Half of all cancer patients do not get support needed, says specialist

Half of all Irish cancer patients are not receiving the counselling and support they need to be able to cope with their illness, a leading cancer specialist has claimed.

Delegates to an Irish Cancer Society conference on the psychological management of patients with cancer were also told of new research suggesting that a positive attitude does not necessarily improve survival chances.

There were "grave deficiencies" in the services for cancer patients in the State, according to Dr John Crown, consultant medical oncologist at St Vincent's Hospital in Dublin. Insufficient funding left too few doctors with too few resources and too many patients.

We had an "underdeveloped support network for our cancer patients", he said. Dr Crown co-organised the conference with Dr Gillian Byers, consultant psychiatrist at the Blackrock Clinic in Dublin.

"There is a great deal of unrecognised stress in cancer patients. Many patients in Ireland are not getting the help they need," he said, with up to half of all patients not receiving the help they needed for significant levels of anxiety and depression after diagnosis.

The conference featured two of the world's leading researchers on the psychological impact of cancer. Dr Maggie Watson, consultant psychiatrist with the UK's Royal Marsden NHS Trust, presented unpublished results of a study which related the mental attitude of cancer patients to survival over five years after diagnosis.

The unique study included 578 women with breast cancer, assessed soon after being told about their illness. They were grouped into categories from "fighting spirit" to "fatalistic".

A key finding was that fighting spirit and a highly positive attitude did not prolong life to a statistically significant degree.

Those in the helpless/hopeless group however had an increased risk of early death or a subsequent cancer event. "It is a modest effect but it is not negligible," she indicated. For this reason she recommended that "depression needs to be treated vigorously" in these patients, through counselling and related support services.

Dr Jimmie C. Holland, the chief of psychiatry services at Memorial Sloan-Kettering Cancer Centre in New York, discussed the great benefits of having psychological supports to help cancer patients. She is an international authority on the issue and a founder of the field of psychosocial oncology.

These services could not be shown to extend patient survival she said, but they had a profound effect on quality of life and mental health. It was normal to be sad and angry about a cancer diagnosis but these feelings could also slide into clinical anxiety and depression, which were damaging for the patient.

"It is not necessarily expensive" to introduce psychological supports, she said. It was necessary to educate doctors, nurses and those providing care to identify the symptoms of pathological depression, but it was also necessary to educate patients and the public, who should ask that these services be provided.

The Irish Cancer Society for the past three years has provided specially trained "Cancer Liaison" nurses, who have the expertise to provide counselling and support for cancer patients and their families. The six nurses, to be increased to eight this year, are funded by the society's annual Daffodil Day fundraising activities.