How the Pandemic Changed Cancer Treatements

Colin

Thank you for joining us for the Sick and Good podcast joining the conversation we have Amy Shapton with us Amy has a masters of health and military social work with 9 years of experience at the Sansum Clinic working at the Ridley Tree Cancer Center in Santa Barbara as the program manager of the oncology social work services but ah welcome Amy thanks for joining us.

 

Amy

Hi. Thank you guys for having me. It's good to hear from you. Both.

 

Dustin

Yeah, so Amy can you tell us a little bit about what got you interested in social work.

 

Amy

Absolutely so you know I've always been drawn to people and you know, kind of understanding their personalities and their history and their behavior so that would be you know, kind of what. Started my interest in getting involved in social work. Um, when I was growing up in high school I was part of some different outreach programs like young life. Um, and we did a lot of community outreach. To different places I think going out to like Mexico and building houses for people and really just getting into the community. There was something that stayed with me. Um and that's kind of what started this journey for me. Um. My father when I was 16 was diagnosed with cancer. He was diagnosed with Periangngioarcoma and had a 6 year battle with that and so I really understood the impact. That cancer has on the family system and how and started to you know, get a real sense of appreciation for the people that supported him and our family like the medical team. The social workers. The. Nutritionists the hospice workers just how everybody came together to fiercely advocate for him and our family and and you know once I accepted that i. Didn't have the math skills to go into marine biology then I decided to go into human services I got my bachelor's in human services and I went on to get my masters in health and military social work.

 

Colin

That's awesome. Thanks Sam was sure sharing that it certainly sounds like there's that personal understanding of what the impact of cancer has on a family union and and and that so sounds like it's really been.

 

Amy

Now.

 

Colin

Ah, driving force ah for your own personal work.

 

Amy

I think it. It's really helped me to be able to empathize on a deeper level with the the population that I work with and yeah, it's ah it's you know it's not not a easy thing to share with people but it's It's definitely part. Part of my story and helps me helps me with with my work. So.

 

Colin

Well, we'd love to hear about your work at the Ridley Tree Cancer Center can you tell us about some of the community outreach that you've done.

 

Amy

Yeah, so um, I working with it's really a joint effort. So my team and I we try especially during covid. It's just a keep our presence out there in the community and try to reach a wider ah audience. Especially. Um, you know people being isolated at home. So we worked on with marketing at Sandsom Clinic to get some community lectures out there in the fall we put out as a team. Um a lecture on. Using cognitive behavioral therapy to address unhelpful thoughts that come up while you're going through cancer which was really fun. Um to do with with my social workers and ah and and there was a good response out in the community. Um, we also have ah. Done some different recordings on our website on Ridley Tree's website for people to access any time having access to some different evidence-based um ah stress reducing techniques like progressive muscle relaxation. Um. Guided imagery some of these kinds of different relaxation techniques that can be really grounding. We're in the process. Um in 2022 in the spring where I'm we're I'm going to be working on a new community lecture on survivorship. So those are some of the. Community outreach things that we've been had going on over the last few months

 

Colin

That's interesting like I wonder how much of that is ah kind of that that pivot to ah then the pandemic you know it makes makes me wonder if ah, some of those resources would be more in-house and rather than having them recorded and on the.

 

Amy

Well absolutely I think you know switching over like if if we're focusing on the the impact of the the pandemic you know once Covid came about. We had to quickly um, quickly transition ah to working.

 

Colin

Ah website.

 

Amy

From home and not seeing our patients face to face anymore just trying to protect this population who are you know you know at extremely at risk with with the compromised immune systems and so we. Ah, it's you know, quickly learned how to use Zoom and turn all of our support groups into Zoom and into a Zoom platform doing counseling via Zoom or teletherapy. So it's it's it's definitely I think there's been positives and. You know obviously negatives with everything that's gone on with with cut well with having to make those transitions. Um, the there's been just and a huge increase in a need for.

 

Colin

Right.

 

Amy

More support for people's mental health I'd say during the pandemic. Um, and so we've definitely been very busy. Ah, but it's been nice to be able to have these different ah these mediums for for doing support I mean I personally have a. Cancer patient that ended up moving to Japan and so I'm able to do counseling with her over Zoom while she's over in Japan getting treatment over there and there's you know so those kind of positives being able to like people that live out more rurally are able to log in and. Be part of a community support group. So I try to look at the positives and things as well.

