Patient Perspective: COVID Vaccine and Cancer

Transcript

00:00 --> 00:02Support for Yale Cancer Answers
00:02 --> 00:04comes from AstraZeneca, dedicated
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00:10 --> 00:13More information at astrazeneca-us.com.
00:13 --> 00:16Welcome to Yale Cancer Answers with
00:16 --> 00:18your host doctor Anees Chagpar.
00:18 --> 00:20Yale Cancer Answers features the
00:20 --> 00:22latest information on cancer care by
00:22 --> 00:24welcoming oncologists and specialists
00:24 --> 00:26who are on the forefront of the
00:26 --> 00:28battle to fight cancer. This week
00:28 --> 00:30it's a patient perspective on cancer
00:30 --> 00:32treatment during the pandemic with
00:32 --> 00:34Christina Allen and Doctor Tara Sanft.
00:34 --> 00:36Christina is a cancer survivor and doctor
00:36 --> 00:39Sanft is an associate professor of
00:39 --> 00:41medicine and medical oncology at the
00:41 --> 00:44Yale School of Medicine where Doctor Chagpar
00:44 --> 00:47is a professor of surgical oncology.
00:47 --> 00:49Let's start with you
00:49 --> 00:52Christina, tell us a little
00:52 --> 00:54bit about your story.
00:54 --> 00:58Sure, thanks so I was 38 years old at
00:58 --> 01:02the time of my diagnosis and I have a
01:02 --> 01:06diagnosis of locally advanced breast cancer.
01:06 --> 01:10I was not experiencing any symptoms prior
01:10 --> 01:14to my diagnosis and like so many other
01:14 --> 01:18people I did not have a family history
01:18 --> 01:20of breast cancer either.
01:20 --> 01:23So the cancer was found after
01:23 --> 01:25I felt a small lump,
01:25 --> 01:29which I initially thought was a bug bite.
01:29 --> 01:31It was over the summer,
01:31 --> 01:35this past July I had been swimming and
01:35 --> 01:39really thought not much of it until the
01:39 --> 01:42following morning when I woke up
01:42 --> 01:45and it was still there and felt almost
01:45 --> 01:50like a little pebble under the surface.
01:50 --> 01:53And at that point it was
01:54 --> 01:56a bit of a freeze moment, OK
01:56 --> 01:58do I do something about this?
01:58 --> 02:01What do I do?
02:01 --> 02:05So I reached out and was able to
02:05 --> 02:10see my OBGYN within a day or two.
02:10 --> 02:13At which point she had referred
02:13 --> 02:15me for further imaging,
02:15 --> 02:19and that's when I became connected to Smilow.
02:19 --> 02:22I think another important thing
02:22 --> 02:25to mention is that throughout
02:25 --> 02:27my treatment and my illness,
02:27 --> 02:30I have continued working and I
02:30 --> 02:32am a licensed clinical social
02:32 --> 02:36worker in healthcare and have been
02:36 --> 02:38working in hospital systems for a
02:38 --> 02:41little over 12 years now.
02:43 --> 02:45So Christina you were diagnosed,
02:45 --> 02:47I mean this really happened
02:47 --> 02:50this past July, July of 2020,
02:50 --> 02:53right in the middle of this pandemic.
02:53 --> 02:55Talk to us a little bit about,
02:55 --> 02:59you kind of mentioned this,
02:59 --> 03:02Oh my gosh, what am I going to do moment,
03:02 --> 03:05I can only imagine that that was
03:05 --> 03:07even heightened with what am I
03:07 --> 03:10going to do in the midst of Covid?
03:10 --> 03:12Is my doctors office open?
03:12 --> 03:14Do I do a virtual visit?
03:14 --> 03:16Do I go into the office?
03:16 --> 03:18How does that work?
03:18 --> 03:20Tell us a little bit about that
03:20 --> 03:21thought process and whether
03:21 --> 03:24you ended up seeing
03:24 --> 03:26your doctor using telemedicine,
03:26 --> 03:28or whether you went into their
03:28 --> 03:30office and whether you had
03:30 --> 03:31any challenges with that.
03:34 --> 03:37That's a great question.
