by Dina Szynkarsky, MSW
Department of Social Service, Adult Sites
McGill University Health Centre
In 2003, the World Health Organization (WHO) predicted that by 2020, cancer rates could continue to increase by 50% to 15 million new cases. Research (Davis, 2009) has indicated that the assistance of a multidisciplinary team including doctors, nurses, social workers, nutritionists, psychologists, and physiotherapists is necessary for patients to have the best chances of coping well with diagnosis and treatment as well. Equally important is the support that patients receive in the phase called “life after cancer”.
Oncology social workers are the primary providers of psychosocial services in cancer treatment centers around the world. With their expertise in cancer and its psychosocial impact on patients and their family/community, social workers have training in dealing with psychosocial issues such as anxiety, family relationships, changes in lifestyle during and following treatment. Social workers are also there to help you with re-integration in to the work force and to cope with fears about recurrence and death which are stressors experienced by many cancer patients (reference). Oncology social workers can assist with practical needs such as employment and financial stressors caused by the illness. The social worker is an important link in the chain of communication that takes place in a busy hospital. Social workers accompany patients through all phases of the illness trajectory including diagnosis, treatment, life after cancer, and supportive∕ palliative care. The following sections describe the role of the social worker in more detail along the treatment trajectory.
During this phase, as a new patient, you and your family may be in a state of upheaval. The uncertainty that accompanies the news of a diagnosis can have a ripple effect on your family life, your employment and financial situation, and your emotional state. Social workers will evaluate your situation in order to understand the full impact of the illness on you and those around you. During this time, you and your family will receive information about your illness, assistance with how to negotiate time away from work responsibilities, information about medication programs and community and financial resources. You will need support both from your social network as well as from your health care team. The social worker in oncology is well placed to be a bridge for good communication with the health care team.
Oncology social workers are trained to assess how you are coping and provide illness adjustment counselling to you and your loved ones including young children. Social workers will also screen, monitor and refer patients to appropriate services if they are identified as dealing with depression, anxiety, or anticipatory grief. Particular attention is given to assess whether there are other stressors happening in your life during the time of diagnosis such as family conflict, abusive relationship, etc. Doing so can help social workers provide support needed to make living life with treatments somewhat easier.
During this phase the social worker’s goal is to monitor how you are coping with changes in your life as a result of treatment. This is the phase in which many families find that the instrumental and financial burdens are the highest. With frequent visits to the hospital requiring transportation and days missed from work, the costs can be significant. Social workers can help by finding volunteer or community resources that can take some of the burden off caregivers. As well, social workers can help with the coordination of community provided care. Social workers are often the source of referrals to home care agencies and can be instrumental in mobilizing homecare resources so that you can remain at home and avoid unnecessary hospitalizations. If you are hospitalized, your social worker will work with your multidisciplinary team to help plan your discharge home so that your transition can be seamless. For those of you who will require daily radiotherapy in addition to your chemotherapy, speak to your social worker to explore what option there are for assistance with parking, transportation or accommodations if you are coming from remote areas.
Receiving a diagnosis of cancer is a significant life challenge. However, you are not alone. We often say that “it takes a village” to raise a child and the same is true of your journey through cancer care. Seek out your social worker to see how she can help you and those around you during your cancer journey. You may discover that there are many things we can do to make this time in your life a little easier.