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News Archive - Progress Newsletter Summer, 1999 Online

A Safety Net for Survival

For cancer survivors living with, through and beyond the diagnosis of cancer, issues of survivorship continually flow in and out of their lives. "We sometimes think patients can forget about their disease once they leave this hospital. But every day of their lives, they are reminded," says Lynn Dworzanin, R.N., M.S., nurse practitioner in U-M's Breast Wellness Clinic. For the first time, the U-M Comprehensive Cancer Center has initiated a clinic to recognize the special needs of long-term survivors in the pursuit of quality living.

Diane Heidenberger

When the clinic opened this past fall, Diane Heidenberger, eight-year breast cancer survivor, was the first patient. Diane had a lumpectomy at University Hospital in February 1991, followed by chemotherapy and radiation treatments. She then returned to the Breast Care Center for check-ups first every two months, then three months, then six months and finally every year. Along the way, she took part in a patient focus group that helped design the Breast Wellness Clinic and decided to switch her long-term follow-up care to this new clinic.

"I had mixed feelings about switching to the Wellness Clinic. I think that it is good for a patient in active treatment to see a living example of someone who has come through this. But I also felt that, as well as I was doing, I did not want to take the oncologist's time that could be spent with patients in active treatment," explains Diane.

She came away from her first visit to the Wellness Clinic with a wealth of information on survivorship issues and intends to continue her care there. "During the visit, I had a health exam, discussed my blood work and other tests, and then talked with my wellness provider about nutrition, exercise and other topics not directly related to my cancer. The staff really wanted to be in tune with how I was feeling beyond the cancer," says Diane, 43.

"This clinic emphasizes health rather than disease and promotes a healthy lifestyle with an emphasis on each woman's control over her own situation," explains Virginia LeClair, R.N., M.S., another nurse practitioner in the Breast Wellness Clinic. With 30-minute appointments, the staff of three nurse practitioners and one physician assistant can devote themselves to discussing many topics of importance to breast cancer survivors, including lymphedema prevention and management, menopausal symptoms, osteoporosis, sexuality and mental health.

As survivors move beyond their active treatments, new concerns and challenges arise. "You get a different perspective on things. You become more concerned about health issues that you hadn't thought of before," says Diane. When Diane started taking kick-boxing for aerobic exercise, she spoke with other breast cancer survivors and became concerned about taking precautions to prevent lymphedema (swelling due to blockage of the lymphatic vessels). Diane called the Wellness Clinic and had a prescription for a lymphedema sleeve the next day.

"I think of the Wellness Clinic as a safety net, and you need that," explains Diane. Along with the millions of cancer survivors in the nation, Diane has had to readjust to life in the healthy world again. After living so long within the medical community, this is not always easy. Many survivors experience separation anxiety from the medical staff members who have cared for them. Aches and pains take on a new meaning, and it is not always easy to know when to call a health care provider and even who to call.

The staff of the Wellness Clinic thinks of themselves as the friendly gatekeeper. When people call between visits, the staff helps assess the problem and determine if a return to the clinic is needed or if a visit to an internist or other provider is required.

"We continue to walk this journey of uncertainty alongside our long-term survivors. The Breast Wellness Clinic is a comfortable, secure, follow-up program that offers more than peace of mind regarding recurrent cancer, it offers satisfaction, self-esteem and hope," says Dworzanin.

Maxine Solvay
Promotion Coordinator, Cancer Center


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