[MINI-PODCAST] Ep 77: Virtual Integrative Services

Find the CANCER BUZZ podcast on Apple Podcasts, Spotify, or wherever you get your podcasts!

When the pandemic brought in-person patient services to a halt, the Pluta Integrative Oncology & Wellness Center developed a virtual platform to provide patients more widespread access to integrative oncology modalities.

Hear how a virtual integrative format can enable cancer programs to adapt touch modalities to self-interventions, leverage opportunities for research, and overcome social and economic barriers, while impacting a greater number of patients at lower costs.

Alissa Huston, MD
Co-Medical Director, Pluta Integrative Oncology & Wellness Center
Associate Professor of Medicine, James P. Wilmot Cancer Institute at the University of Rochester

"…not every patient has the access and ability to afford what we are able to offer. And so by offering these services in a virtual format it really breaks down some of those barriers…"

Related Content:

• Oncology Issues journal, "Development of a Virtual Integrative Oncology Center"
• Views: A Pandemic's Silver Lining: Building a Collaborative Integrative Therapy Program
• Rapid Practice Change During COVID-19 Leads to Enduring Innovations and Expansion of Integrative Oncology Services
• Telehealth in Action
• Adoption and Expansion of Telehealth Solutions
• CANCER BUZZ Podcast: Telehealth After COVID-19
• [WEBINAR] Using Telemedicine to Assess Psychosocial Health
• [WEBINAR] Virtual Assessment of Physical Function in Adults with Cancer: Practical Tips

This podcast is part of a special series with ACCC's Oncology Issues journal. For a deeper dive into this content, please read, “Development of a Virtual Integrative Oncology Center,” from V37 N2.

Transcript

CANCER BUZZ: Welcome back to CANCER BUZZ. I'm your host Summer Johnson. On this quick episode, an inspiring integrative oncology center. During the pandemic, the Pluta Integrative Oncology and Wellness Center adapted its services to continue to meet the needs of its patients and developed a robust virtual catalog of classes and counseling. The result was a virtual platform that helps them connect with patients and overcome social and economic barriers facing their patients, not just during the pandemic, but moving into the future.

Dr. Alissa Huston is the Co-Medical Director of the Pluta Integrative Oncology and Wellness Center at the University of Rochester Medical Center, Wilmot Cancer Institute.

Dr. Alissa Huston: So, our integrative oncology center by way of background opened in 2018 as an in-person center, we have four core areas. So, exercise, touch, modalities, acupuncture, massage nutrition. We were running a monthly in-person cooking for wellness program where patients would meet, make a plant-based healthy meal, and then share that meal at the end. So very much in-person interaction, as well as in-person classes, yoga, meditation, Tai Chi, chi-gong, art therapy.

So, we had a lot of in-person classes that were happening. And then when COVID started, of course, everything immediately ground to a halt, and we had to shut everything down. And as what our services are offering are really an evidence-based symptom directed, supportive modalities to help cancer patients as they're going through their treatment.

CANCER BUZZ: Was your initial concern with your patients in a pandemic?

Dr. Alissa Huston: The biggest focus initially was how do you even get patients through their chemotherapy and active treatments with what we were doing? Kind of falling a little lagging a little bit more behind appropriately. Our big concern was how do we keep our patients on treatment? So after a few, I'd say maybe a week or two of, kind of just everything coming to a halt we met and said, okay, as we were starting to see telemedicine the development of more zoom online, virtual options, what could we do in our center that would still provide support and resources to our patients, even if they couldn't come into the center with what services we have.

So, it started small, our program manager at the time started with a series of newsletters. She would send out just with little points, eating the rainbow. Here's some exercise interventions you can at home. And then it evolved into some short videos. We started to use Facebook to do some of our yoga classes. So, we would broadcast our yoga instructor would broadcast from her home and you'd be able to put that up on our Facebook page. And then from there, we began to develop a series of recorded videos under our four core modalities.

So really trying to create more of a structure, not quite a curriculum, but a structure under each pillar that we have so that we had several meditation videos, movement videos.

CANCER BUZZ: One of the things that you did that was really unique was adapting touch modalities. How did that happen?

Dr. Alissa Huston: That's a great question because two things that our patients really drive benefit from, and that there's a lot of growing research and science on our two touch modalities. So that is oncology massage and acupuncture. So, one example is that our acupuncturist created a few short videos on self-acupressure. So, neuropathy is a common symptom, many patients receiving chemotherapy experience, and they were able to create just a short video about self-care to help with hands and feet.

And these are things that a patient could do for themselves at home without having to come into the center. So, trying to find ways to provide that support, even if patients weren't able to come in directly and receive those touch services.

CANCER BUZZ: Are you finding that the virtual format is giving way to research interventions?

Dr. Alissa Huston: Yes, so, we've learned a lot—and others, I know in our article, the Zakim Center at Dana-Farber Cancer Institute also published some of their initial work, looking at this and really showing that you can continue to do research even when you've had to pivot midway into a more virtual format. We are also looking at adapting other ways. So, for example, taking the idea of self-administered, what we call acupressure and now looking at developing a true intervention for a specific symptom that many patients face and being able to teach that online virtually to patients that allows greater expansion.

Our Cancer Institute has a lot of regional cancer center sites. And so being able to have resources that support our patients, but that we can more widely offer, so someone doesn't have to come two hours up. If we can do a video consult over zoom and then make recommendations, they can attend a virtual meditation class or participate in oncology, yoga from their home. And that could be two, three hours away, but they're still able to engage in the services we have that can help them in mitigating their symptoms as they go through treatment.

CANCER BUZZ: So, you quickly and successfully adapted your services for the pandemic. What did you learn about patient care and what are the plans for the future?

Dr. Alissa Huston: I think one of the things that we've learned, and are still learning, as we are looking at—how do we keep this component of our program growing and is that these modalities can be expensive for patients. And so going in and receiving acupuncture or receiving oncology massage or attending a yoga class. We are fortunate that our center provides these services. We have an incredibly generous, the Pluta Cancer Center Foundation that does fund our programming, but not every place is able to offer that.

And not every patient has the access and ability to afford what we are able to offer. And so by offering these services in a virtual format, it really breaks down some of those barriers that there isn't the cost they can attend online, virtually it eliminates some of the travel costs driving in two hours. That can be a lot of gas for a patient that needs to be able to have that economic resource, to get to their treatments coming in for something additional. They may not have the resources to be able to do that.

So, if we can continue to enhance how we can support our patients in a virtual way, that I think allows a greater number of patients, especially when we look at our regional and rural sites, and we have growth of many of our cancer sites within more regional locations that allows those patients to have access to what we have here.

CANCER BUZZ: For a deeper dive on what we discussed today. Check out the latest edition of Oncology Issues in your mailbox and online. Now next week on CANCER BUZZ, the story of Jack's Caregiver Coalition, a caregiving resource, just for the unique needs of men who take care of those with cancer. You won't want to miss that one, make sure to follow us on your favorite podcast app to get that episode. As soon as it's published until then this is Summer Johnson.

CANCER BUZZ: This is a resource of the Association of Community Cancer Centers.