SUMMER 2018 CHANGE IS HEALTHY 216-77-TREAT CANCER CENTER NEWS (216-778-7328)

Pharmacists Crucial to High Quality Care MetroHealth’s oncology pharmacists are in the treatment process and have Meeting with patients. Pharmacists an integral part of the cancer care team, ready access to providers to help them regularly meet with patients to address promising the evidence-based and safe make quick adjustments to complex symptom management, medication administration of chemotherapy and therapy plans. reconciliation and adherence. “We make “We’re really other medications to patients. Implementing quality and safety sure patients are taking any at-home “We help the provider ensure that they checks. Oncology pharmacists review medications or oral therapy at the right are administering the best care,” said all treatment plans for appropriate dose and the right time,” said Kover. engaged Jan Kover, pharmacy hematology/ weight-based dosing, drug timing In short, the oncology pharmacists make oncology specialist at MetroHealth’s and to ensure lab parameters providing cancer treatment safer, more Cancer Center. “We’re really engaged are appropriate for treatment. accurate and more successful. with providing with providing a great service for our Pharmacists check orders to confirm Meeting high compounding patients.” the medications are in the right fluid standards. All infusion locations a great at the right concentration, with the SOME OF THE MANY SERVICES meet the standards for sterile product appropriate bags and vials. “We PHARMACISTS OFFER INCLUDE: preparation as mandated by United also have a dispense prep and check States Pharmacopeia (USP) 797. This service Building all treatment plans in Epic process that occurs through EPIC that includes environmental protections such Beacon, an oncology electronic medical allows the technicians and pharmacists as special air flow workstations and record (EMR). “This allows us to alert to document that they’ve pulled the clothing to ensure pharmacist safety for our or communicate with providers about right product,” said Kover. the safety of medications,” said Kover. and product sterility. Participating in provider huddles. The pharmacy can also use the EMR Our pharmacists fulfill an essential role patients.” These meetings allow pharmacists, to notify physicians and nurses about on our cancer care team: supporting our physicians, nurses and other providers when bloodwork should be ordered for commitment to the care and safety of to discuss patients, prepare for the day’s treatment monitoring purposes. our patients. workflow and streamline care. Offering support at all MetroHealth infusion centers and the inpatient Preparing for the days ahead. unit. “We’re imbedded where doctors Pharmacists conduct a pre-review of are prescribing chemotherapy and incoming orders so they can identify nurses are administering it,” said inconsistencies in timing, dosing or Kover, adding that these locations delivery of a treatment regimen. They include MetroHealth Medical Center’s also verify that new or specialty drugs CONTRIBUTOR main campus, Heights, and are in stock and make sure providers JAN KOVER Parma. Pharmacists are highly involved know how therapies should be Pharmacy Hematology/ administered. Oncology Specialist CANCER CENTER UPDATES

Congratulations to our faculty members who were recognized as winners of the 2017 Provider Communication Award. Thank you for your dedication and devotion to your patients. Bruce Averbook Joanna Brell George Gelehrter Michael Harrington Paul Hergenroeder Natalie Joseph Benjamin Li Tim O’Brien Susan Sharpe Complex Oncologic Care a Priority Sareena Singh Michelle Treasure at MetroHealth Cancer Center A multidisciplinary approach to cancer care for complex malignancies such as gastric, esophageal and pancreatic 3rd Annual Cancer Symposium cancers is vital to improving patient outcomes. Friday, August 31, 2018 Theme: Palliative care in cancer Decades ago, surgery for more holistic manner, considering underlying Guest speakers will include these cancers resulted in comorbidities, as well as functional and Elizabeth Weinstein, MD, five-year survival rates nutritional status when creating treatment plans. Kathleen Neuendorf, MD, and an of 20 percent at best. Interdisciplinary Panel. As such, prehabilitation is often an important Over the last 20 years, part of care. Assessing an individual’s functional with the introduction of and nutritional status at baseline and working multidisciplinary care, to improve these before surgery, especially Community Health Fair many patients began during neoadjuvant chemotherapy or radiation receiving adjuvant Saturday, September 29, 2018 therapy, can help to improve outcomes. We are chemotherapy with or without radiation — 8 a.m. - 12 p.m. fortunate to have Susan Sharpe, MD, who is depending on cancer characteristics and stage Iglesia Sagrada Familia Church fellowship trained in complex general surgical — to improve outcomes. However, survival gains oncology, and Yevgeniya Dvorkin Wininger, MD, 7719 Avenue could be modest. More recently, oncologists Cleveland, 44102 a physical medicine and rehabilitation specialist began prescribing neoadjuvant chemotherapy and with additional fellowship training in cancer radiation to shrink tumors, making surgery less rehabilitation at Memorial Sloan-Kettering Cancer extensive and improving the chances of obtaining 14th Annual Edward G. Mansour, MD Center, to provide prehabilitative evaluation and clear surgical margins. There have been studies care for these patients. Lectureship in Surgical Oncology to support the usefulness of this approach. Saturday, October 13, 2018 With rehabilitation and ongoing nutritional The next step in the evolution of complex, support, improving patient wellness continues 8 a.m. multidisciplinary care is using genomics to tailor long after cancer treatment has ended. Patients MetroHealth Medical Center chemotherapy and targeted therapy regimens who are in good shape have the best chance of to each patient. Our pharmacy hematology/ Medical staff, residents, fellows and making a full recovery from their cancer, which is oncology specialists, overseen by Jan Kover, nurses are invited to attend. our ultimate goal. are critical to ensuring the safe administration Look for more details coming soon. of these medications. Genomics may also help to personalize radiation therapy and surgical approaches to eradicating tumors. In addition to genomics, oncologists are Benjamin D. Li, MD, FACS increasingly assessing patient health in a Cancer Center Director Prehabilitation Boosts Patient Ability to Contend with Cancer Treatment A new prehabilitation program at our cancer center aims to improve the health and wellness of patients, enabling them to better tolerate and recover from treatment.

