Jennie Barbieri, MD, FACP
A cancer diagnosis 20 years, even 10 years ago, meant something different than it does today. With today’s advanced treatment options, including chemotherapy and radiation, Proton therapy, CAR T cell therapy, and other forms of immunotherapy, patients with a cancer diagnosis are living longer. However, even when cancer is in remission, side effects, or other health concerns left unattended during cancer treatment, can still affect patients’ health.
That’s where Jennie Barbieri, MD, FACP, enters the picture. Barbieri is the first director of Bridging Oncology Care and Wellness Recovery at the Ann B. Barshinger Cancer Institute of Penn Medicine Lancaster General Health.
Seizing an opportunity for improving care
The new department and position were created because ABBCI saw an obligation to not only treat a patient’s cancer, but also to treat the side effects and promote the lifestyle changes that need to happen so the patient can continue on the path to recovery.
Barbieri provides a holistic, collaborative approach to wellness issues for cancer survivors to help improve their quality of life, delay or prevent heart disease, and manage other long-term effects of cancer treatments. She consults with patients in rehabilitation to hear their story and how post-cancer life has been for them. Based on their experience, Barbieri and the patient together will set goal(s) for their health and wellness and celebrate their small victories as steps to living a healthier life. The patient will see Barbieri three to four times over a six-to-eight-month period—and if they have lost their connection with a primary care doctor during their cancer treatment, she triages them to the primary care setting that is right for them.
Treatment takes a toll
Although cancer is often treatable, surgeries, radiation, and medications can leave patients at risk of long-term side effects such as cardiac disease, endocrine disorders including diabetes, and mental and physical limitations during recovery (sleep disturbances, weight gain, depression and anxiety, etc.). A 2023 survey by the National Coalition for Cancer Survivorship (NCCS) stated the top side effects of treatment listed by cancer survivors were exhaustion, depression, anxiety, and other mental health concerns; uncertainty status of the cancer; and loss of appetite and/or taste.
However, in that same survey, 77 percent of respondents said their main focus is/was eradicating their cancer. Since many patients forgo seeing their primary care physician during active cancer treatment, and often don’t share other concerns with their cancer team, these side effects and any other undetected health concerns will need to be addressed during remission.
“Putting it all together” for patients
Samuel Laube, a previous patient of Barbieri’s, said, “Dr. Barbieri was the one that helped me realize that I need to take care of my whole health, and not just my cancer, while I live with chronic myeloid leukemia (CML).”
Before meeting with Barbieri, Laube had not seen his primary care doctor since his cancer diagnosis over seven years ago. But after their first hour-long conversation, they had forged a plan to ensure his blood sugar levels were healthy due to a family history of diabetes, regularly check his blood pressure, emphasize self-care and mental health strategies, and schedule a double knee replacement surgery.
“I felt like I was constantly putting out fires when it came to my health,” Laube said. “But she helped me put it all together in my head—that if I do things to take care of my mind, body, and spirit, these things will keep me physically and mentally healthy. They are all connected.”
“Once in recovery, it’s about empowering the patient and giving them back some control over their life,” Barbieri said. “When you have cancer, you just have to survive; but now, we reevaluate what healthy and unhealthy habits they had during treatment so we can make small, attainable changes.”
Barbieri and her patients also discuss their “why”—a patient’s main motivator for living a healthy life. For some patients that may be playing with their grandchildren or spending time with their partner outdoors; others have lofty athletic goals they would still like to achieve.
This role has been deeply fulfilling for Barbieri—cancer patients hold a special place in her heart. Working in wellness recovery provides her the chance to share her knowledge on topics such as a whole-food plant-based diet, exercise, sleep, meaningful human connection, mindfulness, and curtailing tobacco and alcohol use, to get cancer survivors on the road to a healthier lifestyle.
“If patients aren’t bringing up these issues to their oncologist, and if they aren’t seeing their primary care doctor, they aren’t having them addressed,” she said.
Specializing cancer treatment at ABBCI
To meet the growing number of cancer survivors, the ABBCI team has grown to support the new generation of patients. The broad team of specialists includes cancer surgery, radiation therapy, medical oncology, physical and behavioral therapy, and now wellness. ABBCI also has a dedicated wellness subcommittee with members from across specialties, focusing on supporting patients’ wellness concerns. Barbieri co-chairs this committee along with Mariannette Calon-Munoz, CRNP, a radiation oncology nurse practitioner.
“The holistic care team provides patient-driven cancer care, which means that we listen to our patients and to their families,” said Randall A. Oyer, MD, executive medical director of ABBCI. “And a big concern when facing a cancer diagnosis and treatment is how a patient regains their health and wellness —so we knew adding a wellness specialty was needed at ABBCI.”
Survivorship programs across the Penn Medicine system
Patients with cancer from across the Penn Medicine system have access to survivorship and wellness care no matter where they live. Starting in 2001, Penn Medicine has been addressing the need for long-term survivorship care by starting the first adult cancer survivorship program at the Penn Medicine Abramson Cancer Center in Philadelphia. Patients can also access the OncoLife Survivorship Care Plan which helps cancer survivors learn about prevention and monitoring for long-term and late after-effects from their treatments, customized according to their medications and other treatments. (As of early 2024, it had been used to create over 122,000 survivorship care plans.)
OncoLink is a website dedicated to providing patients and providers with cancer information—and is celebrating its 30th anniversary this spring.