Care Partner Resources Archives


The Nitty Gritty on Care Partnering

For those of us who are sometimes patients, and at other times care partners, it can be useful to have a checklist to make helping a friend or family member navigate cancer treatment, or treatment for any other medical condition.

Here’s a short list that can be used in any patient-with-a-bedside-care-partner situation. If you have any ideas for things that would be good to add, hit me up via @MightyCasey, or shout out to @Power4Patients, on Twitter.

Here we go.

  • Make sure you – the care partner – have been named in your patient buddy’s Advance Directive as the person who can speak for your friend when they can’t speak for themselves due to intubation, anesthesia, or loss of consciousness. Here’s a handy link with downloadable forms to create an Advance Directive in all 50 US states.
  • Since you’ll be speaking for your friend in situations where they can’t speak for themselves, it’s critical that you know what their wishes are in scenarios from “coming out of anesthesia” to possible life support situations. What are your friend’s wishes? These are sometimes tough conversations, since facing mortality isn’t something humans are naturally wired to do. Two tools that can help you and your friend figure out the what-ifs for their wishes are Engage With Grace and The Conversation Project. Pick one, get started.
  • Do you have access to your buddy’s patient portal? Most EHR software platforms have “share” utilities where you can share your record with a care partner. Get that organized early in the care partnering process, so you can be able to answer questions about medications and patient history when your friend can’t speak for themselves.
  • Speaking of medication lists, make one. It can be as simple as a notes file on your phone, or a printed sheet that you can refer to, and copy, for anyone who needs it. Update it as/if medications are added to your friend’s list. Make sure you have dosages and timing for all of them on that sheet or in that note file, too.
  • Is surgery involved in the treatment plan? If so, make sure you and your buddy keep a calendar of pre-op testing requirements – blood work, scans, and so forth. A shared Google calendar can be a great tool here, or you could go old-school and just use a wall calendar with large blocks to write on each day.
  • Will you need durable medical equipment (DME) during the treatment and recovery process? DME is stuff like wheelchairs, walkers, knee scooters, woundVAC systems. You can either buy or rent this gear. Pro tip: Amazon and Walmart pricing on this stuff is much less than from a traditional medical supply house.
  • On that supplies front, there might also be what are called “expendables” required: bandages, wound wraps, bandage tape, wound packing material, and so forth. Another pro tip: if you need to buy this stuff, Amazon is the medical supply house with all the best deals. What costs you $40 at the local drugstore will cost you $8-10 or less on Amazon.
  • Will home health care be part of your friend’s recovery? Working with the Nurse Care Manager at the hospital or health system where your buddy’s getting care, get a list of reputable home health agencies in your geographic area, and interview them. Asking questions about how they coordinate care across nursing, occupational therapy (OT) and physical therapy (PT) sessions. Recent personal experience here is that a home care agency that has a system in place for “who’s on next” and “when are they coming” that’s left in the patient’s home, useable by them (the patient) and the home care crew is who you want to hire.

Care partnering with someone isn’t something to be taken lightly – if a friend asks you to do it for them, it’s a mark of how much they trust you. If you’re someone facing a Big Medical Adventure, figure out who you trust enough to walk with you through that adventure, making decisions that align with your wishes when you can’t speak for yourself. It’s one of the most human acts of kindness you can perform, care partnering.

How to Be a Good Care Partner 101

How to Be a Good Care Partner 101 from Patient Empowerment Network on Vimeo.

 What is the most important aspect of being a good care partner? MPN Network Managers, Jeff and Summer give tips on best practices for being a phenomenal care partner. Jeff breaks down his strategy for managing Summer’s myelofibrosis, including modifying their schedules due to Summer’s fatigue.

Most important tip?
Jeff: “To be a good caregiver, you have to take care of yourself.”

Want to connect our MPN Network Managers, Jeff and Summer? Email them,

Empowered! Podcast: Meet Andrea Conners

Today, we’re extremely proud to introduce our first-ever Empowered! podcast. Empowered! will bring you conversations around topics that are important to patients and care partners.

For our first episode, we meet Andrea Conners. Andrea is Patient Empowerment Network’s Executive Director. Andrea shares a little bit about herself, about PEN, and her inspiration in getting involved.


Confused About Immunotherapy and Its Side Effects? You Aren’t Alone

“You don’t look like you have cancer.”

More than one patient undergoing immunotherapy to treat cancer has reported hearing statements like that. Immunotherapy is one of the recent advances in cancer treatment that belie the stereotypes about the effects of cancer treatment. 

The side effects of immunotherapy are different from those associated with chemotherapy and radiation. However, that does not mean immunotherapy does not have side effects. Patients and care partners need to be aware of these potential side effects and to be vigilant in addressing them with their oncologists because they can signal more serious complications if left untreated.

What is Immunotherapy?

Despite the increase of immunotherapy treatment options in recent years and considerable media attention paid to advancements in this field, there remains confusion about immunotherapy and its side effects. Many cancer patients are unaware of whether immunotherapy treatments are available for their specific diagnosis. Others don’t know that genetic profiling of their tumors is usually required to determine if immunotherapy is an option and not all treatment centers routinely conduct genetic profiles of tumors. A  survey by The Cancer Support Community found that the majority of patients who received immunotherapy knew little to nothing about it prior to treatment and were unfamiliar with what to expect.

Immunotherapy works by manipulating the patient’s immune system to attack cancer cells. It is perceived as gentler and more natural than chemotherapy and radiation, without the same destructive effect on the body’s healthy tissues.  This, combined with a lack of prior understanding of immunotherapy, can lead patients and care partners ill-prepared for possible side effects.

Furthermore, immunotherapy is a category of therapies, not a single type of treatment. There are a variety of immunotherapy drugs, most of which are administered via infusion.  Side effects will vary by drug, the cancer and its location, treatment dose, and the patient’s overall health.

The following are the most common types of immunotherapy.

