CAMAGÜEY.- Psycho-oncology is a field of study and intervention in the psychosocial aspects associated with the diagnosis and treatment of patients, their families and the health team, and also linked to aspects that affect the risk of developing cancer. In this sense, categories, methods and techniques related to health psychology are used in two large areas: the study of the psychosocial elements that can intervene in the etiology and course of cancer and in the intervention to improve the quality of life of those involved.

Said this by Daisy Varona López, Bachelor of Psychology, MS. c. in Clinical Psychology, and psychologist of the Organ Coordination and Transplantation Service of the Manuel Ascunce Domenech University Hospital, in this city, we delve into:

—How do cancer patients get this type of care?

—There is always a care process that can start from their health area until reaching the secondary level, in this case and in that of Camagüey’s patients, at the María Curie oncology hospital, where there is a multidisciplinary team. The Cancer Patient Care Program as such includes the oncology specialist, the nursing staff, the social worker and, of course, the psychologist. Assistance is offered at the beginning, that is, from the very diagnosis of the disease.

— Would they always have to go back to secondary level health?

—No, there are psychologists in primary care and they are very well trained in the abilities and skills to deal with support, even in the face of the need for palliative care. This is due to the fact that the patient is not in the hospital all the time, at some point he returns to his health area, although this does not mean that he does not need to be in the hospital again to attend his consultations, receive treatment or new income, they are undoubtedly monitored in their health area as occurs with the other programs designed.

—According to your experience, how can you assess the impact of this type of care?

—It is becoming known throughout the disease process due to the follow-up and help that is offered, even before the treatment itself, which can be chemotherapy, radiotherapy or surgery, and even in how the patient prepares to face any of these stages or more than one. First it helps to face the diagnosis and then the rest.

"The meaning that is assumed when diagnosed with cancer is important, especially if we know that this is a disease that the population associates with death and the first thing that the patient thinks of is: 'I am going to die' and from that moment the intervention of the psychologist is vital.

"Another psychological action lies in the management of the patient's family. It is a triad: patient, family and health team. The family is not always prepared to respond to the patient's situation and not infrequently they have claudication crises because they face very painful situations and sometimes only one person is in charge of that responsibility because it is not shared with others for various reasons.

"The psychologist is in charge of helping that family member, what to do in the face of a claudication crisis, how to manage the situation of children with very close sick relatives, how to break this news, and also to those who suffer from cancer and what would take us a chapter".

—I think that any illness that leads to death is painful; however, it seems to me, that term of "long and painful illness" or "painful illness" is used too much when it comes to cancer, what do you think about it?

-I totally agree. This fatal terminology is erroneous, especially if we know that there are many types of curable cancers, which has a great influence if they are detected in the early stages.

—Not all people accept the disease in the same way. How is it managed in each case?

-That's how it is. The psychologist must investigate to know what the patient wants to know and to what extent, that is why an important issue in these cases is the communication of bad news. It is necessary to know if the patient is prepared to receive that revelation and that is why we speak of the bearable truth.

"We are always in favor of telling the truth for ethics, it is his right, he has a life project, and the truth makes us free and this allows the person to live realistically without unattainable expectations, with legal decisions to leave everything in order if it were the case, and something relevant is that the patient cooperates when he knows that truth, although there are debates in that sense, then comes the argument of what truth and from there what I mentioned before and it is the bearable truth".

—Do you mean that some want to know the diagnosis and prognosis and others don't?

—Indeed, and that must be respected because it is their right. Sometimes the family is the one that hinders this to know more about the situation and there are not a few patients who already know it without their closest relatives being aware.

"Current technology makes it easier for the patient to know about his diagnosis before his doctor tells him, hence the importance of communication and the family is important because they also get depressed, and the medical team needs the help of the psychologist."

—Can psychology contribute to the fight against cancer?

—Of course. Preventive factors are fundamental, such as: avoiding risky habits and behaviors or modifying them if you already have them, such as smoking, alcoholism, feeding and inappropriate behaviors, and in this way certain types of cancers would be avoided. Psychology is emotional support and to achieve it you have to accompany, to offer, to care and thus also to avoid.

Translated by Linet Acuña Quilez