Frontline Cancer: Caring collaboration


By Dr. Scott Lippman

Many people in our community grieved the loss of San Diego Hospice, which ceased operations in February. It was a large and vital center for the treatment and care of terminally ill patients. But San Diego Hospice served other critical needs as well. It hosted, for example, the largest training program in the country for the extraordinary men and women who seek to become palliative medicine clinicians, doctors specialized in relieving and preventing the suffering of patients.

The hospice trained as many as 12 palliative medicine clinicians each year, an astounding 5 percent of the national total. It was the only program of its type in San Diego.

Part of palliative care is hospice care, but palliative medicine clinicians also use their holistic and team approach to support patients undergoing curative therapies. This enables patients to better tolerate their treatments and to achieve better outcomes while maintaining independence and control.

Unlike hospice, people do not have to choose between comfort and cure to receive this care.

While this care is not limited to cancer patients, as an oncologist I see these benefits when my patients visit the Doris Howell Palliative Consultation Service at UC San Diego. The service is named after Dr. Doris Howell, a beloved doctor in San Diego who launched palliative and hospice care in in our community. Her picture is prominently displayed on the second floor of the UC San Diego Moores Cancer Center.

The palliative care service helps my patients who have issues like pain, shortness of breath or nausea. Treating these symptoms allows patients to better tolerate necessary chemotherapy, radiation therapy or surgery.

Similarly, cardiologists believe palliative care helps heart failure patients tolerate needed therapies. This is true for many other specialties as well. In addition, integration of palliative care helps patients and families to better handle the diverse stresses of serious illness.

UC San Diego and Scripps Health have long recognized the value of this care. They have been partners in the San Diego Hospice training program for many years. Both organizations are committed to bringing back this important program to help address the current and projected shortages of palliative medicine clinicians, locally and nationally.

Gary Buckholz, M.D. led the training program at San Diego Hospice and is now at UC San Diego, where he is an associate clinical professor at Moores Cancer Center and part of the Doris Howell Palliative Consultation Service in La Jolla and Hillcrest.

He is working with Dr. Holly Yang at Scripps Health, as well as leaders of both organizations, to rebuild a world-class palliative care training program.

In this, he has the unqualified backing of Doris Howell, who recently told me “I believe deeply that cooperation and collaboration of like-believers can greatly enhance the contribution to the community at large.

“Historically collaboration has been an extremely important part of building palliative care in the community. It’s much needed and I’m thrilled that this effort will continue and the training program will be revived.”

Buckholz believes such collaboration creates the opportunity to rebuild a training program second to none. “Scripps Health has started a hospice program and plans to re-open the hospice inpatient facility in Hillcrest. Trainees will have the opportunity to work with nationally recognized faculty from both UC San Diego and Scripps in inpatient, outpatient and homecare settings. More importantly, patients will have better access to palliative care.”

Historically the federal government via Medicare has funded doctor-training programs. The new program, however, will not receive government funds because it is a relatively new specialty, officially recognized just eight years ago. It and other programs like it depend upon philanthropy to succeed.

In the past, the program has benefited from generous support from Audrey Geisel, Daniel and Violet McKinney, Richard and Kaye Woltman, the Donald C. and Elizabeth M. Dickinson Foundation, and the Kenneth T. and Eileen L. Norris Foundation, among many others.

Just as we all need basic and specialized medical assistance when we are hurt, sick or ailing, there is a need for the benefits of palliative treatment offered by this collaboration. When you or a loved one is confronting serious illness, you want — and deserve — the best care possible. That includes integrated palliative care.

— Scott M. Lippman, MD, is Director of

UC San Diego Moores Cancer Center. His column on medical advances from the front lines of cancer research and care appears in the La Jolla Light the fourth Thursday of each month. You can reach Dr. Lippman by e-mail: