346 - Life After Cancer: Survivorship, Support & Next Steps (Kimmie Carney, RN)

Adjusting to life after a cancer diagnosis goes well beyond the initial treatment. Survivors adjust to a new normal that requires a comprehensive support plan and team to help them navigate survivorship. In this episode, Kimmie Carney, RN, care coordinator at the Nassif Community Cancer Center, joins Dr. Arnold to discuss survivorship support.

For more information, call the Community Cancer Center at (319) 558-4876 or visit communitycancercenter.org/survivorship. 

If you have a topic you'd like Dr. Arnold to discuss with a guest on the podcast, shoot us an email at stlukescr@unitypoint.org.

Transcript

Dr. Arnold 0:07

This is LiveWell Talk on Life After Cancer, Survivorship Support, and the Next Steps. I'm Dr. Dustin Arnold, Chief Medical Officer at UnityPoint Health St. Luke's Hospital. Adjusting to life after cancer diagnosis goes well beyond the initial treatment. Survivors adjust to a new normal that requires a comprehensive support plan and a team to help them navigate survivorship. Joining me today to discuss survivorship support services is Kimmie Carney, Care Coordinator at the Nassif Community Cancer Center. Kimmie, welcome to the podcast.

Kimmie Carney 0:38

Thank you. Good to be here.

Dr. Arnold 0:40

To start off, how'd you get interested in how'd you end up in Cancer Line? You know, we we don't blush, but you know, I've often said on the podcast that some of my favorite guests are people from the Cancer Center. So passionate about it. They just take ownership. They seem and really enjoy their job and enjoy helping people. How'd you end up over there?

Kimmie Carney 1:00

Um, well, ironically, I um had started my um nursing career in the emergency department, and I moved to the PACU. And when COVID hit, things changed a lot, and um, so I needed to find a new role. And I wasn't looking to be um in oncology, um, but I feel like nursing is a vocation, and I feel like I am called to um to this service as a nurse, and um I feel like God called me to this oncology department. I um have um I applied um just really unsure of what to expect. And when I met with the people during my interview in the um Helen G. Nassif's cancer center, I just felt at home. I felt right away.

Dr. Arnold 1:47

No, it's a good team, great culture. I mean, I I say that and I mean it.

Kimmie Carney 1:51

Yeah, they build each other up. Yeah, and we we really work cohesively with one another, and that is really paramount when you're working to make um things be patient-centered. And so we're I we're we have a great team, and I'm very fortunate to be a part of it.

Dr. Arnold 2:05

Well, I think this is I think this is gonna be an interesting discussion because sometimes when someone has cancer, that kind of becomes their identity, you know, and and then they survive it, but and then that all the resources that were helping them while they're being in cancer, uh, kind of goes away. And then, you know, then and that was so much part of their life, right? I mean, they survived cancer. And then then there's imagine there's kind of an emptiness afterward or potential for that. So tell me about your thoughts on that.

Kimmie Carney 2:45

So it's interesting that you bring that up because we pride ourselves at the Helen G Nassif Center. We there is no end. So survivorship starts at the day of diagnosis. And when those patients that are going through the cancer treatment, they are they're moving, they're praying, they're healing daily, every day to be a survivor. And so we as care coordinators are fortunate to be able to walk alongside them. Um, and at we are the only um cancer center in the community that offers a lifetime membership. So it doesn't expire. So even though they're in remission and their cancer is cured or potentially still fighting the cancer, we're there with them every step of the way. So we're we are unique in that.

Dr. Arnold 3:34

What is what are some of the services that you provide in that's that survivorship program?

