Psychosocial care for people facing cancer
For people dealing with anxiety and depression after cancer treatment, psychosocial services offer help.
Sometimes one of the most challenging parts of having cancer comes after the cancer is gone. For some survivors, returning to routines after treatment is when they experience the most anxiety.
“Often a patient is fine emotionally through diagnosis and treatment,” Dr. Alan Bates says. “Then they are given the all-clear and that’s when they experience anxiety, depression or both. And it’s frustrating because they feel like they should be ‘normal’ again.”
But there are many reasons someone who has successfully completed treatment might have these emotions, says Bates, the provincial practice leader for psychiatry at BC Cancer. One is what’s called a “vacuum effect.” If a patient has been dealing with cancer for years, it can become a part of his or her identity, and its absence leaves a confusing void. In addition, many patients develop close relationships with their care team and their oncologist, and that loss of contact can contribute to anxiety.
When it comes to the people around them, survivors “find that life has continued as normal during that time,” says Bates, noting it can be difficult Psychosocial services offer help for people dealing with anxiety and depression after cancer treatment to integrate back into work and friend circles. As part of the psychosocial oncology services offered at BC Cancer, Bates sees patients in a clinical setting to address common cancer-related emotions, such as anxiety, depression and grief.
Counsellors can help patients manage side effects of cancer and treatment, such as physical changes or something known as “chemo brain,” in which people receiving some forms of chemotherapy find their thinking is less sharp. Another common emotion Bates deals with is fear of recurrence.
EXPANDING SPIRITUAL CARE
Dr. Alan Bates is leading a donor-funded project to establish a sustainable spiritual care program for BC Cancer patients. A Spiritual Care Specialist will establish linkages with spiritual and religious leaders as well as network with Spiritual Care services within the Provincial Health Services Authority. Educational opportunities in spiritual care will be created for all BC Cancer staff in order to improve the overall ability to respond to spiritual distress and existential suffering experienced by patients.
A DIFFERENT TYPE OF TREATMENT
Treatment is offered through a variety of approaches that may include cognitive behavioural therapy (CBT), psychotherapy, education or medication. Therapy can also include mindfulness meditation and exercise. All treatment is patient-focused, Bates says. There are several tools available for recovery and to help patients regain an enjoyment of life.
Bates and the psychiatry team work in tandem with their colleagues in Patient and Family Counselling to offer a wide range of services to patients and their loved ones at the time of diagnosis, through treatment, and post-treatment.
“Patients find us in different ways,” says Gina MacKenzie, recently retired provincial lead for psychosocial oncology, which has 80 counsellors across the province. Some patients are referred by their doctors; others hear about programs through other patients.
In addition, when patient has their first visit to a centre, they are given a form to fill out that includes questions for assessment that help identify those who may need support right away. In those cases, a counsellor will contact the patient and check to see if here is anything they need.
Counsellors can help with emotional concerns, practical matters (such as child care, filling out forms or transportation to appointments) and financial issues. Some patients need help communicating with their loved ones about their condition, managing side effects such as fatigue or memory issues, or readjusting to work.
The Patient and Family Counselling department is also looking at ways to address spiritual health and what that model would look like for BC Cancer.
“We are always adding, changing and evolving,” MacKenzie says of the programs offered. There are also many services, including some group therapy sessions, offered online for those who can’t attend in person or feel more comfortable accessing the program remotely.
Depending on the region, some programs are also offered in different languages, such as Mandarin or a current pilot program in Punjabi.
Donors support psychosocial oncology services by providing the necessary funding for pilot programs and other studies to develop programs that meet specific needs of patients and their families.