Episode Transcript
[00:00:00] Speaker A: From Riverside Health System, this is the Healthy youy Podcast where we talk about a range of health related topics focused on improving your physical and mental health. We chat with our providers, team members, patients and caregivers to learn more about how to maintain a healthy lifestyle and improve overall physical and mental health. So let's dive in to learn more about becoming a healthier you.
Welcome to the Healthy youy the the podcast where we explore everyday health topics and talk to people who help keep our communities well. I'm your host, Frankie Myers, and today we're tackling a topic that's on the minds of many people. You have cancer and what next. Joining me is Julie Kilbourne, a medical social worker who supports patients and families as they navigate the emotional, practical and psychological impact of a cancer diagnosis. This episode is a vital one for our listeners or anyone experiencing or supporting someone through cancer. So, Julie, tell me a little bit about how you ended up in this profession as a social worker.
[00:01:12] Speaker B: Okay. So I always knew I wanted to help people and I liked helping people, but I didn't really know what that looked like as a career.
And then I became a social worker at Riverside and have been there 15 years. Inpatient and outpatient. Oncology, primarily oncology patients are really special in the sense that they're very grateful for all the help that you provide them during a really difficult time.
[00:01:40] Speaker A: Yes, yes.
So talk a little bit about what is the route to become a social worker. Sometimes you'll hear care manager, case managers, care coordinators, and social workers.
So talk to our viewers a little bit about more specifically in general, what a social worker does.
And then what's the difference in those different career paths.
[00:02:04] Speaker B: Sure.
So there's lots of licensing differences. Care coordinators can be licensed social workers. They can be just social workers as a job title, can also be nurses.
And so in the hospital, oftentimes they're used as case managers or discharge planners.
And then there's social workers that work in the community, you know, social services and home health and hospice.
And there's different levels of education. You can have your master's degree.
I have mine in health and wellness with a focus on end of life.
[00:02:39] Speaker A: Okay. Okay. Well, thank you for what you do and your commitment to serve because, you know, social workers are so pivotal to communities and helping our patients and families navigate many aspects of their care and care needs.
[00:02:57] Speaker B: Sure.
[00:02:58] Speaker A: Thank you. Before we dive into today's conversation, let's consider the scale of how cancer touches lives across the country.
Just a little background. According to the American Cancer Society's 2025 report, over 2 million new cancer cases are projected to be diagnosed in the US this year. That's more than five cases every day. That is scary.
The lifetime risk of developing cancer is approximately one and two for men and one in three for women. So higher for women.
As of 2025, more than 18 point million Americans are living with a history of cancer. And that number is expected to grow.
These numbers remind us that while treatments have advanced, the emotional experience and diagnosis remains as heavy as ever.
So talk to us about your role and how you support patients and families more specifically.
Which.
Just looking at that information and those numbers is a great need.
[00:04:06] Speaker B: Yeah, the cancer center is a very busy place, unfortunately.
[00:04:10] Speaker A: Yes.
[00:04:11] Speaker B: My role or as a social worker? We have several social workers within our cancer centers. We have coverage throughout all of them.
We provide a lot of emotional support to patients and families, connecting them to community resources, kind of reviewing barriers to care.
A lot of times there are geographic concerns like where the patient lives could change their needs.
[00:04:37] Speaker A: Right.
[00:04:38] Speaker B: For example, patients who live on the Eastern shore, some of them are self employed, may not have.
[00:04:43] Speaker A: And it's more rural. Right?
[00:04:44] Speaker B: Yeah. They may not have insurance and they live far away from the treatment centers usually.
[00:04:49] Speaker A: Okay.
[00:04:50] Speaker B: So. So their needs may be different than a patient who lives in Williamsburg.
[00:04:54] Speaker A: Okay.
[00:04:55] Speaker B: And so we just assess those needs in detail and then adjust accordingly.
[00:05:00] Speaker A: Okay. So navigators, you see them across other specialties now, but you know, I'm a nurse myself, 33 years.
I remember it starting in oncology. So do you work closely with this? So the navigators are kind of helping them navigate through this new diagnosis.
And in oncology and experience, do you work hand in hand with them or.
[00:05:27] Speaker B: I do. We collaborate daily.
We are on the same office space.
And then, you know, they do generally start off in the very beginning where I start off more in the treatment piece.
[00:05:39] Speaker A: Okay.
[00:05:39] Speaker B: And so if they meet a patient that they know is going to have needs, they will let me know. And then when they start coming to the clinic, that's when I would get involved.
[00:05:48] Speaker A: That's really good. Good stuff. Great information.
So let's stay in the moment. After a patient hears you have cancer, what do you find they need most in those early hours and days? I think it would even start from the time you find out there's something suspicious, you know?
[00:06:08] Speaker B: Yeah. I mean, working where I work, even going to get a mammogram, I'm thinking, oh no, what's going to happen?
