surgical trials, and we’ve got a strong relationship with a lot of the GYN physicians across the state. Because we train the residents and then they go out and practice in the state, so we know the majority of the providers in the state because we’ve all – the GYN oncologists have largely been here for 20, 30, 40 years. so, a great relationship with the community physicians.
But I’m also proud of our research and our clinical trial research and our laboratory research working on novel ovarian cancer treatments and ways to overcome mechanisms to cancer resistance is a very exciting part of what we do beyond just patient care and then the third part of our mission is educating the next group of great young physicians and surgeons who are going to provide care for Kentucky’s future. So, that’s a little bit about GYN oncology and what we believe in and what we’re doing.
Host: Well it seems to be a very exciting time to be in your field as things are rapidly advancing. Aside from physical health for cancer patients, there’s a concern across the board really for all of us, but specifically cancer patients about our mental health during this. What are you telling your patients every day Dr. Ueland about that stress and how it can make it so that they can’t deal with their cancer quite as well. How are you helping them deal with mental health at this time?
Dr. Ueland: Well it is a conversation that is worth having and one perhaps the cancer docs are a little more open and capable of having because it’s not infrequently a problem even without the COVID pandemic crisis. But it’s something we think a lot about both for our patients and our providers too because this is difficult for many of the providers as well. But we have a great social work support group. They are in our clinic or do Zoom calls or telephone calls to connect with our patients who have so many personal needs. We have what we call our psych-oncology unit, terrific really help our patients get the resources they need and answer a lot of the questions that they have. So, a lot of unique supportive services in the Cancer Center just because it is a common problem both during COVID and just fighting cancer alone.
Host: Well Dr. Ueland, what you and your staff are doing really is amazing. It’s wonderful and as you said, it can be stressful, but you really are the heroes right now so thank you for that. As we wrap up, kind of summarize how you’re taking care of patients that need cancer care despite the COVID-19 health crisis and what you’d like them to know about Markey Cancer Center.
Dr. Ueland: Well first, I’m just so proud of our faculty and staff for what they’ve had to do to continue to provide this safe cancer treatment. It’s been long nights and there’s great reward in that but their commitment and determination to getting it right, so we have the safe workflows for our patients. So, when the patient comes here, they know it’s in the safest possible way that we’re screening everybody, that we’re testing those who need to be tested, that we really take this seriously and it’s a huge commitment and effort from our faculty and staff and they’ve done a terrific job. Very proud of them and of course the commitment to the patient is in the forefront of everybody’s mind and I’m proud to say it’s been very effective. We’ve been able to treat without any significant sequelae related to the virus and we’re just – hope it declines soon. The sooner the better. But until then, we’ll continue to provide all the necessary care we can.
Host: Thank you so much Dr. Ueland for joining us today and telling us what Markey Cancer Center part of UK Healthcare is doing to keep the community and cancer patients safe. Thank you so much again. To learn how UK Healthcare is dealing with COVID-19 and for information please visit our website at www.ukhealthcare.uky.edu/covid-19. That concludes another episode of UK HealthCast with the University of Kentucky Healthcare. Please remember to subscribe, rate and review this podcast and all the other University of Kentucky Healthcare podcasts. For more health tips and updates follow us on your social channels. I’m Melanie Cole.
Melanie Cole (Host): Welcome to UK HealthCast with the University of Kentucky Healthcare. Today, we’re talking about cancer care during COVID-19. I’m Melanie Cole and joining me is Dr. Frederick Ueland. He’s the Clinical Operations Leader for the University of Kentucky Healthcare Markey Cancer Center. Dr. Ueland, thank you so much for joining us today. these are unprecedented times for medical care across the board really. But for cancer patients, this can be an especially difficult time to navigate. With this pandemic changing how clinics and offices are operating at Markey Cancer Center; tell us a little bit about how you’re providing care for cancer patients at this time and how this care has evolved.
Frederick Ueland, MD (Guest): Thank you Melanie. Happy to. And thank you for hosting. So, several things that the Cancer Center has done, and that other cancer centers and clinics are doing across the country is introducing Telehealth as an option for patients and prior to COVID several of our cancer services were providing forms of Telemedicine but they were limited to these provider to provider settings. Meaning that the patient had to actually drive to a local facility that had an established Telemedicine connection with the Cancer Center. But with the COVID pandemic came a relaxing of some of these Telehealth restrictions across the nation and the Markey has been very quick to transition to what’s called patient to provider connections and that’s been a real breakthrough. Because now the patient can connect with their doctor anywhere provided, they have a cellular or internet connection and can use their Smart Phone, their tablet, their desktop computer for their visit. So, it has enabled us to reach more patients at their convenience and they are very satisfied with that experience.
Certainly, not all appointments are appropriate for Telehealth visits but when they are, it saves the patient travel time and money and it keeps both the providers and the patients healthy and safe from unnecessary exposure.
Host: So, what types of visits are appropriate for Telehealth appointments?
Dr. Ueland: That’s a great question. Because certainly not all visits are appropriate but a lot of the well patient visits, they may be annual follow up visits or six month routine check visits can be established and performed by Telehealth. Cancer survivorship visits which are really useful for our patients once they’ve completed their therapy, are perfect for Telehealth visits. And other routine surveillance visits following say infusion or following hospital discharge or following a procedure; we can connect with our patients through Telehealth without having them get in the car and drive all the way to Lexington. And in some cases, since patients travel sometimes four or five hours to get here, it can be a really helpful way to begin a new patient visit. Because we can coordinate if they have to see several other consultants or they are going to have an operation or a diagnostic procedure; we can get all that arranged through a Telehealth visit first and then their one in-person visit can be very comprehensive in nature.
