Blue Note Therapeutics hosted a panel discussion in May 2021 with clinical experts and patient advisors from Memorial Sloan Kettering Cancer Center (MSKCC) to discuss cancer-related distress and how to navigate it in both a patient and caregiver role.
Jimmie Holland, MD, a psychiatrist, pioneered the field of psycho-oncology to what it is today. She was very interested in the emotional aspects of cancer and wanted to address the humanistic elements of dealing with cancer. Each of the panelists continues to work towards what Dr. Holland initially set out to do—help patients undergoing treatment at MSKCC face the stressors associated with the various stages of diagnosis, treatment, and survivorship. Both patient advisors have been through each role as a patient, caregiver, and survivor and highlighted how psycho-oncology has helped them cope with everything.
Cancer-related distress, Haley Pessin, PhD said, “stems from having an illness and centers around that. But it can take a lot of different forms: It can be sadness and depression, it could be anxiety, worry, it could be anger, it could be feeling helpless and hopeless, feeling overwhelmed, not being able to navigate things.” He explained that while the statistics may vary depending on the study, about 35-80% of cancer patients experience distress, compared to 8-10% that may experience it in the general population. The clinicians use a distress thermometer that lists about 40 items to address concerns and problems appropriately and to understand the origin of stressors in the patients’ lives.
When the panel was asked whether treatment for cancer-related distress could influence other areas of the disease like physical pain or the need for opioids, William S. Breitbart, MD said, “There are several areas in which psychosocial interventions can be used to ameliorate these nonsomatic components of cancer pain.” Another panelist, Wendy Lichententhal, PhD, spoke about how mental health providers can help alleviate stress and potentially improve medical outcomes. Psychological support can ease concerns and stressors and can help patients adhere to their medication and treatment regimens.
Even while receiving psycho-oncology treatment, it is very common for patients to yo-yo in their feelings of stress. For example, at the onset of diagnosis, patients might experience high stress levels, which might be lower post-treatment. This is very common not only for patients but also for caregivers. When encountering such a rollercoaster of emotions, patients might feel like a burden when wanting to ask for additional help from their medical team, but Allison J. Applebaum, PhD, says it is not a burden at all. Instead, it is as simple as saying, “I am having difficulty coping. Who, here or in the community, can provide support to me?” Not only are patients and caregivers encouraged to advocate for themselves, but also healthcare professionals should be doing the same.
Highlighting the importance of mental health, Anne Marie, a patient advisor, said that it is of prime importance when coping with any serious health condition. Her recommendation is that when asked on a distress screener, patients should let the medical team know when they need help managing and handling issues beyond just their medical symptoms. There are many services and resources available to help patients and caregivers who may be struggling with their mental health. Learn more about them here: https://coloncancerfoundation.org/mental-health-cancer/.