YaleCares Newsletter - December 2011
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December 2011 Volume 5 · No 11
The Temperature of Distress
Online Resources
New booklet from American Society
of Clinical Oncology's patient
education web site, Cancer.net,
"Cancer Survivorship." Printable PDF
available for free.
Learn More >> Holiday Tips for Cancer Survivors.
Learn More >>
Coalition to Transform Advanced
Care.
Learn More >>
New resource from the Connecticut
Cancer Partnership: Cancer Trials in
Connecticut.
Learn More >> Continuing
Education
Yale Schwartz Rounds Second Thursday of the month
12:00 PM Last month we discussed patient-centered communication.
Patient-centered care is certainly not a new concept, but it has
received more attention in recent years as a goal for planning
and delivering quality health care, and is being included in
guidelines and standards. An example is the new Commission
on Cancer (CoC) publication Cancer Program Standards 2012:
Ensuring Patient-Centered Care. CoC is an accrediting body
for cancer centers. A new Standard (3.2) mandates
psychosocial distress screening for all patients and appropriate
clinical response for those who evidence signs or symptoms of
distress. The standard invokes the Institute of Medicine report,
Cancer Care for the Whole Patient: Meeting Psychosocial
Health Needs (2007), and the clinical practice guideline,
Distress Management (2011; free registration required)
released by the National Comprehensive Cancer Network
(NCCN).
The NCCN describes 'distress' as a "multifactorial, unpleasant
emotional experience of a psychological (cognitive, behavioral,
emotional), social, and/or spiritual nature that may interfere with
the ability to cope with cancer . . ." It recognizes a continuum
from normal sadness and fear to severe and disabling
emotional and psychological problems. The word 'distress' was
chosen because it is less stigmatizing than a term such as
'psychiatric' and, importantly, can be defined and measured by
self-report. There have been other calls to integrate distress
screening and management with other aspects of cancer care.
It has been advocated as a 6 th vital (pain assessment being
the 5 th ), incorporated as such in the Canadian Strategy for
Cancer Control, and adopted as a standard by the Union for
International for Cancer Control and the International Society of
Pediatric Oncology.
There is ample evidence that distress is common among
cancer patients and survivors. It is also clear that there are
personal and systems barriers to routine screening. A simple
validated screening tool for distress, the "Distress
Thermometer" is gaining popularity in clinical settings and is
recommended by the NCCN Guidelines (page DIS-A). It is
pictured as the familiar vertical thermometer with an 11-point
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YaleCares Newsletter - December 2011
Second Thursday of the month, 12:00
PM. Lunch is provided. Smilow
Cancer Hospital at Yale-New Haven
in the Park St. Auditorium (CME) Learn More >> Yale Bioethics Center End of Life
Issues Study Group 77 Prospect Street, Rm A002. See
website for full schedule. (CME)
Learn More >> Connecticut
April 17
Save the date: Cancer Patient
Navigation Conference. Sponsored by
Connecticut Cancer Partnership.
Cromwell. Registration details to
follow.
Elsewhere
April 17 - 24 &
November 7 - 13
The Program in Palliative Care
Education & Practice [includes
pediatric track]. Cambridge, MA.
Application deadline: Feb 6, 2012
(88+ CME)
Learn More >>
June 14 - 16
Biennial Cancer Survivorship
Research Conference: Translating
Science to Care. Arlington, VA.
Learn More >> Online
Wickham R. Osteoporosis related to
disease or therapy in patients with
cancer. Clin J Oncol Nurs
2011;15(6):E90-E104 (Available at
online edition of JCON; institutional or
personal subscription required).
(CNE)
Learn More >>
scale: 0 = No Distress, 10 = Extreme Distress. The next step is
to complete a 28-item checklist in 5 categories: Practical
Problems, Family Problems, Emotional Problems,
Spiritual/Religious Concerns, and Physical Problems. There is
also an area for the patient to fill in concerns not addressed in
the checklist. In practice, a threshold score of (for example) 4
could trigger a more focused assessment for an individual
followed by appropriate intervention or referral. Recent
research suggests that the thermometer model can be
expanded to tease out specific types of emotional distress
such as anxiety and depression.
