• Meeting the Needs of Inner-City Cancer Survivors

    It's hard enough to face cancer treatment and the complications that may occur months or years afterwards – whether they're heart disease, anxiety, fatigue, sexual problems, or the risk of developing other cancers.

    So imagine confronting those challenges on top of pressing daily obstacles, such as poverty, lack of transportation, or even mistrust of the health care system.

    Such is the reality for many of the adult patients who typically visit Whittier Street Health Center, which serves some of Boston's neediest residents.

    Now Dana-Farber and Whittier are helping to lessen these burdens through a monthly cancer survivorship clinic at the Roxbury, Mass., center. The clinic, operated by Whittier clinicians, helps participants navigate the road to wellness through medical care and education delivered in a supportive and culturally sensitive environment.

    Launched in October 2008 with support and training from Dana-Farber's Adult Survivorship Clinic, the Whittier Street Health Center program provides each survivor with a personalized plan that describes how his or her illness was treated (such as diagnosis and dates), as well as recommended follow-up care (such as screenings) to address or prevent possible late effects.

    The collaboration, funded by the Texas-based Lance Armstrong Foundation (LAF), also offers monthly classes on topics including pain management, employment issues, physical changes, and nutrition.

    The clinic is one of several programs developed by Dana-Farber in recent years to extend its expertise and programming to help survivors of both adult and childhood cancers who are living in rural, suburban, and urban settings throughout New England.

    "The mission of our Community- Based Collaborative is to provide care and support to cancer survivors where they live and work," says Kenneth Miller, MD, director of the LAF Adult Survivorship Clinic and co-director of the Perini Family Survivors' Center at Dana-Farber with Lisa Diller, MD.

    "Through our partnership with Whittier Street Health Center, we have been able to develop a model of survivorship care that meets the cultural needs of its diverse population and, most importantly, provides access to high-quality cancer survivorship services within the walls of a community health center."

    The Whittier clinic has been steadily booked each month and has served patients ranging from age 40 to 75. Observers attribute its success to a strong staffing model that includes a nurse, social worker, and two case managers; enthusiastic support from the center's leadership; and alternating morning and evening clinic hours.

    They also credit the work of Dana-Farber staff, including nurse Richard Boyajian, RN, MS, APN, social worker Amy Grose, LICSW, administrator Maureen Flynn, and others who have provided ongoing training and guidance.

    "It's been a really strong collaboration," says Alma Petrovic, MD, MPH, former director of public health initiatives at Whittier. "The staff at Dana-Farber have been very flexible, and we really understand each other."

    For breast cancer survivor Debra Groomes, the Roxbury survivorship clinic provides a convenient and welcoming place to discuss her medical and emotional concerns and ask questions without feeling rushed.

    She has received literature, met with various providers, and attended a support group of survivors facing different cancers. That group "made it more comfortable for me to share," the 51-year-old says. "I knew I wasn't alone with this."

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