The relationship between behavioral health and oncology is a rapidly evolving field aimed at supporting the mental and emotional well-being of cancer patients. Correspondingly, a cancer diagnosis is often an emotionally shattering experience, and the consequent treatment can be demanding (ACS, 2022). Cancer effects approximately 1.9 million Americans each year. In addition to this, approximately 600,000 people a year, die from cancer (ACS, 2022). In the past, the focus on treatment for cancer looked at how to ease medical symptoms (ACS, 2022). Presently, researchers are starting to look at how people are affected by cancer psychophysiologically because of integrated healthcare professionals like Doctors of Behavioral Health. (Burg & Oyama, 2016; Gray, 2021; Talen & Valeras, 2013).
With this in mind, the cancer patient’s experience is viewed as a whole-person experience, not just a physiological one (ACS, 2022; Burg & Oyama, 2016; Gray, 2021). Through various methods like patient-centered communication, exercise, and eHealth tools, oncologists and behavioral health, without a doubt, professionals have a new aim to ease issues for individuals who are on this challenging journey (Epstein et al., 2017; Jones & Alfano, 2013; Ramsey et al., 2020).
Emotional Toll of Cancer Diagnosis
Learning that one has cancer can be a traumatic event (ACS, 2022). For example, it can lead to a wide range of emotions like fear, anxiety, and depression. Under those circumstances, patients often grapple with uncertainty and existential questions. This level of existential anxiety can manifest as sleep problems, poor adherence to treatment plans, and strained family relationships (ACS, 2022). What’s more, such emotional disturbances warrant urgent behavioral health interventions to optimize patient outcomes.
On the positive side, providers who are in tune with integrated health techniques and trauma-informed care methods are more likely to be successful in helping patients cope with the emotional toll of a cancer diagnosis (ACS, 2022; Talen & Valeras, 2013; U.S. Department of Health and Human Services [USDHHS], 2016). This is because providers who are aware of the various aspects of integrated healthcare and trauma-informed care ensure that communications about and with the patient, are patient-centered (Epstein et al., 2017; USDHHS, 2016).
One of the ways to manage emotional distress with patients is through open and patient-focused communication with the oncologist (Epstein et al., 2017). Due to the patient grappling with serious, distressing, and painful medical news, the oncologist should actively listen, offer empathy, and provide precise information tailored to each individual patient (Epstein et al., 2017; Villani et al., 2013). This approach not only builds trust but also empowers patients to take an active role in their treatment decisions. Integrated healthcare professionals, such as Doctors of Behavioral Health, are poised to help medical providers, like oncologists, understand the psychology that drives a patient’s behavior when the patient feels unheard or mistreated (Burg & Oyama, 2016; Talen & Valeras, 2013).
Doctors of Behavioral Health, as well as other integrated healthcare professionals, know that when it comes to behavior, the mind and body are almost always working together to create it (Burg & Oyama, 2016; Gray, 2021; Talen &Valeras, 2013). This is why, when one gets their body in better attunement, their symptoms usually alleviate a little, and the patient’s behavior stabilizes.
Exercise and Oncology
Researchers have found that physical activity has promising results in alleviating some of the emotional and physical symptoms of cancer (Jones & Alfano, 2013). In contrast, one may think that this is impossible, as cancer is an invasive, distressing, and sometimes incurable illness. To put it another way, how could physical activity help? It is important to realize that exercise can improve mood, reduce fatigue, and even enhance the efficacy of certain treatments (Jones & Alfano, 2013). Many cancer centers now incorporate exercise programs tailored to the needs and limitations of each patient as part of their comprehensive care plan. On one hand, this does not mean that this behavioral treatment works for everyone having oncological issues. On the other hand, societal factors cause some populations experiences to be far worse.
Psycho-Oncology and Black Women
Black women have unique challenges in the oncology landscape, especially with a higher incidence of aggressive forms of breast cancer (Chinn et al., 2021; Lechner et al., 2013). Cultural and societal factors often affect their psychological response to the diagnosis and treatment (Chinn et al., 2021). By being a culturally competent provider, one can help black women manage their feelings of betrayal, medical neglect, health inequity, and abandonment, and aid them in feeling heard in their psychological response to finding out they have cancer (Lechner et al., 2013).
