Patient: Understand That Cancer has a Psychological Impact

As time went on after Juan Davila’s 2018 diagnosis of advanced lymphoma, he realized that he was dealing with more than cancer. “After five years, I was completely broke,” says the 60-year-old former advertising executive from Coral Gables. “I had to sell my house.”

Davila’s treatment at Sylvester Comprehensive Cancer Center began with an eight-month R-CHOP chemotherapy regimen. 

He responded well and went into remission. 

Then he completed a course of immunotherapy. But around six months later, the cancer returned. 

“I had to do a bone marrow transplant … or I had two months to live,” he says. 

Thankfully, his sister was a perfect match. Today Davila is in remission. But the experience rattled him — emotionally and financially.

Throughout most of his treatment, Davila felt good. 

“Even when I got sick, I never looked bad,” he says. “But there was some trauma that I wasn’t aware of.” Although he was insured, the out-of-pocket expenses and missed workdays took a toll. Eventually, he lost his job. He went from positive and energetic to stigmatized and depressed.

“I lost a lot of purpose and ambition,” he says.

Davila’s emotional state was reflected in his responses to the My Wellness Check.

Piloted in 2019 and launched systemwide in 2022, My Wellness Check helps Sylvester caregivers assess the needs of cancer survivors and develop comprehensive plans to meet those needs, reduce the burden of cancer, and enhance the quality of life.

In fact, in previous Sylvester studies, researchers found that survivors who complete the My Wellness Check assessment report fewer emergency department visits and hospitalizations. 

This is supported by a new Sylvester study published in June 2023 by the Journal of the American Medical Association which shows that when physical, emotional, and practical needs are met, survivors are less likely to visit the emergency room or be hospitalized. Therefore, using My Wellness Check to identify and address these unmet needs is crucial to improving clinical outcomes in our patients. 

My Wellness Check is an assessment that Sylvester patients are asked to complete 72 hours before most of their appointments. The patients’ responses to the questionnaire are inserted into their electronic health records (EHR). The computerized assessments are linked to the patient’s MyChart portal. When a patient’s needs are identified, providers are notified in real time.

Patients can complete the My Wellness Check assessment on their smartphones, tablets, or any computer with an internet connection. “It’s all stored in their EHR,” says Vandana D. Sookdeo, M.D., E.M.B.A., director of administrative operations at Sylvester.

Davila’s responses to the My Wellness Check questionnaire picked up on his feelings and alerted his care team. But he was already aware. 

“I told my doctor every time I do the wellness check, there is a section on mental health and the more I fill it out, the more I realize my lack of motivation, my lack of ambition. I’ve become a procrastinator, so we’ve got to fix that.” 

Davila’s physician, who had already been alerted through My Wellness Check, recommended a therapist with whom he could talk about the trauma of his cancer experience.

According to the American Cancer Society, advances in early detection and treatment have led to an increase in the number of cancer survivors in the United States. 

By 2032, there will be an estimated 22.5 million cancer survivors, a 24% increase over today.

“We’re getting a population not only dealing with a cancer diagnosis,” says Dr. Sookdeo, “but comorbidities from the aging process of life. People are living longer, and we manage post-cancer treatments and these comorbidities too.”

Davila describes himself as compliant and disciplined. 

“By nature, I like to follow instructions when it comes to my health,” he says. “I take my health seriously.” At first, the questionnaire felt to him like “another thing to fill out.” 

Multiple-choice questions, he says, can be annoying. 

“But I wanted to understand the data,” he says. “I decided to partner with myself and take this seriously.” 

The My Wellness Check assessment starts with simple questions such as, Did you fall this week? 

“Then there is more when it comes to mental health,” says Davila. “I thought it was genius in the simplest of forms. You need desperately to understand that cancer has a psychological impact on you whether you have the thickest skin or not.”

 “At Sylvester, we want to create a precision care experience,” says Dr. Sookdeo. “My Wellness Check helps us understand patient needs, assess emotional and mental well-being, provide a unique care plan, and understand the financial impact of cancer care,” as well as patients’ physical activity levels, sexual health, and sleep.

“I learned something from this,” says Davila. 

Cancer inflicts wounds that have nothing to do with cancer. 

Juan Davila

He plans to get involved in helping other cancer survivors. 

“I have years and years of making companies money,” he says. “But I want to devote the last years of my life to making people happy.”

Louis Greenstein is a contributing writer for UHealth’s news service.

Learn more about My Wellness Check.

Tags: cancer care in Miami, cancer journey, Dr. Frank Penedo, Dr. Vandana Sookdeo, mental wellness, my wellness check, Survivorship