Palliative care team brings expertise,
to cancer patients
From the left are physicians Laura Hanson and Stephen
Bernard and nursing coordinator Chip Baker – all affiliated with the UNC
Palliative Care Program.
patients find some relief from their pain or depression requires commitment and
compassion. For Stephen Bernard, co-director of the Palliative Care Center and
professor in the School of Medicine’s division of hematology/oncology, these
attributes seem to come naturally.
“As a cancer specialist, he is compassionate toward the pain
and distress caused by this disease,” said Laura Hanson, co-director of the UNC
Palliative Care Program. “He is tireless and singularly dedicated to the
sickest group of cancer patients.”
Bernard’s path to palliative care, an approach that improves
the quality of life for patients dealing with life-threatening illnesses,
started four decades ago.
He earned his undergraduate degree in biology from the
University of Pennsylvania in 1968 and went on to receive his medical degree
from Carolina five years later.
Then, in 1998, he did a sabbatical at the University of
Alberta with Eduardo Bruera, a Canadian expert in
symptom management and palliative care, and brought his newfound expertise back
to the Lineberger Comprehensive Cancer Center.
Palliative care differs from hospice care that aids dying
patients who forgo treatment. Cancer patients are among the beneficiaries, but
palliative care – which has been an important part of care in other
countries – is not limited to people with cancer. In the last decade,
palliative care has become increasingly recognized in the United States as
active treatment for a patient’s condition.
Bernard helped start a committee to look at pain-management
needs at UNC Hospitals and the medical school. During that process, he
recognized that patients’ emotional symptoms and family needs were not being
met with pain management alone.
After years of caring for patients with advancing cancer,
Bernard and Hanson believed palliative services were needed
They helped initiate the UNC Palliative Care Program,
developed about eight years ago through funding from the Duke Endowment.
Additional funding was provided by the University Cancer Research Fund to focus
on symptom management in outpatients with cancer through the Supportive Care
Consult Service and Clinic.
Supportive care is only for adult outpatients with cancer.
Bernard, along with John Valgus, a pharmacist who is trained in oncology and
certified to write prescriptions, and nurse consultant Sandi Jarr visit patients who are being seen at the N.C. Cancer
Hospital and the surgical, medical, radiation and gynecologic oncology clinics.
After the meeting, the team develops an action plan, runs
the recommendation by the patient’s primary oncologist and, if approved,
implements the plan.
“The goal is to help patients manage their symptoms, whether
they are due to the disease or its treatment,” Bernard said.
Bringing these services to the patients is key because more
than half travel at least an hour to get to Chapel Hill.
The supportive care program sees between 10 and 15 new
patients each month and has been following 200 to 300 patients since the
service began. This is in addition to seeing 400 patients a year in the
Because some patients with complex care issues require a
longer visit, the team also developed a half-day clinic. Soon, Bernard said,
the supportive care program will need additional resources and personnel.
Both patients and their families feel that the combination
of medical, nursing and pharmacy expertise makes a difference in symptom
management, he said. The biggest obstacle has been gaining acceptance by the
“We have made presentations to most of these groups, and
we’ve had a fairly positive reception,” he added.
Bernard, who has clinical interests in gastrointestinal
cancer and palliative/supportive care, also coordinates the palliative care elective
rotation for fourth-year medical students.
For more information about the Supportive Care Consult
Service and Clinic, refer to www.med.unc.edu/pcare/clinical-1/supportive-care-consultation-service-and-clinic. For information about the
Palliative Care Program, refer to www.med.unc.edu/pcare.
Editor’s Note: This article was written by Chala Jones, a junior who is double majoring in
journalism and mass communication and Romance languages.