And so I think you always have that anxiety in the back of your mind.
But in the beginning, patients really feel overwhelmed because you're going to so many different places.
You're getting your mammogram done or your biopsy in this location, and then you're going to the hospital for a scan and the oncologist, and maybe you're getting radiation.
And so they often feel very overwhelmed with the workout process.
So I try to let them know that this is the busiest time, things will settle down and reassure them that, you know, we do settle down after all of this.
[00:06:53] Speaker A: Yes.
[00:06:54] Speaker B: And so we do provide education classes as a group. And so patients and families can come and gather more information on how to take care of the patient and what to expect, which also gives them reassurance. And then after that, we give them a guided tour so they can see what it looks like to give them a better sense of what to expect.
[00:07:18] Speaker A: That's great. That's good information.
The sense of one step at a time.
It feels it's ground and it kind of keeps. Because looking at it as a whole, I would think would be extremely overwhelming. So that's a great way of looking at it. How do you help patients regain some sense of control after an overwhelming moment?
[00:07:38] Speaker B: I mean, I think that a lot of times we try to provide them with tools to help them be better organized. So if you can designate a person to be your communication tool, so you would. That person maybe would come to the appointment with you, be the note taker, and then share the information with the.
[00:07:56] Speaker A: Rest of the family, that's good, because if you're emotional, you're not listening. It's like whomp. Whomp.
[00:08:02] Speaker B: Whomp.
[00:08:02] Speaker A: You're not. Yeah, yeah, yeah.
[00:08:05] Speaker B: And so also, I provide a lot of support to family members and caregivers because they oftentimes feel helpless or don't know what to do.
[00:08:14] Speaker A: Right.
[00:08:14] Speaker B: And so guiding them in ways to relieve the patient by suggesting practical things like you could go to the grocery store. Patients go to the pharmacy so much. They could go to the pharmacy and pick up or help with kids.
And then sometimes more emotional things like just listening or being quiet, Just being there is helpful.
[00:08:39] Speaker A: Yes. Do you have therapists that you can use as well? Because I can see people needing more in depth.
[00:08:47] Speaker B: Yeah, yeah.
[00:08:49] Speaker A: Psychological support.
[00:08:50] Speaker B: Yeah. We do have a list of therapists that we provide.
We also have access to telehealth psychiatry.
[00:08:58] Speaker A: That's good.
[00:08:58] Speaker B: Our psychiatrist is wonderful. You know, I. Selling a psychiatrist to a patient can be difficult, but just share personal experiences. Other patients have been really successful with her.
[00:09:09] Speaker A: Right.
[00:09:10] Speaker B: So I think that that gives them a reassurance to show up and try.
[00:09:14] Speaker A: Yes, absolutely. And if you don't need it, fine. But knowing it's there. Yes, yes. That's great. That's great information. Julie, after the diagnosis, what kinds of support systems are typically put in place for patients? We talked about the therapy one.
[00:09:31] Speaker B: Sure, sure.
So our. At our center, we are made up of lots of different disciplines. So you'll have your doctor. Your doctor has their own nurse, and then they have a medical assistant.
But the support staff that we offer is myself. Social worker, dietitian, massage therapist, music therapy, and all of those services are free to the patient, so they're at no cost.
And so we're different in that we have integrative medicine, and that's funded by donors through the foundation.
[00:10:06] Speaker A: Okay, good, good.
What role does the social worker play?
And we talked a little bit about this during this time.
[00:10:17] Speaker B: Sure. I think that just to reiterate that we do have integrative medicine, but myself in particular, a lot of patients, especially the office that I cover in Newport News, are very underprivileged, low education levels, do not have a lot of money. And so just sitting with them during their visit or going to visit them while they're getting their chemo, simple social interactions mean. Mean a lot to them.
[00:10:47] Speaker A: Yes, absolutely. I think a key takeaway for me is that cancer care is not just medical.
[00:10:54] Speaker B: Right.
[00:10:54] Speaker A: Yeah. There's an emotional. Emotional support is integral to healing. And you've seen, you know, I've seen various cases where the emotional piece of a. Of a patient's mindset is key to their outcome compared to others.
I don't know if you want to touch on that a little bit. Sure.
[00:11:14] Speaker B: Yeah. If you can have a positive mind and. And think positively and surround yourself with people who are also thinking that, I think that it definitely affects your outcome.
You know, attitude is everything, you know?
[00:11:30] Speaker A: Yes, yes.
[00:11:30] Speaker B: So some people arrive in a bad state before they even have a cancer diagnosis, and so to try to pull them up from that can be difficult.
[00:11:39] Speaker A: Yeah, absolutely.
What are the immediate next steps someone could expect after a diagnosis?
[00:11:46] Speaker B: Sure.
