In my three decades practicing clinical and executive management in social service settings, I have witnessed many breakthroughs in cancer treatment leading to better prognoses for people with cancer. However, oncology social workers continue to report that clients feel their health care team has not adequately addressed their emotional and practical concerns.
Viewing the elimination of cancer cells as the singular goal of treatment is not providing comprehensive care. To provide the most effective patient care, the best practice is to address not only medical and nursing issues, but also psychosocial interventions for every patient and their loved ones.
The landmark Institute of Medicine (IOM) report Cancer Care for the Whole Patient: Meeting Psychosocial Health Needs found attention to psychosocial needs to be the exception rather than the rule. Seven years after the report was published, despite overwhelming evidence that support services help relieve emotional stress and lead to better patient outcomes, too many providers undervalue psychosocial care.
Apart from medical challenges, patients and their loved ones must cope with myriad concerns. Some common concerns that impact treatment adherence include feelings of depression and anxiety, barriers to care (such as difficulty coordinating transportation or child care), financial uncertainty, a lack of information about diagnosis and treatment, and difficulty balancing work/school/family responsibilities.
People coping with cancer often share with CancerCare oncology social workers that they feel rushed at their appointments or do not want to bother their health care team with nonmedical concerns. While factors such as personnel shortages, an increased number of cases, and established clinical practice procedures may certainly impact the amount of time spent with each patient, they should not do so at the expense of adequate doctor/patient communication.
The health care professional is not the only one who may underestimate the importance of psychosocial care. CancerCare client Ekata, a young New Yorker coping with chronic lymphocytic leukemia, recalls the skepticism she felt after her health care team and brother recommended seeking individual counseling services. Ekata felt she was doing well managing her feelings of anxiety and uncertainty, but was having difficulty communicating with her family.
“My family looks to me for cues on how to act, so I was concerned about making them worry about me,” Ekata says. “There are certain things I can’t open up about [with them].” She put on a brave front for the sake of her family, but continued wrestling with private anxieties. To assuage her brother, Ekata called CancerCare and was immediately put in touch with an oncology social worker.