“Nurses are uniquely positioned to assist in the screening for mental disorders (eg, anxiety, depression) and overall distress. They get to know our patients well, and sometimes even better than the treating oncologist. They are essential partners in the care of patients with cancer, throughout the cancer journey,” said Don S. Dizon, MD, an expert from the American Society for Clinical Oncology in an interview with Oncology Nurse Advisor.

Dizon explained that this study used a standardized questionnaire to determine the incidence of mental disorders. He stated that routine clinical practice could adopt such questionnaires, including the Beck Depression Inventory, the Hospitalized Anxiety and Depression Scale, or even the National Comprehensive Cancer Network (NCCN) Distress Thermometer. “In addition, all clinicians can watch for signs of distress in our patients, whether it be obvious (excessive sadness, frequent bouts of crying, seeming anxious at visits) or subtle (withdrawn, fighting with loved ones, changes in outlook or persona). And never forget that there is much to be learned about our patients, solely with observation,” he added.

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Study findings showed patients with breast cancer had a higher prevalence of mood disorders than patients whose conditions had less optimistic prognoses, including pancreatic, esophageal, and stomach cancers. “This issue alone warrants further evaluation to better understand why this difference was found,” Dizon said.

Dizon also urged further research to understand how a patient’s mood and psychological health changes throughout the cancer journey. “Further understanding of times when patients may be at more distress than others would be useful,” he said.

Nurses need to acknowledge their patients’ emotions. Dizon stated that nurses can let patients know that their distress is not only real but common, as this study indicated.

When an oncology nurse feels that a patient needs help through psycho-oncologic interventions, Dizon said, “Getting these patients the help they need requires multidisciplinary collaboration, which might include social work or even specialty psychologic or psychiatric referrals. Nurses should feel empowered to bring these issues up with the treating team, all done to ensure our patients get referred to the services they may need.”

Kathy Boltz is a medical writer based in Phoenix, Arizona.


1. Mehnert A, Brähler E, Faller H, et al. Four-week prevalence of mental disorders in patients with cancer across major tumor entities. J Clin Oncol. 2014;32(31):3540-3546. doi:10.1200/JCO.2014.56.0086.