Reena Cherry, an oncology physician assistant, shares why supporting caregivers is essential to high-quality prostate cancer care, emphasizing that caregivers play a critical role in a patient's well-being while often neglecting their own needs. She encourages clinicians and patients to intentionally acknowledge caregivers, foster open communication, and empower them to prioritize self-care so they can continue providing meaningful support throughout the cancer journey.

My name is Reena Cherry. I am an oncology physician assistant at UC San Diego Health. I've been working in the oncology space for over 24 years and just love what we do. Right now, I am working in the geo medical oncology department at UC San Diego Health. So we treat patients with geo malignancies to include obviously prostate cancer, also kidney and bladder cancer. Over the years working with patients, I began to recognize that there were two people in the room who were going through the same experience but differently. And as providers, we're trained obviously to speak to what the patient is going to go through, the treatment plan for the patient, what side effects the patient is going to experience.

But it became obvious to me over the years that the caregivers were really being left out of that conversation. So the first thing I started to do was to try to interact, find ways of engaging with caregivers in the clinic space. And pretty quickly, I found that there were a lot of needs that caregivers had that weren't being addressed. My passion for supporting caregivers evolved over time, but the more I interacted with caregivers, the more I learned and understood that they really do need our support.

So one of the things we also know from the clinical side is that patients do markedly better when they have support at home. And that support can come in many forms. So it can be family members, obviously, spouses, brothers, sisters. It can be friends. It can be church community. Patients do better in general when they have that sort of community support. So caregivers really are essential for the health and wellness of patients.

The other thing that we recognize is that we spend a short period of time with patients really in the clinic. And the rest of our treatment plan is carried out and supported by caregivers. So there's a lot of the medical care that is going on at home that I think we need to recognize.

I've been to a number of conferences recently and we've talked about how difficult it is to find space. It's difficult sometimes to find space to do all that we want to do for patients, but then to find the time to carve out time for caregivers is challenging. One of the things I think we can do as providers, and we can start doing this today, is to acknowledge caregivers. And we need to acknowledge caregivers independently from the patient, and we need to acknowledge them with intention. I think by doing that, caregivers will feel seen and valued, and that doesn't have to take a lot of time.

I've learned over the years how best to do this. When I'm in a room with a patient and I'm looking at a caregiver who looks like they're distressed, the first thing I do is ask the patient permission to address the caregiver directly. And I've never had a patient say no. And then I will usually look at the caregiver and I will say, "How you doing?" Just saying that, the look on my face, the tone of my voice lets that caregiver know that I already know they're struggling a little bit. I will usually ask, "If I could wave a magic wand and make one thing just a little bit better for you, what would it be?" And usually when I say that, the caregiver can pretty quickly identify what their pain point is at that time. And then I can offer a few bits of information or education or help them sort of reshape how they're thinking about something.

Maybe they're worried about something they really don't need to be worried about. So we can have that interaction. It doesn't take long, but I think in doing that, it takes a little bit of the weight off of the caregiver and they leave feeling a little bit less anxious than when they came in with a patient. So that's just one way that I try to do it. When I am talking to a caregiver, I make sure I tell them that it's okay for them to create boundaries for themselves. It's okay for them to create space to work out or go for a walk or read a few chapters of a book or go to that journal club. Whatever it is for them that helps to replenish them, just give them a little bit more energy and be more refreshed. It's okay for them to create those boundaries.

A lot of caregivers do not feel entitled. They don't feel like they're entitled to even create that space for themselves. As clinicians, we really need to encourage caregivers to take that space. And when they do, the hope is that they were going to feel better, their own health and wellness will improve, and they can sustain the work that they're doing for the patient.

I think what is helpful is for patients to understand that caregivers are going through their own journey with their prostate cancer diagnosis. And when there is time, when things are a little bit more calm, to check in because caregivers by and large are not going to talk about how they feel. They won't voluntarily talk about how they feel and they're reticent to do it even when they're asked. But I think if the patient can help create a safe space for that caregiver to really talk about how they feel or talk about how they might be struggling, I think that's huge.

So just trying to just recognize that that is communication that probably needs to be fostered. It's not going to happen naturally, but I think when that happens, there's going to be a better dynamic between the patient and the caregiver, and they can both really, at the end of the day, support each other. Caregivers do an extraordinary job, but they don't hear it enough. What they're doing is, I believe, one of the hardest things we will do as human beings on this earth, and that is to take care of another human being that we love who is sick. And almost across the board, caregivers are doing an exceptional job, but we need to do a better job of telling them that they're doing an exceptional job.

I think the other thing they need to know is that it's never easy. And many caregivers move throughout the days and weeks and months thinking that they're not enough. They don't know enough. They haven't gone to enough appointments. They haven't cooked enough. They haven't cleaned enough. They haven't ... So I think that they need to know that they are enough. And if they are bringing their best selves, their talents, their resources to this fight against prostate cancer, that is absolutely enough. And then hopefully as clinicians, we can support them by letting them know that they're enough when we see them in clinic.