Patient Stories

Oncology Primary Care Clinic: Supportive Services for Cancer Survivors

In the U.S., 70 percent of people living with cancer have a second chronic medical condition such as high blood pressure or diabetes. Paying close attention to these conditions has become vitally important, as around half of survivors treated for cancers like breast, prostate, endometrial and thyroid are more likely to pass away from heart disease rather than their cancer.

Clinical studies show cancer survivors benefit from coordination of care between cancer specialists and primary care providers (PCPs). However, a large percentage of cancer patients do not have PCPs or feel their PCPs do not have sufficient training in the long-term effects of cancer treatment.

Region’s First Hospital-Based Oncology Primary Care Clinic

UC Cancer Center (UCCC) opened the region’s first hospital-based Oncology Primary Care Clinic in November 2019. The clinic delivers primary care services specifically targeted to the needs of adults with a history of cancer.

The Oncology Primary Care Clinic is staffed by Melissa Erickson, MD, family medicine physician, clinical director of the University of Cincinnati Cancer Center’s Cancer Survivorship Program and cancer survivorship team member at Cincinnati Children’s. Dr. Erickson brings extensive experience in cancer survivorship to the clinic.

“I’ve been the medical director of the survivorship program for a few years. In doing this work, I discovered that so many patients didn’t have an established primary care physician (PCP), and these were patients that had other conditions secondary to their cancer, like high blood pressure, diabetes—chronic illnesses that needed to be treated,” said Dr. Erickson.

“Sometimes they’ve never had a PCP; sometimes after having gone through all their cancer treatments they may have put their everyday wellness on the back burner.”

Dr. Erickson seized the opportunity to establish a hospital-based oncology primary care clinic embedded within the UC Cancer Center—bringing services directly to the patients. UCCC treats 2,000 new cancer patients annually.

Bobby’s Cancer Journey

Bobby Rogers is a 61-year-old two-time cancer survivor. He was diagnosed with colon cancer in January 2019 and had a colectomy procedure to remove part of his colon. In January 2020, Bobby found out he had prostate cancer and underwent a robotic prostatectomy to remove part of the prostate.

“I got through the first cancer diagnosis and then got hit with a second cancer — maybe some people would’ve given up; I wouldn’t give up,” Bobby said.

Both procedures were performed at UC Health, and throughout his cancer care it became apparent that Bobby didn’t have a primary care physician (PCP).

At every appointment, Bobby was accompanied by one or two of his friends — Dennis and Helen Sullivan — whom he met at OTR’s Community Church about five years ago. Upon hearing about Bobby’s cancer diagnosis, the Sullivans offered to take Bobby to his appointments and provide an extra set of ears as he navigated the healthcare system.

“I don’t have many friends or family to rely on, so I really needed Dennis and his wife, Helen, who understand medical terminology,” said Bobby.

“You don’t meet a lot of people who will go through all that without expecting anything in return — I give them all my blessings.”

Dennis Sullivan is quick to note that he isn’t a medical professional or a credentialed patient advocate. “Helen and I care, and we always say that when you go to the doctor for something important there should be at least two sets of ears at that appointment. The patient might be nervous, feeling overwhelmed, and might not listen closely or clearly because they’re processing intense emotions,” Dennis said.

Life After Cancer: Cancer Survivor Services

After surviving both cancer diagnoses, Bobby had some gastrointestinal symptoms and was concerned that it could be a sign of something serious.

He wasn’t sure which provider he should contact — he had a urologist, a GI physician, and specialists in oncology.

Then Bobby met Dr. Melissa Erickson.

“I met Bobby in October 2020. His initial concern was the fear of cancer recurrence based on his symptoms. I coordinated with all of his specialists, so everyone was on the same page, nothing was happening in isolation, and we came up with a plan,” Dr. Erickson said.

That plan meant moving Bobby’s scheduled scans up earlier to see what could be causing his symptoms. Dr. Erickson also referred Bobby to a dietician who could study his diet and alter it if it could be part of the problem.

“I’ve never had a PCP before meeting Dr. Erickson, and she’s been wonderful,” said Bobby. “She keeps me up to date on what’s going on with my body — I started off seeing her once a month, now I go every three months or so.”

Dennis and Helen were with Bobby the first time he met Dr. Erickson. “We were jubilant this type of care exists. My mother was a long-term volunteer at an oncology clinic, and she always told me that a patient’s disease is only a by-product — it isn’t their identity. Every doctor provides advice and care, but not every doctor is able to provide that in a personal way to the patient — Dr. Erickson does just that,” Dennis said.

Dr. Erickson took note of Bobby’s history of high blood pressure and seizures and she proceeded to lay out a comprehensive treatment plan.

Survivorship: The Journey to a Healthy Future

Once patients have completed their cancer treatments, the Survivorship Care Team, of which Oncology Primary Care Clinic is a part of, begins the process by listing every treatment the patient has had — chemotherapy, radiation, surgery, etc. — including important scans and pathology reports. Now the patient has comprehensive documentation of all their cancer care located in one place.

Next, patients’ treatment-related side effects are thoroughly addressed. “It’s known that cancer survivors often have side effects that came on during or after their cancer treatments,” said Dr. Erickson. “We check patients for anything that might make them high risk; for example, if they’ve had certain types of chemotherapy or radiation to their chest, we’ll order an ultrasound of their heart. We help manage treatment-related issues such as fatigue, peripheral neuropathy and depression. We also address wellness issues such as diet, exercise, smoking and being up to date on vaccinations.”

Now, Bobby can focus on living a healthy life with a bright future.

“Cancer two consecutive years in a row is by no means a good thing, but it’s also not a death sentence; it’s a challenge to overcome,” Dennis said. “With good doctors on your side, there’s no reason to believe you can’t rise to the challenge and Bobby certainly has.”

Bobby currently volunteers at the Seven Hills Neighbor House and enjoys going to church. “It’s lovely to know I am cancer free after all I went through,” Bobby said. “As long as you have air to breathe, just keep going and don’t ever give up. If you wake up in the morning you have the chance to keep fighting.”

First-Year Findings

Studies are being conducted to measure the impact this Oncology Primary Care Clinic has on patients’ quality of life, satisfaction and overall health outcomes.

Within the clinic’s first year, Dr. Erickson and her colleagues have collected data from 385 patients’ visits via electronic medical records. A sample of the results are as follows:

• Over half of the patients were treated for hypertension, a critically important aspect of cardiovascular health, as heart disease is one of the most common causes of death in cancer survivors.
• Depression and anxiety were commonly treated. Services were provided by social workers in the cancer center, psychologists within UC Health and medication management by the oncology PCP.
• Fatigue was the most common treatment-related side effect of cancer survivors. Patients were referred to UC’s world-renowned cancer wellness program to treat fatigue.
  
• Diabetes management — Patients were assisted with hyperglycemia related to cancer treatments, as well as management of Type 2 Diabetes.

Dr. Erickson’s passion is ensuring that patients with a history of cancer receive optimal care of chronic health issues, often related to their cancer treatment, along with attention to overall wellness through a healthy diet, exercise, smoking cessation and stress reduction.

In her spare time, Dr. Erickson enjoys biking, listening to true crime podcasts, playing the clarinet, gardening and going to Cincinnati Reds games. Most of all, she loves spending time with her husband, son and daughter.

The UC Health Oncology Primary Care Clinic is located within the Barrett Cancer Center and is open for appointments on Tuesdays from 9 a.m. to 1 p.m. and Fridays 9 a.m. to 5 p.m.

For more information about UC Health’s Oncology Primary Care Clinic, call 513-584-3200.