Weaving Compassion Into the Fabric of Cancer Treatment

Richard P. McQuellon,

PhD, HSP-P

Professor of Medicine

Director, Psychosocial Oncology and Cancer Patient Support Programs

The diagnosis of cancer is almost always a shock for patients and family members. It is estimated that 30% to 50% of patients experience some debilitating anxiety or depressive symptoms at some time along their cancer diagnosis and treatment trajectory.¹ Their caregivers likely sustain similar rates of anxiety, depressive symptoms, and distress.

The Comprehensive Cancer Center at Wake Forest Baptist Medical Center provides programs and services that are integrated into the ongoing care of patients in order to make professional assistance available easily and seamlessly.

For example, all patients are screened for distress when they are seen by their cancer healthcare provider. The integration of personalized, patient-centered care at the point of delivery of medical services is a unique aspect of care at our Comprehensive Cancer Center.

The Psychosocial Oncology and Cancer Patient Support Programs were designed to address the emotional distress of patients and family members.² The mission of these programs is to reduce suffering and enhance quality of life of patients as well as caregivers during the diagnosis, treatment, and survivorship process, from the beginning of care throughout the life span.

These programs are woven into a broader network of professional services that are part of the supportive care and survivorship services network for our medical center and community. Research has shown that patients who access three or more supportive care services are likely to have increased satisfaction and better overall outcomes.³

Access to such services is readily available to all of our patients treated in medical oncology, surgical oncology, and radiation oncology. Many studies have reported the efficacy of psychosocial interventions⁴ and the importance of quality of life to patients.⁵

The Psychosocial Oncology and Cancer Patient Support Programs are staffed by approximately 30 volunteers and six professionals trained in counseling, administrative support, and therapeutic music.

Most of our volunteers are either veteran cancer patients themselves or have been caregivers for patients over the years. They bring deep listening and empathy that have been finely tuned through their own experience. Volunteers provide hospitality, empathic listening, and a welcome presence for all patients attending our cancer center.

One of our volunteers, paraphrasing Mother Teresa commented, “I may not be able to do great things as a volunteer, but I can do small things with great love.” Both professional staff and volunteers perform a very important navigation function by helping to connect patients and families to needed services.

A hallmark of our program is the integration of our services into the ongoing medical care of patients. For example, we can see patients for counseling or other services such as massage while they are being seen concurrently by healthcare providers for medical treatment. It is not uncommon for our staff to be counseling with a patient during their chemotherapy treatment. This reduces the necessity for travel and overall cost to the patient for their care.

This dimension of integrated psychosocial care is rare in cancer care facilities given the logistical challenge to doing so. Fortunately, we are well supported by philanthropy and institutional funds to provide these services to patients with cancer and caregivers without charge.

The Psychosocial Oncology and Cancer Patient Support Programs provide counseling services, patient education, patient advocacy, educational/support groups, teaching, financial aid, and research activities nested within the section of Hematology and Oncology in the Comprehensive Cancer Center at Wake Forest Baptist Medical Center. We also are able to provide specialized cancer recovery and survivorship-skills training for patients.

The psychosocial care of distressed patients is linked to important outcomes. For example, successful treatment of depression can enhance recovery as well as reduce the cost of treating patients.⁶

The supportive care and survivorship network within Wake Forest Baptist provides many other services in the medical center. Such services include massage therapy, healing touch, Reiki (a form of alternative medicine in which the practitioner transfers “universal energy” to the patient to encourage healing), therapeutic music, recreation therapy, supportive chaplain services, palliative care, social work services, nutritional guidance, and patient financial assistance.

We also have identified additional services in the community (eg, acupuncture) that can be helpful to patients. Supportive care and survivorship services are made available by a host of professionals within our institution. The Psychosocial Oncology and Cancer Patient Support Programs facilitate many of these professional services during the course of patient care.

While a significant proportion of cancer patients may need professional psychosocial care, all our patients can benefit from kindness, deep listening, and compassion. The Psychosocial Oncology and Cancer Patient Support Programs promote these qualities in all of our healthcare providers and support staff. We provide the type of care that facilitates physical, emotional, and spiritual healing in patients.

We know that the quality of life of our patients can be enhanced by timely and early interventions to help patients maintain their lifestyle even while undergoing life-changing therapies in a cancer center. As one patient suggested, “…I’m not going to give up my life just because I’m in treatment …I intend to live… I intend not only to survive but to thrive through my treatment with all the help I can get...”

References

1. Zabora J, BrintzenhofeSzoc K, Curbow B, et al. The prevalence of psychological distress by cancer site. Psychooncology. 2001;10(1):19-28.
2. McQuellon RP, Hurt GJ, DeChatelet P. Psychosocial care of the patient with cancer: a model for organizing services. Cancer Practice. 1996;4(6):304-311.
3. Wolcott D, Woloson R, Macdonald J. Patient support services & patient satisfaction: can increased use of these services increase patient satisfaction. Oncology Issues. 2009;January/February.
4. Stanton AL. Psychosocial concerns and interventions for cancer survivors. J Clin Oncol. 2006;24(32):5132-5137.
5. McQuellon R, Duckworth KE. Health-related quality of life and cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy. Curr Probl Cancer. 2009;33(3):203-218.
6. Osborn RL, Demoncada AC, Feuerstein M. Psychosocial interventions for depression, anxiety, and quality of life in cancer survivors: meta-analyses. Int J Psychiatry Med. 2006;36(1):13-34.