Supportive care medicine is key to truly comprehensive cancer care

In City of Hope’s Rose Garden, visitors to the Los Angeles campus can find a key phrase rendered in a large wrought iron structure.

“There is no profit in curing the body if, in the process, we destroy the soul.”

These words come from early leader Samuel Golter, executive director of City of Hope for decades. More than a credo, they’re a distillation of the ethos that guides a world-class biomedical research and National Cancer Institute (NCI)-designated comprehensive cancer center rated among the “Best Hospitals” for cancer by U.S. News & World Report for 15 consecutive years.

One crucial implication of Golter’s credo: Defeating cancer isn’t enough. Care must tend to the physical, emotional and psychological burdens of people facing the fight of their lives. This is what supportive care medicine provides.

“Cancer diagnoses and treatments bring tremendous stress to families, with challenges that are uniquely personal,” said Robert Stone, City of Hope’s president and chief executive officer. “Providing patients with access to supportive care programs has a direct impact on their treatment outcomes and our ability to deliver value-based care.”

Establishing a model for transformative, compassionate care

City of Hope approaches cancer differently. The institution has emerged as a pioneer in evidence-based supportive care over the last 15-plus years and is now recognized as a national leader. More than 400,000 patients and family members have benefited to date.

City of Hope’s supportive care medicine department is the first nationwide to be integrated across specialties and woven into clinical care — a team-based practice sharply focused on saving life while safeguarding quality of life. The result is one of the largest professional programs in the country, and a model that has been labeled exemplary at academic meetings and in textbooks.

Beginning at intake, City of Hope’s team of more than 160 supportive care professionals provides cancer patients with physical, psychological, social and practical support services, all under one umbrella. This comprehensive program includes care navigation, mental health (including psychology and psychiatry), survivorship programs, specialists in cancer and aging, spiritual counseling, pain management, integrative medicine (such as yoga, massage and meditation), child life experts, palliative medicine and more — all with a focus on maximizing patient and family strengths, quality of life and the ability to best engage in their treatment journey and beyond.

Indeed, City of Hope’s vision of care makes all the difference for patients.

“City of Hope was there for me emotionally, spiritually and physically,” said Alex Tung, 46, who was treated for leukemia in 2014. “When I got to City of Hope, half of the treatment was the physical: the medical — the machines, the drugs and all that. The other half was a very holistic or spiritual process. Supportive care at City of Hope was holistic with an ‘H,’ and holistic with a ‘W,’ like whole.”

“It’s important that we support patients through the entire process,” said Richard Lee, M.D., a clinical professor in the Department of Supportive Care Medicine, who also serves as medical director of the Integrative Medicine Program.

A home away from home for patients and families

People who turn to City of Hope for help battling cancer find a welcoming hub for supportive care services at the Sheri & Les Biller Patient and Family Resource Center, where they receive the support, education and resources they need. These include patient navigation, a new-patient orientation class, wellness and educational workshops, support groups, a library of educational materials, counseling spaces and comfortable lounges.

“A big part of what City of Hope provides, aside from keeping someone we love alive, is being able to help us with those tough moments that we’re going through,” said Brett Modesti, whose family member received treatment at City of Hope. “The Biller Center became my home away from home where I could catch my breath and have a friendly conversation. I think that supportive care medicine and the Biller Center are every bit as important as the surgeons, the oncologists and the nurses.”

Later this year, City of Hope will open a second Sheri & Les Biller Patient and Family Resource Center on its new campus in Irvine, California. As in Los Angeles, this center will facilitate easy access to a wide range of supportive care programs. The Sheri and Les Biller Family Foundation recently donated another $10 million to City of Hope to help expand its supportive care offerings, both at its own sites and to hospitals across the country through advocacy, education, training programs, innovative technology and scholarship.

Cultivating innovation to address a need too often unmet

In addition to their sharp focus on their patients’ well-being, supportive care medicine experts at City of Hope help raise the bar for whole-patient cancer treatment nationally through their research.

Two City of Hope supportive care leaders will share expertise and ideas with oncologists from around the world at the 2022 annual meeting of the American Society for Clinical Oncology, which takes place June 3 to 7 in Chicago: Lee, of the Integrative Medicine Program, and William Dale, M.D., Ph.D., holder of the Arthur M. Coppola Family Chair in Supportive Care Medicine, professor and chair of the Department of Supportive Care Medicine and director of the Center for Cancer and Aging. Lee will be highlighting several research abstracts within the care delivery and regulatory policy track, and Dale will offer insights on “Decision-Making for Older Patients With Genitourinary Cancers.” He will address the risks and benefits of treatment in this vulnerable group, including multidisciplinary supportive care interventions, as well as the use of a geriatric assessment tool developed by City of Hope researchers.

Increasing quality of life while improving outcomes

As City of Hope investigators redefine the standard for supportive care, there remains much to be done to spread the word about the essential role of the discipline in cancer treatment.

Supportive care ultimately improves patient outcomes, especially when enacted early in the care process. It has been shown to significantly reduce inpatient stays, hospital readmissions and stays in the intensive care unit. There are also findings that it helps prevent complications and enhances patients’ experience, satisfaction and quality of life, as well as improving health equity for marginalized communities.

Unfortunately, fewer than 20% of U.S. cancer patients receive treatment at NCI-designated cancer centers like City of Hope, which offer core functions of supportive care medicine. This means that the vast majority of Americans with cancer get their care in community settings, where such resources are limited and of inconsistent quality.

“Older populations, people of color and economically disadvantaged communities face unique burdens and barriers to cancer care. Supportive care programs can level the playing field in health equity, giving all patients the care they deserve,” said Edward Kim, M.D., M.B.A., professor in the Department of Medical Oncology & Therapeutics Research and physician-in-chief of City of Hope Orange County.

Aside from efforts to spread supportive care to disadvantaged communities, expanding access to City of Hope's supportive care medicine will encompass patients in the organization’s recently acquired Cancer Treatment Centers of America sites, contributing to City of Hope’s goal of extending world-class care to more patients, families and communities.

Expanding access will enable more people to enjoy longer, healthier lives — body and soul —after a cancer diagnosis.

For more information about City of Hope’s supportive care program, please visit www.cityofhope.org/patients/departments-and-services/supportive-care-medicine.