New psychological support services for cancer patients and families launched for South West London

Dr Sahil Suleman is a Macmillan Consultant Clinical Psychologist leading on the development of cancer psychological support services in South West London; here he explains the importance of patients, carers and their families having access to psychological support throughout cancer diagnosis, treatment and beyond.

Being told you have cancer can be devastating and many patients can find it hard to cope emotionally. We also know that psychological and emotional challenges associated with cancer can emerge at any point along the cancer pathway, ranging from just having been diagnosed or being in the middle of a difficult treatment, through to adjusting to life post-treatment or possibly even preparing for life coming to an end.

Psychological distress is an understandable and natural response to any traumatic and threatening experience, and is common among people affected by cancer.

Around 1 in 4 patients affected by cancer will require expert psychological or psychiatric assessment and intervention as a result of their diagnosis and it is not just cancer patients who suffer psychologically; 67% of carers experience anxiety and 42% experience depression.

Psychological issues are more common in the first year after treatment but one third of patients continue to report significant levels of distress well after treatment has been completed, which is often when the emotional impact of cancer treatment can ‘hit home’ and then the input from cancer services reduces. It is also important that our services are able to support those who may have pre-existing mental health issues, as we know that many of these patients can have poorer cancer treatment outcomes when their mental health needs are not attended to.

Whilst each person will experience their cancer differently, common emotional responses to a diagnosis of cancer can include anxiety, adjustment, low mood, hopelessness or anger. Many patients will feel significant shifts in their sense of identity, how they see their bodies or how they are in their relationships with others. Some will struggle with tolerating the side effects of their treatment or adjusting to the losses and life changes that cancer has brought about and others may remain fearful about their future. For some of these patients, their psychological difficulties may even interfere with their ability to access the treatment they need.

A new 18 month Macmillan-funded pilot project is aiming to address the needs of these patients and their families, through the development of Cancer Psychological Support Teams across St George’s Hospital, Croydon University Hospital and Epsom & St Helier Hospitals. Whilst still in the early stages of development, these teams will be made up of counsellors, clinical psychologists and liaison psychiatrists and will spend the first part of the pilot getting a clinical service up and running. It is clear that having only launched a few months ago, our services are already incredibly busy and we need to have teams that are appropriately staffed to address the previously unmet needs of these patients, as well as working with neighbouring community-based services. The second part of the pilot is therefore focused on this task, and further support will be required to ensure that our essential and well-regarded services become a part of routine care for patients affected by cancer and their families going forward.

We know that we only see a subsection of patients who are under cancer services across our hospitals, but that our staff are supporting these patients every day.

As such, our teams will not only be working with patients and their families, but also working with all staff in clinics and on the wards to embed good psychologically-informed care across cancer services through teaching, training and supervision.

(from left) Sahil Suleman — Consultant Clinical Psychologist, Janet Bates — Counsellor, Alexandra Pitman — Consultant Liaison Psychiatrist, Asanga Fernando — Consultant Liaison Psychiatrist

Our experienced team has an excellent understanding of the specific emotional, psychological and psychiatric challenges that particular cancers, symptoms and treatments can bring, and we are all skilled at exploring the unique impact that adjusting to these can have on an individual and their loved ones. We hope to make a real difference to patients, their families and all staff working in cancer services.

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