Saturday, November 26, 2011

Why Cancer Care needs Psychologists? – A brief note


Medical community has recognized that quality of life is as important as quantity of life. At present, psychological concerns are given increased importance in cancer care if it is compared with the past. Psycho-oncologists have the obligation to increase the human touch in cancer care from the screening to rehabilitation for the patients who are successfully treated and palliative care for patients who go through the end-of-life process.

The work of Psycho-oncologists starts from prevention aspects such as tobacco cessation and change in life style. There are many myths related to cancer. One of them is ‘cancer is synonymous to death and the treatment is very distressing’. Thus to alleviate the myths about cancer and cancer care is another responsibility of Psycho-oncologists.

All patients experience some level of distress associated with diagnosis and treatment of cancer at all stages of disease. However very fewer patients are referred for psycho-social care due to under recognition of patient’s psychological needs by primary oncology team and lack of human resources. Thus to reveal the diagnosis and prognosis for ‘difficult’ patients is one of the key responsibilities for psycho-oncologists.

Cancer affects not only the patients and also the family members to a large extent. The burden of care givers is very huge. So burn-out, stress, depression and anxiety are also very common in care givers. To deal with the distress, grief of the patients and family members is again a responsibility of Psych-oncologists.

In the past two decades, dramatic advances in early detection and treatment options have increased the over all survival rates in patients of all ages with cancer. At the same time, these improved treatment options are also associated with substantial long term side effects: fatigue, pain, anxiety and depression. Some patients develop phobias of needles, hospital and blood or conditioned nausea/vomiting related to chemotherapy. Cognitive impairment associated with chemotherapy (often referred as ‘chemobrain’) has also been described in patients with advanced cancer especially CNS Cancers and brain metastases. When it comes to treatment through oral medications, depression and anxiety are the risk factors for non-compliance. It is a responsibility of Psych-oncologist to make the patients comply with the treatment process and treat the mental health issues.

Last but not the least, the health professionals involved in cancer care go through lot of difficulties to deal with the disease and patients. Job satisfaction of health professionals to work is a key factor to maintain the quality of cancer care. Psycho-oncologists take care of their mental health and preserve their quality of life.

Friday, November 25, 2011

Cancer is synonymous to death???



Many people think that cancer often leads to death and it is a killer disease. It IS a big myth. There are many survivors of cancer. Almost all the cancers are curable if they are treated in the early stage. So what we need is ‘AWARENESS’.

There are many more myths available when you talk of cancer and using tobacco.

1.       I will not get cancer.
Cancer is a disease of cells. When the cells divide in the process of metabolism, due to some unknown factor(s) the DNA programming of cells loses the control over the division of cells. And so cells keep growing uncontrollably.

So whoever has cells (all of us) is capable of developing cancer.

2.       Only tobacco usage can cause cancer.
 “The exact cause for cancer is still unknown. Even though some carcinogens (cancer causing agents) are found, the mechanism how DNA programming of cells is changed by carcinogens could not e found in spite of medical advancement.

For tobacco to cause cancer, it takes so many years. Tobacco is a very slow killer. A person who was using tobacco in his young age can develop cancer in his old age also. So, NOT getting into the habit is what the best solution.

3.       Tobacco is less harmful than alcohol, marijuana and other addictive drugs.
Just because using tobacco is culturally accepted, it does not mean it is less harmful. Nicotine is the most addictive substance in the world. That’s why quitting tobacco usage/smoking is very much difficult when compared to other addictions. Using tobacco leads to so many complications for both physical and as well as psychological health.

4.       Branded/Menthol cigarettes are not harmful.
All Branded/Menthol cigarettes also have almost the same amount of nicotine and other carcinogens (that lead to cancer).

5.       Gutka/Pan masala will not lead to cancer unlike cigarette or beedi.
In India, almost 70% of tobacco usage is in the form of smokeless tobacco i.e. Gutka/Pan masala and Snuff powder (Brand Names: Hans, Pan Parag, Manick Chand and etc). The consumption of smokeless/chewing tobacco has been increasing every year. There is a high correlation for smokeless tobacco to cancer when compared to smoking tobacco. The gutka/pan masala damages the cells in the mouth where they are placed and change the biological functioning of cells that lead to cancer.

6.       Foreign country treatment can cure cancer.
Almost India has got all the advanced treatment methods to treat cancer. If the cancer is in advanced stage, objective of the treatment would be ‘pronging life’ and never cure. Many of the treatment methods for advanced cancers in foreign countries are still experimental and not proven enough to cure the disease.

7.       Alternate medicines have certain cure for cancer even if it is advanced
No alternate medicine has proven scientifically to cure cancer in advanced stage.

8.       People with cancer must remain confined in a hospital bed.
Not necessarily. It is based on the site and stage of cancer.