Cancer patients' distress often unaddressed

[MsC1210]

Cancer patients' distress often unaddressed

Last Updated: 2009-01-09 10:43:41 -0400 (Reuters Health)

NEW YORK (Reuters Health) - Only a minority of patients with advanced cancer are referred by their cancer doctor for specialized psychological care, even if they're clearly distressed, results of a study from Canada indicate.

Among a group of 326 patients being treated in a comprehensive cancer center for advanced lung or gastrointestinal cancer, only one third were referred for psychosocial care to a social worker, psychologist or psychiatrist, Dr. Gary Rodin and colleagues report in the Journal of Clinical Oncology.

"Further, more than half of those with clinically significant levels of depression were not referred for psychosocial care of any kind throughout the course of their disease," Rodin told Reuters Health.

"These findings are of concern because they demonstrate that the majority of cancer patients with advanced disease and clinically significant levels of depression may not be referred for psychosocial care, despite mounting evidence for its benefit," said Rodin, who is chief of the department of psychosocial oncology and palliative care at Princess Margaret Hospital, Toronto, Ontario.

Patients who were unmarried and living alone were more likely to be referred, "which may be understandable in terms of their potentially greater social need and distress," Rodin reported.

However, amongst those with elevated levels of distress, there was a remarkable age difference in referral rates, with all of the patients younger than 40 years old referred for psychosocial care compared with only 22 percent of those aged 70 or older.

"The five-fold difference in referral rates between younger and older patients raises the possibility of age bias in the referral for psychosocial care," Rodin said.

"These findings," he concludes, "draw attention to the need for routine screening for distress in cancer patients, for the institution of more routine mechanisms that integrate psychosocial care in cancer treatment settings and for further research to elucidate the potential barriers to psychosocial care in older cancer patients."

SOURCE: Journal of Clinical Oncology, online December 28, 2008.

Copyright © 2009 Reuters Limited.

[Patti B]

Interesting article, Chris. I know when I was diagnosed, they threw a prescription for an anti-depressant at me and told me to use it if I needed it. Noone really asks me anymore if I am depressed or not any more. When I did tell them that I was, they just gave me a prescription for a different anti-depressant and never mentioned referring me to someone.

Hugs - Patti B.

[Barb73]

Thank you so much for posting this article.

I agree that this article is very important.

In all the four years of Bill's treatment, no one has ever asked me or Bill if either or both of us were depressed.

I attributed it to their thinking we were "strong."

Now, my thinking is that it is probably age related. Bill was a few years over 70 at diagnosis, and I was 69.

As it is, the mental health avoidance in the medical field, and in society as a whole, is appalling. The subject has been dealt with as anathema for far too long.

This month, in "AARP Magazine" there is an article on mental/emotional health and Glen Close's interest in it.

Governor and Mrs. Cody of New Jersey stressed the importance of mental health in ads on television when he temporarily took office. They were/are very modern in their approach. We need more of that kind of leadership.

The medical education field is remiss in not addressing this issue more often. It's a vital part of medical health. Along with "bedside manner," it is crucial in dealing with the stresses of a survivor's life.

The cancer patient is not just a series of physical symptoms. They should be treated as a whole human being.

Just recently, a student nurse (applying for her MA) in my GP's office asked me if I were depressed or anxious. Wow, my GP hasn't asked me that in the entire 12 years as his patient.

Barbara