In Cancer Care for the Whole Patient: Meeting Psychosocial Health Needs, published in October 2007, the authors review the most commonly cited psychosocial problems among patients, from depression to financial stress, and lay down 10 practical action items for better recognizing patients in need and matching them with appropriate services and resources.

Treating the Whole Patient

Even if a patient is receiving state-of-the-art cancer care, acknowledgement of and support for dealing with the psychological and social effects of cancer is often subpar, the report finds. In many cases, neglect in these areas often makes it harder for the patient to cope with and bounce back from treatment.

Patients whose depression or emotional problems go unchecked are likely to report lower social and overall functioning, putting them at greater risk for a whole host of physical and behavioral issues, such as sleep problems, fatigue, and substance abuse, all of which adversely affect their ability to stick to treatment plans. Those with financial burdens are vulnerable in many ways, and often in dire need of very basic services such as transportation to and from appointments, financial consulting, and help getting medications and supplies.

According to the report, many cancer patients complain that health care providers and educators have failed to acknowledge their struggles, underestimate their distress, and either don't know or don't offer enough information about support services. The brunt of these unmet needs ends up resting on the shoulders of caregivers, many of whom are already paying a high price physically and emotionally caring for their loved one. (See "Caregivers Often Neglect Their Mental Health".)

IOM's Multi-pronged Plan

According to the report, the problem isn't so much that there aren't enough social services (though more are needed), but rather, oncology professionals, educators, health policy makers, insurers, and consumer advocates aren't doing the best job of identifying patients in distress or making use of available programs.

"Many cancer care providers may be surprised at the array of psychosocial health services available nationwide at no cost to patients," says committee member Patricia Ganz, director, cancer prevention and control research, Jonsson Comprehensive Cancer Center, University of California, Los Angeles. "Our report provides practical guidance to providers about how they can design their practices to better address their patients' needs."

Among the 10 action items are recommendations for large-scale studies into which psychosocial programs work best and for which populations, how to most effectively train oncology professionals to identify and evaluate patients in need, strategies for getting the most current program and resource information to patients and families, and a call for quality oversight of common naming standards and practices for psychosocial services. The report also emphasizes the need to teach patients and caregivers to expect psychosocial help and to make sure that insurance providers support these services.

Matching Patients With Resources

The American Cancer Society is among the resources listed in the report. Patients and caregivers can find information here on the Web site, or by calling 1-800-ACS-2345. This toll-free phone line is staffed 24 hours a day, 7 days a week, with cancer information specialists who can help patients and their loved ones find information and local services.

The Society offers a range of support programs, from temporary housing for patients who live far away from treatment centers to a free service for women with cancer that teaches beauty techniques to help enhance appearance and self-image during treatment. For a comprehensive list of ACS's programs, see this index.

Citation: Cancer Care for the Whole Patient: Meeting Psychosocial Health Needs. National Academies Press. Published October 23, 2007. http://www.iom.edu/CMS/3809/34252/47228.aspx.