Dr. Mary Lopresti
I have a very full and blessed life; I am a full time working mom of two children and have the privilege of caring for women with both breast and gynecologic cancer. However, many days, I struggle to get everything done and often find my head swirling with-- Will I get to day care on time? Who is making dinner? Did I write that chemotherapy order? Many days I feel I'm in quasi chaos and can't imagine another thing on my plate.
Yet, in my practice, I am getting to know (and have the privilege to treat) so many women with cancer that are my age, and some, even younger. Some with families, some with hope to have one some day in the future, all of whom show up for their visits, and their chemotherapy, and then for follow-up. All the while, they are striving to reach their own personal goals, keep jobs, and for those with families, to meet their needs too. I realized very early that they are my inspiration. I have a woman right now undergoing chemo-radiation for advanced cervical cancer, while caring for her 3-month old child. Like all of my patients, she did not ask for cancer, but she will do what she must. She is my hero. I also see how challenging life can be after a cancer diagnosis and the treatment journey, and I'm committed to make it easier for them.
I started the "Young Fight Strong" program in order to meet the needs of women 42 and under with cancer. I conducted a needs assessment early on with this group of women undergoing treatment at the Lifespan Cancer Institute in order to set goals and an almost universally expressed need concerned child care. As a busy mom, I could relate to this as an inherently intuitive need. However, I also know that for every intervention, there should be an objective and demonstrable impact, and this is where my passion becomes my program.
The Young Fight Strong Program is aimed at providing services to ease the journey of cancer for young women, but to go one step further to define objectively the tangible benefits provided to the woman, to their caregivers, to the system, and to society. I am looking for funds to help with our initial project, which will concentrate on women with kids under the age of 12. Our intervention will be to provide child care services, and our objectives will be to determine the impact of child care on quality of life for patients and timeliness of treatment. If we can prove that child care is not only the right thing to do but is a smart thing as well, my dream would be for child care services to be incorporated into all centers across the country for young families and that payers will see the value.
As a physician, it is important for me not to only focus on directing my patients to the best life-saving therapies but to address all of their needs as a whole person.
Distress is common in women with young children facing a new diagnosis of breast and gynecologic cancer. Studies have shown parenting to be a concern in these young women; having responsibility for dependent children under the age of 18 may heighten distress and diminish quality of life in this group. We are hoping to offer supports to these young women in hopes of alleviating some of the stressors at the time of treatment. We would like to conduct a feasibility trial evaluating the utilization of provided child care in young women undergoing IV chemotherapy for a diagnosis of breast/gynecologic cancer. We intend to enroll women who have children 12yr or under and see if it is feasible to provide this service. We would also like to measure their psychosocial distress and parenting concerns prior to receiving the service and how they are impacted when child care is provided. We would also like to evaluate whether women can complete their planned chemotherapy treatments on time at the expected intervals as we know that adherence to chemotherapy schedule is important for treatment benefit.
Why is this important?
There are no published studies looking at providing child care to young women undergoing chemotherapy. Our hope is that we can prove it to be feasible. We want to show that by providing child care, women may have less parenting concerns and distress at a challenging time in their life. This intervention may also show that chemotherapy compliance, timeliness, and adherence to schedule are improved, which may allow for better outcomes for these women. If providing childcare proves to be feasible, it may allow for insurers to see the importance and cover this support service in the future.
Who will benefit?
Our breast or gyn cancer patients will directly benefit from this project. They will be able to participate in free child care during the time of their chemotherapy treatments so that they can get treatment on time with out having to worry about child care responsibilities. Their significant others will also benefit from this service by knowing their loved ones are being cared for. The children will also benefit from interacting with others at the day care center.