After patients receive a diagnosis, physiatrists the need for postoperative rehabilitation. The conduct an assessment to screen for literature also indicates that prehabilitation helps impairments and underlying deconditioning patients with postoperative recovery. Enhancing problems, explained Yevgeniya Dvorkin mobility and endurance with exercise may also Wininger, MD, a physical medicine and enable patients undergoing chemotherapy and rehabilitation specialist. Assessments can radiation to better contend with fatigue, added occur before any treatment starts or during Dr. Sharpe. chemotherapy or radiation treatment. Another important part of patient wellness “We look at the whole picture to improve the and treatment recovery is nutritional status. If patient’s functional status and try to address a patient appears to have nutritional deficits, problems early,” said Dr. Wininger. Depending on dietitians who specialize in cancer care are the level and type of functional impairment, she readily available to provide dietary assessments may prescribe an exercise regimen that patients and recommendations, said Dr. Wininger. can follow on their own or physical therapy. Specialists in the prehabilitation program Prehabilitation can help build patients’ strength continue to see patients throughout treatment before major surgery, said Susan Sharpe, MD, and recovery, and can connect them with any a cancer surgeon (surgical oncologist). “It can get needed rehabilitative care at MetroHealth the body to a better place to tolerate treatment,” Cancer Center, added Dr. Wininger. “We can she said. “We’re excited to be able to offer this also transition them to community resources and service to patients.” survivorship programs in the Cleveland area that Notably, Dr. Sharpe has seen prehabilitation help them with exercise and staying healthy.” reduce hospital stay after surgery and decrease

Cancer Center’s Camille Garcia Pitches for Patients

More than 100 people attended MetroHealth initiatives to create the first-ever MetroHealth N.E.T. a healthier Fast Pitch event, held on Friday, Community. April 20, 2018 at Magnolia Night Congratulations to Camille Club in the Flats. Garcia, Community Outreach N.E.T. — Now, Every Day, Coordinator & Senior Patient Tomorrow ­— is an affiliated Navigator at the Cancer Center. committee of the MetroHealth She and her team presented on Foundation Board. Made up of behalf of the BREAST/Amigas a group of civic-minded young program, which aims to reduce professionals, their mission is out-of-pocket expenses for to leverage the resources of the cancer patients. The team was emerging-leaders community to awarded $5,000 toward their promote and sustain project. What does The 15th Join the it mean to be Annual OROC MetroHealth a cancer OutRun Race for the survivor? Ovarian Cancer Cure Team! 5K Run/Walk and 1-Mile A free event for cancer survivors and their Family Fun Run The Cleveland Komen Race for the Cure will families will be Thursday, August 2, 2018. be held on Saturday, August 18, 2018. We Learn what “cancer survivor” means and would love for you, your family and friends to how to get the help you need to thrive during The 15th Annual OROC OutRun Ovarian join our MetroHealth Team for the 5K race. and after cancer treatment. Cancer 5K Run/Walk and 1-Mile Family Fun To join, visit clevelandraceforthecure.com • Learn about managing long-term cancer Run will take place at the Rock and Roll Hall and search for the MetroHealth team. treatment side effects of Fame Museum on Saturday, August 4, 2018. OROC has raised over $1 million for MetroHealth team members receive • Learn about coping with the emotional ovarian cancer research, awareness and $5 off registration when using the special impact of life after cancer treatment education, leading to the early detection of discount code METRO2018. General • Participate in art, music, fitness and the disease and saving lives. registration is $30. healthy cooking demonstrations The event will feature live entertainment as If you are unable attend the Race/Walk • Connect with organizations and community well as activities for the whole family. Great please consider donating to our team. Your resources that support cancer survivors prizes for top male and female finishers. support will fund breast cancer screening, treatment and education programs that save This is a free program, but registration is The pre-registration fee for OROC is $25 lives in our community! required. for adults and $15 for youths 10 and under. For more information and to register online, Participants have the option of registering 6 a.m. – Registration opens visit .org/cancer as individuals or joining forces as part of 8 a.m. – Competitive/Timed 5K run 8:45 a.m. – Survivor and Awards Ceremony Questions? Or to register by phone, a team. 9:15 a.m. – 1M/5K Walk call 216-778-8557. To register yourself or your team, contact Edgewater Park Hermes Sports & Events at 216-623-9933 10 a.m. – 2:30 p.m. 6500 Cleveland Memorial Shoreway or visit hermescleveland.com/roadracing/ Rammelkamp 170 Cleveland, Ohio 44102 MetroHealth Medical Center events/oroc.asp. 2500 MetroHealth Drive Cleveland, Ohio 44109

Connect with CHANGE IS MetroHealthCLE at HEALTHY metrohealth.org metrohealth.org/cancer