  • Checkpoint inhibitors use drugs to block proteins in the patient’s immune system that would otherwise restrain the immune system, often referred to as taking the “brakes” off the immune system.
  • CAR-T therapy modifies the patient’s T-cells in a lab to enhance their ability to bind to cancer cells and attack and kill them.
  • Oncolytic virus therapy uses genetically modified viruses to kill cancer cells.
  • Another therapy uses cytokines (small proteins that carry messages between cells) to stimulate the immune cells to attack cancer.

Immunotherapy can be part of combination therapy. It might be combined with chemotherapy. It might be used to shrink a tumor that is then surgically removed.  Or multiple immunotherapy drugs might be used simultaneously.

What Are The Side Effects?

With immunotherapies, side effects typically occur when the immune system gets too revved up from the treatment. The most common side effects for immunotherapy treatments are fatigue, headache, and fever with flu-like symptoms. Some people also experience general inflammation often in the form of a rash. Many melanoma patients report blotchy skin discoloration, called vitiligo, during treatment. These milder side effects can usually be managed with over-the-counter remedies and adjustments to daily activities.

For checkpoint inhibitors, the fastest growing segment of immunotherapy treatments, mild side effects occur in 30% – 50% of patients. Serious side effects typically occur in less than 5% of patients. (See “Understanding Immunotherapy Side Effects” from the National Comprehensive Cancer Network and the American Society of Clinical Oncology.)

Less common side effects are blisters, joint pain, thyroid inflammation, and colitis (inflamed colon resulting in diarrhea with cramping). Some patients who receive CAR T-cell therapy develop a condition known as cytokine release syndrome, which causes fever, elevated heart rate, low blood pressure, and rash. 

In rare cases, immunotherapy has resulted in lung inflammation, hepatitis, inflammation of the pituitary, and detrimental effects on the nervous and endocrine systems. In most cases, the conditions clear up when treatment ends.  However, there have been outcomes in which immunotherapy caused diabetes or tuberculosis.

“Overall there are fewer side effects [with immunotherapy],” explained Dr. Justin Gainor, a lung and esophageal cancer specialist at Mass General during an Immunotherapy Patient Summit hosted by the Cancer Research Institute. “But the immune system can affect anything from the top of the head down to the toes. Any organ has the potential to be affected.”

As the application of immunotherapy has expanded, so has our understanding of the potential side effects. Like most medical treatments, how one person responds to immunotherapy can be different from another even when the cancer diagnosis and drug therapy are the same.

The essential thing patients and care partners need to know about side effects is they should always be reported to their oncologist or nurse oncologist.

Why Patients Should Talk to Their Provider About Immunotherapy Side Effects

Because immunotherapy has created newer therapy options, there isn’t the volume of experiences as with older treatments. The infinite number of variables that patients provide once a treatment moves beyond clinical trials and into the general patient population generate more diverse outcomes.  And, as most therapies are less than 10 years old, there hasn’t been an opportunity to study the long-term effect of these therapies. This is why oncologists advise patients and their caregivers to be extra vigilant in noting any changes experienced during and after treatment.

Many side effects are easy to treat but medical providers want patients to be forthcoming in discussing any and all side effects. This is in part to improve understanding of side effects, but also because a mild cough or a case of diarrhea might be harbingers of a more systemic issue that will grow worse if left untreated.

Patients should not be hesitant to discuss side effects because they fear they will be taken off immunotherapy.  Sometimes a pause in treatment might be necessary, but the earlier the oncologist is made aware of a side effect, the less likely that will be necessary.

In addition, patients undergoing immunotherapy should always take the name(s) of their immunotherapy drugs and the name of their oncologist when seeing medical professionals outside of their cancer treatment team. This is especially important when visiting the ER.  Because immunotherapy drugs are newer and highly targeted to certain cancers, many medical professionals remain unfamiliar with drug interactions and treating related side effects.

Immunotherapy On The Rise

Immunotherapy treatments have resulted in reports of remission in cases that would’ve been deemed hopeless just five or 10 years ago.  The Federal Drug Administration (FDA) has approved various immunotherapy treatments for melanoma, lung cancer, head and neck cancer, bladder cancer, cervical cancer, liver cancer, stomach cancer, lymphoma, breast cancer, and most recently bladder cancer.  (Here is a list of  immunotherapies by cancer type from the Cancer Research Institute.)

“It’s revolutionized how we treat our patients,” says Dr. Gainor of Mass General about immunotherapy’s impact on lung and esophageal cancer.

Advances in immunotherapy research and trials continue to generate optimism and excitement. A clinical study in Houston is looking at using immunotherapy to prevent a recurrence. Researchers in Britain recently announced a discovery that might lead to advances in immunotherapy treatments to a much broader array of cancers.

While there is excitement around the field of immunotherapy and it has resulted in unprecedented success in treating some previously hard-to-treat cancers, it remains an option for a minority of cancer diagnoses.  It works best on solid tumors with more mutations, often referred to as having a high-mutational load or microsatellite instability (MSI) high. And it is not universally successful for every patient.

With hundreds of clinical trials involving immunotherapy alone or in combination with other therapies, it is certain more treatment options are on the horizon. As more therapies are developed and more patients with a greater variety of conditions undergo immunotherapy, we will also increase our understanding of potential side effects.

Side effects should not dissuade patients and care partners from considering immunotherapy if it is available or from advocating for genetic tests to deteimine if it is an option. Many patients undergoing immunotherapy have previously undergone chemotherapy and report that the side effects are fewer and milder by comparison.  The important thing is that patients and their partners know what to expect and communicate with their treatment team.

If the next 10 years in immunotherapy research and development are anything link eth elast 10, we can expect more exciting advancements in the battle against cancer. For more perspective on what’s ahead for immunotherapy see the Cancer Research Institute’s article: Cancer Immunotherapy in 2020 and Beyond.

Living The Role of The Cancer Caregiver, With Kandis Draw

This WE Have Cancer podcast was published on December 17, 2019 here.

