Psychosocial support is lacking for cancer patients, finds IOM report

For many Americans with cancer, there is a wide gap between optimal care and the care they actually receive, finds a recent report, Ensuring Quality Cancer Care, by the Institute of Medicine's National Cancer Policy Board and the Commission on Life Sciences National Resource Council.

A lack of consistent and comprehensive psychosocial supports for cancer patients and their families was among the report's findings. "Evidence suggests that the United States does not fully use what is known to be effective care for individuals with cancer," said Joseph Simone, MD, medical director of the Huntsman Cancer Foundation of Salt Lake City and vice chairman of the policy board.

Instead of consistent care, the report found significant differences in the quality of care across health-care systems, health-care providers and insurance companies, Simone says. For one, the report found that physicians often fail to recognize the psychological long-term effects of cancer and its treatment. Physicians don't adequately identify signs of depression among patients with cancer and only 13 percent of patients with moderate to severe depression were diagnosed as such by their physicians, according to a study cited in the report.

The National Cancer Policy Board also identified "a great gap in what we think is the best practice for psychosocial support for pain management." Their report cites a study that found 42 percent of patients with recurrent cancer received inadequate care for their pain.

The report suggests that health professionals use mind­body techniques such as hypnosis, relaxation and guided imagery to help cancer patients manage their pain, alleviate the side effects of chemotherapy and cope with their illness.

The board recommends that the federal government and private health-care providers develop new standards for cancer care and sponsors of cancer research invest in new clinical trials to learn more about the most effective ways to prevent, treat and screen for cancer.

--L. Rabasca



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