Dr. Paul D'Alton
We are failing the psychological needs of cancer patients
Late last year, shortly before his death, the brave, generous and dignified Hugh Cooney highlighted the lack of adequate psychological services for cancer patients on the 'Late Late Show'. This issue was so important to him that he used his little remaining strength to bring it to public attention.
Cancer is an illness that goes to the heart of the family, an illness that goes to the heart of who we are as human beings. Cancer has emotional and psychological repercussions that last a lifetime, both on the individual who is diagnosed with it and on their family and close friends.
Graham is father to three young children, and is currently being treated for cancer. This is what he has to say about his experience: "I know the chemotherapy and all that awful stuff will come to an end but I am really afraid that the emotional terror of this bloody cancer will never stop."
Graham's words reflect the emotional response of most cancer patients. Their experience reflects the fact that cancer is not just a physical illness. The psychological and emotional impact of the illness will stay with them and change them forever.
Graham, and the many thousands of Irish people who are treated for cancer every year, need help to deal with the often devastating emotional fallout of the illness.
I acknowledge that we have made great strides in the treatment of the physical aspects of cancer, but unfortunately we are lagging decades behind when it comes to the treatment of the psychological aspects of cancer.
Happily, more and more patients are surviving the physical illness thanks to new treatments and drugs, but the psychological illness is more often than not left untreated.
This is despite the fact that the psychological care of cancer patients has long been regarded as an integral part of quality cancer care.
As far back as 1999, the National Review of Support Services of Patients with Cancer highlighted that psychological problems, though very common, are under-recognised and under-treated. We now have close to 18 years of national recommendations advocating for the psychological care of cancer patients. Right now, getting professional psychological help if you are a cancer patient is entirely dependent on where you live.
We have eight cancer centres in this country. Only two of these centres have a dedicated service specifically providing psychological support to cancer patients. This means that getting this vital service depends entirely on which cancer centre you attend for treatment. This inequality is simply unacceptable. The failure of successive governments to provide adequate psychological care for cancer patients is compromising the care patients and their families require. Without political and HSE action, the many recommendations made over the years, and still gathering dust on shelves in a State agency or government department, are little more than words on paper.
Various cancer charities provide excellent support in this area, but this can never be enough. We need a national plan for psycho-oncology support for cancer patients. Otherwise, the majority of our country's cancer patients are vulnerable to having their psychological needs overlooked completely.
Undoubtedly, the most vulnerable group are those cancer patients with pre-existing mental difficulties, such as schizophrenia. They could be your sister, your brother, your lover, your mother, your father, your son or your daughter.
For them, failure to provide dedicated psychological care may be a matter of life and death, with their chance of survival halved compared with someone without a similar mental health illness.
Very soon, the Minister for Health will receive the draft 2016-2025 Cancer Strategy for consideration. This strategy, when published, will act as a blueprint for our cancer services for the next decade. It is in this strategy, this plan, that the psychological care for cancer patients needs to be firmly embedded as an integral part of quality cancer care.
The new Cancer Strategy needs to include a clear implementation plan with a clearly defined time scale to deliver psychological support to all the cancer patients who need it.
This is our opportunity to provide the services that will save the lives of some of our most vulnerable citizens, help others manage the emotional terror of cancer, and provide the comprehensive and equitable cancer care our citizens deserve.
Originally published in The Irish Independent 11/03/16.