Kandis’ mother succumbed to cancer in 2014. Not only was she her mother’s caregiver she also was charged with caring for her younger siblings. During this time she was literally burning the candle at both ends. During this conversation they discuss:

  • How she wished she knew of the resources available to support her during such a difficult time in her life.
  • The importance of reaching out to people in similar situations as a source of support.
  • The importance of self-care when serving as a caregiver and the enormous challenges she faced while caring for both her sick mother and her younger siblings.
  • How her relationship with with her mother blossomed during her illness.
  • The stigma in the African-American community around going to psycho-therapy and what motivated her to seek support.
  • How she coped with her mother’s passing.

Understanding Patient-Centered Care via Alliance for Patient Access

The Alliance for Patient Access created a video to help you understand patient-centered care.

Triage Cancer’s Quick Guide to Health Insurance: Employer-Sponsored & Individual Plans


Triage Cancer’s Quick Guide to Health Insurance: Medicare


Understanding Clinical Trials: A Jargon Buster Guide

When it comes to cancer treatment you or a loved one may be considering participating in a clinical trial as a treatment option.  Clinical trials are designed to evaluate the safety and effectiveness of a treatment. They may involve researchers administering drugs, taking blood or tissue samples, or checking the progress of patients as they take a treatment according to a study’s protocol.

Learning about clinical trials can be a steep learning curve – not least because the process comes with a lot of new terms, acronyms and jargon.  To help you, I’ve put together this list of the most common terms you will find when you are researching clinical trial information. This is not an exhaustive list but it is a helpful starting point. At the end of this article you will see links to find more information.

Adverse Effects (AE)

Also called Adverse Events, or Adverse Drug Reaction, AEs are any harmful event experienced by a person while they are having a drug or any other treatment or intervention. In clinical trials, researchers must always report adverse events, regardless of whether or not the event is suspected to be related to or caused by the drug, treatment or intervention.


Subsection of people within a study who have a particular intervention.


Bias is an error that distorts the objectivity of a study. It can arise if a researcher doesn’t adhere to rigorous standards in designing the study, selecting the subjects, administering the treatments, analysing the data, or reporting and interpreting the study results. It can also result from circumstances beyond a researcher’s control, as when there is an uneven distribution of some characteristic between groups as a result of randomization.


Blinding is a method of controlling for bias in a study by ensuring that those involved are unable to tell if they are in an intervention or control group so they cannot influence the results. In a single-blind study, patients do not know whether they are receiving the active drug or a placebo. In a double-blind study, neither the patients nor the persons administering the treatments know which patients are receiving the active drug. In a triple-blind study, the patients, clinicians/researchers and the persons evaluating the results do not know which treatment patients had. Whenever blinding is used, there will always be a method in which the treatment can be unblinded in the event that information is required for safety.


When a treatment for a specific medical condition already exists, it would be unethical to do a randomized controlled trial that would require some participants to be given an ineffective substitute. In this case, new treatments are tested against the best existing treatment, (i.e. a comparator). The comparator can also be no intervention (for example, best supportive care).


A trial is considered completed when trial participants are no longer being examined or treated (i.e. no longer in follow-up); the database has been ‘locked’ and records have been archived.


A group of people in a study who do not have the intervention or test being studied. Instead, they may have the standard intervention (sometimes called ‘usual care’) or a dummy intervention (placebo). The results for the control group are compared with those for a group having the intervention being tested. The aim is to check for any differences. The people in the control group should be as similar as possible to those in the intervention group, to make it as easy as possible to detect any effects due to the intervention.


How beneficial a treatment is under ideal conditions (for example, in a laboratory), compared with doing nothing or opting for another type of care. A drug passes efficacy trials if it is effective at the dose tested and against the illness for which it is prescribed.

Eligibility Criteria/ Inclusion and Exclusion Criteria

Eligibility criteria ensures patients enrolling in a clinical trial share similar characteristics (e.g. gender, age, medications, disease type and status) so that the results of the study are more likely due to the treatment received rather than other factors.


Observation over a period of time of participants enrolled in a trial to observe changes in health status.

Informed Consent

A process (by means of a written informed consent form) by which a participant voluntarily agrees to take part in a trial, having been informed of the possible benefits, risks and side effects associated with participating in the study.


The treatment (e.g., a drug, surgical procedure, or diagnostic test) being researched. The intervention group consists of the study participants that have been randomly assigned to receive the treatment.


A person responsible for the conduct of the clinical trial at a trial site. If a trial is conducted by a team of individuals at a trial site, the investigator is the responsible leader of the team and may be called the principal investigator (PI).

Multicentre Trial

A clinical trial conducted according to a single protocol but at more than one site, and therefore, carried out by more than one investigator.

Number needed to treat (NNT)

The average number of patients who need to receive the treatment or other intervention for one of them to get the positive outcome in the time specified.

Outcome Measures

The impact that a test, treatment, or other intervention has on a person, group or population.

Phase I, II, III and IV Studies

Once the safety of a new drug has been demonstrated in tests on animals, it goes through a multi-phase testing process to determine its safety and efficacy in treating human patients. If a drug shows success in one phase, the evaluation moves to the next phase

  • Phase 1 tests a drug on a very small number of healthy volunteers to establish overall safety, identify side effects, and determine the dose levels that are safe and tolerable for humans.
  • Phase II trials test a drug on a small number of people who have the condition the drug is designed to treat. These trials are done to establish what dose range is most effective, and to observe any safety concerns that might arise.
  • Phase III trials test a drug on a large number of people who have the condition the drug is designed to treat. Successful completion of Phase III is the point where the drug is considered ready to be marketed.
  • Phase IV trials can investigate uses of the drug for other conditions, on a broader patient base or for longer term use.


A fake (or dummy) treatment given to patients in the control group of a clinical trial.  Placebos are indistinguishable from the actual treatment and used so that the subjects in the control group are unable to tell who is receiving the active drug or treatment. Using placebos prevents bias in judging the effects of the medical intervention being tested.


