Cancer Initiative Seeks Better Health Outcomes Via Counseling

WASHINGTON--The Center for the Advancement of Health is workingon a 3-year cancer initiative whose purpose is to increase supportfor psycho-social and biobehavioral research and services forcancer patients, said executive director Jessie Gruman, PhD. TheCenter was founded in 1992 by the John D. and Catherine T. MacArthurFoundation and the Nathan Cummings Foundation.

In an interview with Oncology News International, Dr. Gruman saidthat the scientific community has sought solutions to diseasessuch as cancer by looking for the biologic causes. Yet there arenonbiologic factors (social isolation, socioeconomic class, anddepression) that also affect health outcomes and that have beenneglected.

Evidence shows that these factors influence morbidity and mortalityacross diseases, Dr. Gruman said, but this concept has found littlesupport in mainstream biologic research, which explores each diseaseseparately and looks for a single etiology.

Three Projects

The Center's Cancer Initiative, now in its second year, is anattempt to help cancer patients by recognizing some of these psychosocialfactors. As part of this initiative, the Center is currently directingthree separate projects.

The first project involves training cancer patients to be theirown best advocates. There is evidence that individuals who areactively engaged in maintaining their own health and medical careenjoy an improved quality of life and better health outcomes.The Center is currently developing a resource guide and trainingprogram for use at local and national levels to support patientadvocates.

The second project involves developing and implementing psychosocialservices that can be used as models for the rest of the country.The purpose is to identify the most important elements of supportiveand psychosocial services, and to make those elements standardin cancer treatment and care.

The third project involves monitoring psychosocial research funding.The Center serves as a watchdog to track the activities of Congressand the National Cancer Institute. It watches the authorizationand appropriations process through which the NCI receives fundingand monitors the extent to which the NCI responds to patient-identifiedconcerns.

Avoid Terms That Carry Stigma

To incorporate psychosocial services into comprehensive cancercare, says Dr. Gruman, "it is important to remember thatwhen dealing directly with cancer patients, the term 'psychosocial'should not be used because of the stigma attached to the word."

Dr. Gruman noted that many cancer patients who would refuse 'psychosocialservices' are willing to accept help in the form of 'cancer counseling'or 'support and education.' This demonstrates to both the patientsand their caregivers that these services, by any name, are anintegral part of cancer care and not an extra service.