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opinion: investment in psychosocial oncology is needed to treat mental, emotional, social and spiritual side effects of cancer
as cancer rates climb, our ability to support patients through the biggest psychological health challenge they’ll face is dropping even further.
oct 10 2023
4 minute read
more broadly, supportive care includes psychiatry, patient and family counselling, nutrition, speech therapy, vocational rehabilitation, spiritual care, physiotherapy, and pain and symptom management.
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cancer presses an immediate and indefinite pause button on a patient and their loved ones’ lives. school, work, social activities, pastimes and other passions are usurped by endless appointments, grueling treatments, worry, stress and fear.
all exacerbated by waiting for test results, for treatment to hopefully work and, unfortunately for many, for the cancer to return. so much so that “scanxiety” is now an officially recognized term, and just one of the many mental health challenges that accompany a cancer diagnosis.
approximately 17 per cent of british columbians are experiencing a mental health challenge today. for the 80,000 people facing cancer, depression, anxiety and suicidal ideation are significantly more common. and if left untreated, lead to poorer outcomes including life spans shortened by almost two years, on average.
as cancer rates climb, our ability to support patients through the biggest psychological health challenge they’ll face is dropping even further. in order to provide whole-patient cancer care we need to invest in supportive care resources, infrastructure and people, and activate a team-based/primary care approach.
psychosocial oncology services, which focus on the emotional, practical and family-related aspects of cancer, are as crucial to recovery as chemotherapy and radiation. psychiatrists, counsellors and spiritual care practitioners don’t kill cancer cells, but they ensure patients get to the appointments where this life-saving work happens, and help them tolerate any adverse aftereffects.
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while life-saving, chemotherapy, radiation treatments and hormone therapy can initiate psychiatric side effects such as extreme anger and irritability, fatigue, “chemo brain,” or loss of cognitive function. all of which can limit a patient’s ability to return to a normal life, let alone the daily demands of work and family.
parents, particularly those with young families, struggle with how their cancer diagnosis impacts their children. people already experiencing mental health issues or substance use, or who live in poverty, alone or socially isolated are even more vulnerable, and experience poorer outcomes and survival rates.
more broadly, supportive care includes psychiatry, patient and family counselling, nutrition, speech therapy, vocational rehabilitation, spiritual care, physiotherapy, and pain and symptom management. these services include practical supports such as transportation, accommodation and financial assistance.
as we continue enhancing and expanding mental health services, we must also continue to break down the stigma and barriers around accessing mental health care, so that people touched by cancer can get the help they need to heal. the bc cancer foundation’s beyond barriers patient relief fund is helping supplement some of the financial, geographical or cultural barriers to care for at-risk patients to help ease the mental health burden of a cancer diagnosis.
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for some, facing cancer is akin to going to war. not surprisingly, up to 20% of cancer patients meet criteria for post-traumatic stress disorder (ptsd) and returning to the same centre in which they received treatment can be as triggering as stepping back on a battlefield.
thanks to donor support, bc cancer – vancouver moved its supportive care services to a separate building to help give patients a fresh start. this novel approach of team-based supportive care in a dedicated setting is acting as a model for other bc cancer centres, and the bc cancer foundation is currently fundraising to support a new space for supportive care in victoria.
mental health needs following cancer treatment can linger, or worsen due to the loss of support, long into survivorship. empowering patients through self-management resources such as websites, videos and group counselling, as well as educating and empowering primary caregivers can help bridge that gap.
research, often only thought of as advancing new treatments, plays an important role in increasing access to mental health support. for example, game-changing data is coming out of a bc cancer study that is using artificial intelligence to read oncologists’ dictations to flag at-risk patients and predict — with an almost 90% accuracy — whether they will go on to require psychiatric care or counselling, potentially catching depression or anxiety before it starts.
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thanks to innovative new treatments and resources, full lives await many patients on the other side of their cancer journey. unfortunately, if the mental health crises that often accompany a cancer diagnosis aren’t treated, patients risk emerging a shell of their former selves.
while the words “cancer free” are glorious to hear, they don’t liberate you from the life-altering mental health challenges that can be just as imprisoning. patients can recover whole and healthy and achieve a life beyond cancer, or peacefully live out the added time with family that treatment provides. but we need to recognize the magnitude supportive care has on quality of life and survival, and rally to continue expanding our mental health resources to afford people who face cancer an opportunity to not only survive, but thrive.
sarah roth is the president and ceo of bc cancer foundation and dr. alan bates is the provincial practice leader, psychiatry and program medical director, supportive care at bc cancer.
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