Fears of further medical neglect and healthcare inequity makes and the psychological turmoil of finding out that one has cancer worse (Chinn et al., 2021). This population does not know what to expect moving forward. Therefore, tailored psycho-oncological interventions, sensitive to these issues, are required to provide effective emotional and mental support to this population (Chinn et al., 2021; Lechner et al., 2013). When helping individuals through their cancer diagnosis, it is all about creating solutions that are beneficial to the patient.
eHealth and mHealth in Pediatric Cancer
Technology offers new avenues for behavioral health interventions, particularly in pediatric oncology. Through eHealth and mobile health (mHealth) platforms, young patients and their families are given access to interactive educational content, reminders for medication, and even virtual support groups (Ramsey et al., 2020). These interventions can significantly reduce the emotional burden on both the patients and their families. It is difficult enough for families and the pediatric patient to have to battle cancer (Ramsey et al., 2020). Technological advances in medicine can help ease the strain on the mental health of the individuals involved. Spiritually inclined behavioral health interventions can easy mental health issues when technology is not enough (Ramsey et al., 2020; Rassouli et al., 2015).
Spirituality and Behavioral Interventions
Many cancer patients find solace and strength in spirituality (Rassouli et al., 2015). They may find that their ailing body makes them feel irritable, off-kilter, and as though they are on an emotional roller coaster. As a result, they may act out in bouts of anger, and sadness, or even feel confused. Providers may find a patient’s behavior off-putting, as they may feel they are doing all they can to alleviate the symptoms (Rassouli et al., 2015). However, it is not always psychophysiology that is driving the behaviors alone. With this knowledge in mind, providers must understand that some interventions that incorporate elements of spiritual care, like mindfulness and meditation, have been found to significantly reduce stress and improve quality of life (Epstein et al., 2017; Rassouli et al., 2015; Villani et al., 2013).
Thus, if the patient reports a sense of tranquility and acceptance, in having spiritual and behavioral health interventions, providers need to ensure these options are available to help with the emotional upheaval that often accompanies cancer (Rassouli et al., 2015). As providers, one also must remember, that the challenges that come with cancer do not end with diagnosis.
Life After Diagnosis and Treatment in Adulthood
Surviving cancer can be as emotionally challenging as the diagnosis and treatment phases. Concerns about recurrence, navigating relationships, and returning to work are common (Stanton et al., 2015). Behavioral health interventions, therefore, should extend into the post-treatment phase to ensure a smooth transition back to normal life. There are many instances that patients must consider (Stanton et al., 2015). What will they do about work? How will treatment affect their ability to live life, their appearance, or how they handle things day to day? Having an integrated healthcare practitioner on site to help with behavioral health interventions is not only beneficial to the patient personally, but can help them in their social sphere as well (Stanton et al., 2015).
Psychosocial Oncology Research Contributions
Research in psychosocial oncology has substantially contributed to our understanding of the emotional and mental needs of cancer patients (Stanton et al., 2015). Researchers have looked at the expectations of society when dealing with cancer patients, as well as how cancer patients are expected to behave. Knowing what people expect in society, and creating educational materials that help people to understand what happens to cancer patients, and what to truly expect, helps to create safer more informed environments for cancer patients (Stanton et al., 2015).
New interventions continue to be developed, and existing ones are refined to suit the ever-changing landscape of oncology. When the public is more aware of these changes, indeed, psychosocial experiences of oncology patients is better. Information can be disseminated quickly through various technological means, typically mobile devices (Stanton et al., 2015; Villani et al., 2013). These devices can also be used to help oncology patients through their journeys.
Self-Help and Mobile Devices
Mobile apps focused on stress management and mood tracking are increasingly available for patients (Villani et al., 2013). Without a doubt, these apps help patients to mitigate the emotions and concerns they may be feeling after diagnosis. The apps offer the benefit of access to relaxation techniques and could serve as a supplementary resource to traditional therapy, with this purpose in mind. The idea behind these behavioral health interventions is to better the quality of care for patients. Additionally, it will improve the care of patients and decrease and eventually eliminate healthcare inequity. It also seeks to improve the provider’s and patient’s experiences, all at reasonable costs for all. Providers who understand this need and future trajectory for oncology patients will be the leaders in innovative oncological behavioral interventions.
