Treating Cancer, Healing People

By Thomas Crocker
Monday, November 20, 2017

As evidence mounts for the importance of addressing cancer’s hidden effects, Methodist Healthcare is building on a decades-old history of pioneering holistic cancer care in San Antonio and south Texas.

The impacts of cancer are far more than physical. The disease can be socially isolating, especially for patients who are immunocompromised. It can lead to challenging behavioral health conditions, such as depression and anxiety, and cause post-traumatic stress disorder years after treatment ends. Conventional therapies can treat cancer’s effects on the body, but healing its mental, emotional and spiritual wounds takes a concurrent, complementary approach.

“The mind and body are two wings of a bird — it’s impossible to fly high without both,” says Behyar Zoghi, MD, PhD, FACP, hematologist/oncologist in the Adult Blood and Marrow Stem Cell Transplant Program of the Texas Transplant Institute at Methodist Hospital. “Alternative medicine, including art, music, prayer and meditation, are as important as conventional forms of treatment. They can change the biology in the body.

“In literature, we find many cases of spontaneous remission in patients whose treatment regimens incorporate alternative medicine. Researchers have shown that complementary therapies can reduce inflammatory cytokines in the body that are associated with cancer formation, such as interleukin-6.”

Methodist Healthcare approaches each patient with cancer as an individual with unique needs, as well as a distinct capacity to benefit from care that goes beyond traditional treatment. That is why the health system provides holistic care to all patients, including the youngest.

A Four-legged Therapy Resource

In September, Methodist Healthcare became the first health system in San Antonio to acquire a facility dog. Unlike therapy dogs, which typically visit hospitals with their private owners, Hazel, a nearly 2-year-old golden retriever, is an employee of Methodist Healthcare and is present at Methodist Children’s Hospital throughout the workweek. She underwent intensive training in hospitals in and around Atlanta to learn to comfort, support and assist in the education of pediatric patients and their families.

In the company of a child life specialist, Hazel can demonstrate how to take oral medications to reluctant children, as well as motivate them to do it. She also assists with ambulation, an important factor in helping young patients avoid the need for respiratory support. Hazel is trained to help families with bereavement. According to her handler, she has an uncanny ability to read a room, determine who needs her support the most and go to that person.

Hazel sleeping on patient’s bed

Bringing Clarity to Challenging Concepts

From the day a child’s cancer journey begins, a Methodist Children’s Hospital child life specialist — one of 10 on staff — is with her and her family every step of the way.

“Child life specialists ensure children have a developmentally appropriate understanding of their diagnosis and treatment,” says Caitlin Pearce, MS, CCLS, Director of Child Life at Methodist Children’s Hospital. “How we explain cancer to a 4-year-old is different than how we talk about it with a 6- or 10-year-old. No matter the age, however, we’re always on the lookout for misconceptions, such as that cancer is contagious or the result of something a child did.”

Child life specialists form close relationships with patients and families to help them cope with the various challenges cancer can pose to children, including interrupted social development due to missed school days, hair loss and treatment-induced weight gain. Those relationships begin with intensive education during the first month after diagnosis and continue with check-in visits in both inpatient and outpatient settings.

Technology plays an important part in helping child life specialists educate children, especially about imaging procedures. As part of the recently developed therapeutic virtual reality (VR) program at Methodist Children’s Hospital, child life specialists use two VR headsets to simulate MRI and other exams.

“We don’t want to sedate children for an MRI if they can hold still on their own,” Pearce says. “By having them go through a VR MRI, we can determine, based on their reactions, if they’re candidates for sedation.”

Creative Expression

Children with cancer may struggle with isolation from their peers, loss of control over many aspects of life, and communicating their feelings about diagnosis and treatment. With funding from nonprofit art therapy program Tracy’s Kids, Methodist Children’s Hospital Art Therapist Courtney Martin, ATR-BC, MA, uses group and individual art experiences to break down psychosocial barriers.

“Social development can almost come to a halt for hospitalized children if they have to miss school or be separated from peers for infection control,” Martin says. “I try to normalize the experience by leading them through art projects they might make in the classroom. These children don’t have control over many things — they have to be compliant with treatment and do as their medical team says. I provide a lot of choices of materials and colors to give them a sense of being in charge of the experience.”

Martin works with pediatric, adolescent and young adult patients on a variety of projects, from making slime and creating works of art on canvas to painting hospital room windows and crafting objects out of wood. Parents and siblings often join in.

“When children can’t find the words to put to their experiences,” Martin says, “they use the arts as an avenue for expressing themselves.”

Art does not have to take place as part of formal therapy to be beneficial — the emotional and spiritual lift patients can experience from enjoying art for its own sake can be powerful medicine. When battling leukemia as a teenager, Constanza Aileen Roeder experienced art’s vast capacity to serve as a coping mechanism.

