8 NOVEMBER 2023IN MY OPINIONIN MY OPINIONStress associated with a diagnosis of cancer has been shown to induce considerable psychological morbidity, and 25­50 percent of all cancer patients indicate significant levels of distress. Two sub-groups of patients exist within the 25­50 percent of individuals who evidence high distress: those who meet the criteria for psychiatric illnesses such as major depression or adjustment disorders (up to 25 percent of all patients) and patients who report distress levels that do not meet criteria for a psychiatric diagnosis but interfere significantly with quality of life and functional status (15­25 percent of all patients).Even patients who do not meet criteria for a psychiatric diagnosis may experience worries, fears and other forms of psychological distress that impact daily functioning. Feelings of guilt, loss of control, anger, sadness and uncertainty are common in people with cancer. Further, cancer patients can face spiritual and existential issues involving faith, mortality and the meaning of death. Some cancer survivors report feelings of anger, isolation and diminished self-esteem in response to such stress.Family members also have psychological needs. A cancer diagnosis for a family member creates fear and concern about the suffering that may be experienced. Caregiver psychological distress can be as severe as that of the person with cancer. Studies of psychological distress in both patients and their caregivers found that the psychological distress was parallel over time, although when the patient received treatment, caregivers experienced more distress than the patient. Thus, helping family members to manage their distress may have a beneficial effect on the quality of life for people with cancer. LEVERAGING TECHNOLOGY TO MANAGE PSYCHOLOGICAL DISTRESSBy Jeffrey Kendall, Director, Oncology Support Services, University of Minnesota Cancer Care
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