Getting the Psychosocial Support You Need
by Alan B. Astrow, MD
At one time, physicians focused mainly on the technical aspects of cancer treatment and paid little attention to the psychological or social needs of the people they were treating. For instance, men with prostate cancer may have been unprepared for the bodily changes that accompanied surgery or radiation, and young people who were cured of leukemia after physically difficult treatment courses may not have known what to expect later on.
Today, we understand that each individual must be viewed as a physical, emotional, and spiritual being, not just a collection of body parts. Physicians can help by taking an interest in who you are – your values, important relationships, and goals. By asking a few questions during a visit, physicians can gain a wealth of knowledge about the person in front of them.
A diagnosis of cancer may change your perspective, but it doesn’t have to leave a scar.
You can also take initiative by expressing what’s on your mind or by having family and friends help relate their concerns to your doctor. Some people feel it’s a sign of weakness to admit they are experiencing emotional, financial, or interpersonal stress, or they may feel uncomfortable raising these issues with their doctors. However, your physician will not be able to help without first knowing your concerns.
In many cancer centers, physicians, nurses, social workers, nutritionists, psychologists, and chaplains work as a team. Physicians and nurses should ask you how treatment is going, and if they don’t, you should volunteer the information.
All oncology practices should screen for evidence of distress. Distress refers to “an unpleasant emotional experience of a psychological, social, and/or spiritual nature that may interfere with the ability to cope effectively with cancer, its physical symptoms, and its treatment.” If needed, your physician will refer you to other members of your healthcare team for specific psychosocial services.
If you are experiencing distress, you are not alone. As many as 40 percent of people newly diagnosed with cancer report some form of distress. This may include feelings of fear, sadness, or worry, all of which are normal in the face of troubling news. A smaller percentage of people will have more severe psychological symptoms of anxiety or depression that require further treatment.
Organizations such as SHARE (sharecancersupport.org) and the Cancer Support Community (cancersupportcommunity.org) can serve as reminders that others have gone through treatment and are now well. If you are feeling extremely despondent, talk to your doctor about the many new medications available to help manage depression. If you have spiritual or existential concerns, consider meeting with a chaplain.
Keep in mind that recovery continues past completion of treatment. In many cancer centers, a dedicated oncology social worker will help to determine the best team member to address your psychosocial needs.
A diagnosis of cancer may change your perspective, but it doesn’t have to leave a scar. Well-organized supportive services can supplement your own strengths and resources, help you get through treatment, and help you find your “new normal.”
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Dr. Alan Astrow is director of Hematology/Medical Oncology at the Maimonides Cancer Center in Brooklyn, NY.
This article was published in Coping® with Cancer magazine, March/April 2012.