Studies show that integration of palliative care through consultation with a palliative care team early on after cancer diagnosis is most effective in improving HRQOL, increasing satisfaction with care, and mitigating depression (629631). For patients with advanced cancers, including those with solid and blood cancers, ongoing consultation with a palliative care specialist throughout treatment led to improved communication between patients, caregivers, and the clinical care team leading to an overall increase in life expectancy (632). Palliative therapy, which aims to relieve symptoms of cancer through surgical or therapeutic intervention, can also improve quality of life for patients. As one example, patients with gastric cancers, who develop complications in advanced stages of the disease, can benefit from gastric resection, gastrojejunostomy, stenting, chemotherapy, and radiotherapy, which reduce gastric obstruction and bleeding, and improve patient quality of life (633). Improving Mental Health The psychological challenges faced by survivors of cancer necessitate approaches that improve the mental well-being of this population (see Challenges Faced by Cancer Survivors, p. 132). Psycho-oncology is an interdisciplinary subspeciality within the cancer care continuum that aims to address the physical, behavioral, emotional, and psychosocial distress that arises for cancer survivors and their caregivers. Experts who are trained in psycho-oncology apply a holistic approach to destigmatize and address behavioral and psychosocial distress that is often caused by a cancer diagnosis and treatments (see Sidebar 45, p. 139). What Is Palliative Care? Palliative care is specialized care that provides, if needed, an extra layer of support to patients with and survivors of serious illnesses, such as cancer, and their families and caregivers. Palliative care is given throughout a person’s experience with cancer, beginning at diagnosis and continuing through treatment, follow-up, survivorship, and end-of-life care. Palliative care given near the end of life when curative treatment has stopped is usually referred to as hospice care. Palliative care can be given in addition to cancer treatment or to those with no curative treatment options. Palliative care addresses many of the challenges that can affect quality of life after a cancer diagnosis, including: • Emotional challenges, such as anxiety and depression. • Physical symptoms and adverse effects of the disease and its treatment, such as pain, nausea, vomiting, fatigue, difficulty sleeping, and loss of appetite. • Practical challenges, such as navigating the health care system. • Spiritual challenges. Adapted from (389). SIDEBAR 44 Helping Patients with Cancer Through Psychooncology Research The field of psycho-oncology comprises psychiatrists, psychologists, nurses, and social workers who are dedicated to addressing the behavioral, emotional, psychological, and social challenges faced by cancer survivors and their caregivers. Approaches to helping these individuals tested in recent clinical trials include: Physical exercise (aerobic, resistance training, running, and free weights), psychological interventions (cognitive-behavioral therapy, psychoeducational interventions), and mind-body interventions (yoga, mindfulness, hypnosis) have been shown to be effective at reducing cancer-related fatigue and sleep disturbances among patients with cancer (634). To help young women with breast cancer and their partners deal with the effects of their diagnosis, a program called Oncofertility! Pyscho-Education and Couple Enrichment provided stress coping and marital communication strategies along with information about fertility preservation services. Couples who participated in the study had reduced posttraumatic stress symptoms, improved stress-coping behaviors, and better marital relationships (635). SIDEBAR 45 Supporting Cancer Patients and Survivors AACR Cancer Progress Report 2023 139
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