Understanding the unique challenges and concerns patients face following a gastrointestinal cancer diagnosis, the Simms/Mann-UCLA Center for Integrative Oncology has developed an orientation program to guide patients and loved ones through the range of services available at UCLA Health.
Navigated by staff psychologist Jenny Tran, PhD, the program also assists patients with connecting to ongoing virtual and in-person support services with Simms/Mann Center staff.
"These GI cancers are complex in nature because the gastrointestinal tract is involved in different functions of the body that can impact one another, or are located in difficult places to access and thus treat,” Dr. Tran said. “Understandably, it can be overwhelming for patients when they receive a diagnosis of GI cancer, and suddenly have all of these new referrals and additional appointments. We created this program to offer guidance about the various resources available to help them through coping with cancer and to offer education around how and when to utilize them."
Through the monthly orientation, Dr. Tran provides information about Nutrition Oncology services, Palliative Care for symptom management, and psychosocial support at the Simms/Mann Center. She also answers the many questions a patient may have about their cancer care navigation, where to call, and how to communicate with their doctor and care team. While she loves seeing patients in person, Dr. Tran said, offering the orientation and other services virtually broadens the reach of the Simms/Mann Center and decreases the demand on patients to travel long distances.
"We want patients across all regions — all the way north in San Luis Obispo, east in Alhambra, and down south in Laguna Niguel — to know about these recommended supportive care services at UCLA Health for GI cancers, and of course, about the special programs offered at Simms/Mann," Dr. Tran said, of the Center’s whole-person services. "They don't have to travel out to Westwood or Santa Monica to manage their symptoms or to receive support. They can meet with staff online, via telehealth platforms."
Learning about GI cancer
Dr. Tran defined “GI cancer” as a range of cancers affecting the gastrointestinal system, including the esophagus, stomach, colon, rectum, anus, gallbladder, as well as pancreas and liver.
"These vital organs are involved in the digestive system and play a major part in our daily functioning and well-being. It is involved in eating and processing food into energy for the brain and body, for our bowel movements to remove waste,” Dr. Tran said.
“As such, there can be many complexities that arise with GI-related cancers, so patients tend to have a range of questions and concerns at the beginning of their cancer care as well as throughout,” she said. "That is why we emphasize a team-based approach and collaboration with different providers and clinicians to address the needs of the whole person, not just the cancer. We want to normalize the range of emotions that arise, to recommend helpful supportive care services, and to empower them with clarity and confidence going forward."
The GI program is intended to provide a road map for patients who may already be referred to additional specialists, as well as resources to address needs such a finances, transportation, or peer and group support.
"This was created alongside their medical oncology doctors who are managing their cancer-directed treatments like chemotherapy or immunotherapy, as well as with those who are co-managing symptoms and treatment-related side effects like their palliative care provider or nutrition provider, such as a dietitian. There are a lot of different people to care for you now, so our orientation helps to organize new information being offered,” Dr. Tran said.
Quality of life
Dr. Tran said her mission and passion is to help patients and their loved ones feel taken care of during an overwhelming time in their life, to feel hopeful in moments of uncertainty, and to feel valued in accessing excellent whole-person care.
"Research has shown that utilization of supportive care services earlier on in their cancer care can improve the quality of life for the patients and may even reduce length or frequency of hospital stays," Dr. Tran said.
The feedback Dr. Tran and her team receive illustrates the success of the program. She smiles as she reads an email from a parent of an adult child with cancer who attended a virtual GI orientation:
"Jenny, I just wanted to say, thanks so much for helping to put this program together," the parent wrote. "As someone who has helped our son for over five years now, having all this information available through UCLA will be priceless."
A shared journey
During each orientation, Dr. Tran extends the opportunity for patients to talk to each other and share their fears or concerns after diagnosis and facing cancer. Group sizes vary, but six to eight people is typical, so the conversations are personal and intimate, Dr. Tran said.
"This orientation space often naturally evolves into a brief support group for people who have just been diagnosed or have been managing a GI cancer for longer. It can be very helpful for a patient to hear from others going through the same thing they face, but no one is obligated to share unless they really want to. Every orientation is a little different, depending on the patients involved," she said.
Personal interaction is one reason Dr. Tran prefers to present the virtual orientation live, rather than as a pre-recorded video.
"I think there's something special about sharing that space and time with others, even if in a virtual meeting. It is much more personal. We want to build connection with what's available and cultivate more of a personal understanding between patients when we get those opportunities to make this experience feel less isolating," Dr. Tran said.
"My hope is for patients to carry new knowledge and strategies with them during treatments or follow-up appointments, such as leaning in more to how to communicate with their oncologists, knowing what to ask for and from whom and when, or coping with stressful moments while waiting,” she said. “So they feel more comfortable and confident with being at the center of their care and can find their way if they ever feel lost.”
