Psycho-Oncology Is a Core Component of Comprehensive Cancer Care

In the complex landscape of oncology, a patient’s physical battle with cancer is often intertwined with significant psychological and emotional challenges. From the moment of diagnosis through the rigors of treatment and into the long-term journey of survivorship, the mental and emotional well-being of patients can be as critical to their recovery as their medical care.

Boris M. Kiselev, MD, a consult liaison psychiatrist at Atrium Health Carolinas Medical Center, an assistant professor of the Psycho-Oncology Program in the Department of Supportive Oncology at Atrium Health Levine Cancer Institute, and an assistant professor in internal medicine, sheds light on the pivotal role of psycho-oncology, a specialized field that addresses these unique needs. He emphasizes that integrating psychological care is not just about improving a patient’s quality of life but is an essential component of a holistic treatment plan that can directly affect their ability to undergo and benefit from medical interventions.

Transcript:

The role that psycho-oncology [creates] in the care of any patient depends a lot on the severity of their distress and their most pressing symptoms. For some patients with high levels of distress, psycho-oncology can play a central role. At some point, a high level of those types of concerns will interfere with a patient’s ability to receive treatment. By addressing those symptoms directly, we’re not only improving their quality of life but we’re improving their ability to get the care that they need during and after treatment. Every patient should be screened for distress, and that’s recommended by the [American Cancer Society] Commission on Cancer guidelines as well as the [American Society of Clinical Oncology] and other guidelines. The idea is that [when] there are some needs identified, there should be an appropriate referral to services. During treatment, patients would identify concerns and would be matched with the options that fit them best, whether that be individual or group psychotherapy, peer support, outpatient or inpatient psychiatric treatment.

Patients with social concerns who are improving with treatment—things like transportation or housing, food insecurity—they should be connected with a dedicated social worker who can assist with working through those barriers, and the goal as well as psycho-oncology care should be integrated into the greater cancer treatments that should allow for collaboration between the patient’s psycho-oncology providers and their oncology team. For survivors, psychological and emotional issues can sometimes be even more [impactful] than they were during treatment. We often will frame the process of adjusting to life after cancer like one of grief. People are processing losses that they experience, whether that be their physical health they had before, their work, their finances that can be affected, or sometimes even their relationships. They will have had changes to how their physical body is, and they will often have chronic symptoms afterward, whether that be pain, neuropathy, or other complications of treatment. In that survivorship phase, things like fear of recurrence can be extremely disabling for patients, and that’s where psychotherapy and other psycho-oncology care can be helpful for them.