New cancer guidelines – a world first

An estimated 50,000 Australian suffer anxiety or depression each year following a diagnosis of cancer according to the chief executive officer of the National Breast Cancer Centre, Professor Christine Ewan.

New clinical guidelines launched today by Federal Health Minister Senator Kay Patterson are the first of their kind to describe the emotional, physiological and practical impacts of Australia’s leading forms of cancer.’These impacts of cancer have been largely undetected and untreated until now because health professionals have had little education or training about these problems or good evidence on how they can best be prevented and managed,’ said Professor Ewan.’The guidelines explain how people with cancer face many emotional, psychological and practical day-to-day demands on top of the debilitating physical impacts of the disease and its treatment,’ she said.Titled ‘Clinical Practice Guidelines for the Psychosocial Care of Adults with Cancer’, the guidelines were prepared by the National Breast Cancer Centre and the National Cancer Control Initiative.They address the most commonly occurring cancers in Australia – breast, colorectal, gynaecological, head and neck, lung, melanoma, pancreatic, prostate, urogenital and Non-Hodgkin’s lymphoma.The guidelines are the first of their kind for health professionals who deal with cancer patients from diagnosis through treatment and palliative care according to Dr Jane Turner who chaired the expert committee that produced the guidelines.’They’re aimed at GPs, cancer specialists such as radiation and medical oncologists, surgeons, nurses, social workers, psychologists, psychiatrists, physiotherapists and occupational therapists,’ said Dr Turner, who is a consultant psychiatrist at the Royal Brisbane and Women’s Hospital.’The guidelines point out that people not only feel distressed or fearful when diagnosed with cancer, but up to two-thirds go on to suffer long-term emotional distress.’These emotional and psychological issues often hinder people’s ability to cope with the disease and can reduce their willingness to agree to or continue some forms of cancer treatment.’We also know that much of this emotional fallout is undetected and untreated by health professionals and has major impacts on a cancer patient’s family, friends. Social networks and employment,’ said Dr Turner.Dr Jane Turner, said good communication by health processionals was critical in recognising cancer patients; needs and giving them appropriate information and psychosocial support.Good communication means more that a mere facility with words according to Dr Turner.’It means a willingness by health professionals to engage with people emotionally,’ she said.’There’s a belief among many people that it’s better for cancer patients to avoid emotive issues because it only makes them more distressed.’That needs to be challenged,’ she said. ‘There’s often social pressure on people with cancer to deny or hide their distress or depression and to put on a brave face.’The message to people with cancer is that anxiety and depression are common so don’t be afraid to speak up. The message for doctors is to help cancer patients put those feelings on the table,’ said Dr Turner.The director of the National Cancer Control Initiative, Professor Mark Elwood. said the Guidelines were designed to provide useful, authoritative guidance for the treatment and support of cancer patients.’These guidelines were developed to assist health professionals in the supportive care of adult cancer patients,’ said Professor Underwood.’This includes providing information and choice to patients, assisting them to deal with procedures and treatments they may require, providing emotional and social support, continuity of care, and dealing with specific concerns which may arise including anxiety and depression.’The development and publication of the Clinical Practice Guidelines for the Psychosocial Care of Adults with Cancer was funded by the Commonwealth Department of Health and Ageing. The National Health and Medical Research Council approved them in April 2003.