1. Take Action on Cancer Distress
Cancer distress can be defined as “an unpleasant emotional experience of a psychological, social and/or spiritual nature which extends on a continuum from normal feelings of vulnerability, sadness and fears to disabling problems such as depression, anxiety, panic, social isolation and spiritual crisis” 25,26. Cancer distress is therefore a major factor of poor quality of life, whose wide-ranging detrimental consequences can affect not only cancer patients and survivors, but also their caregivers, families, partners and friends. Beyond the trauma represented by cancer and its treatment, the burden of cancer distress can be reinforced by additional elements, including:
• Cancer stigma, particularly present in the case of certain cancer types, such as lung cancer;
• Fear of cancer recurrence, very frequently experienced by cancer survivors; and
• Anticipatory grief and survival guilt, faced by caregivers, families, partners and friends ahead of and/or after losing a loved one.
Importantly, it may also be associated with delayed or denied treatment, reluctance to disclose cancer status, difficulties in attending support groups and lower survival as a whole27,28,29.
Against this background, psycho-oncology interventions have been demonstrated to be effective in improving psychosocial outcomes in cancer patients30,31,32,33,34,35,36. Key components of psycho-oncological care include:
• Early, systematic and regularly updated psychosocial screening and monitoring in all phases of the cancer disease trajectory37,38,39,40, notably through digital means, allowing to capture issues which affected individuals will typically not report spontaneously;
• Comprehensive and stepped psychosocial assessment, taking into account physical, emotional, practical, family and spiritual/ religious concerns41,42,43; and
• Treatment of cancer distress through provision of relevant forms of psychological support, such as individual and group psychotherapies, psychoeducation, cancer coaching and counselling, relaxation training, and a broad range of self-directed interventions made available to affected individuals through digital means, of particular relevance during the ongoing COVID-19 pandemic44.
Psycho-oncology is regularly identified by cancer patients as an area of unmet care need. This notably relates to long-lasting under-recognition of psycho-oncology by health systems and chronic mismatch between generated care needs and allocated resources45,46.
Crucially, cancer distress does not stop at the end of the cancer patient’s active treatment phase. Instead, it may last during the entire survivorship phase, leading to detrimental impacts on quality of life in the long-term, including for caregivers, families, partners and friends, independently from the outcome of the cancer47. However, even when psycho-oncology services are in place, and as a result of poor coordination of care, the transition between these two phases often results in psycho-oncology care needs being neglected or inconsistently managed, and in affected individuals being thereby left uncertain or exposed to conflicting messages across the care pathway.