Kimmie Carney 3:40

We have, of course, um, like myself, I'm a nurse and I'm a care coordinator. So we um provide a timeline. We let the patient know what to expect once they're diagnosed. Um some people, for instance, I am work a lot mostly with breast patients. And so we'll talk about they come into the office and we discuss what kind of cancer they have, that is treat treatable, that it's curable, that the potentially will start with surgery. They might need chemotherapy and radiation. So having a timeline empowers the patient to know exactly what's gonna go on. The caveat to that is that timelines do change, but they have the support system to back them up. Okay, well, we're gonna have to wait because now we need an MRI before we do that surgery. So having that support system there is very valuable. Um, we have oncology social workers, and their list is endless. They help patients provide transportation. We have patients from all kinds of areas in the community that come thankfully to Nassif Cancer Center, and so they can help with transportation. Some of our cancer patients are devastated, not because they have cancer, but they're providing care for people in their home, whether it be a child or a parent. And we can help those social workers can help them get respite care for the person at home. Um, they help with um insurances and um paying the bills. You know, we have a community that's been very, very blessed to provide monetary gifts to the cancer center. And so if that happens for a patient, our social workers are able to give them that help that they need. We have dietitians, um, patients who have been diagnosed with like a head and neck cancer, they are um oftentimes on a G tube. Right. And so we need to make sure that they're getting enough caloric intake and enough nutrients. And our our dietitians are very resourceful when they're going through chemotherapy. Our patients change their taste buds change, and so they don't, they're not hungry for certain things. And so different ideas the dietitians can bring to them, different menus and people that are healing from surgeries. We that we promote um protein intake to promote that healing. And so the dietitians are amazing at helping in that area. We have integrative wellness, which is um a huge um patient satisfier because we meet the patients where they're at. So they come in feeling being fully mobile, and then their bodies have changed after having chemotherapy or surgery or what have you. And Matt and Sadie, our exercise specialists, are able to meet with them potentially before surgery so that we can gain strength before they even have surgery, and then postoperatively um meeting them where their limits are and then increasing that strength as time goes by. We also have um massage therapy and the um Helen G Nassive Center does um they split the cost with the patients. We pay 50% of that so that the patients that are in need of that integrative wellness can get it, so that they're not limited because we all know that cancer is very, very expensive, and we want them to have the holistic approach besides the medical approach. Um, and we also provide Reiki therapy. So we have a whole modality of people that work cohesively together to um, you know, hey, I have a patient that I think would benefit from from your services, and it's been it's been wonderful.

Dr. Arnold 7:21

So they meet you from the beginning. I mean, this I don't have to survive cancer to to meet with you. Um what do you establish like a you know, I know you tailor treatment plans for cancer. Are do is do survivors have different because they're all coming from different places, they all have different needs. So I imagine the survivorship plan might be totally different for one person as opposed to someone else.

Kimmie Carney 7:47

You're right. And we could have five patients who have breast cancer or five patients who have colon cancer, and every story is different.

Dr. Arnold 7:53

Right.

Kimmie Carney 7:54

Every patient is different, every need is different, and it's important to us that we tailor that to each individual patient. We want our patients to feel like they're the only patient that we have when we're with them. Um, because that's the truth, that's who's on our mind. Um, and so absolutely, um, a patient who's had um colon cancer and is recovering from a uh surgery, abdominal surgery and a colon resection has an entirely different need than somebody who has had a neck cancer and needs to build the strength in their shoulders and in their neck, you know. So um, and that comes from different modalities. And it also the support services, you know, you might have five patients who have the same cancer, but they don't have family members in town. Um, so how can we help with transportation? You know, so there's absolutely every survivorship care plan, it does look different, no matter if you have the same cancer or not.

Dr. Arnold 8:48

And I see that, you know, you you see that in patients that have a good patients that have a good social support system tend to do better than patients that don't. You know, I think I mean what is the most severe punishment they can give a prisoner? Isolation. Absolutely, you know. Um, you know, so it we whether no matter how recalcitrant or curmudgeonly someone might be, uh, we we need to have companionship.

Kimmie Carney 9:19

Absolutely, you know, and I think we offer that in our um wellness center. The holistic approach that I mentioned earlier, we have classes like yoga, tai chi, meditation. Um, the list goes on. And they're they're weekly. We have them every week. And so there's a camaraderie. Um, most of those people that come to those classes are in remission. They're not still battling. Some of them are, but most of them are in remission and they're just coming home. They're coming back. You know, nobody wants to be a part of our family, but that's what we are at Hell and G. Nobody wants to have cancer, and we don't want that for anybody else, but we do have a family environment, not just of our staff, but the patients that continue to use our services. They know each other, they lift each other up, they pray for each other, they're, you know, they're a family and themselves. And we are fortunate enough to um assist in that. But it's really their journey that we're invited on, and that's a privilege.