So a lot of times we'll get patients that have had biopsies done, but they maybe need more staging scans like a PET scan or an mri.
And so those will be ordered and scheduled, hopefully quickly.
[00:11:59] Speaker A: And.
[00:11:59] Speaker B: And then a treatment plan will be determined. We provide written information on the drugs for the patient to take home to think about, probably obsess over.
[00:12:08] Speaker A: Yes. And they have so much at their fingertips with the Internet all over it's everywhere.
[00:12:15] Speaker B: We do the written information, and then at that time, if you needed a port, we would schedule a port placement and a chemo education class.
Once you start treatment, you'll expect to have lab appointments, scans, and follow ups routinely.
[00:12:32] Speaker A: Yes, absolutely. That's great information.
How do you help patients manage the overwhelming amount of information? I think one of the things that resonated with me is bringing that person along to be able to scribe for you, take notes, and then when you're in a better place, to just reabsorb the information so that you clearly understand.
[00:12:55] Speaker B: That's exactly right.
I also love MyChart.
It's so easy to reach your provider by MyChart.
Initially, I'll message a patient so that they can direct message me back and let them know that this is an open way to communicate with me.
Especially younger patients, it's hard to pick up the phone and like, ask for help, but sometimes it's easier to text that, and so that's a way that we can communicate. Navigators have cell phones, so it's easy to text.
Not everybody is tech savvy. And so we definitely, you know, can adjust for whatever communication needs. We have a translator system within the office so that people speak different languages. We're able to answer their questions, too.
[00:13:39] Speaker A: That's good. Yeah, that's really good.
So let's talk about the emotions a little bit more. The fears, the anger, the sadness and what's normal. And I think we all have different normal normalcies. Right.
[00:13:54] Speaker B: And a lot of times after a cancer diagnosis, it's a new normal.
[00:13:58] Speaker A: Right.
[00:13:59] Speaker B: I think it's very normal for a patient who's been diagnosed with cancer to feel depressed somewhat.
We definitely evaluate depression at each visit.
And we do that because things change over time. You know, you might be feeling depressed, and now you have an intervention and you're feeling better.
And so I think it's important to make sure that that's assessed and that resources are available for that.
[00:14:25] Speaker A: Yes, great point.
What are some of the healthy ways that people can cope? I know mine is Haagen Dazs ice creams, potato chips, but that may not be a healthy way.
[00:14:37] Speaker B: But I mean, we definitely encourage eating what you can during cancer treatment. The key is to not lose weight. If you gain weight, it's probably the good excuse.
[00:14:48] Speaker A: Okay, okay.
[00:14:50] Speaker B: But, you know, I think we connect them with various resources like counseling or therapy, or encourage them to talk to their doctor about medication management and just, you know, validating that this is a normal feeling. You know, there are certain Cancer diagnosis that actually cause depression. It's a part of it.
[00:15:08] Speaker A: Okay.
[00:15:08] Speaker B: And so just letting them know that this is normal and, you know, there's techniques like exercise or journaling or support groups. We offer all kinds of support groups. Which patients.
[00:15:22] Speaker A: Music is another one. Music therapy, art therapy.
[00:15:25] Speaker B: Nature. Yes, nature's my thing.
[00:15:27] Speaker A: Mindfulness.
Yes, yes, yes, absolutely.
Some red flags.
You know, I know isolation is one.
Are there others that you would think that, you know, even family members should be aware of to help support intervention?
[00:15:45] Speaker B: I definitely think isolation is a big one.
A lot of times when patients come to the center and they're not with their family members, they feel more vulnerable to share because they don't want to burden their caregivers with them.
[00:16:00] Speaker A: Yes. They don't want to worry them.
[00:16:02] Speaker B: Right, right. So I think that if we can pick up on something and share that with the caregiver and help them work through it, I think that's very helpful.
[00:16:11] Speaker A: Yeah, that's good stuff.
And I think what's abnormal is anything that's not your normal pattern, because we're all different, and only people that are close to you would even understand that.
[00:16:25] Speaker B: Sure.
[00:16:26] Speaker A: Yeah.
All right. Cancer affects more than just the patient, so the caregivers need support as well. So you want to talk a little bit about that?
[00:16:38] Speaker B: Sure.
I think caregiver burnout is definitely a thing. I think it's very in the back of patients minds that they don't want to ask for too much.
And so we actually developed a committee that meets monthly to talk about ways that we can support our caregivers and ways that we can do that is by making sure that they're taking care of themselves, keeping on top of their health.
You know, we can look at a caregiver and tell like, you need help.
[00:17:08] Speaker A: Yes.
[00:17:09] Speaker B: And so we spend a lot of time with patients and their families and get to know each other well.
And so I think they're comfortable asking if they do need help.
[00:17:18] Speaker A: Yes.
[00:17:19] Speaker B: That's good.
[00:17:20] Speaker A: That's good.
