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Dealing with the distress of cancer patients

distressmanagement“Distress is a complicated emotional reaction that patients often experience when they are dealing with cancer. It can range from mild feelings of worry to significant depression and anxiety,” explains Dr. Janice Howes, a psychologist and Psychosocial Oncology Clinical Leader with Cancer Care Nova Scotia (CCNS).

Kelly Fenn, Project Manager, Screening    for Distress and Marianne Arab, Manager, Supportive Care
As many as 35%- 45% of all cancer patients suffer significant distress at some point during treatment.  Identifying distress earlier helps patients cope better and improves their quality of life, while living with cancer. “Even though many cancer patients experience significant distress, only about 10%-15% are referred for help,” notes Dr. Howes. “It’s under-identified and under-addressed in the system.” 

For this reason, CCNS is working with national and provincial partners to change this and provide better care. We know that the level of distress a patient is experiencing is just as important to their care as monitoring blood pressure, temperature and other vital signs. 

Working with four district health authorities, CCNS is testing tools used to identify distress so that the patients can receive the help they need, when they need it most.

 “Screening patients in a routine, standard way and offering support and treatment, where necessary, is the goal,” says Marianne Arab, CCNS’s Manager of Supportive Care.

By using the screening tools, many patients will receive help earlier than they would have without such a tool.  Also, screening for distress will bring help  many patients who would otherwise not have identified that they are experiencing distress. 

Screening for distress is being rolled out across the country in Alberta, B.C., Northeastern Ontario, Quebec City, Montreal, and Nova Scotia. Here in Nova Scotia, patient navigators are conducting the screening of new and reactivated cancer patients in four district health authorities: South West Health, Annapolis Valley Health, Pictou County Health Authority, and Guysborough Antigonish Strait Health Authority.

“There is tremendous support for this program across the province, and many individuals and organizations are helping to make it a success,” says Marianne.

“Over the next 18 months, we will be phasing in the screening process,” she notes. “We are ensuring that we do it well by getting it right and then rolling it out in a gradual manner to be available across the province.”

Screening for distress helps patients, their families, as well as their health care providers. “Patients are sometimes hesitant or reluctant to discuss how they are feeling emotionally. By making this screening routine, it overcomes such reluctance.  For health care providers, screening gives a standardized approach and enables them to deal with patients in a more holistic, person-centered way.” Says Dr. Howes. 

For cancer patients who are not located in one of the four DHAs currently screening for distress, help is still at hand. “Patients should feel free to share their feelings, their concerns, and their worries with their health care professionals,” stresses Marianne. “This way they can work on addressing those issues together.”


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