Addressing the Psychological Burdens of Cancer on World Mental Health Day

While our physical health may be more noticeable to others, it is vital to give the same care and attention to our minds as our bodies. Each year on October 10, World Mental Health Day serves as a reminder to tend to our psychological and emotional well-being as much as any physical ailment.

This year, with a theme of expanding access to mental health services in catastrophes and emergencies, the Mental Health Foundation highlights the importance of protecting one’s mental health particularly in the midst of a traumatic or stressful life event. For patients, a cancer diagnosis and the subsequent treatment are prime examples of stressful circumstances. Oncology providers are not immune to psychological distress either, with grief for lost patients and looming burnout from an emotionally demanding field of work cited as chief concerns among staff.

In recognition of the importance of mental well-being and mental health services, ACCC has highlighted 3 thought leadership pieces featured in recent volumes of Oncology Issues that tackle mental health–forward interventions for both patients and providers.

Addressing Existential Distress With Psychedelic-Assisted Therapy

The long-term psychological burdens of cancer are more prominent than ever before, due to the growing number of patients and survivors. However, traditional interventions such as talk therapy and antidepressant medication do not always address the full scope of the depression, anxiety, fear of recurrence, and deep existential distress to which many patients with cancer are prone. A diagnosis can be terrifying in and of itself when patients are forced to reckon with questions of meaning, mortality, and legacy.

A recent Oncology Issues interview with Jennifer Bires, MSW, LCSW, OSW-C, FACCC, executive director, Life with Cancer and Patient Experience at Inova Health System, explores psychedelic-assisted therapy as an intervention being studied in academic and clinical settings as a unique solution to the emotional, spiritual, and existential challenges of cancer. Bires examines emerging research from the field, outlines the therapeutic framework, and describes how psychedelic-assisted therapy can yield holistic healing in the form of enhanced introspection and coping skills.

The Role of Disenfranchised Grief and Countertransference in Oncologist Burnout

Although there are certainly moments of joy and deep human connection in the field of oncology, there is also an inherent and unavoidable grief, as terminal diagnoses and poor prognoses are not uncommon. However, as Janet Abrahm, MD, FACP, FAAHPM, FASCO, professor of medicine at Harvard Medical School notes in her recent article in Oncology Issues, unprocessed grief and countertransference receive little attention in oncology literature.

She describes the tendency of many oncologists to engage in instrumental grief—manifested by the need to do something—in place of intuitive grief, which is experienced through sadness, crying, and loss of sleep. The danger in instrumental grief is that it can be nearly impossible to tell outwardly that the individual needs help and support, increasing their feelings of loneliness and isolation. Equally damaging is disenfranchised grief, experienced by someone whose loss is “not openly acknowledged, socially validated, or publicly mourned,” and who therefore feels undeserving of grieving openly.

In addition to offering personal, interpersonal, and organizational solutions to processing and accepting grief, Dr. Abrahm urges oncologists to “recognize that they have not failed when their patients die; medical science has failed.”

An Innovative Strategy to Address Compassion Fatigue and Improve Resiliency

Leadership at White Plains Hospital’s Center for Cancer Care in New York has seen the effects of moral distress, compassion fatigue, and secondary traumatic stress syndrome acutely in its oncology nurses and providers, especially following the COVID-19 pandemic. To promote and ensure effective, timely support and self-care strategies, the center developed Care Code®, a support program designed to respond to staff stress regularly and on demand, as needed.

Care Code 1 involves scheduled monthly rounds, while Care Code 2 responds to urgent needs, such as grief due to an unexpected patient death or the existence of an ethical dilemma. The program possesses a long list of evidence-based integrative and holistic modalities, including aromatherapy, prayer and spirituality, meditation, and affirmation cards, to name a few. For more on the staggering outcomes resulting from this initiative, dive into the Oncology Issues article. 

Physical health and adverse effects resulting from cancer treatment often take center stage in the minds of patients, caregivers, and providers. But the work of these ACCC program members and many others reminds us how vital it is to care for our psychological well-being as well—both for patients and those who care for them.

Visit the Oncology Issues landing page and read our recent blog for more highlights from ACCC’s bimonthly, peer-reviewed journal.