STAR Treatment

Cancer Center Helps Patients Find ‘New Normal’

David Amar, right, wanted his post-cancer life to be as close to normal as possible—including a return to bike riding—and his care team of Dr. Jonathan Lopez and Maricel Roblez prepared a STAR Survivorship Plan that guided him to his goal.

Most people see their physician once a year for regular check-ups, and perhaps trade a few emails if they have non-urgent medical questions.

But it’s quite different for patients of the NorthBay Cancer Center. “We do wind up building a close relationship with our patients, because they’re in contact with some member of our team on a daily or near-daily basis,” says Teresa Langley, director of Oncology Services.

“It’s so much more than just the time they might spend in the chemotherapy infusion chair, if that’s what their treatment requires. They’re meeting with their doctors, being followed up on lab work, being scheduled for, or perhaps recovering from, surgery.”

All this interaction means a true bond is built between the patients, their families, and our oncologists, nurse navigators, and others in the cancer-fighting effort that can stretch over weeks, months, and even years, Teresa agrees.

This program was a way for me to work on getting back to my ‘new normal,’ without being tethered to physical or pharmaceutical crutches.

—David Amar

David Amar, 56, a Vacaville father of five, is one of those patients. He is quick to tell you how grateful he is for the support he received from NorthBay physicians, surgeons, and cancer specialists, since first starting treatment there in May, 2013.

“There are amazing angels at the Cancer Center,” he says. “Everyone is caring, sympathetic and smiling. Even on the bad days, the ones where it’s hard to get out of bed, the nurses were, without exception, kind, encouraging and accommodating.”

David’s cancer journey began with a visit to his primary care physician in December, 2012. For years he been suffering from stomach pains and intestinal difficulties, but admits he was very reluctant to undergo a colonoscopy. But by December, he was feeling worse.

“My primary care physician at the NorthBay Center for Primary Care in Vacaville understood my discomfort and walked me through the procedure. He probably saved my life, and is one on a long list of true heroes I have met along the way.”

His doctor referred David to Mounzer Al Samman, M.D., a NorthBay gastroenterologist, who performed a colonoscopy. It revealed a very aggressive form of Stage 3 cancer. Within days, surgery was scheduled, and when David awoke, he learned a third of his colon, along with 13 lymph nodes, had been removed. “Things became very real, very serious at that point.”

His recovery was complicated by an extended hospital stay. “I received extraordinary care all the way, and when I was released from the hospital, Jonathan Lopez, M.D., an oncologist at the NorthBay Cancer Center, came into the picture. His bedside manner and communication skills are fantastic; he told me I was going to be an active participant in my treatment, and I appreciated that.”

An aggressive round of chemotherapy began, and during his near daily visits to the cancer center for infusions, David says he was always met with welcoming faces, starting at the front desk and throughout the office.

Once his chemotherapy ended, David’s care team guided him to the next phase: recovery, where he became one of the first patients to enroll in NorthBay’s STAR Program (Survivorship, Training and Rehabilitation).

An avid mountain biker and runner, David had been referred to the STAR Program because he suffered debilitating side effects from the chemotherapy. “I got severe neuropathy. It really knocked me off the rails. I was dropping things, couldn’t walk, lost my sense of balance and even hit my head.”

He was also suffering from “chemo brain,” a kind of foggy mental after-effect of chemotherapy. On many medications and suffering from lymphedema, David was determined to find a way to get better.

“This program was a way for me to work on getting back to my ‘new normal,’ without being tethered to physical or pharmaceutical crutches.”

He was then referred to Maricel Roblez, nurse practitioner and patient navigator for the STAR Program. “When I first met with Maricel, she asked me what I wanted. I told her I wanted as close to normal a life without medications as possible. I wanted to run and ride my bike again.

“Maricel laid it all out, helped me identify my goals and understand what was achievable. She prepared me for what was to be a very challenging and emotional battle.

“It was a very difficult time,” he recalls. “I could have just accepted my limitations and numbed up on drugs. Instead I pushed myself to do the work that Maricel laid out for me.”

Maricel set up a treatment plan for David that included visits with physical and lymphedema therapists. She also continued to set up David’s other follow-up appointments and keep an eye on his CT scans and lab tests. “She was the ombudsman of all my data; she had me covered 360 degrees.”

When he started with STAR, he wasn’t even able to stand on his own at first. “It was very, very challenging.” But, NorthBay’s physical therapists were persistent and patient, and after nine months of therapy and follow-up visits, David is pleased to say he has nearly met all his personal goals.

“My new normal? I may only take Motrin. I can’t run, but I can speed walk! I’m riding a bike, not on mountain trails but on paved roads. In fact, I rode my bike to a Relay for Life event last fall, and when I got there, I looked up and there was a group of NorthBay Cancer Center infusion nurses. When we saw each other, we gave each other hugs and high fives. It was fantastic.”

STAR Shines Way for Patients

NorthBay’s STAR Program (Survivorship, Training and Rehabilitation) was begun in May, 2014, to help patients return as quickly as possible to their pre-cancer functionality. The program uses a team approach to deliver state-of-the-art cancer rehabilitation services to patients, whether they are in remission, living with cancer, or cured.

Patients are referred to the program by their oncologists, and care is covered by most insurance plans. They meet with Maricel Roblez, nurse practitioner, who develops a survivorship plan of care based on individual needs and goals, and may include appointments with physical, speech or occupational therapists, social workers and mental health counselors, with the goal of improving their patients’ daily function and well-being.

For more information about NorthBay’s STAR Program, call the NorthBay Cancer Center at (707) 646-4000.

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