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Improving psychological care for cancer patients

Improving psychological care for cancer patients
Photo: Improving psychological care for cancer patients
Around one in five men struggle to cope with a diagnosis of prostate cancer while international large scale studies show the diagnosis also leads to an increased risk of suicide.

Professor Suzanne Chambers, a health psychologist at Griffith University’s Menzies Health Institute Queensland, says more needs to be done to help men experiencing ongoing high distress as a result of prostate cancer.

“The risk of suicide seems to increase over time and so for some men living with that burden of the changes that prostate cancer brings to their life, it becomes a burden they can’t bear,” she says.

“We’ve done a lot of research on unmet supportive care needs and what emerges very strongly is that with the psycho-sexual changes that come with prostate cancer, half of all men with prostate cancer report ongoing long-term unmet supportive care needs in that area.
“I say to people - just imagine if this was your partner or your dad or your brother who was going through all of this, you’d want someone to do something about that and that’s what motivates my research program.”

Prostate Cancer Foundation of Australia statistics show the disease is the most commonly diagnosed cancer in Australian men, with the cancer claiming more than 3000 lives every year.

An Australian Research Council Future Fellow, Professor Chambers has worked as a practitioner and researcher in psychological support for people with cancer for more than 25 years.

While Professor Chambers’ research focuses mostly on prostate cancer, she says a cancer diagnosis is devastating for people, and while many are resilient and learn to adjust to their new reality, a third of people have ongoing clinical distress.

“That is a debilitating thing and that’s a level of suffering that we want to reduce and hopefully remove entirely,” she says.

“It’s an awful thing to see someone who’s had a diagnosis of cancer and the changes that it’s brought in their life, and to see them struggling with that and not know where to turn or how to move their lives forward in a positive way.”

Professor Chambers says it’s important anyone diagnosed with cancer is routinely screened for anxiety and depression.

The National Comprehensive Cancer Network (NCCN) in the United States has adopted a free, readily available and simple tool, called the Distress Thermometer.

While the tool is being used in Australian treatment centres, Professor Chambers fears it’s not as widely used as it should be.

“I guess the reasons are that sometimes people think if someone’s distressed, they’ll notice it,” she says.

“My answer to them is - well, you probably won’t because they could well be masking that - particularly if they are men.”

Professor Chambers says doctors and any nurses who come into contact with oncology patients should have a psycho-social care framework in their treatment centre that focuses on distress screening on a regular basis.

“Centres need to work out the best protocol that suits them but there’s no question that it’s internationally recognised that distress is the sixth vital sign.
“We should be keeping an eye out for it, screening for it in a systematic way and not relying on people to self-identify as distressed and not relying on ourselves to just pick it up somehow.

“It’s not enough though just to detect distress, you’ve got to do something about it if you find it, and so that’s about understanding what evidence-based care looks like, what your referral pathways are in your local community and where you can refer that person for help.

“It’s important to just check with people - people often feel that they should be grateful that they’ve survived and they shouldn’t be complaining if they’re unhappy but asking that question and inquiring as to how a person is feeling gives them permission, if they are distressed, to talk about that and then that gives you an opportunity to take action.”

As the cancer burden escalates in Australia in line with our rapidly ageing population, Professor Chambers says governments must find clever and innovative ways to provide services while working within their constrained budgets.

She says it’s vital governments consider the bigger picture.

“I think these are particular challenges for psycho-oncology services and research because everyone automatically goes - well, we’ll treat the medical pieces first, they’re the most critical and then we’ll do the other if we have the time or resources,” she says.

“But it’s important to remember if you cure someone and they live the rest of their life miserable, I’m not sure that that’s a great outcome, so it’s about trying to get some sort of balance.

“Then the challenge for people who work in the psycho-oncology and psychology fields is to understand that and learn to talk a language and communicate their work in a way that gets some priority in the highly competitive research scheme.”

Professor Chambers says the better patients are able to cope with their cancer diagnosis, the more likely they are to adhere to their treatment which will help their survival.

“It’s not about think positive and you will live longer, it’s not even about thinking positive, it’s about helping people to live the best they can, to manage their way through their treatments and then to have a good quality of life after treatment has finished.”

* Professor Chambers will be presenting on the history and the future challenges of psycho-oncology care at the Australian Psychological Society’s (APS) Golden Jubilee Conference, to be held on the Gold Coast from September 29 to October 2.

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Karen Keast

Karen Keast is a freelance health journalist who writes news and feature articles for HealthTimes.

Karen regularly writes for some of Australia’s leading health news websites and magazines.  In a media career spanning 20 years, Karen has worked as a senior journalist in newspapers and television. She has covered the grind of daily news and worked as a politics reporter at countless state and federal elections.

Since venturing into freelance writing five years ago, Karen has found her niche in writing about the health sector for editors, businesses and corporations.

Karen has interviewed the heads of peak health organisations in Australia and overseas, and written hundreds of news and feature articles covering the dedicated work of health professionals who tread the corridors of hospitals and health services, universities, aged care facilities and practices, day in and day out.

Follow Karen Keast on Twitter @stylemywords