03:37 --> 03:40Almost right from the beginning,
03:40 --> 03:46covid sort of felt like this parallel
03:46 --> 03:50opponent in my treatment and in my
03:50 --> 03:53illness it was always a consideration,
03:53 --> 03:56always a factor in the decisions that
03:56 --> 03:59I was making and the decisions that
03:59 --> 04:02my treatment team has been making.
04:02 --> 04:06I knew that getting in for a clinical
04:06 --> 04:10breast exam was going to be the
04:10 --> 04:13next step after I felt that lump,
04:13 --> 04:17so I was pretty specific and persistent
04:17 --> 04:21with asking for an in person visit with
04:21 --> 04:23my OBGYN and I really love the flexibility
04:23 --> 04:28that has come out of covid and the
04:28 --> 04:30increased availability of telemedicine,
04:30 --> 04:33but you know some things just
04:33 --> 04:35have to be done
04:35 --> 04:38in person and I knew that I
04:38 --> 04:40wouldn't feel comfortable at that
04:40 --> 04:42point using a telemedicine visit,
04:42 --> 04:46so I was able to get the in person visit
04:46 --> 04:50and then there was a bit of a struggle
04:50 --> 04:54and delay with trying to get imaging
04:54 --> 04:57going because my understanding is that
04:57 --> 05:00a lot of imaging centers had decreased
05:00 --> 05:03capacity or maybe even temporarily closed.
05:03 --> 05:05So I did have to
05:05 --> 05:08advocate for myself to get that imaging
05:08 --> 05:12done and to be very clear that this was not
05:12 --> 05:15routine screening, although that should not
05:15 --> 05:17be deferred either,
05:17 --> 05:20but rather that this imaging
05:20 --> 05:23was diagnostic and those days
05:23 --> 05:28I mean I can remember the seconds, minutes,
05:28 --> 05:34hours and days between visiting my OBGYN and
05:34 --> 05:36getting confirmation that yes,
05:36 --> 05:37this is cancer.
05:37 --> 05:39That was a really,
05:39 --> 05:41really difficult time.
05:42 --> 05:46Tara maybe I'll bring you in here,
05:46 --> 05:49you know, during the pandemic
05:49 --> 05:53talk a little bit about how as a
05:53 --> 05:56health care provider and as
05:56 --> 05:59a chief patient quality officer,
05:59 --> 06:00patient experience Officer,
06:00 --> 06:04things kind of shifted during the pandemic.
06:04 --> 06:07What were the approaches in terms
06:07 --> 06:11of clinic visits in terms of imaging?
06:11 --> 06:15How did facilities shift and what
06:15 --> 06:18ramifications do you think that had?
06:19 --> 06:22Thanks Anees,
06:22 --> 06:25I feel like in recalling and listening
06:25 --> 06:28to Christina's story, it brings me back.
06:28 --> 06:30I'm also a breast cancer oncologist,
06:30 --> 06:33so I treat patients with breast cancer,
06:33 --> 06:36and I vividly remember the process
06:36 --> 06:38of going through a national shutdown
06:38 --> 06:40and talking to many institutions
06:40 --> 06:43on how they're handling it.
06:43 --> 06:45And then I remember the Yale
06:45 --> 06:49response and I have to say that
06:49 --> 06:52with the guidance of the CDC,
06:52 --> 06:54we did everything we could
06:54 --> 06:56to keep our patients safe.
06:56 --> 06:58It was very disorienting.
06:58 --> 07:01As a provider, I was in clinic,
07:01 --> 07:042 1/2 days a week,
07:04 --> 07:04most weeks,
07:04 --> 07:07and then we went through a complete
07:07 --> 07:10shutdown where we really minimized
07:10 --> 07:12in person visits because of the
07:12 --> 07:15virus and really tried to focus on
07:15 --> 07:17the patients who were receiving
07:17 --> 07:19in person IV chemotherapy.
07:19 --> 07:22And so you know,
07:22 --> 07:24patients like Christina coming through,
07:24 --> 07:26we really stressed over what to
07:26 --> 07:28do about patients with suspicious
07:28 --> 07:31findings or needing diagnostic imaging
07:31 --> 07:34that fortunately at Yale,
07:34 --> 07:37I think, that never stopped.
07:37 --> 07:39There were many routine imaging
07:39 --> 07:41that was deferred.
07:42 --> 07:45And we're still feeling the effects of that.
