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With 19 years experience under her belt as an oncology social worker, Megan Melick, LSW, of Penn Medicine’s Abramson Cancer Center is more than well equipped to help patients deal with the nuances and demands inherent to a cancer diagnosis. Melick elaborates “Cancer frequently can’t just be treated in a linear fashion, where, after six months of treatment you’re finished and you just move on. Metastatic cancer often requires treatment for the rest of your life, just to keep the cancer at bay—where the cancer may not be curable, but can be controlled. The impact of prolonged, active treatment creates a host of challenges for patients and their oncology treatment team.”

Oncology social workers are integral, essential members of the care team. While the oncologist tends to the patients’ medical treatment, social workers provide a broad range of support, helping patients with practical concerns, strengthening communication between the patient and their doctors, and helping to address the psycho-social issues that accompany a cancer diagnosis. “I meet with patients and their families in person, not just to provide resources to connect them with community agencies, but to provide support, encouragement, and someone to talk with to help reduce isolation and worry. It’s so important not just to give a person a list of agencies to call, but to join with that person and help them make the phone call, or to provide access to a computer.”

Melick elaborates further, “As patients’ symptoms worsen, socialization and connections to family and friends become increasingly important to their well-being. During the pandemic, simple tasks like grocery shopping, cooking, cleaning, driving, and running errands became huge challenges when patients lost those connections. That’s when programs like Legacy of Hope became invaluable.”

Melick became familiar with Legacy of Hope through Penn’s Social Needs Response Team (SNRT), a new initiative, which is composed of medical, nursing, and social work students, who operate a help line for patients to address the urgent social and financial needs of patients hospitalized during the pandemic. “Food insecurity was a major problem for many patients, and Legacy of Hope met the needs of those patients in Philadelphia.” She emphasizes that “Food insecurity goes beyond just being able to afford food; “Food” means healthy food, not the heavily-processed, high sodium, high sugar food items found in most local corner stores. Access to fresh fruit, vegetables and proteins is crucial to increasing patients’ ability to take care of their overall health.”

“Food insecurity is likely to become more of a problem when you’re going through cancer treatment...” confirms Melick,”’re dealing with lost income, skyrocketing food prices and increased medical expenses; you hit a point where you need to decide–am I going to cover the copay for my pain medicine, or am I going to buy a pound of chicken? Patients typically choose their medication.” As if that choice isn’t difficult enough, Melick notes that “asking for help can be difficult for many people.”

That’s where she relies upon her wealth of experience to help her glean critical information from the patient to find solutions that are right for them. Taking the time to talk with the patient…asking, sensitively about having enough money to make food last, who does the shopping and cooking?, etc…humanizes the experience.”

Melick recollects a memorable case in which she reached out to Legacy for a 49 year-old single mother with metastatic breast cancer. “She’s been going through treatment for over 10 years. She lived outside of Philadelphia, beyond Legacy’s service area.However, they agreed to include her and her daily after learning that she would go to her son’s home in Philadelphia after her chemotherapy treatment, to regain her strength. Legacy quickly enrolled her in the program and delivered fresh groceries to her home. Initially, the patient was unsure of what types of food would be delivered. She was happily surprised by the bounty of healthy food they delivered to her home. She appreciated the thoughtfulness of the healthy food items in the bags. She liked to cook, and could not believe she got fresh spinach! She was so happy to prepare a meal for her family that included fresh spinach.”

Melick appreciates the ease of referring patients to the Emergency Patient Support Network. “You just go to the page; fill in a couple text boxes and Legacy takes it and runs with it.” Not only does Legacy’s help address food insecurity, it has the added benefit of in-person human interaction. It’s more than someone just dropping off the food and leaving, because Legacy’s volunteers frequently stay and chat for a bit with the patients.

Melick acknowledges that the biggest challenge of her work, in the era of Covid, is “helping patients access community resources to help with living expenses, food, utilities, childcare and transportation. The financial implications of lost wages have bigger repercussions in individuals who are low income. It’s so important not just to give a person a list of agencies to call, but to join with that person and help them make the phone call, or to provide access to a computer. Patients can come into our department, Patient and Family Services, to use computers, phones, and printers. Our department also includes the oncology nurse navigators, oncology dietitians, and counseling, which patients have access to during their treatment. We also have all of our support groups online, which has improved access to groups.”

When asked about her favorite part of her work Melick responds “Many people say to me, it must be hard working with people with cancer, and sometimes it is. But my work allows me to bear witness to the incredible strength of the human spirit, and to work with individuals who continue to find meaning in their lives despite cancer.” There’s no doubt that this positive perspective is what has fueled her through nearly two decades of this demanding work; we're thankful that she's still doing this critically important work.

If you’d like to help support the type of work that oncology social workers like Megan Melick is doing, please donate, better yet, become a Legacy of Hope member, which not only helps ensure that no family in Philly goes hungry because of a cancer diagnosis, but also earns you discounts an ever-growing number of Philadelphia businesses participating in Legacy’s membership program.

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