Any guidance for friends and family who don't know what to say? That's huge.
[00:17:26] Speaker B: It is huge.
So, you know, reminding them, providing them with reassurance that. That you're not a burden. I want to be here. I want to do this for you.
I think if you can, you know, people are always like, let me know how you can. How I can help.
[00:17:41] Speaker A: Yes.
[00:17:41] Speaker B: But not know what to say.
[00:17:43] Speaker A: Yes.
[00:17:44] Speaker B: And so instead of saying that, you could say specifically, you know, how can I? Instead of, how can I help you? Can I go to the Store for you. Can I cut the grass for you?
[00:17:56] Speaker A: Offering up specific things.
[00:17:58] Speaker B: Yeah. So that they're not thinking, okay, what, do I need help?
[00:18:01] Speaker A: Or just bring something that you see.
[00:18:03] Speaker B: Right, right, right. And so also, it's important to individualize their journey because we know so many people who have had cancer, and so everybody's journey is completely different.
[00:18:16] Speaker A: Yes.
[00:18:17] Speaker B: And you don't want to share too much about someone else's cancer and someone else's outcome.
[00:18:24] Speaker A: Yeah. Because that's their privacy and it's not helpful. Yes.
[00:18:28] Speaker B: Yeah.
[00:18:29] Speaker A: Yes.
Support groups.
[00:18:33] Speaker B: I love support groups. Yeah.
[00:18:37] Speaker A: All right, so let's close with hope, which I think is so important. What would you say to someone who just started this journey?
[00:18:47] Speaker B: I would say that you are not alone and that we have the support here to help you, and we really work together as a family to make sure that everybody is cared for.
[00:18:59] Speaker A: Yes. Yes.
And you're the perfect person. You're so calm.
I think that's important.
[00:19:07] Speaker B: Thank you.
[00:19:07] Speaker A: Just having that calming support during such a turbulent time.
So, Julie, thank you so much again for your compassion and insight. You've helped us understand what cancer patients really go through and how we can show up to help and support them.
So thank you for what you do, and thank you for taking time out of your busy schedule to come and chat with me a little bit. I feel calm.
[00:19:31] Speaker B: Good, good.
Thank you for having me. And, you know, it really is an honor to take care of patients and families during this time.
It's all I've known for the past 15 years, and I wouldn't change it. I love doing that.
[00:19:45] Speaker A: Yeah. There's so much that goes into taking care of a patient. Some of us are on the front lines. Some of us are in the vaccines and are never seen. But we could not do the work without the collective effort of all of our commitments. So thank you for being a part of the team.
[00:20:03] Speaker B: Thank you so much.
[00:20:04] Speaker A: And thank you to our listeners. If this episode helped you, please share it with someone you love and visit the Riverside Health Blog for more expert advice and information. Until next time, stay healthy.
Thank you for listening to this episode of Healthy youy. We're so glad you were able to join us today and learn more about this topic. If you would like to explore more, go to riversideonline.com.
[00:28:53] Speaker B: Thank you so much for having me.
[00:28:56] Speaker A: Nice to have you.
Great job.
Oh, yes.
All right. All right.
Yeah.
Don't believe all the hype on the real. And this stuff is hard.
[00:29:15] Speaker B: It's okay.
[00:29:16] Speaker A: All right, all right. So when I say Cheese. Just smile right at this camera.
[00:29:21] Speaker B: Okay.
[00:29:21] Speaker A: Glasses off. All right. All right. Say healthy you. On three. There you go. Yeah. It's all about it.
All right. I was gonna count down. Okay. Count down. Yes. Count.
Yeah.
Okay.
[00:29:36] Speaker B: One, two, three.
[00:29:38] Speaker A: Healthy, you.
Great.
Thank you. I won't get up. I got one more.
We have lunch. We have lunch. Great job. Thank you. Than you. Great job. Thank you. I did. I do feel calm, Julie. You did calm me down.
Social workers calm you down. They're the. They're the quiet force in the unity.
All right, before she goes, just FYI, that's horizontal. That's not vertical. What happened? Do you need a vertical shot?
[00:30:09] Speaker B: Horizontal. Okay.
All right.
[00:30:14] Speaker A: Thank you. Thank you for keeping me on track.
This is hard, but you know what? This has helped me in every aspect of public speaking. Oh, I bet. Oh, my gosh. I can talk on it, Sam.
Joining me is Julie Kilbourne. Hi, Julie. Julie is a medical social worker who supports patients and families as they navigate the emotional, practical, and psychological impact of cancer diagnosis. This episode is vital to our listeners and anyone experiencing a cancer diagnosis or. Or. Supporting someone through cancer.
Yeah. Last line. Through cancer.
Supporting someone through cancer.
This is harder than you think.
Okay. I'm gonna do it all over again. You want me do it all over?
