People with cancer can experience a range of physical and emotional side effects during their treatment, such as pain, nausea, anxiety, and depression. Part of NYU Langone’s Perlmutter Cancer Center, the Supportive Oncology Program uses palliative medicine to assist patients with their quality of life and help ease their discomfort from physical symptoms, psychosocial issues, or spiritual or existential distress. The program is directed by Arum Kim, MD, assistant professor in the Departments of Medicine and Rehabilitation Medicine.
Palliative care, also known as supportive care, is specialized medical care used at any stage of a person’s illness and can be delivered alongside curative treatment.
“Studies show that involving palliative medicine early in the course of cancer treatment improves quality of life and even mortality,” says Dr. Kim. “Palliative care is another layer of support for patients and their families as they’re living with serious illness, or in our case, people living with cancer.”
In addition to Dr. Kim, the Supportive Oncology Program includes two part-time attending physicians: Arpit Arora, MD, clinical instructor of medicine and rehabilitation medicine, and Akash Shah, MD, clinical instructor of medicine. These physicians rotate between Perlmutter Cancer Center and Tisch Hospital for outpatient services and Kimmel Pavilion for inpatient services on a monthly basis, providing continuity of care for patients.
The physicians in the Supportive Oncology Program focus on helping patients manage symptoms, including pain, nausea, fatigue, loss of appetite, and difficulty breathing. They also help patients understand their treatment options and discuss the goals of their care. For some people who are ready to transition to hospice services, or end-of-life care, program faculty discuss the philosophy of hospice and the available levels of care with patients and family members. Ideally, patients can avoid unwanted emergency room visits and hospital admissions by the timely addition of home hospice services.
Advance care planning, which includes a person choosing who can make decisions in the event that his or her medical condition changes, also plays a large role in palliative medicine. “We discuss the types of treatments available to the patient that would be beneficial toward the end of life,” Dr. Arora says. “Getting to know patients and their families is really paramount in that process.”
The Supportive Oncology Program uses a multidisciplinary approach to cover all of the patients’ complex needs. In addition to physician support with managing symptoms, a nutritionist typically sees patients on the infusion floors during treatments. Oncology social workers, who specialize in each specific type of cancer, are also available. Patients can also be referred for psychiatry services, pain psychologists, and rehabilitation specialists at Perlmutter Cancer Center, and have access to spiritual, religious, and chaplaincy services.
“Patients with chronic illness, and specifically our cancer patients, have a lot of needs,” says Dr. Shah. “They may not be experiencing physical pain, but pain can also be psychosocial, existential, or spiritual. Having a multidisciplinary team allows us to address all those different elements of pain and other symptoms much more effectively.”