A consortium of professional and advocacy groups has formed
the Alliance for Quality Psychosocial Cancer Care (Yale
Cancer Center is a member of the Alliance). The goal is to
work toward implementing the IOM "whole person"
recommendations, including screening and intervention for
cancer-related distress.
In the News
Advisory Committee on Immunization Practices
recommends all 11-12 year-old males get vaccinated against
HPV. See also the CDC's web page on Human Papilloma
Virus (HPV).
Learn More >> Family Health History Day We missed the official "Family Health History Day," but the
idea is good any time: share and record your family health
history in a place where all family members can access it. The
Surgeon General has created a free, secure web site, My
Family Health Portrait, for recording important health
information. "An important first step in preventing illness and
disability is learning about health conditions in our families that
may put us at increased risk for diseases such as diabetes,
heart disease, some cancers, Alzheimer's Disease, mental
illness, and many others," said Surgeon General Dr. Regina
Benjamin. The site allows an individual to print out a report to
take on a health care visit. Learn More >> The Centers for Disease Control and Prevention (CDC) has
released a Basic Infection Control and Prevention Plan for
Outpatient Oncology Settings.
Learn More >>
Journal Watch
Survivorship
The October 2011 issue of Cancer Epidemiology,
Biomarkers, and Prevention is devoted to research
articles in cancer survivorship. http://campaign.r20.constantcontact.com/...XZWaiFyqj2jmCoXq6lYwdJetchxhLVTXLgsKaUejv-orb1D9bTO6637vbgzvuznJ-q&id=preview[1/27/2012 3:55:46 PM]
YaleCares Newsletter - December 2011
Read More >>
Bains M, et al. Return-to-Work Guidance and Support
for Colorectal Cancer Patients: A Feasibility Study. Cancer Nurs. 2011 Nov;34(6):E1-E12. Read More >>
Bains M, et al. Helping Cancer Survivors Return to
Work: What Providers Tell Us About the Challenges in
Assisting Cancer Patients with Work Questions. J Occup
Rehabil. 2011 Aug 26.
Read More >>
Kwan ML, et al. Exercise in patients with lymphedema:
a systematic review of the contemporary literature. J
Cancer Surviv. 2011 Dec;5(4):320-36. Read More >>
VanderWalde AM, Huria A. Second Malignancies
Among Elderly Survivors of Cancer. Oncologist 31 Oct
2011. Read More >>
Wilkins KL, et al. Life After Cancer: Living With Risk. Cancer Nurs. 2011 Nov;34(6):487-494.
Read More >>
End-of-Life Care
Chirco N, et al. The Trajectory of Terminal Delirium at
the End of Life. J Hosp Palliat Nurs. 2011 Nov/Dec;13(6):
411-418.
Read More >>
Sibbald RW, et al. Checklist to meet ethical and legal
obligations to critically ill patients at the end of life. Healthc Q. 2011;14(4):60-6.
Read More >>
Palliative and Supportive Care
The November 30 issue of Oncology (Vol 25 #13) is
devoted to palliative care in oncology. O'Sullivan CK, et al. Psychological Distress during
Ovarian Cancer Treatment: Improving Quality by
Examining Patient Problems and Advanced Practice
Nursing Interventions. Nurs Res Pract. 2011;2011:351642.
Read More >>
Morrow PKH, et al. Hot Flashes: A Review of
Pathophysiology and Treatment Modalities. Oncologist 31
Oct 2011.
Read More >>
Wickham R. Osteoporosis related to disease or therapy
in patients with cancer. Clin J Oncol Nurs
2011;15(6):E90-E104 (Available at online edition of
JCON). (CNE)
http://campaign.r20.constantcontact.com/...XZWaiFyqj2jmCoXq6lYwdJetchxhLVTXLgsKaUejv-orb1D9bTO6637vbgzvuznJ-q&id=preview[1/27/2012 3:55:46 PM]
YaleCares Newsletter - December 2011
Read More >>
Other Articles of Interest Special issue of NCI Cancer Bulletin devoted to the
obesity-cancer link. Free full text.
Read More >>
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