 

Colin

Yeah I think as being a a mental health provider I've definitely seen that that pivot to having more telehealth services offered um and and really how that has.

 

Amy

We.

 

Colin

Increased access to mental health treatment and services. Well want to ask about some specific resources that the really treat Cancer Center offers to cancer patients. Ah.

 

Amy

Absolutely.

 

Amy

Yeah, so oh sorry, go ahead.

 

Colin

Oh they I guess I could make make that more general questions. Maybe if you could just tell us about the resources.

 

Amy

Yeah, um, so our specifically our social work department. We try to get patients connected when they're starting their treatment and making sure you know we're we're completing biopsychosocial assessments. Stress screenings trying to identify any any stressors that are happening whether it's you know, regards to practical, emotional or physical um factors and so from there we work with. Our team of social workers and case workers and administrative assistance to get people connected to transportation assistance to um, getting food delivered to their house maybe getting them connected to outside agencies that also provide support like. And I can mention those a little bit later but um and then also obviously we provide counseling relaxation support groups Financial assistance. Um, really any we tried to access. Whatever. Resources are needed at the time whether it's you know, getting just some durable medical equipment like a walker or getting groceries at one of the like unity shop in Town. We just try to anything that we can help.

 

Colin

Yeah.

 

Amy

People with while they're going through this just to make their make their treatment easier is is really the goal of of our department.

 

Dustin

This sounds really rewarding to be able to provide so many resources to your patients.

 

Amy

You know it. It is really rewarding. It's I Wish there was It's never you know there's still. There's still are needs that are we're unable to fully meet. But I mean we do our best. We do our best in every situation too. To help.

 

Dustin

Okay, ah, can you tell us about your role in the oncology social work services.

 

Amy

Yeah, so so I'm the so I'm the licensed clinical social worker. Um So a big part of what I do is you know the social work with patients like I said doing counseling and connecting to resources doing Grant Writing. Um. Getting funds to Cover. You know their medical treatments and then I'm and then I'm also the program Manager manager so I manage our team of social workers we have ah we have 4 of us. Social workers One bilingual Social Worker. We have 3 caseworkers who are amazing and help support the social workers and the patients and our administrative assistant who helps you know with a lot of behind the scenes and getting patients enrolled into. Copay assistance programs to help cover their medical treatment. We have a gentleman who helps facilitate our prostate cancer support group and also have him on hand for. Patients that you know really would prefer to have a male because all of our social workers right now are are female So We like to have that ah ability to support patients. Yeah, did that answer your question.

 

Dustin

Um, yeah I think that did um so yeah.

 

Colin

It sounds like you're not doing enough. It's what I'm saying.

 

Amy

Ah I'm not I'm not that busy. So.

 

Dustin

It sounds really chill like you must be ah, spend a lot of time just in the break room watching Tv.

 

Amy

Ah, so let's wait that would be funny.

 

Colin

Yeah, lots of downtime in there.

 

Dustin

Yeah I don't I don't think a lot of patients really know what social workers do I mean from when I was a patient I wasn't really explained the social worker would just show up and just say hey are they feeding you are they do you feel like you are being mistreated.

 

Amy

I Think the.

 

Dustin

And I would just be like who is this person like are they a nurse. Oh they're not wearing a white coat. Um sure. Yeah I think they're treating me all right.

 

Amy

Well, that's good I'm glad they they were watching out for you. So but yeah I think they're they I think we try you know we try to act as a safety net just to to help support patients.

 

Dustin

Yeah, are they not watching offer others.

 

Amy

Through this whole process. This is one of the hardest things that a person goes through is as you guys know you know cancer diagnosis treatment and the impacts that has on your life. So Obviously we can't control that medical piece whatsoever. But. If we can instill a little bit of hope and joy and some levity that's kind of like where I That's what I try to do um and you know try to remove those those stressors those barriers to getting through treatment. That's. That's all I can do. That's all that we can do.

 

Dustin

That all sounds like amazing stuff and I yeah it's like what do the doctors do what? what? do? What do? the doctors Do it's sound like the social workers are ah where it's at and I think since the doctors have white jackets. Maybe.

 

Colin

Yeah I was just going to say like I provided joy and levity.