A group of people with a common link, such as the same medical condition or living in the same area or sharing the same characteristics. The population for a clinical trial is all the people the test or treatment is designed to help.


A plan or set of steps that defines how something will be done. Before carrying out a research study, for example, the research protocol sets out what question is to be answered and how information will be collected and analysed.

Randomized Controlled Trial (RCT)

A study in which a number of similar people are randomly assigned to 2 (or more) groups to test a specific drug, treatment or other intervention. One group has the intervention being tested; the other (the comparison or control group) has an alternative intervention, a placebo, or no intervention at all. Participants are assigned to different groups without taking any similarities or differences between them into account. For example, it could involve using a computer-generated random sequence. RCTs are considered the most unbiased way of assessing the outcome of an intervention because each individual has the same chance of having the intervention.


The ability to get the same or similar result each time a study is repeated with a different population or group.


People in a study recruited from part of the study’s target population. If they are recruited in an unbiased way, the results from the sample can be generalised to the target population as a whole.


In clinical trials, the people selected to take part are called subjects. The term applies to both those participants receiving the treatment being investigated and to those receiving a placebo or alternate treatment.

Trial Site

The location where trial-related activities are conducted.


The Canadian Institutes of Health Research (CIHR)

TROG Cancer Research


Further Resources

American Society of Clinical Oncology’s Cancer.Net trials site

National Cancer Institute (NCI) Clinical Trials lists open and closed cancer clinical trials sponsored or supported by NCI. database of privately and publicly funded clinical studies

CenterWatch Clinical Trials Listing

Complete Guide To Mindfulness

Suja Johnkutty Hi there ! I’m Suja Johnkutty, MD a conscientious mom and neurologist . My one simple goal is to provide you honest, practical, simple action steps to experience better relaxation in your life.

Anxiety Management for Patients and Caregivers

This podcast was originally published by The Cancer Cast with Weill Cornell here.


Kelly Trevino, Ph.D., Clinical psychologist at Weill Cornell Medicine and NewYork-Presbyterian Hospital – Speaker Bio
  • Why anxiety management is so important for all those affected by cancer, plus actionable coping strategies.

    Guest: Kelly Trevino, Ph.D., a clinical psychologist at Weill Cornell Medicine and NewYork-Presbyterian Hospital.

    Host: John Leonard, M.D., world-renowned hematologist and medical oncologist at Weill Cornell Medicine and NewYork-Presbyterian Hospital

Care Coordination for Your Loved One Living with Cancer and Other Health Problems

This podcast was originally published by Cancer on June 17, 2019, here.



Topics Covered

  • Overview of Cancer & Co-Morbidities
  • The Role of Caregivers in Care Coordination for People Living with Cancer & Co-Morbidities
  • Tips for Communicating with the Health Care Team about Care Coordination
  • Challenges of Coordinating Your Loved One’s Care & Follow-Up Appointments
  • Adherence – Taking Pills on Schedule
  • Lead time in Refilling Prescriptions & Planning for Visitors, Weekends, Special Occasions, Travel & Holidays
  • Resources for the Costs of Care, including Homecare
  • Finding the Practical Help You Need: Co-Pay Foundations & Federal, State & Local Programs
  • Legal Advocacy Tips for Caregivers
  • Learning How to Appeal Insurance, Medical, Medicaid & Provider Denials
  • Other Resources, VA Benefits & Family Medical Leave Act/FMLA
  • Tips on Choosing Community & Medical Resources to Improve Your Quality-of-Life
  • Time Saving Self-Care/Self-Advocacy Tips for Caregivers
  • Questions for Our Panel of Experts

Our Panel of Experts

Stewart B. Fleishman, MD

Former Founding Director, Cancer Support Services, Continuum Cancer Centers of New York, Author, Researcher in Oncology

Guadalupe R. Palos, RN, MSW, DrPH

Clinical Protocol Administrative Manager, Office of Cancer Survivorship, The University of Texas MD Anderson Cancer Center

Debra J. Wolf, Esq.

Senior Supervising Attorney, LegalHealth, New York Legal Assistance Group (NYLAG)

Carolyn Messner, DSW, OSW-C, FAPOS, FAOSW

Director of Education and Training, CancerCare

How To Be A Better Caregiver When A Loved One Gets Sick

This podcast was originally published on National Power Radio on July 12, 2019 here.

None of us are prepared to be caregivers — the role is thrust upon us.

Maskot/Getty Images/Maskot


None of us are prepared to be caregivers — the role is thrust upon us. More than 40 million Americans are caring for an elderly parent or loved one. Here are six tips to make the caregiving burden more sustainable:

1. Accept help, and don’t be afraid to ask for it.

People will ask you what they can do early in your parent’s illness, so strike while the iron is hot, says Katy Butler, author of The Art of Dying Well.

“Right after a crisis, friends and family rush in and say, ‘Is there anything I can do?’ ” Butler says. “And you’re often so overwhelmed you can’t even think. But strike while the iron is hot and take advantage of it.”

Ask for specific things like a meal or caregiving relief to allow you to take some time out.

2. Break down caregiving tasks into bite-sized solutions.

Figure out the tasks that sap your energy the most (is it bedtime? Dressing? Transportation?) then think about who you can get to help with those specific tasks. It’s a lower-cost solution than full-time care or institutionalization.

The National PACE Association can provide services that help support family members so the people they love can continue to live at home. PACE operates in 31 states; check to see if your state is one. Other options include Home Based Primary Care through the VA for eligible veterans, van services and Meals on Wheels.

3. Don’t tell your loved one what to do. Ask about the quality of life they want and how you can get them there.

Minimize conflict with your family members by identifying their goals rather than issuing them orders. That way, you can work together to achieve them.

Make a list of things your loved one really loves doing, whether it’s a weekly bridge game, listening to music or having tea with a friend. You can also find ways to help outsource these kinds of tasks, too.

