Sunday, January 31, 2010

Expert advice on maintaining emotional heath during cancer treatment

Editor's note:Many cancer patients don't learn about helpful services until it's too late. In the whirlwind of diagnosis, asking for one more referral can feel overwhelming. Here is Hester Hill Schnipper's excellent explanation of how and why you should utilize the services of an oncology social worker.

Social workers in general often have pretty bad PR. Oncology social workers in particular are usually unknown to the general public--unless or until someone has cancer. When I am asked to describe what we do, my usual shorthand response is something like this: "Oncology social workers are responsible for helping with everything about your cancer experience except the disease itself." We all know that a cancer diagnosis changes everything about life, so our purview is large.

We are fortunate at my hospital to have a very experienced group of oncology social workers who work with patients and their families in Hematology/Oncology, Radiation Oncology, and the in-patient services. All of us have been doing this work for more than twenty years and love what we do. In addition to the clinical staff, we have two Patient Navigators and an Oncology Community Resource Specialist. The CRS' job is to help connect patients with any programs, resources, community groups, or entitlements that could be helpful.

Almost all people with cancer are treated by a team of healthcare providers: physicians, nurses, and other specialists who work together to provide often complex medical care. Oncology social workers are integral members of many multidisciplinary oncology teams. They are recognized as leading experts in providing psychosocial care to people affected by cancer and their families.
It is understood that cancer never happens in a vacuum, and it is imperative that a person's whole life circumstances be considered when making treatment decisions and planning care. Oncology social workers are trained to respond to individual situations and issues and help ensure that people with cancer and their families have access to and receive the best possible cancer care.

In 2009, the Association of Oncology Social Work, a non-profit, international organization with more than a thousand members, celebrates its 25th anniversary. Oncology social workers, however, have been practicing, providing clinical services to people with cancer and their families, since the 1970s. They work in teaching and community hospitals, outpatient clinics, home care and hospice agencies, community organizations, advocacy programs, colleges and universities, and private or group practices. Licensed oncology social workers are committed to helping people with cancer and their families achieve the best possible quality of life during and after their cancer treatment.

What can an oncology social worker do for you?
The core service is likely to be individual, couples, or family meetings or counseling to help you adapt to your diagnosis, treatment, and challenges of survivorship. Unlike other healthcare providers who focus on the provision of particular treatments, oncology social workers focus on YOU:
    What life experiences do you bring to the moment of diagnosis that likely can help you through this crisis?
    What are your greatest fears about your diagnosis and cancer treatment?
    What side effects can you expect and how can you best manage them?
    What are the common emotional reactions?
    Are there particularly useful ways of managing the stress of cancer? What will the impact be upon your spouse or partner?
    How can you talk with your children?
    What should you tell your elderly parents?
    Who are your supports and how can they best help you?
    What are the other current problems in your life and how are they likely to be affected by your illness?
    Do you anticipate financial difficulties or problems with your employment?
    Do you have adequate medical insurance?
    Are there community resources that could be helpful to you and your family?

Oncology social workers can answer these and many other questions. They often facilitate support groups and offer educational programs related to family issues or coping with treatments. Trained as therapists, many oncology social workers can work with you and/or your spouse, partner, or family to help you manage the intense emotions that accompany cancer. If necessary, they are knowledgeable about end of life issues and can support and help you through these difficult decisions. They may offer case management services or help you navigate through complicated medical institutions and systems. They can help you find financial assistance lodging options, transportation, and community services. They can advocate for you with community and entitlement programs. They can be considered your "ace in the hole," the person you can turn to with any problem, question or worry.

How do you find an oncology social worker near you?
Most major academic medical centers and many community hospitals and oncology practices employ oncology social workers Ask your doctor or nurse. If they can't identify someone, call the nearest major cancer center and ask for the social work department. Even if you are not treated there or live some distance away, they are likely to have suggestions or referrals. You can also contact the Association of Oncology Social Work to locate an experienced oncology social worker who can help you.

After Breast Cancer: A Common-Sense Guide to Life After TreatmentHester Hill Schnipper, LICSW
Chief, Oncology Social Work
Beth Israel Deaconess Medical Center, Boston
survivor of two breast cancers

Want to read more from Hester? She has a very valuable and informative blog. She is also the author of "After Breast Cancer" which you can pick up in our Amazon store just a few inches away.


  1. Educating people about Oncology social workers is great, but oncology staff need to be educated, too. I asked for help over and over during treatment and was never given an opportunity to talk with a social worker. After all, as the staff said, I wasn't getting chemo, "just" radiation not "real" treatment and I "ought to be able to handle something this easy." 3 years later I still have flashbacks and nightmares about how I was treated and how my begging for help was ignored.

  2. Reading that comment makes me so sad. I admit I was slightly discouraged from attending the support group at my cancer center, because I was not having chemo. If you can email us I will see what sort of resources we can find.