Dr. Arnold 10:18

I mean, there's it's comforting a familiar face. I don't care what station or illness you might have, even if it's you know, the ballet, someone that knows your name and remembers you, it just it really does influence your outlook.

Kimmie Carney 10:34

It does. And I'll tell you, the our administrative um assistants are amazing. Um, Lisa and Rachel work when you first walk in our our center, they've heard patients in their in their stories, they've heard patients in their scaredness, and they will just step away from their desk and sit and they'll pray with that patient that needed it, or they will get the tissues for the patient that needs it. They know the those two gals know so much about of our patients because that's the face of our center. They're the smile, they're the calm when they walk in.

Dr. Arnold 11:09

Front office, whether any business. This isn't just healthcare, but any business, but specifically in healthcare, front office takes your practice or your clinic to the next level. Yeah, you know, there's this basic customer service, right? Yeah. Uh, but then that people that could take to the next level um are just something special. Yeah. I personally, I go to Dr. Butler, just they got a great front office, you know.

Kimmie Carney 11:35

They just you because that's where your identity starts. Yeah, you know, and they recognize that.

Dr. Arnold 11:40

That's your that's where so true. Um, okay, what if what if I've had cancer and I got treated at another hospital uh down the street or an outside house or mail? Let's let's do that. Let's say go to mail, I had a cancer, I'm treated there. Is there still an opportunity for me to participate in the survivorship program?

Kimmie Carney 12:02

100%. We welcome everybody. There are, it doesn't matter if you had your treatment here, if you were diagnosed here, or if you lived in Texas your whole life and just relocated here, anybody who's had a diagnosis of cancer is welcome to come to our our Helen G Nassif Community Cancer Center. Then we'll we'll meet with you and decide what ways we can serve you best. Um, and and with that, um, you know, we like I mentioned the classes, not everybody in that class has to have survived cancer. If you want to, if you've survived cancer and you're new to town and your wife is with you, come bring your wife, have your companion with you so that you feel a little bit more safe and secure. Always that they can bring a companion to any of the events that we have. And we have so many events. We have, besides our classes that we have weekly, we have our Christmas party for um the the patients who have children. Um, you know, we have that at the um country club. We have baseball games and hockey games and all kinds of events that are no charge to the patients or their families because we want them to continue to live. That's that's the most important thing. Yeah. That they feel seen, that they're able to do what they love to do and spend time with the people that they care about at no cost to them.

Dr. Arnold 13:17

Right. Well, don't you think it's true that I think a majority of patients, if not a supermajority, are motivated to survive illnesses because they have loved ones they want to still take care of and they don't want to leave them. Right. You know, I I don't really have a lot of patients who are like, oh, I want to survive this illness because I'm just selfish and I want to live to be a hundred. I don't hear that. You know, I don't feel that. I really feel like I have people that depend on me. Absolutely. I want to be there for them.

Kimmie Carney 13:46

Yeah, absolutely. And we're uh we're finding so many more young patients being diagnosed. That's why screening is so important.

Dr. Arnold 13:55

Yeah. We've we've talked about that. It's shifting down.

Kimmie Carney 13:58

It is. Um, you know, patients that I talk with um 40-year-old females that are coming in for their baseline mammogram, and they're finding out they have metastatic breast cancer or that they're they they have a breast cancer. Um, James Vanderbeek, a 46-year-old you know, actor, was diagnosed with colon cancer and died within two years. Um, he he had to, he did a GoFundMe page just shortly before he passed away because of the monetary um expenses that cancer can cause. And and so, yeah, it's not, it's they're not established. They're they're not, you know, not that it's easy for a 70-year-old to have breast cancer or colon cancer or what have you, but sometimes they're their um monetary goals have been met, and it's not as hard for them to pay for some of their cancer journey where some of these young kids or younger folks are really struggling because they still have little children at home that take so much money.

Dr. Arnold 15:02

So yeah, and I think that's pretty common that you know the people marry later in life than they did, you know, and then probably achieve that financial security later in life compared to previously. Yeah, so you're right, yeah, that's true. I've observed that.