“You’ve got to be thinking about what makes this person’s life worth living,” says Butler.

4. Be an empowered medical advocate for your loved one.

The inertia of aging and medical care will lead your loved one down a slope of more tests and procedures if you don’t keep track of the big picture. For many elderly parents, a good quality of life is much more valuable than more years spent suffering or tethered to medical appliances. A key caregiver job is asking how a proposed procedure will improve your loved one’s quality of life. If it won’t, then don’t.

5. Get your legal ducks in a row so you can focus on your relationship

As a caregiver, you’ll be called on for medical and financial decisions. The sooner you brave those difficult conversations for end-of-life care, the better you’ll be able to stick to your loved one’s game plan for the future.

Help your loved one create an advance directive (if they haven’t already), a documentation of a patient’s preferences regarding their care. According to surveys, only about a third of Americans have one. You can find inexpensive templates online at sites such as Five Wishes.

6. Make sure to take care of yourself, too — you are more than a caregiver.

Caregiver burnout is a real phenomenon. Taking on the role of caregiver often starts in crisis and becomes the new norm, which can alter your life forever. Make sure to take time out to care for yourself; getting away for a bit is good for you and your loved one.

Also, savor the little moments with your loved one. Your relationship roles may have changed, but you’re still family.

“Remember that you are more than just a caregiver,” Butler says. “You’re also that person’s son or daughter. If there are ways that they can still mother or father you, even in their decline, even with their disabilities, soak them up.”

What Every Cancer Caregiver Should Know, With Kaycee Carmichael

This podcast was originally published on WE Have Cancer Show by Lee Silverstein on May 21, 2019, here.

Kaycee and Jane Carmichael – WE Have Cancer




In 2016 Kaycee Carmichael’s mother was diagnosed with Colorectal Cancer. Though her mother died only four months after her diagnosis, Kaycee learned some valuable lessons about life as a cancer caregiver as well as dealing with grief.

We discussed:

  • Her Mother’s life as a teacher and the incredible impact she left on her students.
  • How her mom came to be diagnosed.
  • How she managed the challenges of a cancer caregiver and some helpful tips and advice for other caregivers.
  • How she deals with the grief from her mom’s passing.

Links Mentioned In The Show

Lotsa Helping Hands –

Connect with Kaycee on Facebook –

Follow Kaycee on Instagram –

WE Have Cancer Links

Subscribe to the show –

Follow WE Have Cancer on Social Media

Like our Facebook page –
Join our private Facebook group –
Follow us on Twitter –
Follow us on Instagram –

Caring for a Spouse with Cancer

This podcast was originally published on by Scott Joy on September 20, 2018, here.


Caring for a loved one with cancer can be challenging as well as rewarding. But you are not alone. In this series of podcasts, developed in collaboration with LIVESTRONG, Aditi Narayan and Mike Threadgould interview family caregivers, who share their stories and offer advice for others facing similar situations.

In today’s podcast, Scott Joy, a testicular cancer survivor and patient advocate, discusses his experience when his wife Judy was diagnosed with multiple myeloma, including some of the bright spots and challenges, things he wishes he had known at the time, and tips for other caregivers.



ASCO: You’re listening to a podcast from Cancer.Net. This cancer information website is produced by the American Society of Clinical Oncology, known as ASCO, the world’s leading professional organization for doctors who care for people with cancer.

The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions. Guests on this podcast express their own opinions, experience, and conclusions. The mention of any product, service, organization, activity, or therapy should not be construed as an ASCO endorsement. Cancer research discussed in this podcast is ongoing, so the data described here may change as research progresses.

Caring for a loved one with cancer can be challenging as well as rewarding. But you are not alone. In this series of podcasts, developed in collaboration with LIVESTRONG, Aditi Narayan and Mike Threadgould interview family caregivers, who share their stories and offer advice for others facing similar situations.

In today’s podcast, Scott Joy, a testicular cancer survivor and patient advocate, discusses his experience when his wife Judy was diagnosed with multiple myeloma, including some of the bright spots and challenges, things he wishes he had known at the time, and tips for other caregivers.

Aditi Narayan is a social worker and Director of Programs & Strategy at LIVESTRONG, and Mike Threadgould is Senior Manager of Marketing & Communications at LIVESTRONG. Scott Joy is a LIVESTRONG senior leader and a member of Cyclists Combating Cancer.

ASCO and LIVESTRONG would like to thank Mr. Joy for discussing this topic.

Aditi Narayan: I’m Aditi Narayan.

Mike Threadgould: And I’m Mike Threadgould.

Aditi Narayan: And we’re with the LIVESTRONG Foundation where our mission is to improve the lives of people affected by cancer now. We are joined today by Scott. Scott, thanks so much for being here.

Scott Joy: I’m happy to be here with you.

Aditi Narayan: Thanks. Can you tell us a little bit about who you are and your connection to cancer?

Scott Joy: Yes, I can. My name is Scott Joy, and I’m from the New Hampshire seacoast. I’m a father of four adult children in their 20’s. I’m a business technology professional, a tenor, a recreational cyclist, and a 15-year testicular cancer survivor myself, and a LIVESTRONG volunteer since my diagnosis.

But I’m here to talk about my role as a caregiver for my wife of 26 years, Judy, who was a beautiful woman, intelligent, witty as a can be, a novelist of 2 young adult science fiction novels. And, unfortunately, 10 years after my diagnosis, she was herself diagnosed with multiple myeloma, which is a blood cancer, and only lived with the disease for about 3 months or so. So I’m here to talk about that.

Aditi Narayan: Thank you for sharing.

Mike Threadgould: And so, obviously, here we’re talking about roles as a caregiver. What would be something you would share with somebody else who was facing being a caregiver and the challenges or the opportunities that they would face?

Scott Joy: I think the first thing I would say is to be easy on yourself, that it’s a tough role, and you will make mistakes. And if you can talk them through, mostly with yourself, just be kind on yourself. Do your best. Accept all of the feelings as they come. You’ll have them all. Take help where you can get it. Be sure to take care of yourself, to step back and rest when you need to, and just do what you can.

