The Front Line of Urologic Cancer

George J.S. Kallingal, M.D., M.P.H., and Janet Schadee, M.S.N. - PHOTOS BY SADA LEWIS

JANET SCHADEE HAS TRANSFORMED the urologic oncology practice in our institution. First and foremost, she is the embodiment of superior patient care. All patients with urologic cancer know that Janet will go the extra mile to help them get the care they need. She works to find lodging, hospice care or skilled nursing facilities for our patients and their families. She often helps coordinate the travel and care for soldiers stationed far away to receive their cancer care in San Antonio. When their lives are stressed with cancer, Janet helps to ease the logistic and emotional concerns so they can focus on their cancer treatments. She never turns away patients, and goes through multiple boxes of tissues per week as she empathizes and gives hope to them and their families. Every patient knows where to find Janet. She is their lighthouse in turbulent waters.

This empathy comes from her long history in social work and medical care. She began her career working as a case manager for incarcerated women and neglected children. She helped direct camps to facilitate maternal and child care. She also provided home nursing care for critically ill children needing prolonged care. When she speaks about those neglected children, it becomes very evident how much she cares for them and how much they have impacted her life.

Since 2008, she has been a part of the military health system, dedicating her efforts to the care of our service members. Janet’s care for all of these patients shines brightly, and she genuinely values the contributions that these soldiers, their family members and retirees have given.

Most recently, in 2014, she became the urologic oncology nurse for the San Antonio Military Medical Center. Since starting, she has changed the culture and perception of cancer care for our patients. First, she identified the gaps in care. She organized and created a military prostate cancer support group. This group meets monthly for 35 to 70 attendees, and has been so valuable to both patients with prostate cancer and their significant others. They now have an entire support group to help them. Janet volunteers her time to run this meeting after hours. She also noted the fragmented care that we had for our patients with prostate cancer. Prior to her arrival, these patients would have an appointment with a surgeon, and possibly a second appointment with a radiation oncologist. However, this care was inconvenient and often did not help with the spiritual and psychological components of care. As a result, Janet helped create our Comprehensive Prostate Cancer Clinic (CPCC), where newly diagnosed patients come to meet with a multidisciplinary team that includes a surgeon, radiation oncologist, nutritionist, psychologist and chaplain, all in one day. So far, there have been over 200 patients that have come through the CPCC, and the reviews have been uniformly stellar and have led to very high patient satisfaction. This clinic has been esteemed throughout our entire hospital.

Janet also overhauled and organized the way in which we track our immense population of patients with prostate cancer and bladder cancer. Prior to her arrival, patients were on their own to remember follow-up appointments and coordinate their treatments. She identified all of the patients and created organized scheduling for their cancer treatments, education, physician appointments, radiologic appointments and supplemental care. Now, we have very few patients who forget a treatment or can get lost in the system. Furthermore, despite her many duties, she never delegates direct patient care. She truly values the time she spends educating patients and family members, just listening to them about their concerns or administering care such as hormonal injections. She has coordinated thousands of visits for these patients.

Janet also has been a prostate cancer activist on a health policy front. She was invited to and attended the ZERO Prostate Cancer Summit in Washington, D.C., to advocate for increased research funds for prostate cancer. She even recruited two prostate cancer survivors to join her in this venture. For the community at large, she has coordinated several cancer health fairs and 5K events. She has helped coordinate an all-expense-paid fishing trip for prostate cancer survivors with the Reel Recovery program. In addition, she conducts research and database management, and teaches our residents.

Janet has been the ultimate patient advocate. She advocates and helps our patients in every aspect of their lives, including cancer treatment, emotional support, coordination of care, research and health policy. I am truly blessed to work with her, and our institution is far better because of her efforts. She provides another level of medical care that goes far beyond the science of medicine — and our patients truly benefit.