To begin with, it would be important to explain the word “psychosocial”. “Psycho” means having to do with the mind or psyche. “Social” implies the relationships a person has with family and the society. Therefore, psychosocial support is a specialty that concerns the aspect of care which seeks to understand and treat the social, emotional, spiritual, quality-of-life and functional domains of cancer, from prevention to bereavement [1]. In the mid-seventies, talking about cancer was becoming less of a taboo as the stigma around the
Link to Life Cancer Support Centre, Rep. of Mauritius
International Psycho-oncology society
disease was weakened. This helped the emergence of psycho-oncology as a subspecialty of oncology [2]. Psycho-oncology “addresses the psychological responses of patients to cancer at all stages of the disease, and that of their families and caretakers”, along with “the psychological, behavioral and social factors that may influence the disease process.” [3]
In Mauritius, the notion of caring for the cancer patient beyond their medical condition was initiated in 2002 by a group of women who were themselves in remission. Their experience taught them that support at the emotional and social levels could bring relief to people affected by the disease. Initially, such support came in the form of volunteers visiting and befriending patients in radiotherapy wards. Then in 2006, a talk group composed of women having different types of cancer, led by a volunteer retired nurse and a social-worker, was constituted. Link to Life Cancer Support Centre was thus created.
Cancer patients now had the space to talk about the feelings accompanying them along their illness and treatment journey. However, this type of support had limitations. Counselling and group support delivered was not consistently seeking to address more complex psychological issues that the patient might encounter along their cancer trajectory. Group therapy sessions contained over twenty participants, the therapist needed further training in psychotherapy and facilitating cancer groups. As a result, specific needs of clients remained unmet. For instance, cancer survivors who accessed support services still presented adjustment difficulties, high anxiety and sometimes emotional distress [4], many years post-treatment.
Since 2013, the therapeutic program at Link to Life made a shift from a ‘one size fits all’ approach to support towards setting up treatment strategies that focused on enhancing patients’ quality of life, reducing their psychological burden as well as that of their family. The organization now runs diverse psychosocial services such as supportive-expressive group therapy for advanced female cancer patients; psycho-education groups facilitated by a trained psychotherapist assisted by an oncology nurse; a home visit service for incapacitated patients; and systematic psychosocial assessment at different phases of illness and treatment. Programs and support are accessible in the central and northern part of the island. The northern branch, found in Pamplemousses, is a five-minute walk from the national hospital’s chemotherapy day-care clinic. This makes it easy for patients and their family to walk in and access information as well as counselling shortly after a medical appointment.
Psychosocial care for cancer is constantly growing in parallel with clinical oncology [5]. In 2014, Link to Life sent the only Mauritian representative to the International Psycho-oncology Society’s (Ipos) congress in Lisbon, Portugal. This has been the start of a continuous professional development and networking venture, with the aim of promoting psychosocial cancer care nationally and regionally. However, despite this exposure, there is still a long way for this discipline to be recognised by the clinical community as an integral and important aspect of cancer care.
There is a need to create a platform for oncologists and psychosocial professionals to exchange knowledge, develop programs and promote an interdisciplinary approach in our interventions. Indeed, a more coherent care would be delivered if the psycho-oncologist and the physician could discuss a patient’s difficulties in adjusting to treatment, for instance. Further benefits to reducing the gap between biomedical and psychosocial care would be in the areas of training and research where we have yet to grow.
Oncology care is evolving both in terms of treatment strategies and infrastructure. The government is planning to set up a new specialised cancer care centre in the near future [6]. As a psychosocial care professional, I hold the hope that its program incorporates psycho-oncology as a core aspect of the service delivery in this initiative.
Sources
- Definition of psychosocial oncology
https://www.capo.ca/patient-family-resources/what-is-psychosocial-oncology/
- Holland, J. C. (2002). History of Psycho-oncology: Overcoming Attitudinal and Conceptual Barriers. Psychosomatic Medicine, 3(2), p 206-221.
- Medical definition of Psycho-oncology
https://www.medicinenet.com/script/main/art.asp?articlekey=33446
- McFarland, D and Holland, J. C. (2017) ‘Distress, Adjustment, and Anxiety Disorders’, In M. Watson and D.W Kissane (ed.) Management of Clinical Depression and Anxiety. New York: Oxford University Press, pp. 1-21.
- Bultz, B. D. (2016). Cancer Care and the Role of Psychosocial Oncology: Where are We and Where are We Going? Asia-Pacific Journal of Oncology Nursing, 3(2), p 118–120.
http://doi.org/10.4103/2347-5625.182929
- “New cancer centre to be constructed in Vacoas, announces Minister Husnoo”