Patient Care
Cancer can be tough to swallow
Digital Swallowing Workstation (Photo courtesy Kay Elemetrics)
Swallowing seems automatic — something no one has to think about, like breathing or blinking. But for countless cancer patients, trying to take a gulp results in what’s called dysphagia — difficulties including gagging, coughing, dryness or pain.
The radiation therapy that knocks down cancers in the head and neck can often damage healthy tissue, too. And it takes more than 50 different muscles and nerves in the area working in perfect harmony to push food and fluid from the mouth to the stomach. That leaves a lot of room for error when it comes to swallowing.
City of Hope now is one of the few centers in California with a high-tech system that can help. Called the Digital Swallowing Workstation, the technology enables speech and language pathologists to watch what happens as a patient tries to swallow.
Tracing the process step by step, experts and patients can see which tissues aren’t working right during the swallowing process. That information leads to a sharing the right swallowing exercises or strategies along with educational resources that can make it easier for patients to enjoy eating again.
When radiologists treat cancer, the results are electric
City of Hope radiologists are using the NanoKnife, a medical tool that destroys tissue using electricity, to zap stubborn tumors that do not respond to chemotherapy or radiation and that lie in locations that are difficult to reach with traditional surgery.
NanoKnife (Courtesy of AngioDynamics)
John Park, M.D., chief of the Division of Interventional Radiology in City of Hope’s Department of Diagnostic Radiology, and several of his colleagues have started using the new unit. The NanoKnife consists of several probes wired to an electric source. While a patient sleeps under anesthesia, doctors carefully insert the probes into the patient’s body so they surround the tumor. The physicians know just where to place the probes because they use CT scans, real-time ultrasound or other imaging methods to see the tumor’s location and size.
Once the probes rest in place around the tumor, the physicians send pulses of electricity into the NanoKnife. Electrons jump from probe to probe, jolting the tumor and punching holes in the cancerous cells in their path. The electricity flows for as little as 30 seconds. When it’s over, the tumor cells are damaged beyond repair. The body’s immune system then steps in to clean up dead cells.
The NanoKnife also affects nearby healthy tissues, but unlike surgery and procedures that use extreme heat or cold to kill tumor cells, the NanoKnife leaves the basic structures necessary for the body to rebuild the area with healthy cells. Best of all, patients report little or no pain following the procedure. “Patients want to go home as soon as they wake up,” Park said.
According to Park, the NanoKnife is most commonly used to treat tumors in soft tissues, such as in lung, prostate, pancreatic and liver cancers. Because clinical researchers are testing how well the NanoKnife works for specific cancers, the device currently is used only for patients with no other options or as part of a clinical trial.
Zumba gets people movin’, movin’, to learn about colorectal screening
It can take a little creativity and education to get some people to go through a colonoscopy for the first time, but it’s worth it: When colorectal cancer is caught early, doctors can treat it fairly easily and survival rates are high.
A Zumba class gets people moving. (Photo by Patricia Duff Tucker)
City of Hope and its community partners are trying to spread the message about early cancer detection and colorectal health through an exercise craze that’s swept the country: Zumba.
Zumba’s Latin music booms and pulses with an infectious groove, getting dancers to jump and clap. Lines of Zumba fanatics routinely go out the door at exercise studios before classes start. That attraction recently drew participants to a series of Zumba classes in Duarte, Calif., — part of a health education effort by City of Hope’s Center of Community Alliance for Research & Education, or CCARE, and Set for Life, a community-based nonprofit focused on wellness. The groups plan to offer more classes in the future.
The class encourages health through fitness and provides potentially lifesaving health information for San Gabriel Valley residents age 50 or older. People attending an educational workshop about colorectal cancer can join the Zumba class for free.
The effort raises awareness about the importance of colorectal cancer prevention through healthy lifestyle changes and early detection. Just in time for Minority Cancer Awareness Month in April, the recent events aimed to reach Latino and African-American community members in particular. Latinos in the U.S. are less likely than people of any other ethnic group to get screened regularly for colorectal cancer. Too few African-Americans get screenings, too. Colorectal cancer tends to be more advanced when it’s diagnosed in these groups.
Recent sessions also introduced City of Hope experts to community members and featured a talk by City of Hope colorectal surgeon Julian Sanchez, M.D.
If you’re interested in Zumba, are age 50 or older or take care of someone 50 or older, and you live in the Los Angeles area, check City of Hope’s calendar or Set for Life, or call 626-644-7672 for any upcoming events.
Comfort in cancer care draws on pediatrics’ lessons — and on the input of patients
When you want to learn how to make cancer patients more comfortable in the hospital, go right to the source: Ask the patients themselves.
City of Hope Helford Clinical Research Hospital
Designers who created City of Hope Helford Clinical Research Hospital consulted patients and their family members to make sure the facility had the small touches that could make a big difference to people struggling with illness. They put sleeper couches in patients’ rooms, allowing family members to stay overnight. They created recreational spaces, too, and the hospital offers recreational therapists who play games with patients and organize events like bingo.
It’s part of a comfort movement among a few hospitals that was recently chronicled by ABCnews.com. The national news outlet highlighted leading treatment centers that draw on lessons learned from pediatric care to help adult patients feel more at home when they’re in the hospital.
In the article, patient Hannah Komai, 21, described her experience at Helford Hospital for treatment of bone cancer. “They offer a lot of opportunities to get out of the hospital room, so I was able to spend time outside the room so I wasn’t cooped up,” says Komai. She also praised the hospital’s use of smaller needles during her stay to draw blood, causing less pain.
City of Hope factors in the opinions and recommendations of two advisory councils of patients and family members — English and Spanish speakers — when planning programs and services. And the organization’s iCARE program aims to make patients and their caregivers welcome and comfortable when they arrive at the medical center.
Sometimes comfort comes from offering patients more choices. “We all know that kids can be picky eaters and typically have allowed them great freedom in menu selection while hospitalized,” says Shirley Johnson, R.N., M.S., M.B.A., chief nursing and patient services officer. “We now do that for adults, as well.”