Aditi Narayan: And would you say that those are things— I mean hindsight is 20-20, right? So are those things that you did yourself? Did you accept the feelings during the process, or was that something you wish you had done after?

Scott Joy: It’s always a mix, right? So there are some things that I— I felt fairly prepared just because at that point, I’d had 10 years of experience myself in the patient role. I had friends from the LIVESTRONG community. I felt I had lots of resources I could turn to, both for information and for emotional support and just for the practical, “what should I do?”

But it’s still hard. Knowing that you can do it and feeling that you can do it are awfully different things. So I did feel somewhat prepared, but I had a lot of learning to do along the way to feel like I’m not doing enough: there’s got to be something more we can do. I’m doing too much: Judy’s now feeling overwhelmed with all of the options I’m trying to provide to her, and she just wants to talk to the doctor, and get into treatment, and not worry about all of the other things I might be able to do to help her. I’m going too far now. So I had a lot to learn.

Aditi Narayan: Yeah. It sounds like it. And so would you say that communication line between you and Judy seemed to be really important in keeping that open?

Scott Joy: It absolutely is important. I’m not going to say I got it right all the time, for sure. But I do think that her diagnosis actually helped our communication in some ways. She could now sort of suddenly understand some of what I’d gone through and appreciate it more. She told me at one point, “You know? I would marry you all over again,” which is something I hadn’t heard in a while. [laughter] So there were good points.

Mike Threadgould: And I think we’ve spoken before, and we know at LIVESTRONG we talk a lot about the fact that there are a lot of resources now for cancer patients, to deal with their emotional challenges, and we provide those in different ways. But a lot of the time the caregiver is not aware of those challenges and the emotions that come with it. What were some of the challenges that you felt as a caregiver which maybe was different than being a patient?

Scott Joy: Let me think about that. One of the things that was just so different is that in the patient experience, I sort of still felt like I was in control about decisions that needed to be made, because it was all about me. And in the caregiver role, I had to realize that I’m not in control of anything. It really is about what she needs. And although I need to try to get all of the information I can and absorb all of that and help where I can, I also need to realize that what I want isn’t what matters right now. It matters some but it doesn’t matter as much as, “what does Judy need?”

So that was a big change and, obviously, the realization that this is an incurable disease that she had. I had a disease that could be treated and cured. She had one that needed to be managed and sort of coping with that from the beginning, that I am going to lose my wife. I don’t know when. Maybe it’s going to be 10 years down the road. Maybe it’s longer. Maybe it’s shorter. I had no idea it was going to be 3 months. And just understanding that someday— all of us are going to have limited time on the earth, so it’s not a surprise. But just the realization of this is going to change my life. That was a big deal. So strap in. Do what you can. Be there for her in sickness and health. That’s what I promised to do, and I did the best I could.

Mike Threadgould: We all find our way in our way I suppose.

Scott Joy: Right.

Aditi Narayan: Was there anything that was a part of your experience and your journey that you would say was unexpected or surprising?

Scott Joy: I think the unexpected part for me, other than just the diagnosis itself, the I’m no longer the cancer patient in this family here, right? was the difference in the role. I expected that all of the information and the support that I had would be enough, and it wasn’t. It just wasn’t enough to solve the problem and to get to the cure, to get past it and live a long, healthy life together. That was the surprising part. And then just the not being prepared for the what-ifs, the pushing that aside and focusing solely on the treatment and the path to cure, and not thinking about the, “what if this doesn’t work?” It was always, “what’s the next step going to be, and the step after that?” and not the preparing for the worst-case scenario.

Aditi Narayan: And what was the impact—because you mentioned at the start of this conversation that you’re the father of 4, and your kids are now all in their 20’s—but what was the impact in terms of caregiving, not only for your wife who had cancer, but also for 4 children at the time?

Scott Joy: That was the one thing that I wish I had more help with was knowing the right way to help my kids. We’re so focused on the practical things of the getting to the hospital and the meal delivery and the– they’re all still– at that point were all still in school. Three of them were still in high school, and one was off in college. And I would love to have known how to better help them with what they needed. My sons, in particular, I think were maybe more, setting that aside and thinking, “I’m going to class, and I’m going to soccer practice, and I feel for mom, but I’m also living my own life as a teenager.” And I don’t know yet, still, how that’s impacted them and will show itself in the years ahead. I think my daughters tell me more about it, and my sons just sort of shrug it off.

Mike Threadgould: So in a similar kind of realm, and you said that they were going to school every day and trying to live day-to-day, how did being a caregiver affect you day-to-day? Obviously, you had to change your routine, as you mentioned having meals delivered. What was that experience like?

Scott Joy: So part of it was trying to stay as much as possible in the routine and continuing to work, which is necessary to support the family, and not feeling like the world is as shaken as it is. So I did keep going to work. It’s hard not to feel distracted every moment—but you know that things that have to be done in the office—but to be open to leaving when you can to help, and to get to a point and to make sure that Judy had the company she needed.

I was lucky that we had a neighbor up the street, a close family friend, who could step in and help with a lot of that so I could continue to work without feeling like I was abandoning my wife.

I think I’m stepping away from the question now. Can you help me back to it?

Mike Threadgould: I think you’ve touched on that. It was more just the day-to-day. Like you say, going to work, that’s, obviously a big shift in emotional energy that you have to go through, and the day-to-day becomes a very different routine when you’re a caregiver.

Scott Joy: Right, yeah. It really does. Between the mix of trying to stay normal and the needing to take on new responsibilities, things that Judy would have done. We were both working parents and were more partners before, and to have to have that shift where now I’ve got to worry about making sure the house stays clean, and the pool gets vacuumed, and all of those things that just weren’t on my plate before.