 

Amy

Acquier.

 

Dustin

Social workers should wear like gold jackets or like rainbow jackets. So everybody knows who they are yeah the gold the gold where's your gold Jacket Shooter mcgavin.

 

Amy

Ah, yeah, that's oh that's yeah, good like yeah, like that you know and I have to say this the the social workers I mean obviously I think that.

 

Colin

So they know that they've won the golf tournament.

 

Amy

We do amazing work. But you know we work with it's It's really a community. It's a team effort like it's the doctors the nutritionists the navigators, the genetic counselors people in research the the nurses the Nurse practitioners. The. Physician Assistants The you know the patient service representatives like everybody we all work together to get to you know, get patients through their treatment and so it's It's definitely a team effort I would say.

 

Colin

Yeah, that integrated approach and and what I'm really hearing is that the whole body approach.

 

Amy

Yep yep, and even you know outside of Ridley tree we work so close with different community agencies ah like cottage hospital the social work department over there. The financial assistance over there hospice of Santa Barbara you know getting food to patients through like food from the heart organic soup kitchen I mean I I could go on and on listing the people that help and help on a community macro level. So.

 

Colin

Yeah, yeah I was gonna ask about some of those community resources. You said to that you could speak to that I wanted to say if there's anything else you wanted to add as far as ah, assistance programs or anything that you feel would be kind of just a helpful to include.

 

Amy

Sure, yeah, um, yeah, so I mean obviously we couldn't do anything without the support of the cancer foundation of Santa Barbara and the funds and the generous donors that contribute to our. Salaries as well as to assistance for patients same goes for sandsom clinic. Um, both. Ah Ridley Tree and sansom has access to charity funds patient assistance funds for patients that are. Unable to afford or struggle financially with paying for their medical treatment. So we're able to use those in-house funds to help get them through There's also um, am I jumping into financial resources right now.

 

Colin

Sure if you'd like to I'm I'm certainly happy to have you take the lead.

 

Amy

Sorry.

 

Amy

Okay, um, so we also work with getting financial assistance for patients because a huge part of that an impact of ah you know going through this is not being able to work and. The financial hardship that results from that sometimes you know financial devastation. So we're able to work with some local foundations like the Cecilia fund to help with medical expenses. Ah Jefferson found ah Jefferson Foundation Help us pay for patients rent bloom again is a strategic partner and they have been instrumental in helping some of our female patients that have been impacted by um, by a cancer diagnosis and unable to work helping with like multiple months. Of rental assistance. Um, again, there's like so many I don't I will leave out so many if I try to name them so I'm just going to thank them all. But um, we also a big piece of what we do is the cost of cancer treatment itself is really expensive like the.

 

Colin

Amazing. So.

 

Amy

Medications um, some of the medications aren't covered by insurance and so the social workers we work on obtaining copay assistance funds and free drug funds through the manufacturers. So you know on a yearly basis. We secure. You know, um, multimillion dollars in funds for patients. So It's pretty pretty phenomenal.

 

Colin

I Think that is ah quite the comprehensive list of citizens of some programs and the the county and the that local area. Um, thank you very much for for sharing those? um you know one thing I was ah.

 

Amy

Yes.

 

Colin

Wanting to ask is if ah, there are specific barriers for the population that you serve or if there's ah perhaps adjustments that you've made to that specific population.

 

Amy

Absolutely um I think some of the barriers for patients you know, especially there. There's a ah ah large majority of undocumented workers and people here in Santa Barbara and so some of some of these ah these patients don't have insurance or um, you know are are working jobs that they don't have access to things like state disability or social security disability to. Help supplement their income. So it's I think a barrier is not. You know, not having health insurance. 1 thing. That's a challenge that I see pop up for our team is. If ah, somebody who's undocumented. They're in the process of becoming a citizen and they try to get they. They're they're trying to get access to healthcare like medical that can put a that can prevent them from becoming a citizen. Um, also like if there's a program called prucall which is for undocumented persons and you know if you sign up for prucall. It can give you full scope medical insurance. But there's a risk to that you have to sign off on. There's a chance that you know you could be deported so people are having to face. You know, losing leaving their families for getting healthcare and so I think that's that's a huge barrier. Um, and I don't have a solution for that.

 

Colin

Wow.