07:45 --> 07:49Yale is a system that I have to say I thought,
07:49 --> 07:52did a really wonderful job
07:52 --> 07:53especially in communicating,
07:53 --> 07:56because this was the first time for
07:56 --> 07:58any of us to go through a pandemic
07:58 --> 08:00and so really understanding the
08:00 --> 08:02protocols and how things are changing
08:02 --> 08:05everyday was paramount in our response,
08:05 --> 08:07and as a provider I felt very well
08:07 --> 08:10informed and I was able to convey
08:10 --> 08:12those messages to my patients.
08:13 --> 08:15So Christina ultimately, you
08:15 --> 08:18were able to advocate for yourself,
08:18 --> 08:20which I think is such a strong
08:20 --> 08:22message for patients at large,
08:22 --> 08:25whether there is a pandemic or no pandemic,
08:25 --> 08:27but particularly during these times,
08:27 --> 08:29to advocate for yourself to get
08:29 --> 08:32the in person visit with your OBGYN
08:32 --> 08:34to get the diagnostic imaging,
08:34 --> 08:37and it sounds like ultimately to
08:37 --> 08:40get the biopsy and the diagnosis.
08:40 --> 08:42And so then what happened?
08:45 --> 08:48After the diagnosis was confirmed,
08:48 --> 08:51I was referred to a medical oncologist
08:51 --> 08:55and a breast cancer surgeon,
08:55 --> 08:57and then shortly afterwards,
08:57 --> 08:59my radiation oncologist,
08:59 --> 09:03so I started to have that treatment
09:03 --> 09:06team built up around me and
09:06 --> 09:09I have an awesome treatment team.
09:09 --> 09:11Doctor Tristen Park,
09:11 --> 09:15my breast cancer surgeon, Doctor Knowlton
09:15 --> 09:17my radiation oncologist and doctor
09:17 --> 09:20Kanowitz, my medical oncologist.
09:20 --> 09:23They've all been wonderful,
09:23 --> 09:29so it may sound a little strange, but
09:29 --> 09:31once the diagnosis was confirmed,
09:31 --> 09:33I had this team,
09:33 --> 09:35we started putting plans in place,
09:35 --> 09:39it was a little bit less of the unknown.
09:39 --> 09:42I'm somebody who likes to have a plan.
09:42 --> 09:45OK, this is what we're going to do.
09:45 --> 09:48This is how we're going to approach this.
09:48 --> 09:51These are the people you can contact
09:51 --> 09:54with questions or when you need help,
09:54 --> 09:57so getting that ball rolling felt
09:57 --> 09:59like a bit of a relief to me.
10:03 --> 10:05And were those visits that you
10:05 --> 10:07had with those providers in
10:07 --> 10:10person as well?
10:10 --> 10:15Some were and some weren't, and now I'm
10:15 --> 10:18recalling some things from earlier on,
10:18 --> 10:21I do recall that initially when I was
10:21 --> 10:24scheduled with my breast cancer surgeon,
10:24 --> 10:28it was set up as a telemedicine
10:28 --> 10:30visit and I didn't quite understand
10:30 --> 10:32the rationale behind that,
10:32 --> 10:35and was sort of wondering,
10:35 --> 10:38is this best to meet her for
10:38 --> 10:41the first time over Tele Medicine
10:41 --> 10:43when she's somebody who is
10:43 --> 10:47going to be operating on me so I actually
10:47 --> 10:49reached out to Doctor Park directly
10:49 --> 10:53and asked her if she felt that that
10:53 --> 10:55was the best thing to do clinically to
10:55 --> 10:59meet for the first time over Tele Medicine,
10:59 --> 11:02or if she thought it would be more beneficial
11:02 --> 11:05to come into the office in person.
11:05 --> 11:07She was extremely responsive,
11:07 --> 11:09and gracious and said no,
11:09 --> 11:11I would prefer
11:11 --> 11:14to see you in person so
11:14 --> 11:17she switched the visit from Tele Medicine
11:17 --> 11:21to in person and I really appreciated
11:21 --> 11:24that flexibility and input from her
11:24 --> 11:28because this is not my area of expertise,
11:28 --> 11:31I don't know sometimes is
11:31 --> 11:34it better to see somebody
11:34 --> 11:35in person versus telemedicine.