“I found a lot of emotional release through engaging in the arts,” she says. “Making art allowed me and other cancer patients to share our stories with each other on a deeper level. It really helped facilitate human connections.”

“The body has an innate healing ability that we should embrace. The mind and soul, if empowered, create potent medicine.”
— Behyar Zoghi, MD, PhD, FACP, hematologist/oncologist in the Adult Blood and Marrow Stem Cell Transplant Program of the Texas Transplant Institute at Methodist Hospital

Roeder is the founder and president of Hearts Need Art: Creative Support for Adults with Cancer, an organization that brings artists and musicians to Methodist Hospital to sing at patients’ bedsides, put on “corridor concerts” in the halls of the oncology unit, and lead art, chair yoga and meditation classes.

“Sometimes, patients sink into despondence or depression, which can lead them to become less compliant with treatment or less likely to engage in the physical activity, such as walking, that they need to get well,” Roeder says. “An interesting shift happens, however, when we engage them with art, which can have powerful effects on mood and motivation. It’s the most wonderful thing to give the gift of art to these patients.”

Showing the Way

At Methodist Healthcare, eight cancer nurse navigators — four for breast cancer, and one each for blood cancers, liver cancer, lung cancer and complex gastrointestinal cancers — help adolescent, young adult and adult patients through the complexities of diagnosis, treatment and survivorship.

Melissa Threlkeld, FACHE, Regional Vice President of Oncology at Methodist Healthcare and Sarah Cannon

“The patient/navigator relationship typically begins at diagnosis and continues for as long as patients need,” says Melissa Threlkeld, FACHE, Regional Vice President of Oncology Services for Sarah Cannon, the Cancer Institute of HCA Healthcare, at Methodist Healthcare. “No question is too big or small for our navigators, and they answer questions of all types from how to get more information about a patient’s treatment or tips for how to cope with hair loss during chemotherapy. Nurse navigators connect patients to resources in our health system and community that can help them overcome the everyday challenges of cancer, such as a support group, finding nutritional education or a fertility consultation. Many patients have told me that our nurse navigators are their lifelines during a cancer journey.”

Helping Patients Heal Each Other

Sandwiched between the pediatric and adult patient populations, the adolescents and young adults (AYA) with cancer face unique challenges.

“AYA patients can experience a tremendous amount of distress related to isolation from peers, body image, sexuality and fertility,” says Nikki Yuill, LCSW, Psychosocial Oncology Programming Supervisor at Methodist Hospital. “Survival rates for these patients have not improved during the past 30 years.”

Established three decades ago, Methodist Hospital’s Psychosocial Oncology Department is the oldest of its kind in San Antonio, and AYA patients are a key population of focus for it. The hospital is the only one in the city to employ full-time clinical psychosocial oncology social workers, with a roster of three. These providers offer individual and family counseling to patients and families to help mitigate stressors they may experience, such as adjusting to a loss of independence or new living situations.

The Psychosocial Oncology Department was instrumental in establishing San Antonio’s first inpatient support group for young adult cancer patients, which meets weekly at Methodist Hospital.

“Two cancer survivors who were hospitalized here attend the group as ambassadors and mentors,” Yuill says. “The group provides a wonderful link between survivors and patients who, having just been diagnosed, may be frightened or overwhelmed. What we’ve found to be most therapeutic for these patients, however, is the relationships that develop outside of the group, when they connect through social media and meet out in the community.”

A Methodist Hospital clinical oncology social worker facilitates an outpatient sister support group, It’s a C Thing, that meets monthly at a San Antonio restaurant and is open to AYA cancer survivors from throughout the community. Each March, Methodist Hospital hosts the It’s a C Thing Yearly Event, a first-of-its-kind gathering for San Antonio, in recognition of National Young Adult Cancer Awareness Week. Held at a local restaurant, the event brings together AYA survivors and their former medical providers to socialize and enjoy entertainment.

“We treat more than just cancer cells because a journey with this disease is bigger than chemotherapy, radiation therapy and surgery.”
— Melissa Threlkeld, FACHE, Regional Vice President of Oncology at Methodist Healthcare and Sarah Cannon

Sophie and Amy DeYoung performing in a Corridor Concert

Forming connections with others — fellow patients and survivors, healthcare providers, and loved ones — is one of the most powerful forms of alternative medicine, and it is central to cancer care at Methodist Healthcare.

“Humans are wired for relationships,” Dr. Zoghi says. “By incorporating holistic services, we humanize cancer treatment for our patients and their families.”

For more information about oncology services at Methodist Healthcare, visit