November 16, 2009
Cancer. The diagnosis can send shock waves through patients and their families, creating overwhelming fear, anger, frustration and life disruptions. Patients face a host of new challenges, both physically and mentally. Some patients experience depression, anxiety or emotional problems caused by or exacerbated by cancer. Ultimately, the emotional turmoil can pose a serious threat to a patient’s ability to fight the cancer and return to health.
“Cancer is a life-altering event as patients deal with their own mortality,” explains Marty Clarke, PA-C, PhDc, a Washington University physician assistant and psycho-oncologist at Barnes-Jewish Hospital. “The cancer diagnosis creates uncertainty and chaos as it disrupts families and careers. It also can cause significant financial burdens. In addition, some medications can cause psychiatric problems such as depression or mania.”
The Institute of Medicine advises that care of the whole patient – including psychosocial needs – should be the standard of quality cancer care. All cancer institutes, including the Alvin J. Siteman Cancer Center at Barnes-Jewish and Washington University School of Medicine, strive to follow these recommendations. Barnes-Jewish is the only hospital in St. Louis with dedicated psychosocial oncology services.
Making a Difference for the Whole Patient
Clarke and Dan Haupt, MD, Washington University psychiatrist and medical director of psychosocial medicine, Siteman Cancer Center, provide psychiatric consultations to hospitalized cancer patients every day. They serve all patients at Barnes-Jewish on the six primary cancer floors, covering a total of 166 beds. Clarke consults with about eight patients a day in the hospital, and conducts weekly outpatient clinics. He also sees about four or five patients a day in his office, often to check their medications, which are complex and always changing.
“Some patients just need reassurance and perspective, while others need more psychotherapy or medication,” Clarke says. “If patients have a psychiatric history and then are diagnosed with cancer, they need help with their medications. Others may have had depression in the past that comes back with cancer. The health care team or family also may notice mental status changes in a patient that we can help with. We make a difference for patients in many ways.”
No Patient is Turned Away
Clarke and Dr. Haupt also work with two psychologists, Teresa Deshields, PhD, and Shannon Nanna, PhD, from the Siteman Cancer Center to offer care for outpatients. “We’re a tag team,” explains Deshields, manager of psycho-oncology services at Siteman. “We mainly see outpatients and their families for counseling needs. Or Marty may see a patient in the hospital and ask us to help with follow-up therapy. We don’t charge for the services, so we can see anyone, with or without insurance.” With more than 10 years experience working with cancer patients, Deshields brings a wealth of skills. “All we do is work with oncology patients so we understand their unique and individual needs,” she says. “We share coping strategies and connect them to other services that can help them.”
Deshields says she helps patients with symptom management, too. “We’re a complement to medical care and often serve as an advocate for patients. Our goal is to enhance the quality of life and make their journey easier. Research suggests if patients are more comfortable, they can tolerate treatment better.”
Deshields appreciates the opportunity to provide psycho-oncology services to all patients at no charge. “We don’t have to turn anyone away. Many patients are overwhelmed and stressed financially, so it’s a wonderful thing to see the relief on their faces when I tell them they don’t have to worry about how to pay for our services. It’s a gift to them and they’re so grateful. We have a high volume of patients and we would love to grow the service but we don’t have the resources.”
Clarke strongly agrees. “Our challenge is that we have one of the most prestigious cancer centers in the country, yet because of our volume and the often-complicated nature of our patients’ cases, we have an extraordinary level of psychosocial needs that require treatment as well. Ideally, we would function as a multidisciplinary service to address patients’ needs from various angles. We could really use our own corps of service providers including psychiatry, psychology, social workers, pastoral care and a peer support system. We also could conduct research if we had more people. Gifts would ensure every cancer patient receives the right care for the whole patient, which will improve cancer outcomes.”
Steps are currently underway to grow support for the psychosocial oncology program. In December 2008, Barnes-Jewish Hospital committed $1.4 million to endow a fund to enrich the resources for psychosocial oncology. An anonymous donor raised the endowment by $100,000 in June 2009. “The program hasn’t reached its full potential yet, but it’s poised to do so,” Clarke adds.
For information on how to give to support psychosocial oncology services at Barnes-Jewish Hospital, please call Pamela Morris, CFRE, at 314-286-0447 or e-mail firstname.lastname@example.org.
From Barnes-Jewish Hospital Foundation’s Giving Magazine, 2009, Issue 2