11:35 --> 11:37The risks versus benefits there.
11:37 --> 11:40So I really had to depend a lot
11:40 --> 11:43on the team and let them tell
11:43 --> 11:46me what's the better way to go.
11:46 --> 11:48But for example,
11:48 --> 11:50my first meeting with Doctor Knowlton that
11:51 --> 11:53was telemedicine and that was more
11:53 --> 11:56or less to establish a relationship
11:56 --> 11:58with her and for her to hear a
11:58 --> 12:01little bit more about my history,
12:01 --> 12:02knowing that the radiation
12:02 --> 12:05was going to be at the
12:05 --> 12:07tail end of my treatment
12:11 --> 12:13and that even allowed me to
12:13 --> 12:15work almost a full day
12:15 --> 12:17and just take
12:17 --> 12:20an hour out to go somewhere quiet
12:20 --> 12:22and private and do the telemedicine
12:22 --> 12:24visit and then get back to work.
12:25 --> 12:27So certainly, I mean,
12:27 --> 12:31it seems like the pandemic which
12:31 --> 12:33caused this versioning of Tele health
12:33 --> 12:36visits might actually have been a little
12:36 --> 12:39bit more convenient for some visits.
12:43 --> 12:47How did you kind of think about
12:47 --> 12:50which visit should be Tele medicine,
12:50 --> 12:52which visit should be in person.
12:52 --> 12:55And going forward, do you think that
12:55 --> 12:58Tele Medicine might play an increasing role,
12:58 --> 13:00particularly when you hear
13:00 --> 13:01stories like Christina's
13:01 --> 13:03where
13:03 --> 13:06you can work the whole day and just take
13:06 --> 13:09an hour off for the visit instead of
13:09 --> 13:12having to take half a day off,
13:12 --> 13:13find parking,
13:13 --> 13:15and go through the whole rigmarole
13:15 --> 13:18for what might be the same visit.
13:20 --> 13:22Yeah, when the pandemic first started,
13:22 --> 13:25we often didn't have a choice.
13:25 --> 13:27Many of our visits were converted
13:27 --> 13:30to Tele medicine again in the hopes
13:30 --> 13:31that we weren't exposing patients
13:31 --> 13:34to a contagious virus in person.
13:34 --> 13:36So a lot of our new patient visits
13:36 --> 13:39where we would normally see them in the
13:39 --> 13:42office were done on Tele medicine in
13:42 --> 13:44retrospect some of that was good.
13:44 --> 13:46It was very disorienting.
13:46 --> 13:48You know, we're all learning new
13:48 --> 13:50ways to take care of patients,
13:50 --> 13:53and I think as time goes forward,
13:53 --> 13:55the most important thing will
13:55 --> 13:56be what Christina mentioned,
13:56 --> 13:58which is a shared decision.
13:58 --> 14:00Are you comfortable doing this
14:00 --> 14:01on Tele medicine?
14:01 --> 14:03Do you feel there is a good reason
14:03 --> 14:06to be seen and examined in person?
14:06 --> 14:08And I think providers are learning
14:08 --> 14:10the value of listening to those
14:10 --> 14:11patient preferences in order
14:11 --> 14:13to accommodate and honor
14:13 --> 14:14what is preferred and
14:14 --> 14:15probably what's necessary,
14:15 --> 14:18so patients know inside it's
14:18 --> 14:21OK to just do this one on video and
14:21 --> 14:23next time in person or they know
14:23 --> 14:25I think I need an exam and we
14:25 --> 14:27need to really pay attention to
14:27 --> 14:29those preferences and honor that.
14:29 --> 14:31We're going to take a short
14:31 --> 14:33break for medical minute and then come
14:33 --> 14:35back to learn more about Christina's
14:35 --> 14:37experience with cancer and the Covid
14:37 --> 14:39vaccine right after this short break.
14:39 --> 14:40Please stay tuned.
14:41 --> 14:44Support for Yale Cancer Answers
14:44 --> 14:47comes from AstraZeneca, working to
14:47 --> 14:50eliminate cancer as a cause of death.
14:50 --> 14:53Learn more at astrazeneca-us.com.
14:53 --> 14:56This is a medical minute about Melanoma.
