August 03, 2022
5 minute read
Disclosures: Alfonse does not report any relevant financial information.
Along with her research and clinical work on breast cancer, Lori Alfonse, DO, has made the development of multidisciplinary teams and community engagement for cancer care one of the main focuses of his work.
Alfonse, deputy chief medical officer at the Lehigh Valley Topper Cancer Institute, spoke to Healio about her personal connection to cancer and her first-generation steps through college and eventually into the medical field, which led her to treat cancer patients.
She also spoke about the importance of ensuring that these patients are cared for in all necessary aspects, from diagnosis to survival.
“When you hear people say medicine is a calling for them, that was really a calling for me,” she said.
Alfonse said she grew up as a “Pennsylvania girl” in a blue-collar family, attending the public school system before heading to Penn State University and eventually the Philadelphia College of Osteopathic Medicine, or PCOM, to medical school. She later became a breast fellow at Bryn Mawr College and is the only fellow-trained breast surgeon in the Lehigh Valley Health Network.
“I’m the first person in my family to go to college, and I don’t know what made me do it, but I felt like there was something more for me” , she said.
Her desire to turn to medicine became personal, as she witnessed her mother’s breast cancer diagnosis and treatment and eventual death from lung cancer. Several other family members were also diagnosed with breast cancer, with members from her father’s side also facing oncological conditions.
Alfonse said it left her, the younger of two siblings, spending time in hospital watching how her family members were cared for.
“Medicine has always felt like a kind of investigation to me, and cancer care is a team sport,” she said. “It was not a doctor who made all the decisions, but rather a team of people. Even back then, before I knew what I know now, I thought team care would deliver the best outcomes for those we cared for.
After attending PCOM, Alfonse began a breast cancer program at Mercy Women’s Health Care in Blue Bell, Pennsylvania, before “going home” when the opportunity presented itself for a position as a surgeon at the breast trained by a fellowship at the Lehigh Valley Health Network. , where she has worked for more than 11 years.
Many oncologists have been faced with the same questions, including “why treat cancer?” » » and « why this specialty in oncology? Alfonse was similarly asked about her choice of breast cancer care.
“Breast cancer care is something I will never know everything about. I will never come home at night and I think I have learned everything there is to know about this area. I’m not in it alone either,” she said.
She added that she works with the smartest people in medicine, from medical oncologists and radiation oncologists to nutritionists, nurse navigators “who hold the patient’s hand every step of the way” and geneticists who “find out why these things happen”. ” in the first place.
She said the multidisciplinary clinics at Lehigh Valley Topper Cancer Institute provide a way to show patients that coordinating their care is a priority.
“It’s rare that a patient who comes to me with cancer only needs surgery,” Alfonse said. “Cancer care in particular must include a whole team approach.”
She continued that during multidisciplinary conferences, not only is the healthcare team there, but also the patient and their family so that, in a collective effort, the team can create an opportunity to relay the treatment plan and allow the patient and their support network to ask questions.
“When we first started doing these conferences, I thought they might be overwhelming for a newly diagnosed cancer patient,” Alfonse said.
However, she found that patients ‘far’ left the conferences saying they felt they had a better idea of what was to come next than before meeting the team.
“If so, then we’ve done our job,” she said.
As important as the multidisciplinary team is to guide a patient through treatment and survival, the very beginning of the cancer journey also requires a balance of support and understanding.
“The great part of Lehigh Valley Topper Cancer Institute is that we make it easy for the patient, because we recognize that a cancer diagnosis can be very overwhelming, and the last thing we want a patient to have to worry about, it’s knowing who he needs to see for an appointment and when – that’s why it’s all built into the institute for each patient,” Alfonse said.
She continued that between the nurse navigators and other practitioners on the team, all visits are arranged for patients, so that the institute can ease the burden on the primary care provider or referrer.
“Likewise, our network is big, but it’s still personal,” she said. “When we see a new patient, their family doctor has probably been caring for them for 25 years, and now all of a sudden there’s a need for coordination between services and doctors. As part of our approach, the Lehigh Valley Health Network uses cross-departmental communication tools to communicate with each other, which also reassures primary care providers that their patients are receiving the best care and treatment.
When it comes to ongoing health care support, most facilities and networks have information on their websites. However, between the disruptions due to COVID-19 and patients “feeling well”, there can be challenges in ensuring there is adequate follow-up. Alfonse noted that she needs 5 years of follow-up to make sure the patient doesn’t encounter “bumps in the road.”
This includes making sure they keep up with annual screenings, checking how they are doing in general, and even how they are handling things financially.
“Coming out of cancer treatment, it’s one thing to pay the bill for everything you had during cancer treatment, but sometimes that means catching up afterwards,” she said. declared. “So we actually have a designated place for survivors where we refer patients who might need ongoing help.”
Early career advice
Finally, Alfonse shared one of his main goals as a treating oncologist.
“What I urge anyone in cancer care to focus on is ‘prosperity,’ not survival,” she said. “There are a lot of patients going through their treatment, and they can have hills and valleys. Some of them go through it smoothly, some of them struggle with the treatment, but they’re all warriors.
She added that, especially with her patients, she believes patients are stronger after treatment, after dealing with serious illness and the mental fatigue that comes with it. She admits that the treatment and diagnosis can be traumatic and that many struggle to come to terms with what they have been through, but she encourages them to come to terms with their ordeal and realize how strong they were to come through it. go out.
“I tell them, ‘You never thought you would have to do this and we hope you never have to go through this again, but you did it. It makes you so strong, it makes you level all the things in your life that didn’t matter and you didn’t know it,” she said.
Alfonse concluded with two messages she would encourage anyone heading into oncology care to achieve. First, and unfortunately, you cannot prevent an established diagnosis. So, second, it’s important to celebrate success.
“No matter what, I am with each of my patients throughout their journey, making sure they feel safe, understand their diagnosis and next steps, and feel comfortable and cared for,” she said. “The reality is that sometimes you can’t do anything about that diagnosis, but you can definitely do something about the patient experience – and know that someone is going to be honest and available when they have questions. issues where their family is concerned is the most important aspect of the process.
For more information:
Lori A. Alfonse, DO, can be reached at 888-402-LVNH (ext. 5846).