And how much of it can I take on? And how much of it is fair to ask the kids to try to help with? And how much can we feel comfortable depending on other people and take the help? People are offering it and want to help, so don’t be embarrassed or worried that you’re becoming a burden. If people are willing and able to do that then, by all means, let them. It’s good for everybody.

Mike Threadgould: Absolutely.

Aditi Narayan: So you mentioned that you had a neighbor who came in and stepped up and was really helpful to you. Who were some other people that really helped with your day-to-day caregiving tasks?

Scott Joy: I think a lot of the day-to-day caregiving fell to me and to Marnie. And the practical side of things, I guess, would be supported, of course, by the hospital staff and not just the doctors but the nurses for certain. They have some emotional support resources. That’s less on the practical and more on the emotional, but you can’t get the practical done without the emotional help, or you fall apart. So that’s a certainly a big part of it is just having somebody to lend an ear to keep you going.

Mike Threadgould: And you mentioned earlier the importance of taking time for yourself. Do you feel like you managed to do that? What we hear from a lot of caregivers who they only do that when they reach the end of their rope. They don’t do it early enough that it actually helps them through the process. They kind of get to this point where oh god, I’ve got to take time for myself. Did you feel like you went through that in a positive way, or was it— how would you explain it?

Scott Joy: I think it was learning. It was a struggle to feel I was getting it right. There’s some guilt when you step back and think I’m not doing enough. I’m not filling the role I need to.

I thought we were going to be doing this for years, so I wasn’t sure how much to pace myself. I did enlist family help. Now that I had got it, Judy has had 3 older sisters and a brother. And 2 of her sisters were– 3 of her sisters, all of her sisters, were able to come and spend some time. So I took advantage of that and didn’t cancel my attendance at a business conference. So I escaped to Orlando for a few days in October which I wouldn’t have done if I had known, that was 6 weeks, I guess, from Judy’s death. I wouldn’t have gone. I absolutely would not have gone. But I got away for that.

I stayed true to my commitment to go to the LIVESTRONG Challenge here in Austin. So I was expecting that that was going to be my break. And then I would go home, and we would get ready for the bone marrow transplant that was planned in January. And we just didn’t get that far. So I think I was pacing myself more than I would have if I had known which should have been a good thing. I should have been taking the time I needed for myself.

Mike Threadgould: Exactly. It’s so hard to know when a diagnosis has no defined limits to. It could be three months. It could be 10 years. How do you pace yourself through that? There’s such uncertainty. You obviously want to make the most of life, but you’ve got to find that balance of taking time for yourself and re-energizing yourself to be there for your partner, or whoever it is, that you’re helping. So a difficult situation for sure.

Aditi Narayan: We’ve talked a little bit about your support systems. We’ve talked about Judy’s family. We’ve talked about your neighbors and, perhaps, other friends who were supportive. Were there any resources, other than family and friends, that you took advantage of or that you accessed that were really helpful for you and maybe for your children as well?

Scott Joy: The local Stratham Community Church, a lot of support from that group. Really, friends and neighbors. The meals that kept coming which they managed to pace well for us so that we weren’t feeling completely overwhelmed by that, too, which can be if everybody’s trying to help so much that you don’t know how to control the help as it comes in. We didn’t have to. We had somebody who was helping with that.

I think really just the knowing how to help my kids and more family resources than practical resources, I guess. If we’d had other people who had been let us take the kids for the day or— because with the only help there was people who were trying to talk to the kids about their experience. And the kids didn’t want to have those conversations.

Aditi Narayan: So somebody to really normalize, to some extent, their day, to sort of not focus on the cancer for a while.

Scott Joy: Right, right. I guess to do that in a way that feels respectful and if they’re open to what they want to talk about, great. And it’s a tough balancing act to know what’s right. I don’t think I got it right.

Aditi Narayan: I think that’s a really interesting feeling and thought. And I’m sure it’s something that many caregivers struggle with is did I get it right or feeling like they didn’t get it right. But really what is right? It’s such an arbitrary concept.

Scott Joy: Yeah. You don’t know. And I think it was different for each of them. I think my daughters were closer in how they reacted and what they needed. My sons were closer in what they needed and how they reacted. But all four of them have different personalities and perspectives and needs. And understanding that on top of—we’ve got to be 100% focused on Judy. But they need help too. And what is that help?

Aditi Narayan: Yeah. And I wonder for– you’ve talked a little bit about how at some points Judy felt overwhelmed with the attention that she was receiving as a result of her diagnosis and care. I wonder how that puts a strain on dynamics between you and your spouse, but also the parents and children as well, is how everybody’s trying to find that balance of wanting to normalize but also wanting to acknowledge that something’s not right.

Scott Joy: Right, yeah. And the other complicating factor was, of course, the difference that all of the pain medications had in just Judy’s behavior some of which was just alertness and ability to understand. Opioids really take a toll when you’re so dependent on the pain medications to not feel terrible all of the time. That was a struggle for her.

Mike Threadgould: Do you feel like your healthcare team prepared you for those struggles in terms of, particularly with the medication and the changes that are going to be physical and mental that that would bring to her, but also how it might impact you?

Scott Joy: I think that was another big surprise for us and certainly for me. I don’t know, honestly, how Judy– how much she knew about what the impact, whether it was just happening. I’m sure she recognized that in the changes and the phone calls she would make and just bewildered, “I’m not sure. I think I just took a pill, but I don’t know. What should I do?”

And I don’t know how to help with that from my desk at work. I can’t tell whether you just took a pill. How do I help you? So some of that was a big challenge. And I don’t think we were well-prepared for it to know these are the things that may happen, and what you should do when they happen, and when you should call us for help. I think we could have used some more guidance.

And there was so much more concern, I think, about the practical parts of it about making sure we got the dosages right, and the pain was under control, and less about the here’s how this may affect your relationship and your cognitive function. And those things just– I don’t recall them coming up. You had to discover them.

Aditi Narayan: So you just mentioned something interesting that the healthcare didn’t quite address how Judy’s care was going to impact your relationship. So how did it impact your relationship?