14:56 --> 14:58While Melanoma accounts for only
14:58 --> 15:00about 4% of skin cancer cases,
15:00 --> 15:02it causes the most skin cancer
15:02 --> 15:04deaths and when detected early
15:04 --> 15:06Melanoma is easily
15:06 --> 15:08treated and highly curable. Clinical
15:08 --> 15:10trials are currently underway to test
15:10 --> 15:12innovative new treatments for Melanoma.
15:12 --> 15:15The goal of the specialized programs
15:15 --> 15:17of research excellence in skin cancer
15:17 --> 15:20or SPORE grant is to better understand
15:20 --> 15:23the biology of skin cancer with a focus
15:23 --> 15:26on discovering targets that will lead
15:26 --> 15:28to improved diagnosis and treatment.
15:28 --> 15:30More information is available
15:30 --> 15:31at yalecancercenter.org.
15:31 --> 15:35You're listening to Connecticut Public Radio.
15:35 --> 15:35Welcome
15:35 --> 15:37back to Yale Cancer Answers.
15:37 --> 15:39This is Doctor Anees Chagpar and
15:39 --> 15:41I'm joined tonight by my guests
15:41 --> 15:44Christina Allen and Doctor Tara Sanft
15:44 --> 15:46and we're talking about Christina's
15:46 --> 15:49journey with cancer through Covid,
15:49 --> 15:51and ultimately to the Covid vaccine.
15:51 --> 15:54So Christina right before the break
15:54 --> 15:57you were telling us how you were
15:57 --> 16:00diagnosed right during the pandemic
16:00 --> 16:03and you ended up having some of
16:03 --> 16:06your visits virtually some of your
16:06 --> 16:09visits in person tell us a little bit
16:09 --> 16:12more about how the decision-making
16:12 --> 16:15went in terms of your treatment strategy.
16:18 --> 16:20Sure. At the beginning everything
16:20 --> 16:25was so overwhelming for me and I
16:25 --> 16:28really didn't realize just how many
16:28 --> 16:31decisions there are to make about
16:31 --> 16:34the treatment and about the strategy.
16:34 --> 16:38And then what the options are.
16:38 --> 16:42I did my best to educate myself and
16:42 --> 16:47then of course I have to heavily rely
16:47 --> 16:51on my treatment providers and really
16:51 --> 16:55deeply trust them because they are
16:55 --> 17:00the experts at treating breast cancer.
17:00 --> 17:04I was worried all throughout that
17:04 --> 17:07Covid would possibly delay or
17:07 --> 17:10defer parts of my treatment,
17:10 --> 17:13although that did not turn
17:13 --> 17:17out to be the case,
17:17 --> 17:20so I was starting chemotherapy
17:22 --> 17:26about a month after we had
17:26 --> 17:28confirmed the cancer diagnosis,
17:28 --> 17:33I did make a decision to receive my
17:33 --> 17:37chemotherapy at one of the outpatient
17:37 --> 17:41clinics for Smilow in North Haven,
17:41 --> 17:43which was extremely convenient
17:43 --> 17:47for me, closer to my home,
17:47 --> 17:51and also much easier to park,
17:51 --> 17:56to get in and out of and also just less
17:56 --> 18:01congestion and traffic then Smilow proper.
18:01 --> 18:03So it was really,
18:03 --> 18:06really great to have that option
18:06 --> 18:10to use the North Haven location
18:10 --> 18:13for my chemotherapy visits.
18:13 --> 18:16And I felt very
18:16 --> 18:19safe there the entire time.
18:22 --> 18:24Tara, NOTE Confidence: 0.8432569
18:24 --> 18:27did you find that in your
18:27 --> 18:30management of breast cancer patients
18:30 --> 18:34that you may have switched
18:34 --> 18:36therapies or the sequencing of
18:36 --> 18:40therapies or the location of therapies
18:40 --> 18:42given considerations of the pandemic?
18:44 --> 18:47Yes, we did all of those things.
18:47 --> 18:50So fortunately we have a robust cancer network
18:50 --> 18:53here with locations all over the state.
18:53 --> 18:56And just as Christina got
18:56 --> 18:58her care in North Haven,
18:58 --> 19:01I frequently recommended my patients
19:01 --> 19:04be treated close to home rather than
19:04 --> 19:07coming down to the main hospital
19:07 --> 19:09for some period of time.
