SCCA care beyond boundaries

It was mid-December and Judy Johns was confronting a flurry of Christmas preparations in her home in Helena, Mont. So when her sciatic nerve started acting up, it seemed like one more thing demanding attention. "I have a really high tolerance for pain," Johns said. "But after awhile, I decided I'd better go to the doctor." Her doctor shrugged it off, and Johns went home with a painkiller. But the agonizing pain persisted, and the 65-year-old Montana native knew something was very wrong. "It finally got so bad I couldn't take it anymore," she said.

Her husband helped her into the car for a trip to the local emergency room. There, a computerized tomography scan revealed a large cancerous growth was eating her second vertebrate. Local doctors encouraged her to stay close to home, directing her to the oncology program in Helena. But, realizing the gravity of the situation, her husband, Ben, insisted that his wife make the 600-mile trip to receive treatment at the Seattle Cancer Care Alliance.

On Jan. 7, Judy and Ben were on a flight to Seattle. By that point, she was having severe pain in her left arm and right leg. "It was getting really difficult to get into bed," she said. Shortly after arriving at the SCCA, they learned the problem was far more serious than first believed. The vertebrate was actually in danger of collapsing.

Eleven days after arrival, Johns was under the blinding lights of the operating table, having her first and third vertebrae fused together. And although it was major surgery, Johns was quick to leave the hospital. "I'm quite active normally," she said. "I do a lot of hiking and gardening, so I was out of the inpatient facility after about five days." However, Johns stayed in Seattle for follow-up appointments.

Six weeks after surgery, the couple returned to their home on the side of Mt. Helena. While they remain hundreds of miles from Seattle, the SCCA has, in a sense, come to them.

Access and opportunities

Around the time that Johns was learning she had cancer, the SCCA, the Great Falls Clinic and its affiliated Clinic Cancer Care were cementing an alliance to better serve patients in outlying areas. For Johns, the agreement means she stays at home and makes the trip to Great Falls — about an hour and a half drive — for her chemotherapy treatments and follow-up appointments.

Clinic Cancer Care in Great Falls is home to four oncologists, but the link to the SCCA gives them far greater capacity to serve patients than they would otherwise have in a clinical setting.

"For us, it really opens up doors to many different opportunities. The formality of the partnership allows us to go to Seattle researchers with our questions, concerns and ideas," said Dr. Christine Kowalski, director of the Great Falls Clinic. "That's the important piece; we have access to these world-renowned centers and information that we can bring back to Great Falls."

The Montana site joins a growing list of clinics that have formalized an affiliation with the SCCA, including the Olympic Medical Center in Port Angeles, Skagit Valley Hospital in Mount Vernon, and most recently, Wenatchee Valley Medical Center, which joined the network in January.

According to Dr. Ben Greer, medical director of the SCCA network, the arrangement benefits everyone. "It's driven by the mission of the SCCA, which is to provide the best patient care and education and to improve cancer care across the region," Greer said.

Improving regional care translates into helping local physicians tap into the wealth of knowledge at the SCCA. "There's a great educational opportunity for physicians to have access to our collective knowledge. Here, within the building, most all of the medical oncologists, are very site-specific. In a small community, the doctors take care of a whole variety of things; it's hard enough within your own specialty to be on the front of the wave of knowledge, let alone try to be there for all," Greer said.

To help, the SCCA provides continuing education credits for network members. But the relationship is of mutual benefit; researchers in Seattle now have a greater pool of potential patients to recruit for clinical trials. All of the work back and forth ultimately benefits the patients.

"About 85 percent of oncology can be done within a community," Greer said. "If we can improve the level of care in the community, it's a win for our mission of best patient care and education and a win for the physician and the network affiliate. The big win is for the patient — bottom line."

The SCCA team is highly selective about which clinics are able to join the network. "We do a thorough assessment of their oncology programs. We also look at how far they reach into the community," said Cecila Zapata, strategic planning director at the SCCA. "We are not aggressively recruiting; the clinics contact us to be a part of the network."

Kowalski said her clinic was a natural fit with the network. "We have a number of services available to treat the whole person and their family. From the moment they walk in the door, they're not just a cancer diagnosis, they are people who've been slammed broadside with this cancer diagnosis. And we help them through that journey. I think that looking at the patients as people is what sets us apart."

The clinic in Great Falls, which serves 75 to 100 people per day, provides patients with access to clinical trials and complementary medicine services, such as massage therapy, acupuncture, yoga classes, chi kung breathing classes and support groups. Clinic Cancer Care hasn't been open quite two years, but the affiliation with the SCCA is a meaningful attribute. "This partnership means we're forming more of a team of people that is treating the patient. And it's nice for patients to know that all the members of their team are talking," Kowalski said.

"It was just wonderful. At my first appointment, Dr. Thomas Warr knew everything about me," said Johns of her oncologist in Great Falls.

For Kowalski, the potential is incredibly exciting. "We're just thrilled that it's finally beginning. We feel that the sky's the limit. We're going to take every opportunity to avail ourselves of everything that's there for our staff and patients," she said.

For Johns, the partnership means she can push through her treatments while staying active in her community, where friends and family can provide support. "I'm a real goer," she said enthusiastically. "My husband has just been wonderful. Neighbors and people from my church have been wonderful. And you know, something good will always come out of whatever you're facing. As far as my cancer, it's just another hurdle to climb over. I'm going to stay positive and keep going."