Dr. Laura Velutti, lead Oncologist of Medical Oncology and Hematology at Humanitas, and her team were recently honoured with two awards. The team is responsible for support and pain relief therapy in cancer patients at all stages of the disease and hospitalization as well as home care under the Homecare service for Palliative Care (ODCP). The awards reward a daily effort at the hospital of Oncology, in consultation with other departments of the Cancer Center at the home of the patients cared for by the group providing simultaneous care and support therapy .
The AIOM Award “Pain management in cancer patients”
“Off-label drugs in home care: non established evidence-based practice” is the title of the poster on the treatment of cancer pain, and third place was awarded during the XVIII National Congress AIOM (Italian Association of Medical Oncology), held in Rome at the end of October.
As Dr. Velutti explains: “The work is a collection of clinical data on continuous infusion therapy using mixtures of drugs. This is a review of our series since we started the service in July 2010. We reviewed more than 500 patients, 250 of whom were treated with continuous infusion therapy for several days using elastomers, with subcutaneous or intravenous access. It was a great team effort, in which the commitment of nursing staff has proved central to the success.
The SICP prize Vittorio Ventafridda: “The time of palliative care”
The Italian Company Palliative Care has awarded Laura Velutti the third prize in the field of oral communications, during the XXIII National Convention held in Rome 16-19 November. “In this case we have presented an analysis of the dynamics between health professionals, patients and caregivers (or the patient’s emotional network) on the knowledge of the diagnosis and especially the prognosis of cancer patients at an advanced stage “.
What does the groups Simultaneous Care and Support do?
“Our Unit is structured in the Pathology Groups, the group of Simultaneous Treatment and Supportive Therapy is the only group of our organization to be “cross-departmental”. We deal with all solid tumors and take charge of cancer patients in various stages of the disease: from a toxicity during adjuvant chemotherapy, to a symptomatic patient suffering from advanced stages of the disease.
We work in various settings of care: in the ward, where we have dedicated beds for patients in need of support therapy; in the clinic where we follow patients in need of pain therapy and supportive care, at the other departments of the Cancer Center, where they call us for advice and also at the patients home who are in ODCP. This service is intended for patients with cancer in advanced stages and terminal patients; those patients who have completed treatment – chemotherapy, radiation therapy, hormonal therapy, biological therapy – but are in need of support that can be provided at home.
We take care of patients who are referred to us by our other institutions, by general practitioners or by the families themselves. We follow them with a multi-professional team according to the needs that arise during the care pathway.
House visits are scheduled according to the needs of the individual patient with a weekly service; we also perform unscheduled visits during holidays if necessary. Having a 24 hour-a-day availability, provided by a pair of doctor and nurse, we are able to give a response even at times when we would not normally operate, 365 days a year. We move around a territory that includes 16 municipalities around our Institute in the southern suburbs of Milan “.
Who is the team composed of?
“Our group is able to offer a 360° service: between us there are oncologists, nurses dedicated and specialized in palliative care, a psychologist and a social worker, two volunteers of the Humanitas Foundation also work part-time. The School of Oncology at the University of Milan also assigns us a graduate for a few months and this year we were joined by the Humanitas University as part of their training course. During the year we also host interns and trainees who come from different professions and enrich our experiences even more. For example, we are the apprenticeship for the top-level Master in Palliative Medicine, of the University of Milan “.
Containing the psychological impact on members of the team
“Being in touch with suffering and terminal illness is not easy, we are exposed to considerable emotional stress. The presence of a psychologist is important beyond the patients. It is also crucial for operators as it helps to contain the inevitable dynamics of our work. Meetings are in fact possible with the individual operator and regular group meetings to contain and accommodate the emotional reactions that individual clinical cases arouse. This is also an opportunity to sincerily thank the Humanitas Foundation that guarantees the constant presence of a psychologist within the team. ”
How many patients can you handle and what does one need to do to join the program?
“We have the capacity to make 90 care paths a year, we follow about 10 patients simultaneously. Enabling our service is simple: Once a patient comes to us we arrange one or more interviews with the patient’s referring persons and with the patient if necessary. This is to evaluate the care, logistics, the reasons for home stay, patient preferences and family and caregiving skills. Once we handle these issues, within a few days we are able to begin home visits “.