19:09 --> 19:11And even during that time,
19:11 --> 19:14some listeners may remember that
19:14 --> 19:17the cancer care was temporarily moved outside
19:17 --> 19:20of Smilow Cancer Hospital for some time,
19:20 --> 19:24and so I even practiced at a location in
19:24 --> 19:27Guilford for awhile while we were again
19:27 --> 19:31minimizing people coming into the hospital.
19:31 --> 19:34We also made modifications to the timing of
19:34 --> 19:38some therapies and that was consensus driven,
19:38 --> 19:42so we really spent some time listening to our
19:42 --> 19:45leaders and colleagues across the nation.
19:46 --> 19:48And I remember logging into many webinars
19:48 --> 19:51where there were conversations about
19:51 --> 19:54how to best care for patients without
19:54 --> 19:57compromising their curative treatments,
19:57 --> 20:00but minimizing their risk of exposure.
20:00 --> 20:03And I think that we made the best
20:03 --> 20:05decisions we could make at the
20:05 --> 20:06time and it was collective.
20:06 --> 20:08Oncology tends to work really well
20:08 --> 20:11together for the good of the patients,
20:11 --> 20:12and I felt that coming through
20:12 --> 20:13during the pandemic.
20:14 --> 20:17Yeah, and so Christina you ended
20:17 --> 20:19up getting your chemotherapy
20:20 --> 20:221st and then what happened?
20:22 --> 20:25How long after that did
20:25 --> 20:27you embark on surgery?
20:30 --> 20:34I recall asking Doctor Park how soon
20:34 --> 20:38after chemotherapy can I have
20:38 --> 20:41my surgery and her response was
20:41 --> 20:46four weeks would be the minimum and I
20:46 --> 20:50think my surgery was like 4 weeks to
20:50 --> 20:54the day that I ended chemotherapy.
20:54 --> 20:58I was ready for the next step
20:58 --> 21:02so there really wasn't any disruption.
21:02 --> 21:04The planning went pretty smoothly.
21:04 --> 21:08I was extremely fortunate that I
21:08 --> 21:11did not experience any delays
21:11 --> 21:13in my chemotherapy,
21:13 --> 21:15I was able to have the treatments
21:15 --> 21:16as scheduled.
21:16 --> 21:19Of course, there were side effects,
21:19 --> 21:20but they didn't sideline me
21:22 --> 21:25so I finished as expected and
21:25 --> 21:27then exactly like 30 days later
21:27 --> 21:29I went in for surgery.
21:31 --> 21:33And so what was that experience like?
21:33 --> 21:36I mean you come into surgery.
21:36 --> 21:38Were you able to bring your family?
21:38 --> 21:41Did you have to wear a mask?
21:45 --> 21:48when you talked about Covid being like
21:48 --> 21:50this parallel line with your your cancer,
21:50 --> 21:53tell us how that kind of
21:53 --> 21:54influenced the surgical management.
21:56 --> 22:00Sure, so masks of course at
22:00 --> 22:03that point they were so commonplace,
22:03 --> 22:05and familiar that it's
22:05 --> 22:08just what what we do, right?
22:08 --> 22:12What was a little trickier was figuring out
22:12 --> 22:14who can be with me?
22:15 --> 22:19Can my husband be with me if he can?
22:19 --> 22:23Can he stay? What does he need to do?
22:23 --> 22:26What do I bring to the hospital
22:26 --> 22:30with me if he can't stay?
22:31 --> 22:34So that was a little trickier than
22:34 --> 22:38even right up to the day that I
22:38 --> 22:41was being admitted for surgery it
22:41 --> 22:44still wasn't clear which portions
22:44 --> 22:48he was going to be able to be there for
22:48 --> 22:51and how long he might be able to stay for,
22:51 --> 22:53so I think you get
22:53 --> 22:55more comfortable,
22:55 --> 22:57sort of living in gray areas and with
22:57 --> 23:00the unknown when you have cancer,
23:00 --> 23:02so that was just another something
23:02 --> 23:04that we sort of had to roll with.
23:06 --> 23:09It was more of, this is the bag I'm going to take
23:09 --> 23:11if you can't come with me.