Scott Joy: Well, I mentioned that in some ways it brought us a lot closer together. That suddenly I felt, we felt, that we had something we needed to solve, to go through together, that she felt, “oh, all of that experience you have from Livestrong and the cancer community suddenly is relevant to me. It’s not something you’re off doing. It’s now part of our life,” and I thought that was positive and healthy. Aside from the effect of the pain meds and how much she really sometimes was in a daze, when she was more alert and willing to talk, it was more open and more candid. And that was all good. I think the hardest part was, you know, we both were focused on, as I said, on the treatment, on the search for the cure, on the let’s get through it.

And we should have talked more about, “when one of us is gone, what does the other want?” I’m now navigating through the how can I continue to have Judy be part of the kids’ life affect what we do as a family. Carrying on the traditions and all of the decisions that had to be made after her death about care for the kids and her own services and all of that. I would have loved to have known because she told me not because I can figure it out. And I can figure a lot of it out, because we spent 26 years in marriage and years before that. We met in high school, and we were high school sweethearts so all of that. I can figure a lot of it out.

But I wish we had talked through more of it which is so hard to do because we don’t want to concede. We’re fighting to the end. And I didn’t talk about the intervention, I guess, where the healthcare team and our minister brought me in and were trying to have some of that conversation about end-of-life care and all of the things that we should have in place. And I think that was frightening for Judy at a point where she wasn’t ready to be scared that way. She needed to focus on I’m trying to get through the day here. But it left us with things that weren’t said and done that should have been. It’s so hard.

Aditi Narayan: Yeah. It really is. Are there those things that you found yourself thinking about but you didn’t feel like it was the right time to bring it up with Judy?

Scott Joy: I had some of those times like out on my bike, right? So part of my keeping it normal was finding time— I wouldn’t do the long rides. Normally, I would do a long weekend training ride, and I would maybe do an hour instead of half a day. But certainly, while I’m out, that’s what my mind is going through is some of the what-if scenarios, and trying to push them out and saying I can’t think about that but I have to. Yeah. So I did have some of that. And then it’s, can I talk to you about it? Should I talk to you about it? And it never felt right. It was always, you’re not ready for that, and I don’t think it’s the time.

Mike Threadgould: We’ve set this series up about caregivers and the phrase caregiver. Do you identify with that phrase? A lot of people use kind of different terms to talk about this role that you take on in supporting somebody that’s going through a disease. Does that identify with you?

Scott Joy: It’s an interesting question because I hadn’t really thought about it until you posed it because caregiver is one that you can grab onto, like survivor, that initially this thing is that’s a word that I can use to describe this. It’s a shorthand and everyone will know what I mean. And then you start to think about it intellectually. And so what else does it mean, and how do I react to it if I think about it instead of just accept it? And it starts to sound a little bit more clinical. And I think how is that different from the healthcare professional role and what the nurses and doctors do? Aren’t they caregivers? And does it feel more like “housekeeper?” So it doesn’t have the same love to it that maybe I would want.

And so I just think of— thought of myself— think of myself as Judy’s husband. And that says so much more to me where it doesn’t necessarily mean what caregiver does, but it’s the word I would choose for myself still. And caregiver was just one that I accepted because it was handy.

Mike Threadgould: That makes sense. And I think how you’re saying if you think of yourself as husband and wife, just because one of you has something in their life that needs support doesn’t change the fact that you’re still husband and wife. And those relationships are built on love and support and doing whatever is necessary. So giving that change a label isn’t necessarily of value to a caring relationship. It’s interesting to think about it that way.

Aditi Narayan:  You mentioned accepting the role, the title, and I was wondering did it feel like you had to feel certain things because someone was putting that role on you, that you are now a caregiver and you should be feeling these things, or you should be doing these things? A lot of “shoulds” involved there.

Scott Joy: That’s a really interesting question and wonder if I had more of those checklists and resources if I would’ve resented them. [laughter] I don’t think I felt that way. I felt that it was a role that I needed and wanted to step into. I didn’t resent it. I can see how one might, especially depending on where you are in your relationship with the person you’re providing care for. I felt it was something that I owed her and wanted to give. But that’s a really interesting question. [laughter]

Aditi Narayan: Scott, we’ve talked a lot about your experience, a little bit about as a survivor, and then extensively about your role as Judy’s husband. What is 1 word you would use to sort of try to capture that experience or describe it?

Scott Joy: I would pick the word “whirlwind.” It’s just the sudden storm of unexpected magnitude, and everything’s circling around you and sometimes feeling like you’re in the eye of the storm. And there are calm moments, but you know it’s all still swirling around you. And it’s a whirlwind, and it just tears everything apart but still moments of calm inside it.

Mike Threadgould: And if you look at where you are now, are you still in a whirlwind? Do you feel like you’ve moved into some other one-word description of your emotional state?

Scott Joy: I’d still pick the 1 word “healing” for where I am now. It’s a long process of coming to terms. It’s one of those things where it hurts to talk about it still, but it hurts a lot more not to talk about it. My kids and I have had some wonderful experiences since. I loved her, remember all of the things that we did together as a family.

I think there’s some mixed opinion on how much we should talk about and remember that, and I love it. And I think how much does it hurt them, and how much does it help them? I think they’re starting to come around now where now my son, Eric, will talk more about it and put on the “We Remember Judy” t-shirt, just spontaneously. So I think it’s a long healing process.

Aditi Narayan: Well, Scott, thank you so much for being here. And thank you so much for sharing so openly and always being willing to share. I think your voice and your experience has healing to it, and I think that can never be emphasized enough in this journey. So thank you so much.

Scott Joy: Well, thank you.

Mike Threadgould: Thank you, Scott.

ASCO: Thank you, Mr. Joy. Learn more about caregiving at, and find support and resources for caregivers at And if this podcast was useful, please take a minute to subscribe, rate, and review the show on Apple Podcasts or Google Play.