Psychosocial Aspects of Cancer: Part I of Interview with Dr. Jimmie Holland

The other day I ran into one of my colleagues who’s an oncologist. He remarked that he’d recently been informed that about 90% of patients diagnosed with a brain cancer called glioblastoma multiforme are at risk for suffering from depression sometime during the course of the disease. However, only 60% of them are ever treated for their depression.  He asked me what I’ve been up to and I summarized what I and others are trying to accomplish in our delirium quality improvement project. He was also very aware of the high occurrence rate of delirium in this cancer patient population as well.

This reminded me of the videotaped interview with Dr. Jimmie Holland, the first of two segments of which is above. The interview was conducted by the Public Relations Task Force (PRTF) of the Academy of Psychosomatic Medicine (APM) in 2007 at the APM Annual Meeting on Amelia Island. You can view it at the APM website as well or hear the audio only at the website of Dr. Michael Blumenfield at http://www.shrinkpod.com/.

Dr. Holland is the Wayne E. Chapman Chair in Psychiatric Oncology at Memorial Sloan-Kettering Cancer Center in New York.  She was interviewed by John Blamphin, former Director of Communications of the American Psychiatric Association and now consultant to the PRTF. She chaired the Institute of Medicine (IOM) symposium on psychosocial services for cancer patients at the 2007 Annual Meeting.

Dr. Holland suggested that a report card system be developed to rate all hospitals on how well they screen for and manage psychosocial distress in cancer patients.  More than occasionally I am called as a psychiatric consultant to clarify issues surrounding a variety of issues with which persons being treated for cancer wrestle. Their oncologists can see them usually only for brief clinic visits and it’s incredibly difficult to discuss at any length a patient’s decision to stop cancer treatment or who mentions thinking about suicide.

I thought it was interesting that psychiatric issues are still stigmatized enough that experts are counseling oncologists to avoid using the word “psychiatry” and to use a quick screening question inquiring how much “distress” their patients have been under for the last couple of weeks on a scale of 1-10. The sense one gets from this video is that addressing psychosocial distress in those who are facing the challenge of cancer should be a team effort that involves nurses, oncologists, social workers and others as well as mental health professionals.

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