23:11 --> 23:13If you can come with me,
23:13 --> 23:16I have this bigger bag that you're
23:16 --> 23:19going to take in with you and then there
23:19 --> 23:21will be another backup plan if needed.
23:21 --> 23:24So just trying to be flexible.
23:24 --> 23:27But he was able to stay with
23:27 --> 23:30me right up until I went
23:30 --> 23:33over to the operating room.
23:33 --> 23:36Tara, you know we
23:36 --> 23:38talk about cancer so often,
23:38 --> 23:41we talk about having a support
23:41 --> 23:43system and how important family is
23:43 --> 23:45and you know clearly the pandemic
23:46 --> 23:48kind of threw a wrench into familial
23:48 --> 23:51support where patients often
23:51 --> 23:53will have their entire families
23:53 --> 23:56with them at clinic visits or in
23:56 --> 23:58the hospital room or in the waiting
23:58 --> 24:01area for their surgeries and so on.
24:01 --> 24:04Tell us about how that that changed
24:04 --> 24:06with the pandemic and what adjustments,
24:06 --> 24:10if any, were made to compensate for that?
24:12 --> 24:14Yeah, thanks for bringing this up.
24:14 --> 24:17I think this is one of the most
24:17 --> 24:20painful changes that came with the
24:20 --> 24:22pandemic because of the risks,
24:22 --> 24:24the decision was made to
24:24 --> 24:26limit or restrict visitors.
24:26 --> 24:27And as you mentioned,
24:27 --> 24:29especially in cancer care,
24:29 --> 24:32those visitors, those loved ones are
24:32 --> 24:36so important to every step of the way.
24:36 --> 24:39And I think that that
24:39 --> 24:41decision was very difficult.
24:41 --> 24:43It was painful for everyone involved,
24:43 --> 24:46especially the patients and their loved ones.
24:46 --> 24:48You know, many efforts were made to
24:48 --> 24:51try to improve the communication.
24:51 --> 24:53Once a patient was hospitalized,
24:53 --> 24:53for instance,
24:53 --> 24:56we did a lot to try to ensure
24:56 --> 24:58communication with the family member
24:58 --> 25:01through all different types of media,
25:01 --> 25:05including face timing on rounds,
25:06 --> 25:08lending iPads to each room and then
25:08 --> 25:11we even had a system where there were
25:11 --> 25:13volunteers who called with updates every day.
25:13 --> 25:16I'm not sure that we did
25:16 --> 25:17that for every patient.
25:17 --> 25:19I know there were many patients
25:19 --> 25:20who felt that the communication
25:20 --> 25:22could have been better.
25:22 --> 25:25And I think that we
25:25 --> 25:27need to look at our processes and
25:27 --> 25:30going forward figure out all the
25:30 --> 25:32different ways that patients prefer
25:32 --> 25:34to be communicated with and then try
25:34 --> 25:38to do everything we can to spend that time
25:38 --> 25:39doing that communication,
25:40 --> 25:43in addition to all of this,
25:43 --> 25:45we were avoiding going into
25:45 --> 25:47rooms for the risk of exposing the
25:47 --> 25:50patient and I know that was also
25:50 --> 25:52a very isolating experience for
25:52 --> 25:55patients hospitalized during that time.
25:55 --> 25:57So it's something that
25:57 --> 25:58in retrospect,
25:58 --> 26:00we will analyze and understand
26:00 --> 26:02how we can do better,
26:02 --> 26:05and we continue every day to try
26:05 --> 26:07to maximize the chances that
26:07 --> 26:10patients and their loved ones feel
26:10 --> 26:12informed and cared for and heard.
26:13 --> 26:16And so then Christina,
26:16 --> 26:19you have your surgery and presumably
26:19 --> 26:24you get out of the hospital.
26:24 --> 26:25Then what happened?
26:27 --> 26:31So I was doing well enough that
26:31 --> 26:35I was able to leave the hospital
26:35 --> 26:39that evening and that was a
26:39 --> 26:43decision that was definitely
26:43 --> 26:46brought on by me and partially
26:46 --> 26:49because I wasn't able to have
26:49 --> 26:51family with me during that time.
26:51 --> 26:55I knew as long as my doctor felt
26:55 --> 26:59that it was safe for me to go,
26:59 --> 27:03I knew that it was going to be better
27:03 --> 27:06for my healing and recovery to be
27:06 --> 27:10around family and to be back home.
