© 2005-2012 American Society of Clinical Oncology (ASCO). All rights reserved worldwide.
Watch the Cancer.Net Video: Caring for the Whole Patient, with Editor-in-Chief Diane Blum, MSW, adapted from this content.
A diagnosis of cancer presents many challenges. In the effort to cure the cancer, the physical effects of the disease and treatment often are focused on most. However, it is also important for the health care team to address the psychosocial effects, which are the emotional and social concerns that can greatly affect patients' well-being. According to a 2007 Institute of Medicine (IOM) report on this topic, Cancer Care for the Whole Patient: Meeting Psychosocial Health Needs, psychosocial problems include:
- Lack of information and support
- Emotional difficulties, including depression and anxiety
- Lack of transportation
- Disruptions to work, school, and family life
- Insufficient financial resources
The IOM report notes that such psychosocial obstacles often interfere with a person's healthcare and diminish his or her health and functioning. However, the influence of emotional and social issues is usually significantly reduced through effective communication between the patient and the doctor. Patients and caregivers can take an active role in addressing these challenges by asking questions and talking with the doctor about both physical symptoms and psychosocial concerns, such as coping with the diagnosis, paying for medical bills, or getting to appointments. There are many support services available for people with cancer, and being linked to the appropriate services usually provides an enormous benefit to the patient's overall care.
Patient information and support
Access to current information about a specific cancer type or the related treatment options help patients make more informed decisions about their health care. Patients also should know the short-term and long-term side effects of their treatment to anticipate how their needs may change in the future. In addition, many national organizations offer a wide range of programs and support services for people with cancer and their families.
Many people with cancer experience emotional difficulties, including anxiety and depression. And, patients with untreated depression or anxiety may be less likely to take their cancer medication and maintain their health. They may also be more likely to withdraw from family and others offering support. There are resources and services available to help patients maintain their emotional well-being and get help for depression or anxiety, such as peer support groups, individual or group counseling, medication, and online communities for support.
Access to transportation
Getting to appointments and picking up prescriptions is difficult for people who don't have access to transportation. Even people who do have transportation may find that driving themselves is difficult if they are feeling ill. Community resources may be available to help; some hospitals or local agencies have low-cost or volunteer transportation programs, and some non-profit cancer organizations provide funds for taxi costs. CancerCare provides information on finding help for transportation.
Financial assistance and advice
Lack of adequate health insurance may prevent many patients from seeking treatment, taking necessary medications, or attending regular appointments. People with a limited income may also have difficulty affording basic necessities, in addition to medical care. Even patients with health insurance may find that the costs associated with cancer treatment are more than expected. Learn more about managing the cost of cancer care, including information on understanding health insurance, a list of national, local, and governmental sources of financial assistance.
Managing health care information
During cancer treatment, there is often a lot of information for patients to remember, keep track of, and act on. For instance, patients need to know when and how to take medication, when to go to appointments, and what to expect after treatment. To manage this flow of information, it is recommended that patients keep a written record of all procedures, treatments, and medications received. Information and education about cancer treatment and recovery is available that can help patients manage their health care. And, ASCO Cancer Treatment Summaries are printable forms that you and your doctor can complete to help you keep track of what treatment is planned, what treatment was received, and what follow-up care is necessary.
For some people, part of their cancer treatment plan includes significant changes in lifestyle and habits, physical activity levels, or diet to help relieve side effects or reduce chances of cancer recurrence (the cancer returning after treatment). For people who smoke, quitting smoking is often an essential part of recovery. These changes are difficult to make, and it is important that patients receive the support and resources they need. Learn more about healthy living after cancer.
Managing life disruptions
Many patients may have a significant change in work schedules, and some people must stop work entirely during cancer treatment. The Americans with Disabilities Act and the Family and Medical Leave Act provide legal protection for disruptions in work due to cancer treatment. Read more about dealing with workplace discrimination and going back to work after cancer. School can also be disrupted; learn about going back to school after cancer. And, patients may also find that they have trouble performing daily activities. Home care services are often available for people who need greater assistance in the home, either with their medical needs or activities of daily life.
Institute of Medicine Report
As mentioned above, the 2007 IOM report, Cancer Care for the Whole Patient: Meeting Psychosocial Health Needs, provides 10 recommendations that can help doctors identify emotional and social needs, refer patients to necessary services, support patients in managing their illness, coordinate psychosocial and medical care, and follow-up on the effectiveness of these interventions. Order a copy of the full report from IOM.