Measuring, treating a patient’s distress is part of shift in attitudes

Years ago, people believed a cancer diagnosis meant death. They were so ashamed of the disease that its name was mentioned only in whispers.

Jimmie Holland, MD, has written, co-written or edited numerous articles, books and book chapters on cancer, including the book "The Human Side of Cancer: Living With Hope, Coping With Uncertainty" (HarperCollins, 2000).

Jimmie Holland, MD, has written, co-written or edited numerous articles, books and book chapters on cancer, including the book “The Human Side of Cancer: Living With Hope, Coping With Uncertainty” (HarperCollins, 2000).

Fast-forward 50 years. “Most people today say, ‘Well, I think maybe I’m going to be OK’ when they get a cancer diagnosis,” says Jimmie Holland, MD, founder of the field of psycho-oncology, who spoke at Upstate this fall. She leads the psychiatric oncology department at Memorial Sloan Kettering Cancer Center in New York.

She credits the attitudinal shift to:

* development of quantitative tools to measure levels of pain, fatigue, anxiety, depression, delirium and health-related quality of life factors. With ways to measure outcomes, scientists could conduct clinical trials that focused on psychosocial issues.

* celebrities including Betty Ford and Happy Rockefeller coming forward to share their cancer diagnoses.

* the National Comprehensive Cancer Network, which in the late 1990s embarked on ways to improve psychosocial care for people with cancer. The group’s research led to the use of the less-stigmatizing word “distress” in place of “psychiatric,” “psychosocial” or “emotional.”

Holland says appreciation for the role distress plays in a patient’s healing is slowly catching on. The network’s standard of care guidelines say distress should be recognized, monitored, documented in patient records and treated appropriately.

Layout 1This article appears in the winter 2016 issue of Cancer Care magazine.

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