Not terribly surprising, but recent research shows that less than one-third of all cancer survivors of adult cancers in the United States ever had conversations with their healthcare providers about their psychosocial needs. The latest study showing this was published in the Journal of Clinical Oncology.1
This study was a large population-based study of 1777 survivors participating in the 2010 National Health Interview Survey (NHIS) was conducted by researchers at the National Cancer Institute, the Patient-Centered Outcomes Research Institute (PCORI), the Centers for Disease Control and Prevention (CDC), and Wake Forest University School of Medicine.
The study examined the level of psychosocial care being provided in clinical practice, following the 2008 Institute of Medicine (IOM) report, Cancer Care for the Whole Patient: Meeting Psychosocial Health Needs. The IOM called for identification of patients’ psychosocial needs, more effective provider–patient communication concerning those needs, and the implementation of coordinated care plans to link psychosocial services to patients who need them.
The NHIS was an in-person, national survey conducted by the National Center for Health Statistics and the CDC. Most of the survivors interviewed (61.2%) were aged ?50 years; breast cancer (20.1%), prostate cancer (15.5%), and melanoma (10.1%).
The survey showed that 55.1% of the respondents did not discuss their psychosocial care needs with any healthcare provider, nor did they use professional counseling or support groups (PCSG); 31.4% reported having only a provider discussion, 4.4% reported accessing only PCSG, and 8.9% reported having both a provider discussion and PCSG. The researchers were able to extrapolated that approximately 7.5 million cancer survivors in the US did not discuss their psychosocial functioning with a healthcare provider.
Despite these findings, the researchers reported that the majority of survivors interviewed (74.9%) expressed satisfaction with how their psychosocial needs were met; those who had provider discussion, PCSG, or both, however, were more likely to be “very satisfied,” than those who did not engage in such discussions or support services.
About one survivor in six who did not access a PCSG indicated that they were not aware that such services exist, or they did not have access to them. Unmarried survivors, who often are more in need of psychosocial support, were less likely to report provider discussions.
In an accompanying editorial,2 William F. Pirl, MD, director of the Center for Psychiatric Oncology and Behavioral Sciences at Massachusetts General Hospital in Boston, and colleagues wrote, “Taken together, these findings provide the most compelling evidence to date that heightened psychological distress in many patients with cancer is still unrecognized and untreated.”
Using this information we should start to develop programs for all cancer survivors. Not only are we going to see a great increase of cancer survivors, but due to our improved treatment options survivors are going to live longer thus undergoing increased psychological strain.
1. Forsythe LP, Kent EE, Weaver KE, et al. Receipt of psychosocial care among cancer survivors in the United States. J Clin Oncol. 2013;31(16):1961-1969.
2. Pirl WF, Jacobsen PB, Deshields TL. Opportunities for improving psychosocial care for cancer survivors. J Clin Oncol. 2013;31(16):1920-1921.
Joel T. Nowak, M.A., M.S.W.