 

Amy

But we try to you know we we try to our our our goal is to you know, get people the the care that they need and so yeah, but that's ah, that's a big challenge I Think another. Barrier is just like cost of living in this community. Um I mean you can be making you know a pretty decent living but it usually just all goes to your cost of living and so If. Somebody's unable to work that can be a you know as I mentioned financially devastating and I you know? Um, um I try to help I try to help navigate that with patients as they go through this and try to connect them with resources that can help.

 

Colin

Yeah, yeah.

 

Dustin

From hearing about all these barriers I'm curious. Is there a particular case that you you were the most proud of being a part of.

 

Amy

O That's a throwing a curve ball for me. Um, fall Um, you know there's been so there's been like there's been so many cases where we've been able to um you know, just get people.

 

Colin

Curp. All.

 

Amy

Insurance get them grants ah get them ah connected to different resources getting them like ah like a ah dream grant ah, ah 1 case I had um couple years back which was. Pretty awesome. Obviously I can't mention any names. But you know this was a really young woman with colon cancer but a very young family and you know they were ah they lacked insurance and lacked support and we were able to. Get them. You know all of those things and we're able to help facilitate them going to Hawaii before she passed away so there's you know there's um, there's a lot of those stories I'd I'd say there's a lot of real I mean I think people there's that stigma. Around cancer as you guys know that it's like whenever I like mentioned that I work for oncology people are like oh that's that's really sad and really hard. But there's so much more positive that I personally took away from that. Um. That makes working through those barriers meaningful. So I hope that answered your question I went a little bit off.

 

Dustin

Yeah, no thank you for sharing all of that I mean the the positives outweigh the negative.

 

Amy

Yeah, that's kind of my how I approach this and you know that's that's what I try to do with with patients. So.

 

Colin

And I think what you were maybe referring to is that that stigma that there's that a cancer diagnosis is a death sentence and that ah you know having just even that label or diagnosis means that.

 

Amy

Okay.

 

Colin

It will be terminal. You know that was something that I had come across ah where you know I had a um you know someone that I grew up with ask my brother. You know if I had died yet and there's just that.

 

Amy

Yeah, yep, yes.

 

Colin

You know, kind of just misunderstanding of ah of what that means and it I'm hoping is something that hasn't been as prevalent I was obviously treated almost ah you know twenty years ago now um I can age myself at all aging myself.

 

Amy

Means.

 

Dustin

Ah.

 

Colin

Um, but ah with the in advances and and cancer treatment I think that um more I would hope that there isn't that same so ah stigmatized thought process or that same kind of misconception is that something that you still deal with it that.

 

Amy

So yeah I think.

 

Colin

That you were say kind of like referring to I just wanted to maybe make sure I was on point there.

 

Amy

Oh No apps. Absolutely I think you know and I I think what somebody gets a cancer diagnosis. It's just like life-shattering because there's still that that stigma there and if you haven't you know, known somebody that's gone through it or it hasn't really impacted your life. And a close way. It's It's extremely scary and so just trying to educate people and to encourage them not to do too much information seeking online telling them to talk to their doctors and. Have faith in their doctors because you know a lot of these a lot of these treatments have come such a long way. The side effects aren't as bad ah not saying that there aren't any side effects because obviously everybody's different. But I Think. Treatments have come a long way and people are living with cancer ah longer than they ever have and going into remission just celebrated ah a dear patient's birthday and she's in a remission-like State. So. There's ah, there's a lot of those stories I think another kind of backtracking a little bit are the cultural. Ah Stereotypes cultural norms that also kind of have an influence on how people deal with cancer. Well I think that's that's something that we have to be mindful of and respect in order for us to build that rapport with patients.

 

Colin

Certainly you know one thing I was ah hearing is that there's ah that recommendation not to do like the lazy Boy doctor I don't know if that's an actual term like. Ah, but just ah to look at Webmd You know my ah my field. Ah I think some things ah is ah that's come up is that social media relying on you know, ah even tiktoks to get some information based off of ah. Ah, medical care.

 

Amy

Um, yeah, absolutely I I try to I I try to you know at point people in a direction. That's they're going to get helpful information because having information is. Vital but yeah, there's a lot of misinformation out there and you know Dr Google will most definitely like will any side effect you have is you definitely have cancer I mean and we're all guilty of doing it. Um, but it it can have an impact on ah you know.