Kimmie Carney 15:18

Yeah.

Dr. Arnold 15:18

We really haven't seen uh I went to the cancer conference about a week ago. Uh, and you know, we thought that when there was a pause during COVID for screening services, that we'd see kind of this tsunami. I've even used that term here in the podcast. And it it there's a drop-off of cancer diagnosis in it, then it just kind of went back right to where it was and the curve continues to increase in younger people. But there wasn't this wave of newly diagnosed, which is a good thing. It is, yeah. Which I think that probably tells us that what we did is the ones that were high risk and needed to be screened, we got them screened.

Kimmie Carney 15:57

We did. We did.

Dr. Arnold 15:58

You know, I think I think we got them into their mammograms, we got their colonoscopies done. Um, I I think that's a reflection that although the healthcare system felt to be on pause, it was still functioning.

Kimmie Carney 16:10

Absolutely.

Dr. Arnold 16:10

And the higher risk patients got the care they needed during that time across the country.

Kimmie Carney 16:15

I think that's true. I do think that's true because um most, you know, unfortunately, a lot of my breast cancer patients had a mammogram last year, and we're finding their breast cancer this year. And so that's why it's it's so important. That's why it's a yearly exam. Exactly. That's why it's yeah, exactly. And that's why colonoscopies are every few years, depending on what your first one showed. You know, it's there's a reason for it. And so um, absolutely, you know, those preventatives, you know, are vital to catching it. You know, we I patients will tell me, I I didn't have anything last year. Why what happened that you know, and nothing happened. You didn't do anything wrong. And yes, it is very small. And so, congratulations to you for coming back every year and having, you know, now it's only three millimeters and it's treatable and we can take care of it.

Dr. Arnold 17:05

Yeah, the uh for a lung knot, this is learned this at the conference that I didn't know for lung nodule to be one centimeter, that's it's doubled 40 times to get to one centimeter. So, you know, that's a lot of doubling that's taken place. And some of the newer modalities that are coming out, CART T therapy, etc., uh were really exciting. Yeah, you know, I think there's gonna be a lot of options to treat cancer, uh, utilizing the body's immune system. Uh I I really think there's a lot on the horizon, which is good. It is a beautiful thing. But it is concerning we're seeing younger people. We have higher cancer rates here in Iowa. Right. Um, you know, and everybody wants to the environmentalists want to attribute it to nitrates, the epidemiologists want to attribute it to, you know, something else. And I it's looking like it's just a multifactoral thing, a perfect storm, so to speak. They're not just one thing.

Kimmie Carney 18:01

Correct. Um that's what we feel too. You know, patients will come in and say, I have nobody in my family has any kind of cancer.

Dr. Arnold 18:07

Yeah.

Kimmie Carney 18:07

Yeah. Or they'll say, um, you know, their dad had prostate cancer. Well, prostate is a hormonal cancer, breast age, breast is a hormonal cancer. Pancreatic is a whole, you know what I mean? So just because we think we're safe, because uh a male figure had it, so I won't get breast cancer, or a breast cancer female thinks that my son is safe.

Dr. Arnold 18:28

But in reality, you know, if there's a history of cancer in your family, then uh radon came up a lot. Breakdown of I think it's uranium. I'm not sure, but uh I can't speak to that either. Yeah, I think it's breakdown of it.

Kimmie Carney 18:45

I know that radon is a huge concern.

Dr. Arnold 18:48

There's that's becoming more of a concern. Uh that was one of the highlights that I took away, as well as alcohol consumption. You know, I was working on some studies show that there really is no safe amount of alcohol. Right. Um, and that uh that is associated with can't, you know, cancers in general, right? Alcohol use. Uh but yeah, the radon, that was one that, you know, that was kind of 70s and 80s commercials, right? You know, and then kind of drifted away, but uh but coming back. So um easy to detect. I think you could get a radon detector. You can. I think newer homes, I think it goes into law this year. New new construction will have radon mitigation.

Kimmie Carney 19:31

And even to buy a used home, you have to have a radon inspection before you can.