27:10 --> 27:15So I went in that morning and I was home
27:15 --> 27:17by like 8:00 PM that evening,
27:17 --> 27:20but my team, Doctor Park was
27:20 --> 27:23texting me that evening, the next day
27:23 --> 27:26checking in on me so I still felt
27:26 --> 27:30like I had a lot of support but had
27:30 --> 27:33the luxury of being back home where
27:33 --> 27:37I was going to get the best rest and
27:37 --> 27:41have the most help from family so
27:41 --> 27:43everything went pretty smoothly
27:43 --> 27:45once I got home.
27:46 --> 27:49Did you worry about potential covid
27:49 --> 27:52risk that your family could bring in?
27:52 --> 27:54That would affect you, particularly?
27:54 --> 27:58You know, not even after your surgery,
27:58 --> 28:02but even during your chemotherapy.
28:02 --> 28:04Was that concerning for you
28:04 --> 28:05in living with your family,
28:05 --> 28:07who you know presumably
28:07 --> 28:10were out in the real world?
28:10 --> 28:15Potentially exposed to the virus and getting
28:15 --> 28:19infected yourself?
28:19 --> 28:22Yes, I live with my husband and he
28:22 --> 28:25had to make a lot of sacrifices.
28:27 --> 28:31And think very carefully about who he
28:31 --> 28:35was around and where did he absolutely
28:35 --> 28:38have to go versus maybe want to go?
28:38 --> 28:42And I really didn't see much other family,
28:42 --> 28:44especially prior to getting vaccinated
28:44 --> 28:47myself and I also didn't bring my husband
28:47 --> 28:50into my chemotherapy treatment, even at
28:50 --> 28:53times when it was better under control.
28:53 --> 28:56And they said I could bring one person,
28:56 --> 28:59and I was worried about what he could
28:59 --> 29:01potentially be bringing into other
29:01 --> 29:04people receiving treatment as well.
29:04 --> 29:06So yeah, that was a worry.
29:06 --> 29:09I mean, it's still a worry.
29:09 --> 29:11Now, even after being vaccinated,
29:11 --> 29:12but less so.
29:14 --> 29:17So in our last minute just tell us
29:17 --> 29:20about your decision to get
29:20 --> 29:23vaccinated, when you got vaccinated and
29:23 --> 29:25how that went.
29:25 --> 29:27I was extremely fortunate that I'm
29:27 --> 29:30working in a hospital environment.
29:30 --> 29:33I work in an emergency room.
29:33 --> 29:36And my hospital did an amazing
29:36 --> 29:38job of rolling out the vaccine
29:38 --> 29:42to staff as soon as possible.
29:42 --> 29:45It was something I had been thinking about.
29:45 --> 29:47As soon as we started
29:47 --> 29:49hearing about a vaccine.
29:49 --> 29:51And of course I talked it over
29:51 --> 29:53with my medical oncologist before
29:53 --> 29:56moving forward with the vaccine.
29:56 --> 29:58But knowing the potential.
29:58 --> 30:01devastating effects of covid
30:01 --> 30:03and seeing what it did,
30:03 --> 30:05it really seemed like an easy
30:05 --> 30:08choice and the right choice for me.
30:08 --> 30:09Christina Allen
30:09 --> 30:11is a cancer survivor and Doctor Tara
30:11 --> 30:13Sanft is an associate professor
30:13 --> 30:15of medicine in medical oncology
30:15 --> 30:18at the Yale School of Medicine.
30:18 --> 30:19If you have questions,
30:19 --> 30:21the address is canceranswers@yale.edu
30:21 --> 30:23and past editions of the program
30:23 --> 30:25are available in audio and written
30:25 --> 30:26form at yalecancercenter.org.
30:27 --> 30:30We hope you'll join us next week to learn
30:30 --> 30:32more about the fight against cancer.
30:32 --> 30:34Here on Connecticut public radio.

Information

Patient Perspective: COVID Vaccine and Cancer with guest sDr. Tara Sanft and Christina Allen March 14, 2021 Yale Cancer Center visit: http://www.yalecancercenter.org email: canceranswers@yale.edu call: 203-785-4095