 

Colin

Dr. Gogor exactly

 

Amy

Impact on everything so being mindful being mindful of that is important.

 

Dustin

Yeah I can kind of relate to I think some of that thought process for patients is you're just feeling like a moment of doubt. So you're like oh maybe Dr Google has got an answer for me and unfortunately. Google doesn't like filter like humans do like oh you have this like Google just vomits like every single occurrence of whatever you're like looking for and it like is too much.

 

Amy

Yes, now is yeah.

 

Amy

Yeah.

 

Colin

Can certainly be overwhelming right.

 

Dustin

Yeah, you have like diabetes cancer renal failure. Um, you're also your your organs like your lungs are made possibly collapsing and you have like your nerves are falling falling out like you know you're just like.

 

Amy

Move.

 

Amy

But.

 

Dustin

My God All these things are happening to me like what.

 

Amy

Well I mean and yeah I mean like going down that rabbit hole that kind of like catastrophic way of thinking can just set you straight into um panic. So I think especially for people that are dealing with anxiety. It's ah.

 

Colin

Game over man game over.

 

Amy

Trying to use some grounding techniques in those moments or when you're start to go down that path can be really helpful in stopping that.

 

Colin

And I think going full circle makes me think of just those ah then resources that you have had kind of pivoted to online resources and the progressive muscle relaxation and and some you know.

 

Amy

So guided imagery up.

 

Colin

Positive images. Yeah, yeah, exactly.

 

Dustin

You know I just thought of like 1 like last question. Maybe we already covered it like but I was thinking like what does a social worker do from like day to day like what is like a moment to moment because I don't I'm wondering if any of our listeners.

 

Amy

Yeah.

 

Dustin

From the start we're like what does the social worker even do I heard Obama was a social worker but like what what is it that they do do they just talk to a lot of people.

 

Amy

Um, you know we you know like from in a day-to-day basis. Ah I can speak for my team and I we um were doing counseling between counseling we are following up on referrals for patients that are struggling. Emotionally. If they're needing transfer don't have transportation to get to their medical Appointments. We're calling them to help resolve that if they're um, you know unable to afford their rent. We're doing a full assessment and seeing what. Resources are available for them and getting them connected with that. Um, if they need to go on medical leave and they need their state disability paperwork filled out. The social workers are filling all that out getting it signed by the doctor getting it mailed in calling to see check the status of it. Um, we're doing you know, somebody's drug they you know potentially lifesaving medication isn't covered by their insurance and it's $10000 a month we are applying for free drug through the pharmaceutical company. Tracking that all the way till it's approved getting the medications delivered to the patients to the facility so it can be Administered. Um I mean the list kind of goes on and that's it Never It's I I say this like it. Never this never ends. It's a constant. Flow of needs of patients so we get sometimes multiple of the same kind of referrals in a day and sometimes they're completely different so but definitely yeah.

 

Dustin

Okay, yeah I have two I have 2 follow-up questions on that one being um, do social workers ever work for yourlance.

 

Amy

Ah, do we?? Ah yeah I mean um I I mean I don't we don't but I I think there's especially with this um with this kind of ah surge and need of telemental therapy. There's a lot more social workers being kind of recruited to do counseling just to meet the needs of all of these like these remote needs does that answer your question freelance.

 

Colin

Um.

 

Dustin

Yeah I think so I just I was thinking you know my mom was my mom was saying years ago. There needs to be somebody who does all of what you're saying who helps a patient who are outpatient.

 

Amy

And mayla.

 

Dustin

And I was like yeah, it's weird that there's nothing like that but an inpatient person has a social worker but an outpatient person whoop.

 

Amy

No well. Okay that that thanks for clarifying that. So so at Ridley Tree we are an outpatient ah we are an outpatient program and we also we help anybody that has cancer.

 

Dustin

Um, yeah.

 

Amy

So anybody in the community they don't have to be. They don't have to be a patient at Ridley Tree they can be a patient at Ucla They can be a patient at you know city of hope wherever it is we we help anybody that has cancer in the community. So in the sense. We are of freelancing. Um, but um, yeah I I hope that hope that addresses that piece.

