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Psychosocial and Psychological Adjustment in Cancer Survivorship Discussion with Dr. Donald Rosenstein

Core Concepts
Variability in psychosocial responses to cancer survivorship highlights the importance of understanding and supporting patients through their emotional journey.
Dr. Ann Partridge and Dr. Donald Rosenstein discuss psychosocial and psychological adjustment in cancer survivorship. Dr. Rosenstein shares his journey into psycho-oncology and survivorship. The conversation delves into the range of reactions patients have to cancer diagnosis, treatment, and survivorship. The challenges patients face post-treatment, transitioning to survivorship, and the importance of support during this period are explored. The discussion extends to the impact on families and loved ones, highlighting the need for understanding and respecting the patient's emotional journey. Dr. Rosenstein provides insights on identifying red flags for severe depression and suicidality in cancer patients. The importance of patient-reported outcomes and patient-centric care in oncology is emphasized. The conversation concludes with a focus on supporting bereaved individuals and learning from their experiences to improve care for patients with advanced cancer.
Patients with cancer are at higher risk for suicidal thinking, behavior, and death from suicide. Patients with head and neck cancer, brain tumors, lung cancers, and GI cancers have a higher rate of suicidality.
"I think the resiliency of people with cancer is really quite remarkable." "I think modern cancer care is very highly choreographed." "I think that a core competency for any physician is to be able to be comfortable talking with patients about thoughts of suicide."

Deeper Inquiries

How can clinicians better support cancer survivors during the transition from active treatment to survivorship?

During the transition from active treatment to survivorship, clinicians can better support cancer survivors by providing ongoing psychosocial and emotional support. This can involve regular check-ins to assess the patient's emotional well-being, addressing any concerns or fears they may have about the future, and helping them navigate the uncertainties that come with transitioning out of the structured treatment phase. Clinicians should also educate survivors about the potential physical and emotional challenges they may face post-treatment, normalize their feelings of anxiety or depression, and connect them with appropriate support services such as counseling, support groups, or survivorship programs. Encouraging open communication, validating their experiences, and empowering survivors to take an active role in their post-treatment care can also contribute to a smoother transition and better overall well-being.

What are the potential drawbacks of solely focusing on patient-reported outcomes in oncology care?

While patient-reported outcomes (PROs) are valuable tools for capturing the patient's perspective on their health and quality of life, solely focusing on PROs in oncology care may have some drawbacks. One potential drawback is the risk of overlooking objective clinical indicators or outcomes that are crucial for treatment decision-making. PROs provide subjective information that may not always align with the objective measures of disease progression or treatment response. Relying solely on PROs could lead to missing important clinical changes or delays in appropriate interventions. Additionally, PROs may be influenced by various factors such as mood, perception, or social desirability bias, which could impact the accuracy and reliability of the reported outcomes. Therefore, a comprehensive approach that integrates both patient-reported and clinician-assessed outcomes is essential for a holistic understanding of the patient's health status and treatment effectiveness.

How can healthcare providers effectively address the emotional needs of bereaved individuals while learning from their experiences to enhance patient care?

Healthcare providers can effectively address the emotional needs of bereaved individuals by offering compassionate and empathetic support throughout the grieving process. This includes creating a safe space for individuals to express their emotions, validating their feelings of loss and sadness, and providing resources for grief counseling or support groups. Active listening, acknowledging the unique challenges of bereavement, and offering practical assistance with funeral arrangements or legal matters can also be beneficial. Moreover, healthcare providers can learn from the experiences of bereaved individuals to enhance patient care by soliciting feedback on their interactions with the healthcare system, identifying areas for improvement in end-of-life care, and incorporating their insights into training programs for future clinicians. By valuing the perspectives of bereaved individuals, healthcare providers can gain valuable insights into the emotional impact of cancer care and implement strategies to better support patients and their families throughout the cancer journey.