When a person experiences a cancer diagnosis and undergoes treatment, it can be one of the most distressing experiences they can go through, so it’s important for employers to understand psychosocial oncology.
“We’re now collecting evidence to show that proactive care — psychosocial oncology — is effective in helping people prepare and deal with psychological disturbances,” said Dr. Gary Rodin, head of the supportive care department at Princess Margaret Cancer Centre/University Health Network, during a panel discussion at Benefits Canada’s 2020 Employers Cancer Care Summit.
Psychosocial oncology refers to a whole range of services, he noted, including psychology, psychiatry, social work, art and music therapy, physical rehabilitation, palliative care and nursing. Indeed, psychosocial oncology differs from cognitive behavioural therapy programs, which many employers already have in their benefits plans.
CBT is a psychological intervention that’s brief, practical and effective for treating specific symptoms like anxiety, noted Dr. Rodin, but it’s just a part of a spectrum. People need different kinds of help at different stages. “Something confusing for employers and third-party administrators is that many cancer survivors have prolonged sequelae from treatment. We now know that people can have significant fatigue following chemotherapy. These treatments can affect cognitive function and cause other subtle cognitive defects.”
The treatment isn’t an appropriate approach for a cancer patient, said Dr. Virginia Boquiren, registered clinical psychologist at the Centre for Psychology and Emotional Health, also speaking on the panel. Since cancer is complicated and touches on many different areas, following a standardized CBT protocol isn’t going to work because it won’t sufficiently address those issues, she added. “Adopting a psychosocial oncology frame, recognizing the effects of cancer affect several aspects of life — work, relationships, self-identity, what it means to be a cancer survivor and all the challenges along the way — is helpful.”
Psychosocial oncology interventions are effective. They’ve been found to decrease depression and death anxiety, while increasing individuals’ ability to plan, face and live their lives, noted Dr. Rodin, but people haven’t traditionally understood this side of cancer treatment. “If we can afford very expensive cancer treatments, we can afford something very inexpensive — it’s about whether we value it. Cancer is becoming the leading cause of death in the world and we’re all going to have to face how we manage this disease.”
It’s important that a return to work following a cancer experience is sustainable, said Dr. Boquiren, but ignoring the psychological impact means cancer survivors aren’t going to be successful. “To ignore or underestimate the impact of cancer’s psychosocial effects will be costly for the individual and the company.”
As well, integrating cancer into a person’s existing identity affects how they interact with others and how they perceive themselves, she noted, adding that the stigma of cancer is also present, as well as senses of shame and guilt around what their co-workers will think of them.
Most cancer patients are determined to return to work, added Dr. Rodin. “Having a disease that takes you out of the mainstream — nothing makes you want to return to it more. For many people, it’s a very strong motivation, but symptoms may prevent it.”
If psychosocial oncology isn’t currently covered on an employer’s benefits plan, then the industry doesn’t understood how central it is to well-being and how important it is when managing a serious illness, he said, noting it’s probably the best investment an employer can make.
Dr. Boquieren agreed, noting it would be very shortsighted not to include some kind of support for people who are coping with a cancer experience. “They’re dealing with enough challenges in their personal life just trying to manage this disease. It would be a wonderful thing to see plan sponsors include psychosocial oncology on their plans and to support these individuals as they try and integrate back into their life after such a horrific experience.”
Read more coverage from the 2020 Employers Cancer Care Summit.