Are you feeling distress? We have covered this topic in a previous blog post, but this is worth repeating as I encounter this in my patients every day.
What is “distress”?
“Distress” is purposely chosen as the word we use even though it is a very broad term with many possible interpretations.
Distress can be expressed in terms of practical problems (i.e. child care, housing, financial, etc.), family problems (i.e. children, partners, fertility, etc.), emotional problems (i.e. depression, fears, nervousness, etc.), spiritual or religious concerns, or physical problems (i.e. pain, nausea, shortness of breath, etc.).
It is not uncommon for me to sit down with my patients and have a conversation in which I pick up distress across multiple problem areas.
Why is managing stress so important?
Aside from the obvious benefits on helping individuals better cope with feelings of stress and anxiety, stress management may also reduce the risk of developing (or making worse) a variety of chronic medical conditions (i.e. heart disease, diabetes, depression, etc.)…and cancer.
It is important to keep in mind that each person reacts to stressful events differently, ranging from minimal impact to severe impact. For those who are most affected by stress I think it is very important to get them help. A recent study found that patients who believed that stress had a significant impact on their health had a 50-200% increased risk of developing heart disease compared with those who felt that stress had minimal affect on their health. It is not a far stretch to believe that this may also correlate with increased risks of cancer development and progression among individuals who perceive that stress has a significant impact on their health.
What do you do if you are feeling distress?
If you are feeling distress, please do not suffer alone. It is the responsibility of your oncology team to help address these issues, but you need to communicate this to them. Over the next 2-years, it will actually be a requirement that all dedicated cancer programs will need to screen each of their patients for distress and take the appropriate steps to address it. (It’s unfortunate that this isn’t already a requirement.)
Psychosocial Distress Screening (Commission on Cancer Program Standards)
Assessing distress with a tool
One of the simplest screening tools to assess distress is the one designed by the experts from the National Comprehensive Cancer Network or NCCN (see below.) If your oncology office has not already started using an assessment tool like this one, they likely will by the mandated date of 2015.
The instructions are quite simple:
- If you rate your distress as greater than “4” on the distress thermometer, the oncology staff are will discuss this with you and make recommendations or referrals to help you. Scores of less than 4 indicate that you are coping with your distress relatively well, although I always want to address any score that is not “zero.”
- The “Problem List” questions (on the right of the page below) are for you to answer. Your answers help guide the oncology staff to address these issues.
Where can you go for help?
Always tell your oncology team about your distress. It’s our job to help you. If we can’t directly manage the issues in our office, it’s our responsibility to make a prompt referral to a mental health professional, social worker, or spiritual counselor, or other resources depending on the problems identified in the “Problem List” (check list above.)
Resources:
- American Psychosocial Oncology Society (866-276-7443): patients and caregivers can get referrals to psychological resources in their community.
- CancerCare.org (800‑813‑4673): staff of professional oncology social workers provide support, information and resources to help you better cope with cancer.
- American Association of Marriage and Family Therapy. This organization has a searchable database that lists marriage and family therapists in the United States and abroad.
- Association of Oncology Social Work. This organization provides a list of qualified oncology social workers in your area.
- American Psychological Association. This organization offers an online psychologist locator service.
- Mental Health America. This organization provides a directory of local mental health associations that connect clients with mental health services.
- National Register of Health Service Providers in Psychology. This organization’s searchable database (findapsychologist.org) helps people locate doctoral-level psychologists in the United States and Canada.
