CANCER AND MENTAL HEALTH

By EllenE.Grant PhD, LCSW-R, former Commissioner, Erie Couty Dept. of Mental Health; Former Deputy Mayor, Former Sr.ED, Roswell Park; Community Leader

EllenE.Grant PhD, LCSW-R

Many years prior to 2000, the topic of integrated healthcare was limited. That is- the care of the human body was often limited to just the body, not including the mind. The term integrated care has become more popular in the past thirty years and relevant to providing whole body/mind care. Even spiritual care is now added to wholly integrated care. A healthy body cannot exist with an unhealthy mind and vice versa.

For a formal definition of integrated care as provided by the American Psychological Association “… is an approach characterized by a high degree of collaboration and communication among health professionals…sharing of information among team members related to patient care and the establishment of a comprehensive treatment plan to address the biological, psychological and social needs of the patient”.

This shift toward integrated care recognizes the importance of addressing both physical and mental health concerns together, rather than treating them as separate entities. By routinely including mental health screenings during medical visits, providers can identify issues early and intervene before they become more severe.

The interprofessional health team may include physician, nurse, mental health team (Psychologist, social worker)-depending on the needs of the patient.

In recent years, I’m sure you’ve had questions at the medical office in the intake and or registration process asking “do you feel sad on a scale of 1-10 from none to sometimes, never-asking you to provide a number re your feelings. Seeing your answers, the health care provider must then evaluate if you require additional care and or referral to a mental health provider.

Questions re the mental health of the patient is more prevalent because research has shown that up to 25% of adults experience depression with the diagnosis of cancer.

Questions that patients who receive the cancer diagnosis may have could be -how long will I live? Who’ll take care of my family? How will I pay for this treatment-I don’t have insurance or I don’t have enough insurance. How will I tell my family- my children?  How long will I be able to work? If I can’t work-no regular income coming in-then what?  What if I need home care? How will I travel to the care-I don’t have a car?

These concerns and others I may not have listed here can significantly affect a patient’s emotional well-being. Such concerns may lead to increased stress, feelings of isolation, or even hopelessness. In addition to depression, patients may experience sleep disturbances, loss of appetite, anger or difficulties concentrating. All of these I’ve mentioned can further complicate a person’s ability to cope with the demands of cancer treatment and recovery. Recognizing and addressing these emotional responses early on is crucial for overall health outcomes and improved quality of life during this challenging time.

Once you have the reality of this cancer diagnosis, it is important to decide where you will receive your treatment. In Western New York, we are fortunate to have the Roswell Park Comprehensive Cancer Center. However, if you live in a rural area or in an area whereby you don’t have immediate access to care options, it is important for you to do your research. Asking questions of family and friends who you know have gone through cancer treatment can be part of your own research. Googling “cancer care in WNY” you’ll find many options for your review. Roswell Park (716-845-2300) Erie County Cancer Services (716-858-7376). At any one you select; you will be referred to someone who can answer your care as well as financial concerns for treatment.

Please know that some care places have support groups made up of people who have gone through cancer treatment. These support groups can be helpful to talking through the treatment care they themselves have experienced.

Early identification of mental health issues once the diagnosis of cancer is received and the role of these support groups is important. The necessity of open communication and your active involvement as a patient can give you the best outcomes and enhance quality of life during cancer treatment. If you are a person of faith, you may also decide to include a member of your spiritual care network as you discuss your treatment.

 It is also very important that wherever you make the decision for care, that you are comfortable with your care team. Afterall, these people have your actual life in their hands. Building and maintaining a relationship of trust can enhance your treatment.

Think about and please write down all of the questions you may have BEFORE your first appointment. If you’re not sure of all the questions, ask a family member for their input and or decide if you want someone with you for your first appointment. You are the patient who is the driver of your care. You have that power-don’t give it away. Of course, if the patient is a minor or an adult with mental health challenges,  this will require a different plan of action.

Open communication with your care team is essential throughout your treatment journey. Don’t hesitate to share your concerns, ask questions, and discuss any changes or anticipated changes in your physical or emotional health.  What about my appetite and dietary changes. What about changes in my sex drive? Will I lose my hair? The necessity of open communication and your active involvement as a patient can give you the best outcomes and enhance quality of life during cancer treatment.

Of course, we know even with the best care, you may not have the best outcome. Fears, concerns re these realities are necessary to be discussed and important.

 This collaborative approach not only helps tailor your care plan to your specific needs, but also empowers you to be an active participant in your own healing process.