World-class cancer care

A personal journey reflects multidisciplinary approach

“When you’ve just heard you have cancer, the world is spinning at light speed,” reflects Rick Osterberg, one of the thousands of grateful patients of the Mass General Cancer Center at Newton-Wellesley.

In 2018, after symptoms led him to visit his NWH primary care physician, Nicholas Mascoli III, MD, a CT scan followed by an emergency colonoscopy revealed a malignant mass in Rick’s colon. Only 44 at the time, he’d never imagined the possibility.

As he awoke from the GI procedure, his wife, Jessica Stokes, was at his bedside along with Laurence Bailen, MD, Chief of Gastroenterology, and nurse navigator Kim Doyle to share the news. Kim had already scheduled him to see the trio of cancer specialists who’ve guided his care: Drs. Lawrence Blaszkowsky, Todd Francone, and Theodore Hong.

Today, with his disease stable and virtually no toxicity to treatment, Rick enjoys an extremely high quality of life.

His journey reflects the unique blend of highly per-sonalized and collaborative care that patients with cancer are finding right here, close to home. Looking back, “Did I make the right decision going to Newton- Wellesley?” he asks aloud. “1000%.”

A collaborative team of experts

Rick was born at NWH and grew up only a couple of miles away. He sees today’s Newton-Wellesley as continually “upping their game,” staying true to its mission as a community hospital while being a core part of Mass General Brigham’s efforts to bring the expertise of academic medical centers where patients are.

One of Rick’s most vivid memories is meeting with the three lead physicians on his care team at the same time. “All three of them along with me and my wife were in this tiny exam room,” he recounts. They each had different styles, personalities, and approaches. “What I really appreciated about them as a triad was how they were so in synch with each other,” he says.

In the past, patients tended to see specialists sequentially and get information in bits and pieces. Now, “we offer them a comprehensive, patient-tailored approach,” notes Dr. Francone, a colorectal surgeon and Director of Robotic Surgery at Newton-Wellesley. Being close together at NWH helps the team readily collaborate. They review patients’ cases together prior to clinic and come in with a plan.

“When patients see us together in the same room, they have a tangible feeling that their case is being discussed, ” he adds. It sends a message to their patients: “they’re worth it.”

“It’s natural for people to have fears, and we’re not always able to ease them,” he acknowledges. Yet he and his colleagues do their best to answer patients’ questions and provide reassurance that they’re in the right place. They leave knowing the team, the plan, and what to expect.

As Rick explains, “it’s magic when it happens.”

Multidisciplinary care for any cancer

Rick’s experience exemplifies the team’s approach with every patient. “All of us are seeing the initial results,” notes Dr. Blaszkowsky, Medical Director of the MGCC at Newton-Wellesley and the hospital’s Chief of Hematology/Oncology. “All of us believe it’s important to be actively engaged and informed.”

For NWH patients and their families, he explains, the arrival of medical oncology from Mass General in 2016 began a new chapter in cancer care. Ever since, the list of subspecialties at Newton-Wellesley has grown, including breast, colon, lung, and other cancers. The rise of multidisciplinary clinics has meant that patients benefit from a highly collaborative team of experts in their particular cancer. “Multidisciplinary care for any cancer is the standard of care,” Dr. Francone adds, in echoing his point.

“It’s a very different model from what’s existed in the past at community hospitals,” explains Dr. Hong, a radiation oncologist. While many hospitals describe themselves as having multidisciplinary approaches, he sees NWH as a very unique setup. “It’s unique to have the degree of specialization we have here,” he adds.

His own collaboration with Dr. Blaszkowsky began when he first joined him at MGH in 2005. They’ve built on that since becoming part of the MGCC at Newton- Wellesley together seven years ago. “We’re fortunate to have other great colleagues here who want that same level of collaboration,” he says. “People have embraced working together to provide the best of care. We’re one of the most robust examples of how this can work when everyone’s on board.”

GI cancers are very complex. Today at Newton-Wellesley, “we take care of cases equally as complex as what I see downtown,” Dr. Hong says. “And our team brings the same level of expertise to patients.” From his vantage point, “integrated care delivery is going to be the future,” he predicts, and cancer care will continue to shift closer to where the patients actually live.

On the front lines

“Where we are now has greatly expanded the level of care,” Dr. Laurence Bailen reflects, building on Dr. Hong’s point. “What we’re seeing is the integration with Mass General Brigham while maintaining the uniqueness and specialness of a community hospital.” In talking to patients, he hears how much they value “having all of the same opportunities of an AMC and having it here, close to home.”

He appreciates being part of the increasingly collabo¬rative culture and views it as a key to a truly multidis-ciplinary program where patients get comprehensive cancer care.

Along with Drs. Blaszkowsky, Francone, and Hong and others, he takes part in a GI tumor board conference every Thursday morning to discuss optimal care. Gathering virtually at 7 a.m., “we work closely together to collaborate and communicate,” he notes. While it’s typical of academic medical centers, “I don’t know how many community hospitals have that in place,” he adds. He joined the Newton-Wellesley staff 20 years ago. While a version of a tumor conference existed early on, “today, the multidisciplinary model is much more organized and robust.”

“We as gastroenterologists are on the front lines for seeing patients and diagnosing a cancer,” Dr. Bailen reflects. He frames their role as “first responders, so to speak.”

When someone is first diagnosed, he has complete trust in Kim Doyle, the nurse navigator, to take it from there. “I know when I reach out to her that they’ll get what they need.”

A guiding hand for navigating treatment

To Dr. Blaszkowsky, the nurse navigator’s role sends a powerful message.

In the case of colorectal cancers, if something concerning turns up during a procedure, Kim Doyle will be paged immediately by the GI suite. As in Rick’s case, when patients are learning their diagnosis, she’ll often already be there. “I’ll introduce myself and my role, and explain that I’m here to coordinate your care,” she says. “Sometimes I just sit down with them and hold their hand,” she says. Even if no words are exchanged, she wants them to feel, “We’ve got this.”

Her goal is to get the next steps scheduled right away so they get the care they need without delay.

“I’ll then connect with them later in the day and try to reassure them,” she notes. Thanks to her, “they feel taken care of, and they don’t get lost.”

She stresses to the patients: “This is the hardest time.” Some may call her 10 times. With every conversation, “I try to get a sense of where they are and how they’re coping,” she says. “They just need to know they can get a hold of someone.” She wants them to know that she’ll be there: “You’re my person.”

She’s been at Newton-Wellesley for 20 years. At only 4 years old, she lost her mother to cancer, and her sister was diagnosed with leukemia in her 20s. In Kim’s work, she’s taken care of a nursing colleague who was like a mom to her. “I consider getting to do this work as my silver lining.”

It’s not easy. It’s not straightforward. But it’s so rewarding. “I feel blessed at the end of every single day,” she shares.

Taking the time to know you

“There’s no ‘routine’ cancer,” as Dr. Francone puts it. Every case is individual. While Rick had his initial surgery at MGH with Dr. Francone, he’s relied on the MGCC at Newton-Wellesley for his own ongoing treatment. “I have all the same care and expertise in a smaller and more personal place.”

“I know all the nurses and staff. They know my wife. We have deeper, more personal relationships because of its size,” he says. “I like that I walk in, and people know who I am and know my history.”

At NWH, “it feels like a family,” adds Kim Doyle. She looks at both her patients and her colleagues as “beloved family,” true to the mission.

As she talks, she looks around the infusion room at the Cancer Center. “There’s hundreds of years of experience on the team here.”

“People here take the time to know patients and to realize what they need,” she says. “I’m not sure where else you’re going to get that.”