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Hospitalist Care Service

Conquest - Fall 2013

With longer lives come complications

By Mary Brolley

Although most cancer treatment occurs in an outpatient setting, sometimes it’s an inside job. Cancer patients can require hospitalization for a variety of reasons.

They may be related to complications caused by comorbidities — health conditions like diabetes or high blood pressure that may complicate treatment and recovery — or to the effects of long-ago cancer treatments.

A growing medical specialty aims to meet the demand for skilled care for these acutely ill patients in the hospital. Called hospitalists, these physicians are experts in providing treatment in a multidisciplinary setting, liaising with specialists as needed, and managing comorbidities and complications of therapy and the disease process.

Norman Brito-Dellan, M.D., assistant professor, is one of MD Anderson’s nine hospitalists. The explosion in demand for this specialty is driven by a simple and wonderful fact, he says.

Norman Brito-Dellan, M.D., is one of nine hospitalists 
at MD Anderson.
Photo: Wyatt McSpadden 

“Cancer patients are living longer. Targeted therapies are effective, and even those with metastatic disease have added years to their lives,” he says. “This is a great thing. But with longer lives come unique complications.”

There may be consequences of treatment — past exposure to chemotherapy, radiation and more. Hospitalists are well suited to treating these late effects in acutely ill patients in the hospital. They work cooperatively with supervising oncologists and return patients to their care when the acute issues are resolved.

Split schedule allows for intensive patient care, research


Brito-Dellan came to MD Anderson in 2011 from Intermountain Healthcare in Utah, where he also practiced as a hospitalist. He relishes the demanding pace of the seven-days-on/seven-days-off schedule. His clinical research — on improving the health and quality of life for those with advanced cancer — is conducted on the “off” weeks.

He wouldn’t have it any other way.

“It’s a very interesting patient population,” he says. “For each type of cancer, there may be some distinctive, associated comorbidities. For example, patients with lung cancer may present with acute exacerbations of chronic bronchitis, repeated lung infections and so forth.”

Another research focus is standardizing insulin management among inpatients, most with advanced cancer.

“It leads to better outcomes — fewer complications, improved healing, less infection and reduced mortality.”

His seven-days-on rotations allow him to really connect with patients and their loved ones, he says. “I love caring for these patients. I learn a lot from them. At some of the worst moments of their lives, they’re inspiring. It’s something you don’t get in other places.”

And how does he cope with his stressful schedule? “I run,” he says. “I ran a marathon last year.”

     Related story: Creating an umbrella of care


© 2014 The University of Texas MD Anderson Cancer Center