Stem cell transplant is one of the last options nowadays availablle for the cancer patients. Tgis procedure is carried ooout in Cell and Gene Therapy (CAGT) clinics. Patients usually know little about stem cell transplantation. Unfortunately, most patients are too scared or too anxious to put questions about the procedure to their doctors or consultants, and they mostly don’t follow the requirements they are given. This probllem is decided by limiting the amount of information given to the patients to the essential minimum and establishing trusting doctor-to –patient rellationship.
The emergence of technological web searches makes it easy to find information about any topic. For cancer patients, information could be found about all types of cancer, its symptoms, treatment options, and end-of-life issues for the patients and their caregivers. For every cancer type there is a designated web site along with the corresponding foundation and/or organization and support group. For instance, for leukemia, there’s the Leukemia Foundation and the Leukemia/Lymphoma Society. If the word leukemia is typed in the search window, 20 pages pop-up with at least 20 items per page.
Additionally, there are newsletters and magazines, often at no cost. Patients who face this disease can gather information from books, scientific and popular articles, the Internet and other people. Finding information about treatment options is the most sort out search. Patients devour as much information as possible, wanted and unwanted, about their particular cancer in order to make informed choices. Those seeking the stem cell transplant as a treatment option have experienced previous options and are at the “last resort”.
They have had chemotherapy, surgery, and radiotherapy. This “last stop” lands them in the Cell and Gene Therapy (CAGT) clinic for that hope of another chance. At the initial consultation visit, so much information and terminology is new and foreign. Patients are given a brochure by their primary physician that gives broad and general explanations. Choosing the CAGT clinic was quite a task. According to the Houston Guide (2005), the Texas Medical Center (TMC) comprises of the Baylor College of Medicine, which made history with the first draft of the human genome.
The M. D. Anderson Cancer Center is ranked first among the top 50 hospitals in the United States (US News, 2004). The Texas Children’s Hospital is also located in Houston and the same report describes it as the largest pediatric hospital in the United States. Since opening its doors in 1954, it has cared for one million children from around the world (Houston, Texas Facts, 2005). The TMC consists of 42 non-profit institutions. The Methodist Hospital System (TMH) ranks 10th, 11th, and 13th in treating conditions of neurology, ophthalmology, and urology, respectfully ( US News & World Report, 2004).
The TMH, an acute care facility has a capacity of 868 beds and over five thousand employees. The only out-patient clinic, CAGT, housed within TMH, serves approximately 50 hematology/oncology and stem cell transplant patients a day. Coming to the CAGT clinic, patients have bypassed 41 institutions, including the number one ranked cancer center in the world, the M. D. Anderson Cancer Center. The CAGT clinic hours of operation are Monday through Friday, 7:30 AM until 6:00 PM (or until the last patient is discharged); Saturdays, 8:00 AM until 11:00 AM; closed at Sundays and national holidays.
The staff consists of one Medical Director, one Nurse Director, two Nurse Practitioners, one rotating Medical Fellow, and seven Registered Nurses (all with Oncology Nurse Certifications). There are three patient care associates (formally known as Nurses’ Aids), three secretaries and one Patient Accounts Assistant (handles issues relating to treatment charges, insurance verification, and billing inquiries). Services provided for stem cell patients, include but are not limited to; initial consultations, lab blood draws, EKG’s, chest x-rays, intravenous fluid infusions, transfusions, and pre- and post-transplant treatments.
Relatives, who may be donors, can have their work-ups in the clinic as well. Patients are also entered into the National Marrow Search Pool know as the National Marrow Donor Program (NMDP). Other services available are administration of research and investigational medications and chemotherapy. Some patients are administered red blood cell products, incision care and care of “lines” or implanted ports, which are either peripheral or central venous lines. The members of the multidisciplinary team consist of a social worker, wound care therapist, nutritionist, and emotional counselor (Psychologist).