Future and Integrated Healthcare Solutions for Oncology
In the future, Doctors of Behavioral Health play a pivotal role in shaping the future of oncology care (Burg & Oyama, 2016; USDHHS, 2016)). Additionally, they will help in the design and implementation of integrated healthcare systems. The goal is to provide a more holistic approach to cancer treatment (Gray, 2021). Therefore, such integrated systems are highly effective for treating diseases that require varied, comprehensive, or collaborative approaches, like oncology. Behavioral health interventions in oncology are indeed a key component in modern healthcare (Gray, 2021; Talen & Valeras, 2013).
These interventions provide an improved approach to cancer care (Epstein et al., 2017; Gray, 2021; Talen & Valeras, 2013). This is done with a focus on patient-centered communication, physical activity, technological tools, and specialized care for diverse populations with this intention. As we move forward, the role of behavioral health specialists, behavioral health consultants, and Doctors of Behavioral Health will become increasingly significant as a result. These roles improve both the quality of life for cancer patients and the effectiveness of oncological treatments (Epstein et al., 2017; Gray, 2021).
American Cancer Society (2022). Cancer facts & figures 2022. https://www.cancer.org/research/cancer-facts-statistics/all-cancer-facts-figures/cancer-facts-figures-2022.html
Burg, M. A., & Oyama, O. N. (Eds.). (2016). The behavioral health specialist in primary care: Skills for integrated practice. Springer Publishing Company.
Chinn, J. J., Martin, I. K., & Redmond, N. (2021). Health equity among Black women in the United States. Journal of women’s health, 30(2), 212-219. https://doi.org/10.1089/jwh.2020.8868
Epstein, R. M., Duberstein, P. R., Fenton, J. J., Fiscella, K., Hoerger, M., Tancredi, D. J., … & Kravitz, R. L. (2017). Effect of a patient-centered communication intervention on oncologist-patient communication, quality of life, and health care utilization in advanced cancer: the VOICE randomized clinical trial. JAMA oncology, 3(1), 92-100. https://doi.org/10.1001/jamaoncol.2016.4373.
Gray, A. (2021). Why Model Fidelity is Important in Behavioral Health [Trauma-Informed Integrated Behavioral Health Education]. Paragon. https://gettraumainformed.com/2021/07/15/why-model-fidelity-is-important-in-behavioral-health/
Jones, L. W., & Alfano, C. M. (2013). Exercise-oncology research: past, present, and future. Acta oncologica, 52(2), 195-215. https://doi.org/10.3109/0284186x.2012.742564
Lechner, S. C., Ennis-Whitehead, N., Robertson, B. R., Annane, D. W., Vargas, S., Carver, C. S., & Antoni, M. H. (2013). Adaptation of a psycho-oncology intervention for black breast cancer survivors: project CARE. The Counseling Psychologist, 41(2), 286-312. https://doi.org/10.1177/0011000012459971
Ramsey, W. A., Heidelberg, R. E., Gilbert, A. M., Heneghan, M. B., Badawy, S. M., & Alberts, N. M. (2020). eHealth and mHealth interventions in pediatric cancer: a systematic review of interventions across the cancer continuum. Psycho‐oncology, 29(1), 17-37. https://doi.org/10.1002/pon.5280
Rassouli, M., Zamanzadeh, V., Ghahramanian, A., Abbaszadeh, A., Alavi-Majd, H., & Nikanfar, A. (2015). Experiences of patients with cancer and their nurses on the conditions of spiritual care and spiritual interventions in oncology units. Iranian Journal of Nursing and Midwifery Research, 20(1), 25. http://www.ncbi.nlm.nih.gov/pmc/articles/pmc4325410/
Stanton, A. L., Rowland, J. H., & Ganz, P. A. (2015). Life after diagnosis and treatment of cancer in adulthood: contributions from psychosocial oncology research. American Psychologist, 70(2), 159. https://doi.org/10.1037/a0037875
Talen, M. R., & Valeras, A. B. (Eds.). (2013). Integrated behavioral health in primary care: Evaluating the evidence, identifying the essentials. Springer.
U.S. Department of Health and Human Services. (2016). Treatment improvement protocol—Trauma-informed care in behavioral health services—Tip 57. Lulu Com. https://www.samhsa.gov/resource/dbhis/tip-57-trauma-informed-care-behavioral-health-services
Villani, D., Grassi, A., Cognetta, C., Toniolo, D., Cipresso, P., & Riva, G. (2013). Self-help stress management training through mobile phones: an experience with oncology nurses. Psychological services, 10(3), 315. https://doi.org/10.1037/a0026459