In 1956, long before Patrick Plumeri was born, his grandmother passed away from cancer. By the time she’d been diagnosed, the cancer had spread to other parts of her body. At such a late stage, no one even bothered to ask where it originated. The family, Plumeri said, was resigned to the fact that “she was going to die.”
“My father considered it an open and shut case,” said Plumeri, 47, a medical family therapist. “Now, because the treatments have gotten so much better, we can help our patients and their families adjust to living with cancer; it’s not always a matter of life or death. Patients may be functioning at a different level than before cancer, but I’m able to help them with that.”
Plumeri is one of six medical family therapists with the Duke Cancer Patient Support Program. They provide individual, couples, and family therapy services at no charge — a cancer center practice, unique to Duke, that dates back more than 30 years.
“Once you’ve been diagnosed with cancer, your mortality becomes very real,” said Plumeri. “Those of us who are relatively healthy go on auto-pilot. We get up, we brush our teeth, we leave the house. But when faced with your own mortality, you may question what you’re doing and whether it gives your life meaning and presence: What do I want out of my life? Why am I alive?”
He guides patients and their loved ones as they explore these big life questions and helps them manage, from a practical and emotional standpoint, the daily stresses of the disease.
Plumeri is always on the move — keeping daytime office hours at Duke Cancer Center locations in Raleigh, Cary and Durham, and facilitating four monthly cancer support groups: two separate mixed-disease groups for patients and caregivers; a prostate cancer group; and, with child-life specialist Hannah Sasser, the KidsCan! Wake County family support group.
When cancer throws a family off kilter, Plumeri helps them adapt to their new normal.
Plumeri started his counseling career helping families cope with mental illness and substance abuse. While he had no experience in oncology, he knew how to help families manage stress.
“Whether the threat to family stability is drugs, schizophrenia or cancer, in any case, it’s still a threat to the family,” explained Plumeri. “Helping families adapt to these challenges is really the reward for me.”
This June, he was featured on a Survivorship Day panel discussion in which he answered questions from patients and their loved ones.
“Sometimes I feel pressure from family about medical treatments, what should I do?” one patient asked the panel.
“Any serious illness, not only cancer, has a way of impacting everyone in the family, whether you live together or you don’t,” answered Plumeri. “The important thing to remember is that everybody is on the same team — that they want the best health possible for the patient. It’s important to keep those lines of communication open.”
Another patient queried: “I’ve been given 18 months to live. How do I prepare for what comes next?”
“It’s a horrible reminder of change, but it does give us a chance to talk about what might happen tomorrow, next week, next year or next decade,” he said. “How do we plan for that? Plan for the worst, but hope for the best. And hopefully do so in a way that’s not threatening or frightening for everyone involved.”
One of Plumeri’s “best memories” is having counseled a cancer patient for a brief period during which the patient was preparing to transition from the hospital to hospice. His sister and his girlfriend disagreed with each other about his care plan. The patient didn’t wish to choose sides, Plumeri said, and was “tormented.”
“I had the privilege of helping him find his voice; helping him figure out what he needed, and how to express that to his loved ones, while still embracing them both,” said Plumeri. “It was my goal to help him be at peace. They reconciled enough for him to achieve that… It was a really good ending to a really sad story.”
Being so close to specter of death for more than a decade hasn’t worn Plumeri down.
“I’m not a robot. It can be sad sometimes,” Plumeri admits, quickly adding that “my joy in helping people compensates for any sadness I might have.”
Still, knowing that “tomorrow isn’t promised to anyone,” he hugs his wife and two kids tight every night, grateful for what he has today.
“I wish we could see every family that comes through our doors,” he said. “I personally can't cure cancer, but what I can do is provide support that can be life-changing to a lot of patients and families going through this.”
A Grateful Patient
“Patrick was the bright smiling face we needed when going through a rough time as a family during our cancer journey. He made our family feel comfortable with the KidsCan! group and encouraged us to open up and discuss our emotions in our own way... Knowing that our two little girls and my wife were getting the additional support they needed, allowed me to focus more on my fight against cancer.” — seven-year colorectal cancer survivor Ryan Switzer, a local homebuilder