By Peg Lopata, Contributing Writer
REGION – While huge strides have been made in controlling cancer and ridding the body of it, no doubt it’s scary to be told you have it.
Certainly, some mental health counseling could help, if not your body, then at least your mind.
A survey done by Cardinal Health Specialty Solutions of Dublin, Ohio, sheds some light on this very topic in their recent report, “Oncology Insights December 2021.” This report notes the importance of this problem: as many as one in three cancer patients struggle with mental health distress.
Mental health distress, according to Dr. Bruce Feinberg, DO, vice president and chief medical officer of Cardinal Health Specialty Solutions, could mean patients may be less likely to eat, sleep, exercise, take their prescribed medicines or to consistently go to treatment appointments. The mental health needs of a cancer patient must be addressed.
Shortage of resources
Nearly half of the oncologists surveyed said there were not enough adequate resources available to support the mental health needs of cancer patients.
Feinberg agreed, “There’s not enough mental health professionals who specialize in helping cancer patients.”
But there’s another problem. Feinberg explained that only a minority of the oncologists surveyed regularly refer patients for mental health services. He added, “And there’s not enough resources to help oncologists connect their patients to mental health professionals.”
“My experience and feedback from colleagues in practice indicate that there are additional factors contributing to these problems and others,” said Feinberg. “There’s inadequate training in medical school, lack of time with patients, difficulty in securing timely referrals, and overwhelmed patients who have neither the time or money to see more specialists. All these problems contribute to this complex issue.”
Potential solutions
Feinberg is succinct: “The best solution is to integrate mental health services within the practice.”
The survey showed that half of oncological care teams include psychologists and social workers, so Feinberg’s solution is already happening in many practices. The hope is that eventually all cancer cares teams will include mental health professionals.
Better education for oncologists regarding the mental health care of their cancer patients is also needed.
But, said Feinberg, “Education is only part of the solution. We also need to consider financial incentives.”
Our healthcare systems work like shopping for the best carpenter―a fee-for-service model. On top of that, there are often costly co-pays. To avoid extra costs for their patients, health care providers may be reluctant to refer them for mental health care services.
Palliative care leads to better outcomes
The survey also revealed much valuable information about palliative care.
As explained by Feinberg, some 68% of the oncologists surveyed agree that early introduction of palliative care leads to better outcomes for patients with advanced cancer. But only 17% said they refer patients to palliative care at the time metastatic disease is diagnosed.
Since palliative care can help cancer patients and their families, Feinberg said, “There needs to be incentives to encourage oncologists to invest in palliative care resources.”
Where’s the focus?
“Whether it’s palliative or mental health care, there’s a need,” said Feinberg, “for oncologists to focus more broadly on all the needs of patients, rather than just treating the cancer.”
There’s also a need for all of us to accept that while a positive attitude can help, at times, there’s a better approach.
“Our society puts a strong emphasis on having a positive attitude during cancer treatment and never giving up on ‘the fight,” said Feinberg. “While positivity is certainly helpful, if it means that patients and their caregivers are unwilling to also talk about death when the time is appropriate, this can lead to challenges.”
There may be no more difficult doctoring job than being an oncologist. Sometimes they may have nothing more to offer than compassionate listening, a referral to a counselor or the number to call for palliative care. This survey shows that there are already oncologists who are serving both the mental health and palliative care needs of their patients. The survey also highlights that there’s still work to be done so that all cancer patients get this type of optimal care.
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