Can we talk?

A cancer diagnosis causes patients and their families to have many emotions. It's normal to feel sad, angry and worried about the future. These feelings may intensify right before a medical appointment due to concerns about possibly receiving bad news.

Unfortunately, patients don't always discuss their feelings with their health care team. We at MD Anderson asked patients why they keep their feelings to themselves, and the top answer was, "I don't want to bother my doctor."

Why it's important to open up
Why is managing distress important for cancer patients and their families? Of course, how you're feeling emotionally is important to your quality of life. Also, consider that your distress may:

• interfere with your ability to improve your overall health, such as by quitting tobacco, engaging in regular exercise and maintaining a healthy weight;
• interfere with your ability to complete difficult treatments; and
• reduce your body's ability to be healthy and fight off infection.
  

How you feel is important for your health and may affect how you respond to your treatment.

Get the support you need
Is your distress "normal"? When should you be concerned about how you are coping?

If you're sad most days of the week, have lost interest in things you used to enjoy, are worried often, or are having thoughts about harming yourself, you need to discuss these concerns with your health care team. Please talk about your concerns with your doctor. You are not a bother.

Even if you're managing your distress, and you feel like you're coping well, it still might be worthwhile to seek out resources. Don't allow your distress to reach high levels. Here are some things you can do:

• Talk to the social work counselor in your center, or call 713-792-6195.
• If you need a counselor closer to your home, search at Psychology Today; the American Psychosocial Oncology Society (866-276-7443); the National Register of Health Service Providers in Psychology; the American Psychological Association; or the American Association for Marriage and Family Therapy.
• Consider activities to help manage your stress, such as those offered in the Integrative Medicine Center.
• Maintain a social network through family, friends or a support group. Call the Anderson Network (800-345-6324) to connect with other patients. 
• Learn more about how to manage distress from resources in The Learning Center.
• If your faith is a source of support for you, talk to your religious leader or a chaplain from our Department of Chaplaincy and Pastoral Education.
• When in doubt, always talk to your health care team.
  

Caring for the whole patient
At MD Anderson, we are "changing the culture" with regard to how patients and staff view distress associated with cancer. As such, we are treating distress as a vital sign, just like blood pressure, temperature and feelings of pain. We ask patients to rate how much distress they have and their sources of distress so that we can refer them to providers who can help address their problems.

In fact, the medical community in general is recognizing the need to care for the "whole" patient:

• The Institute of Medicine published a book recently, "Cancer Care for the Whole Patient," which specifies that cancer care should ensure the provision of psychosocial health.
• The National Comprehensive Cancer Network has practice guidelines for the identification, assessment and management of distress in cancer patients. 
• The American College of Surgeons requires that patients have access to services, such as psychosocial distress screening.
  

Remember, taking care of you includes treating your cancer and making sure your emotional, social and spiritual needs are being met, too.