The Dana-Farber/BWH program
Expertise in unrelated donor transplantation is just one of the strengths of the Dana-Farber/BWH program that attract people like the Maybergers, according to Soiffer and Joseph Antin, M.D., chief of the Adult Oncology Stem Cell Transplant Service. The program's international reputation has been built on both the comprehensiveness of the program and the physicians' continued refinement of clinical care.
From the patient's perspective, comprehensive care begins with a program nurse who guides the patient from the first visit through follow-up. During hospitalization, the patient's primary oncologist, a primary nurse and other physicians and nursing staff participate in care. Nutritionists, pharmacists, physical therapists, and other health professionals all support the specific needs of transplant patients. The Kraft Family Blood Donor Center at Dana-Farber and the Blood Donor Center at BWH collect whole blood and platelets for patients. And state-of-the-art laboratories support the clinical and research needs of the program.
Joseph Antin, M.D.
Two full-time clinical workers from the Care Coordination Department are also dedicated to the transplant program. Social workers provide emotional support, counseling for patients and their families, and ongoing psychosocial assessment. "We promote effective coping, communication, and mobilization of the patient's and family's own support systems throughout the transplant process," says Irene Goss-Werner, L.I.C.S.W. "Because the entire family is affected by this experience, we also address parents' concerns about the needs of children, helping them with their children's readjustment and ability to cope. We relate what other patients have found helpful and identify available resources."
The social workers put patients in touch with resource specialists if they need help with housing or transportation. They are also conduits to a wide range of support, including the chaplaincy service; One-to-One: The Cancer Connection, which matches patients with volunteers who have been through a similar experience; a support group for families of hospitalized patients; and two post-transplant support groups: the BMT Group Seminar for those recovering from transplant, and the Stepping Stones support group, which also deals with long-term survivors at least six months following transplant. When patients do not survive cancer and the effects of treatment, social workers support family members through their grief and offer bereavement counseling.
The social workers work in close collaboration with psychiatrists of the Adult Psychosocial Oncology Department. According to Chief Susan Block, M.D., "Transplant patients are trying to take in a lot of information.
They may feel overwhelmed with fear — of pain, of dying, with worries about finances, family, separation, loss of control, even the experience of having someone else's marrow." Block and other staff members offer counseling, prescribe medications for anxiety and depression, and echoing the social workers' goal, help patients and family members identify their existing strengths and resources and how to mobilize them.
"Inspiring...such a privilege" is how psychiatrist Grace Chang, M.D., describes her eight years of working with Antin and the most high-risk patients in the program. "I am impressed by the acts of courage, great and small, that the patients, family members, and staff carry out every day," she says. In addition to her work with patients, Chang is conducting a research study on CML patients, examining the relationship between health habits of patients and their long-term outcomes. Her goal is finding ways to improve those outcomes.