 

Dustin

Okay, and my other question was when you do counseling with your clients or your patients. Um, what usually is a counseling session like is it just like trying to help them emotionally with like handling their situation or like with. Finding their resources that they need.

 

Amy

Yeah, it can that can also depend on the day. Um I All of our social workers are trained in using cognitive Behavioral therapy to address things like depression anxiety Pain Insomnia. And so these are all real common themes that come up while you're going through cancer treatment and so just meet the patient where they're at and and what their needs are that day. Um, you know sometimes ah sometimes like like I.

 

Colin

Great.

 

Amy

And told you guys I had langitis a couple weeks ago and I still did counseling with patients and I was just there on Zoom listening because they needed to talk so just being there for people to support them is really we just were constantly kind of shifting to. Meet the need of the patient in the in their moment.

 

Colin

Really like how you describe the social work the department as that safety net and 1 other thing I was kind of thinking of as I just hearing all the things that you do on a day- to day basis is is almost like a flight navigator. Or not that' not the flight navigator. What's the term I want to use here is like the the flight control tower right? You're yeah, you're really making sure that everything goes smoothly that everything's landing you know and that that you have that eyes on the skies and then get bigger picture.

 

Amy

The control tower. Oh.

 

Amy

I Think we try. Yeah, that's great that is great I think we definitely try. Um, we definitely don't always succeed I mean there's I think at one barrier that I mentioned earlier that I didn't mention earlier is just like the prevalence of homelessness.

 

Dustin

Wow, That's a great analogy colin.

 

Colin

Um.

 

Amy

Um, and homelessness and cancer and you know people coming to us that are really needing you know money for a hotel or money for ah trying to help get people into housing quicker and a lot of a lot of. Those things we just we don't have enough resources. We try to work with the community and the other community social workers to to advocate for patients. But there's there's a lot that we do There's and there's a lot that we. Are unable to do So I I say just want to I just wanted to point that out because I mean we do amazing work. But there's there's still stuff that you know it's a challenge for us as Well. So.

 

Colin

Yeah I'm I'm hearing there's I'm certain certain times when you want to be able to do more want to be able to help more but there's that those limitations or perhaps even barriers to that care like you were saying that the the homelessness in particular and at Santa Barbara County and and having that be.

 

Amy

Both you sir.

 

Colin

A particularly difficult then perhaps social problem that arises. Ah that makes cancer treatment and and services so hard to connect.

 

Amy

Well yeah, not to in on a negative note. But yes, it's It's an issue.

 

Colin

Ah, yeah, yeah, I'm really good at those some summarizing just ah, the negative and and having that be the way that we finish up but um.

 

Colin

Dustin did you have another question for Amy before we ah yeah.

 

Dustin

Before we conclude I just wanted to remind us of that great analogy that you shared earlier about what social workers do call in about how they're the the flight tower I think that's a positive note to end today's discussion

 

Amy

I Love it. It is hey I love that.

 

Colin

Yeah, and maybe just that a way to just do some adding name. So it's.

 

Dustin

So it's not like the very end like everybody said.

 

Amy

Ah, no, there's like I said I I think it's it's important for the people no matter no matter what while they're going through their their treatment is to keep living life. You know I I say I say this.

 

Dustin

Um, David.

 

Amy

A lot to patients that you know this is this is a chapter in your story. This is not your whole life book and in a lot of you know, not for everybody but for um, for the majority of patients I feel like there's a lot of post-traumatic growth.

 

Colin

In.

 

Amy

That happens through this experience. So.

 

Dustin

I Love that this is just a chapter in your life in your life your whole life book. That's like a really I think I might steal that for some of my clients.

 

Amy

Do it it. It doesn't.

 

Colin

You know it also reminds me of that quote from ah the shosh a or debs and where red says you you know, get busy living or get busy dying.

 

Amy

Yeah, yeah, yeah.

 

Dustin

Wow.

 

Colin

How about that for a last note. Ah.

 

Amy

Um, thanks you. Thank you guys for having me. It's been. It's been fun to chat with you both and appreciate the work that you're doing for this community and happy to.

 

Dustin

Um, oh yeah, that's that's it. That's it right? there? yeah.

 

Amy

Collaborate again in the future.

 

Colin

Thank you so much for speaking with us Amy and and sharing your expertise and your your perspective on the the work that you're doing in Santa Barbara

 

Amy

Thank you so much.