Psychosocial issues in the cancer patient.

STUDY DESIGN

Systematic review of the literature.

OBJECTIVE

To identify psychosocial issues affecting patients with a diagnosis of a spinal column or cord tumor.

METHODS

Using the keywords "cancer communication," "psychosocial care," "cancer patient," and "spine cancer patient," a review of the English literature was performed on Medline, EMBASE, and PsycInfo, a database of the psychology and psychiatry literature in the United States. The relevant articles were reviewed; in addition, relevant references from selected articles were searched. The Spine Oncology Study Group, an international panel of spine oncology surgeons, medical and radiation oncologists, identified 2 key questions to be addressed in the course of the systematic review of the literature. Pertinent manuscripts were rated as being of high, moderate, low, or very low quality. Using the Grading of Recommendations, Assessment, Development, and Evaluation evidence-based review system, the 2 key questions were answered using literature review and expert opinion.

RESEARCH QUESTIONS

1. Who are the allied health care professionals necessary for the comprehensive care of the spine tumor patient? 2. Does compassionate communication (in giving life altering information) affect outcome? What tools can be used in communication with the spine tumor patient?

RESULTS

Systematic review of the 3 databases yielded 228 articles pertaining to the psychosocial care of spine tumor patients; systematic review yielded 326 articles addressing communication in cancer patients. Systematic search of the Medline, EMBASE, and PsycInfo databases failed to identify any articles that specifically addressed the 2 questions of interest in the spine tumor patient population. The literature search identified low and very low quality evidence; 2 randomized controlled studies were identified. Although neither specifically pertained to the spine tumor patient population, these articles were reviewed and graded as low-quality evidence.

CONCLUSION

A multidisciplinary group of allied health care professionals is a necessary prerequisite for the effective psychosocial care of the spine tumor patient. Compassionate communication, in the form of group sessions, telephone support groups, or internet based groups, can alleviate the psychosocial discomfort experienced by spine tumor patients.