Surgery is usually the first treatment for cancer. A surgeon might obtain a biopsy for diagnosis or remove the tumor itself. Radiation and chemotherapy before surgery may shrink the tumor and make it easier to remove. Leah Oman, MD, Manuel Lozano, MD, PhD and Paul Zaveruha, MD are experienced board-certified general surgeons. Dr. Oman (pictured) holds a Fellowship in Breast Diseases from the South Carolina Comprehensive Cancer Center. Even if you need specialized surgery off island, you can return to Whidbey for medical oncology care – chemotherapy and ongoing monitoring of the cancer.
Chemotherapy is often the second step for cancer that has been staged as needing additional treatment. Most chemotherapy is given intravenously (IV) in our light-filled outpatient infusion center. We provide two private treatment rooms and eight treatment chairs with numerous amenities in a supportive and comfortable environment. A growing number of chemotherapies are in pill form. (Learn more about the safe handling of oral chemotherapy.) We know chemotherapy can be a challenging experience for patients and loved ones. Our compassion, experience and understanding come from nearly 25 years of providing chemotherapy. You are in good hands.
Cancer care is usually managed by a medical oncologist, who also orders chemotherapy. Three expert medical oncologists from The Everett Clinic come to the island via the Providence Regional Cancer Partnership. Mark Coughenour, MD, Wendy Wang, MD, PhD, and Peter Jiang, MD, PhD see patients at Whidbey General’s Medical Ambulatory Care (MAC) clinic on Mondays, Tuesdays and Wednesdays, respectively.
They collaborate closely with local primary care providers, clinic nurses and inpatient staff. Most cancer care can be managed on Whidbey. If specialized care such as stem cell transplants or a research protocol is needed, your medical oncologist will refer you accordingly and help coordinate care. We want to help you stay in your community as much as possible.
Highly skilled nurses administer IV chemotherapies and teach people how to manage symptoms they may experience with either IV or oral medications.
Better symptom management helps ensure the person tolerates treatment well and stays on schedule. If they do, there is a higher success rate to beat the cancer. Our nursing staff, which is led by an Oncology Nurse Practitioner, includes more than a dozen Oncology Nursing Society-chemotherapy certified nurses. In addition, most staff are oncology nurse-certified. Many of our nurses are experienced in oncology nursing in bone marrow transplant, hospice/home care and inpatient settings.
- Radiation therapy is the third form of treatment and is usually given five days a week for two to six weeks. Radiation therapy is a portion of total cancer care, so patients do not need to get both chemo and radiation care off island.
- Therapy is coordinated with radiation centers in Sedro Woolley at United General Hospital, in Mt. Vernon at Skagit Regional Cancer Center and in Everett at Providence Regional Cancer Center. Referrals are usually made based on patient preference and convenience. A van is available from United General for those with transportation concerns. Passengers using the van report lots of fun and support for each other through treatment!
In addition to the above services, our interdisciplinary Cancer Program team includes expertise in Wound-Ostomy & Continence Care, Nutrition Services, Diabetes Management, Music Therapy, Tobacco Cessation, Acupuncture, Rehabilitation Services, Cancer Survivorship, Home Health Services and Patient Navigation.
Wound – Ostomy & Continence
People treated for cancer may experience skin damage, wounds or have ostomies due to the cancer itself or because of treatment side effects such as radiation skin damage. Specialized wound care may be required because chronic illnesses such as cardiac disease or diabetes, in combination with a suppressed immune system from treatment, may complicate wound healing. Whidbey General has three Certified Wound RNs with the education, experience and credentials necessary to provide top-notch wound care either through MAC/Oncology or Home Health Care. One nurse is also certified and experienced in managing ostomies and incontinence problems.
Supportive nutrition during cancer treatment is essential. Nutrition therapy can reduce chemotherapy side effects and enhance digestion and immunity. Once treatment is complete, targeted nutritional interventions can help correct the biochemical terrain that helped cancer flourish in the first place. Registered dietitian Lori Taylor, MA/MS, RD, CNSC (pictured), develops customized nutritional plans for patients. Trained in both conventional and natural medicine, Taylor brings the best of integrative nutrition to cancer care. She holds a bachelor’s degree in Biochemistry from UC Berkeley, a master’s degree in Education from Stanford University and master’s degree in Nutrition from Bastyr University.
Cancer care can complicate diabetes management because of steroids used during treatment or due to poor eating resulting from treatment side effects. Line Goulet, RN (pictured), is one of two Certified Diabetes Educators in the clinic with oncology nursing experience. Diabetes can be well managed. When blood sugars are under control, we can prevent further complications and keep people on schedule for their treatment.
Music can boost the immune system, enhance relaxation and decrease pain and/or anxiety. Music may help reduce the use of sedative and analgesic drugs. The Live Music Program brings in community volunteers to play music in the MAC clinic and elsewhere, which supports the healing environment at Whidbey General.
Licensed acupuncturists Ryan Vos and Carol O’Brien (pictured) are experienced in using acupuncture to help relieve symptoms such as nausea, pain, anxiety and fatigue. In 2010, Vos participated in a study with Bastyr University to examine the effects of acupuncture on chemotherapy-induced peripheral neuropathy. Vos and O'Brien provide acupuncture through Rehabilitation Services.
Rehabilitation is a growing area of focus as more people are surviving and living with cancer. Two Whidbey General physical therapists have more than 10 years experience in specialized management of lymphedema (swelling in arms or legs due to cancer or its treatment). Seattle cancer centers often refer patients to Whidbey General for this care. Rehab services are also provided for people struggling with “chemo brain” and memory changes. People are taught to improve their memories and given tools to cope with changes they are experiencing. Finally, research shows that physical activity can help people tolerate treatment better, as well as beat fatigue – a common complaint of patients. For a better quality of life with cancer, rehab services can help keep you as strong, active and safe as possible.
Cancer survivorship has been described as “living with, through and beyond cancer.” Survivorship starts at cancer diagnosis, a change from years past when such a diagnosis was considered a death sentence. In the future, Whidbey General will provide more services to, among other objectives, help survivors regain their strength after initial treatment and monitor and improve their overall health. At right, members of the Cancer Committee attend a webinar on cancer rehabilitation care, considered a key aspect of survivorship.
Read more about survivorship in this article from the fall 2014 Pulse magazine.
Home Health Care
Home Health Care is provided through Whidbey General. Services are available for many people as they experience their cancer journey. Home care may work with patients who are recovering from surgery or other treatments and require nursing management at home. People are required to be home bound, meaning that it takes significant effort to leave home for physician or clinic visits. Palliative care assists a person and their family during the final stages of their cancer journey. Spiritual care, social work and music therapy, along with skilled and experienced nurses work together to care for the dying person and their family. Pain control and symptom management are a major focus along with comfort for the family. Call 360-678-7605 or 360-321-6659 for more information on Home Health Care.
Patient Navigation Program
A cancer diagnosis is devastating to most people. The sheer volume of information about cancer and treatment options can be overwhelming and confusing. To help patients with cancer find their way through the health care maze, Whidbey General offers a Patient Navigation Program, which seeks to provide better access to cancer care and lead to more positive outcomes. Oncology-certified nurse Jackie Bruns, RN (pictured), one of our patient navigators, can answer questions on your diagnosis, care and symptom management. She can also refer you to those who can assist with financial or community resources. Learn more about our Patient Navigator Program.
For questions on any of our services, please call the Medical Ambulatory Care clinic at 360-678-7624 or 360-321-5173.