Lifespan Cancer Institute, Providence, RI, USA; The Warren Alpert Medical School of Brown University, Providence, RI, USA; Department of Psychiatry and Human Behavior, Lifespan, Providence, RI, USA.
Lifespan Cancer Institute, Providence, RI, USA; The Warren Alpert Medical School of Brown University, Providence, RI, USA; Department of Palliative Care and Hospice Medicine, Lifespan, Providence, RI, USA.
Ann Palliat Med. 2024 Mar;13(2):287-300. doi: 10.21037/apm-22-1287. Epub 2023 Dec 29.
The evolution of psychiatric care for patients with cancer has played out over the last century. The first collaboration of psychiatry, oncology surgery, and radiation-oncology occurred in the mid-1950s and represented the early seeds of psycho-oncology. The role of a psychiatrist specializing in treating patients with cancer, a psychosocial oncologist or psycho-oncologist, spans the care continuum from prevention to end of life. The specific needs of patients with gastrointestinal (GI) malignancies range from management of anxiety and depression to focused management for adjustment to an ostomy to sexual dysfunction to treatment in the face of a neuroendocrine tumor (NET).
This is a scoping review; we compiled and summarized psychiatric illnesses commonly encountered in care of patients with cancer in addition to unique GI oncology-related issues. We conducted an electronic PubMed search between 1990-2022. We are presenting the data and providing our insight into psychosocial oncology care for this special population.
The field of psycho-oncology is relatively new. We failed to identify any randomized prospective studies, the majority of the studies were retrospective or longitudinal. The majority of the publications were in the form of review. We reviewed the GI literature to identify the psychological impact of ostomies, sexual impairment and metabolically active NETs. We provide suggested treatment interventions targeting the biological, psychological, and social aspects of patient and family lives.
The role of a psychosocial oncologist as part of the collaborative multidisciplinary treatment team provides nuanced care with attention to unique cancer-related issues that arise during the disease course. The psycho-oncologist brings expertise in combining targeted therapeutic strategies with pharmacologic interventions to address the multi-dimensional symptomatology patients experience. Using a layered approach, patients with mild symptoms can be supported by the general team, while those with moderate to severe symptoms require specialty psychiatric consultation.
精神科护理在过去一个世纪中不断发展，为癌症患者服务。精神科、肿瘤外科和放射肿瘤学的首次合作始于 20 世纪 50 年代中期，代表了心理肿瘤学的早期萌芽。专门治疗癌症患者的精神科医生、心理肿瘤学家或精神肿瘤学家的角色跨越了从预防到生命末期的护理连续体。胃肠道（GI）恶性肿瘤患者的具体需求从焦虑和抑郁的管理到造口调整、性功能障碍、神经内分泌肿瘤（NET）治疗等方面的针对性管理。
这是一项范围界定综述；我们汇编并总结了在癌症患者护理中常见的精神疾病，以及与 GI 肿瘤学相关的独特问题。我们在 1990 年至 2022 年间进行了电子 PubMed 搜索。我们正在为这一特殊人群提供有关心理肿瘤学护理的数据并提供我们的见解。
心理肿瘤学领域相对较新。我们没有发现任何随机前瞻性研究，大多数研究都是回顾性或纵向的。大多数出版物都是评论形式。我们回顾了 GI 文献，以确定造口术、性功能障碍和代谢活跃的 NET 对心理的影响。我们提供了针对患者和家庭生活的生物、心理和社会方面的建议治疗干预措施。
作为协作多学科治疗团队的一部分，心理肿瘤学家提供细致的护理，关注疾病过程中出现的独特癌症相关问题。心理肿瘤学家将专业知识与靶向治疗策略相结合，以解决患者所经历的多维症状。使用分层方法，轻度症状的患者可以由普通团队支持，而中度至重度症状的患者则需要专科精神科咨询。
