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Promise and Progress - Interview: The Cancer Patient's Advocate

Sidney Kimmel Gives Hopkins Its Biggest Gift Ever

Interview: The Cancer Patient's Advocate

Date: December 1, 2002

James Zabora, Sc.D., was appointed to the Cancer Center’s top social work position in 1983. Introducing innovative changes such as a Cancer Counseling Center, homelike residential facilities for patients and families, and psychosocial research and screening, he has made the oncology social work program a model for the nation.

When Jim Zabora was growing up in Dundalk in the 1960s, there were three career options for a boy like him—working the assembly line at General Motors, manufacturing telephone and cable wire for Western Electric, or enduring the blast furnaces “down the Point” at Bethlehem Steel. Zabora wanted more. And, after working as a summer intern at the city’s Department of Social Services, he made social work his life’s ambition.

Q: Why did you choose to work with cancer patients?

A: Cancer is the most difficult issue you can put before someone. Every patient is in a potentially life-threatening situation. Sure, we’ve made a lot of progress, but there’s still not a 100 percent cure for any cancer. I was excited about the Oncology Center job because it was not just a pleasant add-on. It was an opportunity to make psychological care an integral part of therapy. The trick to cancer is not just surviving, but coming out of it with a life worth living. That’s the aspect we specialize in.

Q: You’ve earned international acclaim for psychosocial screening of cancer patients. What is this?

A: It’s a short questionnaire that takes all of a minute to fill out, but it provides the social work staff with invaluable information. Cancer patients show up with more than cells that have run amok. They bring problems—psychological, social, and practical. The questionnaire helps us identify patients that may need social work intervention. Is the patient depressed?  Are there problems in the family?  Are they worried about paying their bills?  These are things that affect people in their everyday lives, but when you’re in a crisis, they become more serious. The questionnaire gives us a systematic way of identifying them.

Q: Most of us don’t think of social workers as doing research, but you’ve published more than 40 papers and oversee community research. What is involved in this aspect of your work?

A: Our job is help people decrease the stresses caused by cancer. Whether that is counseling, prayer, support groups, meditation, information. Whatever it is, we need to learn about these things and study them to validate their usefulness to patients and families and to learn the most beneficial and effective way of providing them. In that sense, research is an integral part of what we do. We are one of the smallest groups in the country, but there’s not another cancer center that has produced more abstracts and presentations at a national level than this group. We have incredibly talented people and generous support of donors such as Mrs. Lois Duffy. It’s an incredible combination and that makes us successful.

Q: In 1999, you took over as director of the Center’s community outreach program and began addressing the high cancer rates in Hopkins’ own inner city neighborhoods.Have you been successful?

A: I can look out of my office window directly into the neighborhoods with possibly the highest cancer rates in the nation. As a comprehensive cancer center, we have an obligation to apply our knowledge to help these communities. Certain populations experience higher levels of cancer risk due to economics, genetic, racial, behavioral, and environmental factors. Clearly, these people aren’t coming to us, so we decided we better go to them. We work with the churches, centers, and organizations in the community and take our experts to them to provide cancer education and screening. We’ve reached thousands of people, so I would say it’s been successful.

Q: What are your plans for the state-funded public health grant you recently received?

A: We were given $1.5 million from the state Cigarette Restitution Fund to expand our community outreach and focus on Maryland’s most common cancers. Baltimore City’s African American men have the highest prostate cancer death rates of any other city in the nation, so that has become our focus. Our goal is to provide physical exams and PSA (prostate specific antigen) blood tests to at least 2,500 African American men. This money will also be used to provide treatment for anyone diagnosed with cancer. We are working with University of Maryland and Sinai Hospital at six community sites located in Baltimore City neighborhoods. While prostate cancer is our current focus, we will also assist Maryland and Sinai in cervical and breast cancer screening.

Q: You are an associate professor at one of the most esteemed medical institutions in the country. You have earned a master’s degree in social work and a doctorate of science in social and behavioral science. Your department has been ranked as the best oncology social work department in the United States. How do you manage to stay so humble? 

A: I didn’t do this the easy way. I worked my way through high school. I worked my way through college. When I went back for my doctorate, I took one class a semester for eight years. I started my homework after helping my kids with theirs. For me, it’s not about praise and recognition. I care about the people. And remember, I didn’t do all of this on my own. Probably my greatest talent is surrounding myself with good people.

Editor’s Note: Excerpts taken from Dome article “Zabora’s Way” written by Mary Ellen Miller.