Dr. Arnold 19:36

But but I think all new construction will have the mitigation starting in 2027 has to have the radon mitigation just built in.

Kimmie Carney 19:43

That's great.

Dr. Arnold 19:43

Or associated with limestone. That's regionally, it's uh more anyway. That's enough radon trivia for the thing. So how how can I how would a patient get enrolled in the survivorship take me to that?

Kimmie Carney 19:57

So we try to make it as easy as easy as we can. And so the um there'll be a number on the screen that you can call. Um, Lisa and Rachel will be answering those phones, or um we have a website as well. And you can just type in, you know, what your name is, your phone number, and um a couple information about your cancer that you did have, and we'll reach out and give you a call. And it's um it's not an email that will respond. We'll respond to your email, but we're gonna call you. We want to have a conversation with you to see how we can meet your needs. It's it's a patient-centered driven um situation, and so we want to meet the needs that they have and not just guess. So a phone call is a lot easier than just answering an email. So they they just send us the message and then we respond.

Dr. Arnold 20:43

Yeah.

Kimmie Carney 20:43

Excellent. Or if you're in the PCI building, you can always stop in in the front desk. Lots of times I'll have um patients that have been there before or somebody who's never been to the cancer center before, and they'll just stop in and they'll grab whoever, Rachel or Lisa will grab whoever is um available, and we'll just see how we can help that individual.

Dr. Arnold 21:03

That's outstanding. That's you you guys do a great job. Thank you. You know, and I don't I don't have any skin in the game. I don't, you know, uh from that standpoint, but I've just always impressed with the staff from the cancer center and the leadership that Andrea provides.

Kimmie Carney 21:18

Just we we do. I will I will say I think it starts at the top. Absolutely, always, always does. Yeah, they care about our us, they care about, you know, it's hard as a breast cancer coordinator. I've done the biopsy and then I call the patient and I tell them, I'm so sorry, but you've been diagnosed with breast cancer. Yeah, and so even though the pathology is what's changed their life, I'm the one who delivers it in in some situations. And um, before every phone call, I say a prayer for that patient because I just want them to be held. And um, and so I think that is uh I think it's a privilege to be able to walk with somebody and be a small beacon of light, if if I'm able to be.

Dr. Arnold 22:06

You know, and I I I've said this to other people and said it myself many a times. 30 years of practice, that's still a tough phone call or a tough conversation to have. Uh it doesn't get easier. Uh anybody that says that they're good at it is lying. Yeah. Um, because it's it's a tough situation to be in. And I guess in a way, it's good that it stays a difficult because that means I'm emotionally invested in caring for this person, this patient that's trusted me. Um, you know, if I if you get good at it, then you know you you might have some other personality traits that are I feel like that.

Kimmie Carney 22:45

I feel like when I can call the patient and it doesn't make my heart hurt, then I need to move on because routine.

Dr. Arnold 22:53

Yeah, yeah.

Kimmie Carney 22:54

Yeah.

Dr. Arnold 22:55

Well, as we say in medicine, on your worst day, you go home late, but just be happy because they needed you, you know, and that's that's why we do it. Yeah, you know, absolutely. You you started by saying nursing nursing's a vocation, a calling. I think that's true. I think healthcare in general is that way. It is because sometimes I say to myself, why would anyone sign up to do that? Right?

Kimmie Carney 23:16

Yeah.

Dr. Arnold 23:17

Why would somebody do this? Well, it's because it's a calling.

Kimmie Carney 23:20

Yeah, you know, it is absolutely yeah.

Dr. Arnold 23:23

Kimmie, thank you so much for joining me. This is always a great conversation. We have staff from the Helen G Nassif Community Cancer Center. Once again, this was Kimmie Carney, care coordinator at the Nassif Community Cancer Center. For more information, call the Community Cancer Center at 319-558-4876, or visit communitycancer.org backslash survivorship. Thank you for listening. Live well talk on. If you enjoyed this episode, don't forget to subscribe. And if you want to spread the word, please give us a five-star review and tell your family, friends, neighbors, strangers about our podcast. We're available on Apple Podcasts, Spotify, Pandora, or wherever you get your podcast. Until next time, be well.