So, those are the specific Telehealth appointments that we are utilizing right now.
Host: So, before I ask you about some strides made across the commonwealth; tell us a little bit about what cancer treatments people have had to come in for. Infusions, radiation, chemotherapy. These thing have not stopped, correct and how has that been working?
Dr. Ueland: Yeah, so you’re exactly right. Many medical specialties can sort of reduce dramatically the number of visits but when you are caring for a cancer patient, many if not most can’t be delayed because the radiation treatments have to be given on time. If there’s a delay in the radiation treatment, there’s a repopulation of cancer cells and it can be very detrimental to the patient. So, making sure our patients get in as scheduled for those treatments is critical. Same is true for their chemotherapy infusions or immunotherapy infusions or operations. I mean we are able to delay a few low risk cancer operations for a month or so and not have any detrimental effects to the patient, but most are very, very important.
So, we’re doing several things to try to keep our patients safe in that setting during this COVID pandemic. Screening, screening all employees and screening all patients and all the visitors, testing everyone prior to surgery or prior to receiving high risk infusions like bone marrow transplantation are just a few of the things we’re doing to really help our patients get the care they need in a very safe environment if they need to come see us at the Cancer Center.
Host: Well thank you for that. So, Dr. Ueland, as Chief of the Division of Gynecologic Oncology; take a few minutes for us to discuss the strides Markey Cancer Center has made across the commonwealth as it pertains to gynecologic cancers.
Dr. Ueland: GYN Oncology, we are very fortunate. We have a wonderful diverse group of talented doctors to treat female cancers across the state and we’ve got six faculty and a nurse practitioner. We’ve got great supportive services, social workers, genetics, physical and occupational therapy and financial counseling et cetera. So, we really have a great team to work with to help the women in Kentucky. We believe in our Tri part mission, clinical care and research and education all three are very, very important to us. We perform about 1000 surgical procedures every year here and half of which are minimally invasive, and some are very challenging operations which we do with our surgical colleagues in the Cancer Center. We’ve got all kinds of opportunities for clinical trials which includes novel immunotherapy and chemotherapy and surgical trials, and we’ve got a strong relationship with a lot of the GYN physicians across the state. Because we train the residents and then they go out and practice in the state, so we know the majority of the providers in the state because we’ve all – the GYN oncologists have largely been here for 20, 30, 40 years. so, a great relationship with the community physicians.
But I’m also proud of our research and our clinical trial research and our laboratory research working on novel ovarian cancer treatments and ways to overcome mechanisms to cancer resistance is a very exciting part of what we do beyond just patient care and then the third part of our mission is educating the next group of great young physicians and surgeons who are going to provide care for Kentucky’s future. So, that’s a little bit about GYN oncology and what we believe in and what we’re doing.
Host: Well it seems to be a very exciting time to be in your field as things are rapidly advancing. Aside from physical health for cancer patients, there’s a concern across the board really for all of us, but specifically cancer patients about our mental health during this. What are you telling your patients every day Dr. Ueland about that stress and how it can make it so that they can’t deal with their cancer quite as well. How are you helping them deal with mental health at this time?
Dr. Ueland: Well it is a conversation that is worth having and one perhaps the cancer docs are a little more open and capable of having because it’s not infrequently a problem even without the COVID pandemic crisis. But it’s something we think a lot about both for our patients and our providers too because this is difficult for many of the providers as well. But we have a great social work support group. They are in our clinic or do Zoom calls or telephone calls to connect with our patients who have so many personal needs. We have what we call our psych-oncology unit, terrific really help our patients get the resources they need and answer a lot of the questions that they have. So, a lot of unique supportive services in the Cancer Center just because it is a common problem both during COVID and just fighting cancer alone.
Host: Well Dr. Ueland, what you and your staff are doing really is amazing. It’s wonderful and as you said, it can be stressful, but you really are the heroes right now so thank you for that. As we wrap up, kind of summarize how you’re taking care of patients that need cancer care despite the COVID-19 health crisis and what you’d like them to know about Markey Cancer Center.
Dr. Ueland: Well first, I’m just so proud of our faculty and staff for what they’ve had to do to continue to provide this safe cancer treatment. It’s been long nights and there’s great reward in that but their commitment and determination to getting it right, so we have the safe workflows for our patients. So, when the patient comes here, they know it’s in the safest possible way that we’re screening everybody, that we’re testing those who need to be tested, that we really take this seriously and it’s a huge commitment and effort from our faculty and staff and they’ve done a terrific job. Very proud of them and of course the commitment to the patient is in the forefront of everybody’s mind and I’m proud to say it’s been very effective. We’ve been able to treat without any significant sequelae related to the virus and we’re just – hope it declines soon. The sooner the better. But until then, we’ll continue to provide all the necessary care we can.
Host: Thank you so much Dr. Ueland for joining us today and telling us what Markey Cancer Center part of UK Healthcare is doing to keep the community and cancer patients safe. Thank you so much again. To learn how UK Healthcare is dealing with COVID-19 and for information please visit our website at www.ukhealthcare.uky.edu/covid-19. That concludes another episode of UK HealthCast with the University of Kentucky Healthcare. Please remember to subscribe, rate and review this podcast and all the other University of Kentucky Healthcare podcasts. For more health tips and updates follow us on your social channels. I’m Melanie Cole.
